Saturday, November 22, 2008

Universal Healthcare: A new Concept That Can Work

If you've read any of my previous posts, you'll know that I am not a firm believer that any of the proposed solutions to the current healthcare crisis will work. Universal healthcare is a lofty goal but if there is any hope that it will work, it has to involve every American as an invested individual, equally and fairly. In a conversation I was having with a few colleagues, an idea came to me that seems so simple it just has to work.

Let us assume that some form of universal healthcare will be enacted. We must also assume that in order for the insurance companies to survive, only the largest and most efficient, able to take advantage of economies of scale, will be likely to surivive. Participation in any form of universal healthcare will be mandatory, whether it is sponsored or offered by an employer or the government. You will have little or no choice. When there are only a few suppliers or producers, you have an oligopoly. An oligopoly is defined as "A market dominated by a small number of participants who are able to collectively exert control over supply and market prices". Does insurance fit his definition? Yes it will.

If we do have a situation where a few large suppliers or producers dominate a market, we as consumers, need regualtion and protection from them just like we do in the utilities markets. You may not be aware of their presence, but the public utilities commissions of your individual states make sure that the suppliers of your water, electric, natural gas, railways and telephone services are treating you, the public, fairly. They are also responsible for the oversight of those industries, review requests for rate increases and monitor the industry's return on equity and investment to their respective shareholders. Can this model be applied to health insurance? Absolutely.

Anthem BC/BS was a mutual insurance company until it changed it's status and was later acquired by Wellpoint, Inc. A mutual company is defined as " A company whose profits are distributed in proportion to the amount of business each participant does with the company". Sounds like a perfect structure for universal healthcare.

Since there will likely be mandaory participation, all payments to the insurance companies will come from the governement in the form of direct or indirect payments. If each household is given a "share" in their insurance provider for each covered life, that household has a direct invested interest in seeing that their insurance company is as successful and profitable as possible. They would be encouraged to utilize their healthcare resources only when necessary. Decreased utilization by the individual covered lives means lower insurance company expenses , greater profits and additional distributions (dividends) per covered lives. Since every person covered receives a share when they sign up for insurance, you receive a direct financial dividend when your insurance provider earns a profit. The most efficient insurance companies that are also providing the best healthcare benefit will naturaaaly attract more participants, increasing their efficiencies through economies of scale. In an effort to increase "shareholder" satisfaction, these companies, like their untility company counterparts, will seek to be more efficient, maximize value, return on investment and equity and take the greatest advantage of financial leverage.

Rather refreshing for an insurance company to be operating on your behalf, as a shareholder, instead of only a hostage or paying customer. It makes much more sense to combine the benefits of a regulated industry where each covered life is treated like a shareholder with a voice, in conjunction with what will be mandatory participation. Under this scenario, you are as important to the insurer as a consumer as you are as a shareholder. The shareholder's voice of displeasure can effect who runs the insurance company depending on how they vote at the annual shareholdeer's meeting.

You also have a voice on how well you feel your insurance provider cares for you as a consumer. If they do a good job, you'll tell others, attracting more members/shareholders. If you don't like how you are being treated, you'll change insurance carriers and tell all your friends and co-workers.

I don't have a lot of confidence in the government to fix the problems with healthcare and I have less confidence that the insurance industry will do anything in the indvidual's best interest unless they are made to do so. But, if I am in a position to benefit directly from their quality and efficient care to patients (me and mine), I would feel much better about universal healthcare, government regulation and the insurance companies continuing as ongoing concerns.

Doc B

My opinion is free.
Advice is worth exacly what you pay for it.

Monday, November 10, 2008

Bedbugs; Recurrence of an Age Old Scourge

When I was a child my parents would tuck me into bed and say "Sleep tight and don't let the bedbugs bite". It was horrifying to hear, especially as a child, but mostly because I had no idea what the hell they were talking about. I really had no idea they were even a real "bug" until the last few years. Bedbugs have made a roaring comeback. I believe the word "epidemic" is being used to describe their resurgence as one of the most difficult pests to eradicate. If you haven't been infested with them, you probably know someone who has.

Most people assume that if you have bugs you must be dirty. Not the case with bedbugs. They are a true non discriminating, equal opportunity offender. They do not care about your income level, age, sex, level of education or your fine pedigree. You are a warm blooded human being. They love you for who you are. You can provide a blood meal. You are perfect. Thank God they don't spread disease. At most they are a nuisance and may cause some itching or red spots, but they won't really do you any harm. Still, I just don't like the thought of the little buggers coming out of hiding at night to feast on my wonderfulness, while I'm sleeping.


