This is an article which is a long time coming. Unless you've had your head in the ground, you can't have missed the discussion on health care going on lately. I've had plenty of chance to muse over the issues myself, both on my own, with my wife and with a number of my friends. I've heard a lot of good ideas, but also some misunderstandings and I'd like a chance to lay things out as I see them.

Background

In my time as a working adult I've had the opportunity to experience pretty much the whole range of health care options. I started at the top, working for a large company who had quite a few options. We picked the one that matched our coverage needs the best, based on the fact that we were planning to start a family. When that momentous occasion came, we ended up payed very little out of pocket. It was quite nice, in fact. And for all that, the cost was very reasonable, my share of the cost, anyway.

Many Americans are in this boat and I think for them, their perspective is clouded. They see a decent system, payed for by the economy of scale of a large company, which gives them good options at decent rates. But such is not the case for everyone.

Jump forward just a few months. The tech bubble burst and I ended up out of a job. For over a year we squeaked by without any insurance. It was rather scary actually. Our new son needed shots, of course, but they were $70 a pop at the doctor. He recommended we go to the county health department instead where the shots where subsidized down to about $10. We had a few things come up. Our son had some breathing trouble early on, something that delightfully has disappeared, and every time he'd have trouble we'd be stuck with a hefty doctor's bill. We would panic if he started having trouble on a weekend and generally we'd (well, he would) suffer through until Monday morning when a doctor's office visit was much cheaper.

I would not wish that experience on anyone, but it's something 40 million Americans experience every day.

After suffering for a while I finally landed a decent job at a small company. The drawback was they didn't offer any benefits, but compared to slogging extended warranties or worse, it was a huge step up. Once we'd saved up a small amount, managed to move out of the in-laws' house, we looked to our options for health care. We came away somewhat depressed. In the end we found a plan on the open market which gave us basically what we needed for basically what we could afford.

Since we were coming in without a current health plan they were very emphatic about not covering preexisting conditions, especially pregnancy. In fact, to cover pregnancy at all required a separate rider, a separate waiting period, and a separate deductible. That was the time of our lives so we shelled out the extra cash and put our family on hold for a bit. Things worked out OK, but I would rate that experience somewhat lower than our first insurance scenario.

Eventually we moved on to a new company, where I'm still working in fact, and they had some pretty good plans. The deductible was higher than we would have liked, and it didn't quite cover as much as we wanted, but it worked and it wasn't outrageously expensive either. But nothing stays the same, and this was no different. Every year our premium went up by $40 a month. Every month some small aspect of the plan was reduced or dropped. Vision care, gone. Dental care, optional. Coverage amounts were lowered but somehow we kept paying more.

The current situation is that we're now on a high deductible health plan coupled with a health savings account. There are some benefits and some drawbacks, the primary one being that every expense is now out-of-pocket making for a strong disincentive to seek necessary care. I'm not yet certain how I feel about this plan but so far (it's been just 3 months) I'm not convinced.

My Options

So hypothetically speaking, if I'm dissatisfied with my situation, what can I do? Well, I do have a few options.

1. Drop my health care. Obviously that's not a reasonable solution, not with the costs of health care in this country. Just about anything is preferable to that.
2. Seek out a health care on the open market. For all the people working for small companies, or who own their own business, that's their only choice. The costs are high, the benefits not all that great, and the selection is limited. Consider the amount of leverage a single customer has and you can see it's not really in the company's interests to be competitive.
3. Get a new job. In this economy that's often easier said than done, and the simple fact is I like my job. I like where I work and what I do. And even more importantly, why should that have anything to do with my health insurance? Does my employer choose my car insurance? My home insurance? My grocery store? The simple fact is that it's rather ludicrous for a health care plan to be tied to employment at all. It's merely a historical happenstance that it occurred that way at all and now we're stuck with it. Life would be much simpler, for both me and my employer, if the two were separated completely.
4. Or just stick with the one plan that's offered me.

Socialism

Let me switch topics just a bit and address a point which I think is entirely overblown by far too many people: the term "socialism". In some circles even mentioning the word is like preaching vi usage to an emacs mailing list. Too geeky for you? How about wearing a Yankees jersey to Fenway Park? You get the idea I hope. Many people have made "socialism" a religious issue when it needn't be so.

I put the word in quotes above because it's a very mis-understood word and used completely out of context. Consider for a moment a few very socialist institutions: your local police force, the school system and the Forest Service. If we were to take a strictly capitalist approach to those organizations we would have private armies, private schools and private forests. Well, we do. We have both, so don't let anybody convince you that one cannot exist in the presence of the other.

But just looking at the police for a minute, I think we can see that a capitalist police force would be much less efficient. Those with money to hire guards would be able to protect themselves. Those without, well they'd have to fend for themselves. That in turn would encourage more crime by those more destitute which would lead to a pretty miserable feedback loop I fear. So it's in everybody's self-interest to provide for a common police force. And in this country I would argue we've done a good job of it. There's the occasional account of corruption or pandering, but far and away most cops are good folks doing a good job.

