The Trouble with Single Payer

Tonight, at a neighborhood party, I listened to three men, each of whom own small businesses: one employs 5, one employs 17, one employs 52. 

They all said the percentage of their overhead which went toward employee health insurance was from 15-30%, but that wasn't the worst of it: They did not know, from year to year how much it would rise. It was impossible to plan for this cost. One simply resorted to telling his employees he would cover only 50% of the insurance premium--they were on their own for the other half. 

The guy with 52 employees surprised me. He is slightly to the right of Ghenghis Kahn on most social issues, but he said health care is simply "something we should do."  He said his company spent more on health insurance than it did on aluminum last year and he makes things on a Defense Department contract out of aluminum. 

I pointed out that the health insurance companies were only doing what these businessmen were doing in their own businesses--trying to maximize profits--in this case for shareholders.  The guy with the Defense Department contract said his profits were fixed by the government and they could do the same for the health insurance companies. 

"Oh, so you're for price controls now?"
"Well, yeah, I live with them. Why can't they?"
"Because they are publicly held companies and the CEO of each wants to maximize shareholder value so he can get his $30 million bonus."

I suggested the problems they had detailed all arose from one basic problem: Health insurance and health care are two different things and health care should not be profit driven, not a profit center. This shocked them at first, but the idea seemed to grow on them, until one of them said, "But how many people do you think work in health insurance? If you eliminated all their jobs, there'd be a Depression."

I have tried to get estimates of this number from Professor Google, but it's a hard number to pin down: You should include all the health insurance company employees of course, but many of the insurance companies sell multiple types of insurance, so it's not clear everyone at these companies would be out of work if we shut this commercial health insurance system down. But there are also all those clerks at doctors' office who do nothing but deal with insurance companies. Ditto for hospitals and outpatient clinics.

What is the number of all these superfluous people whose jobs would become unnecessary if we shifted to a National Health System or a single payer or a Medicare for All? 500,000?  250,000? Who knows. A lot of jobs would be lost.

When hospitals and doctors' offices switched to electronic medical records, all those people who worked in medical records offices, transcribers for doctor's notes and correspondence--all those jobs went "poof!"

But, the plain facts are:
1. American industry is burdened unnecessarily and unfairly with the cost of health care for its employees, a burden our foreign competitors in the global economy do not bear.
2. The entire health insurance industry is unnecessary, and we are carrying this dead weight as an albatross around the neck of companies, large and small businesses and health care providers. 

We are doing things the way we do them because we have done things this way since 1941, when employers, scrambling to attract workers while half the work force was away fighting the war, started enticing employees with health insurance.

That was 76 years ago. Seventy six years during which America has fallen behind because we as a nation have been too chicken to try something else. We have been scared into sticking with the horse and buggy system we have by loud mouthed marketeers of gloom and doom and the rest of the world has sped past us.

The 800 pound gorilla in the room, nobody wants to talk about is: We do not need health insurance companies.  They are a frill. They add nothing of value to health care. They do not innovate. They do not save lives. They do not care about lives. They care about money, profit and their own jobs. They do not care about you.

The trouble with single payer is not that it wouldn't work, or it would drive health costs up--it would cut costs by 90%--the problem is, a lot of people would lose their unnecessary jobs if we eliminated or substantially reduced commercial health insurance. We have been carrying these people on our back for 76 years and nobody wants to admit it.

Trophy Elephants

Beryl Markham got paid to fly her airplane over the Tanzanian grassland to find elephants for big game hunter rich men to shoot.

She tells the tale in "West With The Night" one of the best English language books ever written. It's been years since I last read it, but I think I remember her story about her job spotting elephants pretty well. She said after a few weeks of flying over groups of elephants, looking for big males with big tusks, she realized she was having trouble finding proper trophy elephants, not because she could find no elephants--elephants were plentiful in those days--she was having trouble because whenever she flew over,  the elephants would circle up, with their heads pointed inward in the circle, so she could not see any tusks.

She thought about that for a while and decided to quit this job, which paid very well, and there weren't that many options for a female bush pilot in that part of Africa at the time.

But she could not shake the idea that if these animals were actually doing what she thought they were doing, hiding the big tusk elephants, protecting their fellow elephants, then these animals were smart enough she did not want to be an agent of their slaughter.

Consider what that story could mean, if true: It might mean the elephants connected the airplane which flew over them with the appearance, hours later, of men with guns driving up in Jeeps to shoot them.

Flipper with big ears.

Now President Trump has to decide whether to impose a rule forbidding importation of elephants as trophies, shot by big game hunters like his son in law and his sons.

Shooting big herbivores for sport? It's not like it's even a halfway even fight. Where is the sport in that?

Read "The Short Happy Life of Francis Macomber"  (Hemingway) if you want some idea of what white big game hunter rich guys are like.

This is the essence of the pink puffer fish himself, an impotent white guy carried aloft by his paid staff after somebody else, someone with skill and courage, actually does shoot the lion for him.