A great website describing the life cycle of bedbugs, their preferred habitats, treatment options and some photographs can be found here. From what I can gather from news reports, articles and the website, we have a problem that we are not going to be able to control. Our most effective pesticide for combating bedbugs, DDT, was banned several years ago and that is when their numbers began to increase. Major metro areas are having problems that even their Departments of Health cannot afford to tackle.

Bedbugs can be spread during travel, from hotel rooms, hospitals, spring break, college dormitories and visiting the mansion down the street. They are everywhere and we have been helping them travel, by using us as their means of transportation. Once we drop our bedbug load, they make a home and start reproducing.

May be time to think about the development of new pesticides or at least take another look at DDT. If not, the time will come when everyone we know and everyplace we go will have them. I don't want to be an insects nightly snack. Do you?

Doc B

My opinion is free.
Advice is worth exactly what you pay for it.

Wednesday, November 5, 2008

Back to Healthcare Related Issues

Now that the election is over and a Democrat will be taking office, maybe we can get back to where we were when Clinton was in office. During the Clinton years, stem cell research advanced by leaps and bounds. Researchers were on the verge of developing stem cell lines for the treatment of diabetes, parkinson's and advances in spinal cord injury. During the Bush administration's hysterical ban on embryonic stem cells, beginning in 2001 and at least until Barack Obama takes office, the development of new stem cell lines was essentially illegal.

What Bush did do inadvertently was to push stem cell research in new areas. Much of the research was done overseas in collaboration with their American counterparts. Researchers in the US were forced to develop methods to encourage their existing stem cells to become pluripotential again for differentiation into different cells. They also were able to find and exploit adult stem cells from the tissues and blood of adults. After a very slow start, the stem cell community is ripe for the development of multiple lines that have the potential to treat and/or cure many diseases. All they need is the support that Obama will have the authority to give.

Interestingly enough, both McCain and Obama support stem cell research. During the last 3 years they both supported the same four pieces of legislation regarding stem cell research, including embryonic stem cells. Their main area of disagreement was in the use of embryos created for use in fertility clinics. The excess embryos are typically destroyed. Obama supports their use while McCain did not. Both supported the ban on the use of embryos created for the sole purpose of research. Now that Obama is president, hopefully he can get legislation passed that allows the use of those excess embryos from fertility clinics for stem cell research.

I have a particularly strong personal interest in this area. Type 1 diabetes runs in my family. My father died of complications related to his diabetes after suffering a heart attack and an amputation of his lower leg due to poor circulation. He had diabetes for more than 50 years. When you think about, he actually did quite well considering the fact that most of the advances and understanding of diabetes occurred in the last twenty years. Unfortunately, diabetes is genetic. My daughter and I are also type 1 diabetics. My hope is that even if there is no "cure" during my lifetime, there will be for my daughter.

While it may seem initially that my motivation is selfish (and I admit that I am looking at this from a personal perspective also), the statistics are overwhelming and crying for a cure. The current estimates(2008) state that there are currently 21 million Americans with diabetes and 54 million with pre-diabetes. Deaths due to diabetes and it's complications are 224,000 per year. If the current trend continues, a person born in the year 2000 has a one in three chance of developing diabetes in their lifetime. For minorities, that lifetime chance of developing diabetes is a staggering one out of two!

The economic costs related to diabetes should place it on everyone's radar for control and cure. A paper published by the American Diabetes Association entitled Economic Costs of Diabetes in The U.S in 2007, estimates that in 2007 there were 17.5 million diagnosed diabetics and another 6.6 million who were undiagnosed. Combined, that represents 8% of the total US population. For the diagnosed diabetics, the ADA calculates the "economic burden of diabetes caused by increased health resource use" to be $174 Billion per year. The increasing prevalence of diabetes means increasing expenditures for years to come.

From a purely fiscal point of view, it would make sense to prevent or cure a disease that has such a high cost to society. This can be accomplished in many ways. Stem cell research can, and will, find a cure for Type 1 diabetes eventually. But Type 1 diabetes represents only a small percentage of the total diabetic population. The epidemic of obesity, a major contributor to the development of Type 11 diabetes, has to be controlled as well.