We've established that some scenarios just play out better with a socialist scheme, and I would also argue that many scenarios work better with capitalist setups. And many more are a mix because dogmas rarely work perfectly in the real world. The task we face is to select the one that is the best fit. We shouldn't let ourselves be driven by blind ideology or clever witticisms about liberty or freedom. Never let yourself be so vain to think that your ideals are without fault.

Possibilities

Well then, where does that leave us? First and foremost, before you make any choices you need to go watch Frontline: Sick Around The World from PBS. It's the most honest, unbiased collection of the facts of health care around the world that I've ever seen. I reserve the right not to debate anyone who has not watched it. Yes, it's that good.

Next, take a glance at two good Washington Post articles about our current system and the proposed changes.

Now that you've done that (I'm very patient, aren't I?) I can suggest to you what I would prefer. I would like health care to be divorced from employment. I would like minimum health insurance standards to be enforced on insurance providers and required of citizens, with subsidies for low income levels. I would like the option to buy up to better insurance if I felt it would benefit me.

Speaking to a few specific points, I would like to have the public option merely for the fact that it fills a needed gap and provides a certain incentive for private companies to stay competitive. I'm not convinced yet that co-ops would fill that role, but I'm not opposed to those either.

I'm also not against a single payer system (aka the Canada system) in principle. The devil is always in the details but I don't believe we should exclude it just because it's "socialist" or because the moose people do it.

The biggest stumbling block I see to coming to consensus on health care, to bringing affordable insurance to all Americans, to reducing the nightmare that is our heath system, is that people aren't willing to listen to each other any more. I see too much hate. Too many ideologues. Far too much 24 hours cable news. We have to forget our biases and start acting civilly again. If we do, I think we all stand to benefit from the results.

It looks like the latest credit reform bill is going to become law. I've read through the law and it really sounds fair to me. What always surprises me is when people make comments similar to those contained in this BBC News article, "the industry has warned that the measure could backfire, leading banks to issue fewer credit cards thus making it harder to get credit". I'm failing to see the problem. Many people do have too much credit.

Now I'm not against credit. It's certainly a useful financial tool, without which I likely would not own my own home. But it needs to be done wisely, and that's a challenge when credit companies get to write all the rules such as when you can go bankrupt. This bill will equalize the system and hopefully stem some of the nonsense going on.

Congress passed a new law requiring the Department of Homeland Security to create a new terrorist watch list. This one is actually a list of people who are not terrorists, but have been mistakenly labeled as such. That would be thanks to the famous no-fly list that the TSA maintains which is riddled with inaccuracies but doesn't provide for any practical way to get yourself off of it, until now. So in a sense, this is a step forward. It addresses problems that the TSA has been burdening Americans with. Unfortunately, it's only a partial solution. The whole idea of a list of people so dangerous that they can't fly, but innocent enough that we can't arrest them is ludicrous. The fact that the list is poorly maintained and horribly inaccurate is just icing on the cake. The only sensible thing to do would be to dump it and spend our money (estimated at $100 million per year) on something much more effective.

Don't even get me started on the liquids ban.

For a while now I've wanted to create a full list of all the political topics being debated and how the various candidates feel about them. See then I could rank them and come up with an algorithm to figure out who most aligns with my view. Luckily, I decided to google around first and I found somebody already did it: Vote Gopher.

Vote Gopher is a non-partisan site devoted to getting facts out, without any spin. I've only been browsing around for a few hours tonight but so far I'm impressed. I compared their candidate position statements with some I found at other places around the net and they appear to all agree, so from what I see their information is accurate. I've also been giving them a very critical eye regarding neutrality and thus far I see no reason to doubt them.

What I find most refreshing about the site is that it skips past all the mumbo jumbo and gets straight to the details. No more yammering about how old McCain is or whether Obama is wearing a US flag pin, as if those things really matter. The real questions are what will the next President do and they have extensive statements from each candidate on that.

So far I've found that I'm pretty split on both candidates. In fact, both candidates are surprisingly similar in many areas, such as stem cell research (both favor) or carbon cap-and-trade (both favor). What's nice is that generally the areas they agree on are the ones which align with my views (and I suspect most American's, hence the concensus).

Don't wait. Run over right now and sign up for an account. Start tallying up your issue votes and see who you really support.

Accordig to The Register a man was indicted on fraud charges for opening thousands of accounts with ETrade and Charles Schwab. He had them send micro-payments, just a few cents each, and then collected the booty. Interesting story and may he rot in jail. But what I find particularly interesting is that his "undoing came as a result of the USA Patriot Act, which requires financial businesses to verify the identity of their customers". Wait, wait, wait. I thought the Patriot Act was to catch terrorists. Surely that isn't what they're claiming.

Make no bones about it, all these new laws to fight the "war on terror" have ulterior motives. Sure, they may help find terrorists but there is no doubt that LEAs have received a carte blanche for laws they've always wanted. They've learned well from Microsoft, it appears, and have passed around so much fear, uncertainty and doubt (FUD) that our lawmakers have given them pretty much whatever they want. What we really need is to settle down and quite acting out of instinct and fear, and instead use a little of that logic stuff.