Entitled Parents in a Crowd

Lovely concert at the Unitarian Church, South Church, Saturday night. 
Voices, a 200 woman chorus put on their holiday event, with some soloists who were quite astonishing, four women each a solo, two professional and two who could be, singing against the backing of 200 voices. 
The chorus hired sound professionals to record it in the church, which has great acoustics, but they could not do this.

No C.D. from that concert because two twenty something parents each decided to bring his infant to the concert, and in every pause, the howling, mewling of an infant intruded.

W.C. Fields remarked a man could not be all bad if he hated children and dogs. I do not hate children or dogs, but I was ready to throttle each of these two fathers, who not only brought their infants to the concert but remained there, even after it became apparent how disruptive the children were.

Is there anything more annoying than the parent who sees his child misbehave and laughs it off?  

What could these guys have been thinking?
Why  would they remain as their children squawked and howled throughout the performance?
Why not get up and walk outside?
What was so important about that infant being there?

I once drove along a two lane country road in Virginia, and a woman stopped her car, parked it in the lane, and walked across the road to talk to another woman who was standing in her yard. This was not a heated exchange. They were talking quite pleasantly, as if the one woman had not parked her car in the road and left it there as cars began to clot up the road behind it. The road was narrow enough one could not pull around on a shoulder--there was no shoulder. And it was busy enough a constant stream of cars coming in the opposite direction in the other lane prevented any hope of simply pulling around the stopped vehicle. So I was just stuck, amazed, watching this woman chat amiably as if I did not exist.

You see this sometimes in the post office or at a store, where the customer ahead of you keeps up a conversation well after transacting her or his business, oblivious to the line of customers behind.

This happens frequently in New Hampshire. Almost never in New York, where the clerk will usually cut things off to move the line along.

Friends tell of going to "Hamilton" for which they paid a small fortune, and someone in their row brought a child, maybe five, who spoke in that loud voice some kids have, insensitive to the fact there are other people in the vicinity, unaware they are not the only people in the room.  So between the rapping and ballads, a reedy voice would blurt out, "What's that Daddy?"

The wonder is the ushers did not find and eject that kid.

The wonder is these people get through their days in the world without being beaten into a bloody pulp. 
I guess for all the homicidal maniacs with guns blowing their way through America, a lot of Americans are simply orderly and too conflict averse to say anything. 
Ugh.

What This Country Needs

Is not a good 5 cents cigar.
What this country needs is a brain transplant.

Spending way too much time on Twitter lately, which is to say, any time at all.
There are people there I admire, for their work, like David Simon, who simply rants all day in the most inelegant way, sounding like the guys I use to listen to in the locker room, while we were getting into and out of our sweats.

The echochamber is really little different from Redditt Progressive, another site which lost me because it was simply a venting station.
Even the New York Times is a groan.

Van Gogh, Something different

It's far more interactive than in the 20th century, where you'd see an article and a week later five letters. Now Paul Krugman or David Brooks writes an article and within minutes a hundred responses, within hours, thousands of responses. But the quantity bears no relationship to the quality. Ninety percent of the comments begin with, "It just makes me sick" or "It makes me sad" or "I'm so afraid" or "The guy is such an idiot." 

U.S. Capitol

You wonder why these folks bother to write this prosaic stuff at all. 
Really. What are they thinking--beyond the obvious.

No, what this country needs is a sort of anti matter to Rush Limbaugh. A talk show radio host or hosts who thoughtfully examine every story, or tweet, with a yin and yan sort of approach. Well, on the one hand, but on the other.

That's Grant on the horse

It might be called, "Audi Alteram Partem."  Hear the Other Side.

Or it might be called, "Radio Free New Hampshire."

Or "The Show."

VanGogh, Auvers. Saw that church

Radio is so much more powerful than television because you can listen while you drive or walking down the street, while you work, while you are doing other things. 
It's better than social media because it can have actual quality control.

Maybe the show would have guests and the host or hosts would question them vigorously, carefully. You will say The PBS News Hour does this, but the problem with the News Hour is the guests: Always somebody with rank or credentials, who will say exactly what you expect them to say. They never surprise you. Or only rarely.

Not sure. Renoir maybe

And the desire to be civil actually impedes the free exchange of ideas on the News Hour. When Gwen Ifil was alive, she got after people, but Judy and company are simply too quiet and respectful.

Who would be the first guests? Whoever you could get. But with radio, you don't actually need the guests in the studio, so eventually you might get say, Bernie Sanders or Hillary Clinton or Al Franken. Those are the obvious.
But how about people who might actually say stuff you haven't heard before, like retired professors of government, like Andrew Hacker, who don't have to worry about their colleges getting mad at them?

Scandalous 

Grumpy old guys-- that's the ticket.  Guys who have heard it all and know B.S. from Shinola.

Or retired cops.
Emergency Room nurses. 

Alter Ego

People who have seen things.

People who could take us from this world of unreality into a world of hyper reality.

Better than what we've got now

Maybe even retired business people who aren't trying to sell anything any more.

The guy who worked at Apple or Hewlett Packard or IBM, who can tell some tales. 

Whatever it is, it's not what we've got now.