As our new president takes office during the worst economic crisis since the Great Depression, the promise of universal healthcare will still be on many Americans minds as they are laid off, look for work or try to keep their current employment, even though it may offer no healthcare benefits. The enormous cost of implementing universal healthcare begs for cost containment, more efficient use of tax payer dollars, and focusing on disease prevention as a way to decrease our expenditures for chronic diseases. What a perfect opportunity for a progressive president to spend a few billion dollars in support of embryonic stem cell research that will yield an economic benefit worth many times it's cost.

For a president who will make history just by having been elected, imagine the footnote that can be added to his already monumental achievement by stating that he was responsible for the first true cure of a costly chronic disease simply by his support of embryonic stem cell research. With the legislation currently in place, sure seems like a short step in the right direction.

Doc B

My opinion is free.
Advice is worth exactly what you pay for it.

Tuesday, November 4, 2008

President Barack Obama

Now I lay me down to sleep. I pray the Lord my soul to keep. And if I die before I wake, I pray the lord my soul to take.

That's the prayer my ex-wife taught to our daughters. We still say that prayer every night at bedtime. Now that the election is over, McCain has conceded and we have a new president elect, we should all pray. The next president is going to be faced with challenges not faced by any president since FDR and the great depression.

This is not simply an issue of race. Granted, the US has elected it's first black president, but if this were any other country in the world, the color of the elected official's skin would not have been an issue. Now that he is our president elect, he will be scrutinized more closely than any other. Again because the color of his skin and not the tough job that lies ahead. He inherits a mess that any president would have a hard time trying to manage. Let's cut the guy a break from the racial issue, give him the benefit of the doubt and see what he's made of.

I also realize that many blacks (African-Americans) will be holding high hopes that this president will pay special attention to the plight of his kind. But if he does , is he any better than any other president who may have ignored or paid special attention to a particular group or people? He would be placing a blemish on his accomplishment if he does. I hope blacks are not disappointed if he takes the high road and treats all of us the same. I think that is all that Martin Luther King, Jr. ever wanted. And all people, white and black, who sacrificed themselves for equality of any kind. Hopefully, this president will be able to do that for us without being condemned for it.

Congratulations, Mr. President.

Doc B

My opinion is free.
Advice is worth exactly what you pay for it.

Vote

It's that simple. No rants. No raves. If you can't act like a natural born citizen, raised in the US, reaping the benefits bestowed upon you by the greatest country in the world, well.... Act like an immigrant who has struggled to get here and attain citizenship. They are some of the most grateful citizens you will ever meet and probably the first in line to vote this morning.

GO VOTE. MAKE A DIFFERENCE.

Doc B

Monday, November 3, 2008

Enough Already!!!

I thought my last post was good enough to cover the barrage of advertising we are all being bombarded with, but I was wrong. If you recall, I explained that I don't typically use my home phone and prefer to use my cell. A lot of us are of a similar thought. Since I don't use it, I don't usually check for messages. If you know me, you call my cell. But, when I got home today I checked the phone and the caller ID and saw four missed calls since I left for work this morning. One of them was my mother, and she did try my cell, and we had a nice conversation. The others I didn't recognize so I decided to check the messages to see if there was anything important.

I dialed into my voicemail and the very pleasant but monotone, female, computer generated voice asked for my password. I entered it obediently, like I always do and was told by my unsexy female friend that I had 16 unheard messages. 16!!!! I've never had so many messages, ever. Not even on my business line after I've been on vacation for a week. I punched #11 to get my messages and guess what?

Those sixteen messages were from Oct 28 until today. Of the 16 messages, 11 were political. Most were presidential calls. I even got one from Sarah Palin herself. I'd like to think she took the time to call me personally, but I'm pretty sure it was recorded. I got one of those calls from GW in 2004 too. Told my kids I was important and that the president was calling me directly to ask for my support. I even let them listen to the message. Boy were they impressed!

When you add the three that I received in rapid succession yesterday, that is a total of fourteen out of nineteen phone calls that were political advertisements. Twelve of the fourteen were related to the presidential election. How much more of this can we take? I am so fed up with the whole process that I can't imagine how each candidate's supporters must feel. After all of this is over, they'll all need a stiff drink, then go over into a corner somewhere and pass out for a few months. Actually, that sounds like a good idea right now.

When it's all said and done, more than 2 billion dollars will have been spent on this election. All of us have had our senses saturated, invaded, bombarded, abused, molested and violated by the most disgusting presidential advertising campaign to date. I hope that there is actually such a thing as true campaign finance reform that someone proposes in congress after the election. And someone will bring it up. Not because it is the right thing to do , but because Obama kicked McCain's butt raising money, giving him the most lopsided advertising blitz we have ever seen.

I just hope they add campaign robot calls to the no call list. Everything else I can ignore.

Doc B

My opinion is free.
Advice is worth exactly what you pay for it.

Saturday, November 1, 2008

Obama's Money is Buying My Misery; Enough Already!

Earlier one of my posts dealt with the amount of money each of the candidates and their respective parties had raised for the 2008 election year. Disgusting to say the least. As of the date of this post, the airwaves, and our senses, are being saturated with political advertising, local and national, Obama and McCain. Most I can tolerate, but they got on my last nerve tonight.

Southwest Ohio is experiencing an unusual warm stretch the weekend just before the election. Temperatures hovered near teh low 70's and not a drop of rain on the horizon. I took this opportunity to work outside and actually went for a ride on my motorcycle (with a helmet) dressed only in t-shirt and jeans. The slight nip in the air was perfect. Upon arriving home I decided that this was an ideal day to take advantage of the warm weather and get another day of use out of my grill. I thawed out a nice ribeye steak that I had bought on sale earlier last week. Just as I was ready to sit down and enjoy my perfectly grilled steak.....

Of course the phone had to ring. I, like many people, use my cell phone as my primary phone. Anyone who knows me, knows to try my cell phone first. That means that if my home phone rings, either my cell phone isn't working (everyone tries my home number as a back up to my cell) or I don't know you. The offender who was interrupting my dinner today fell into teh latter category.

Caller ID has allowed us to pre-screen our phone calls so we can pick and choose who we wish to talk to, before we even answer the phone. We are so accustomed to it on our cell phones that we can give a name, instead of just their number, to our frequent callers. The name shows up on the screen and again, we can decide whether or not to answer. Just like my home phone, if I don't know the number , I don't answer.

Back to dinner. I let the phone ring until it went to voicemail and then checked to see who it was. The toll free number, 877-622-6264, was in the caller ID display, but without any additional information. Since they left no message, I ignored it and sat down to enjoy my hot, juicy, delicious steak. Not more than 2 bites into my meal, the phone rang again. Guess what? Same number again. This time I answered. I was sure it was some sales call (despite being on the infamous "No Call" list) invading my Saturday evening dinner time and was ready to tear into them and say "No thank you. Please don't call me again and take me off your list". As soon as I answered and said "Hello" an obviously recorded voice began speaking about Barack Obama! I screamed into the phone; "Stop it!! Leave me alone!!" and hung up.

I took two slow deep breaths trying to calm down and relax before taking the much anticipated next bite of my steak. Proper digestion deserves a calm and relaxed consumer of a wonderfully prepared meal. As I relaxed and began enjoying my steak, you will never believe what happened. You guessed it! Another call from the same 877 number. This time I ignored it again and didn't allow it to ruin the moment. I finished my steak (which I enjoyed immensely despite the Obama invasion into my meal time), then headed straight for my computer after cleaning my dishes.

So this is what the candidates are doing with all of the money they've collected? Harassing people at home, on the weekend, at dinner time, who are on the "No Call" list, not once but three times in rapid fire succession! And since Obama has more money than McCain, he is a much bigger offender. I think that this individual, direct to consumer type of advertising, may have the exact opposite effect than what the purveyors of this nuisance wanted. I was so frustrated and angry at this unwanted intrusion into my home, that it left me with an overall bad feeling for Obama.

I'm being bombarded with political advertising in my email, on my TV and radio, placards in yards and on roadsides, and billboards. But the main difference is that these are passive forms of advertising. I can choose to ignore them. They do not require my participation in any way shape or form. By calling my home they have come uninvited, invading my castle and making me an unwitting participant in this year's obnoxious orgy of the gluttony that has become a self-righteous, self serving greed of political spending.

Exactly what is the ulterior motive that would drive the candidiates to be so obnoxious, so disgusting, so political that they would sacrifice friends, family, reputation and dignity? If these are the qualities of our candidates, just what do you think they would say in their adds and to the American public just to get elected?

Doc B

My opinion is free.
Advice is worth exactly what you pay for it.