Saturday, June 19, 2010

Counting Blessings

Blessings, like many things come in clusters. Some parts of the cluster may not seem sweet at the time. When my position at work was one of those eliminated, who would have thought that I would now be oh so much better trained in my church calling as stake employment specialist, Who would have thought that I would make a commitment with the extra time to exercize 6 days a week and would lose 20 pounds (and I know that number will increase), and who would know that when I stopped and took my blood pressure at the self serve BP station by Wal-Mart's pharmacy that my blood pressure would have dropped 25 points and would now be well within the normal range. Who would know that so many good things (and more good things to come, I am sure) would result from the seemingly not good thing of being out of work.

Tuesday, April 6, 2010

Thoughts on Health care legislation

A couple of experiences mold my view of debate over any government actions. The first was seeing some material printed in the 1960’s when going through an old piece of furniture. This article, published by the U.S. Chamber of Commerce, discussed the great problems that would arise if lenders were required to tell consumers what the annual percentage rate of borrowing would be on a loan. The legislation passed and none of the terrible things foreseen came about.
The second incident occurred as I read a book What Kind of Nation

http://www.amazon.com/What-Kind-Nation-Jefferson-Marshall/dp/0684848716/ref=sr_1_1?ie=UTF8&s=books&qid=1270578141&sr=8-1

About the political differences of John Marshall and Thomas Jefferson. They each claimed dire consequences if the other was elected (This was before John Marshal became a Supreme) The political rhetoric of today has nothing on how it used to be. They each in turn were elected and none of the dire consequences occurred.

I am not persuaded that health care is the worst thing that has ever happened in our nation, nor that it is the great panacea that others claim it to be. It contains some good, some neutral, and some bad.

I have worked with people who have had good job offers to go elsewhere, very much wanted to take the offer, but because they were diabetic and would not be covered under the proposed employer’s plan because of the pre-existing condition, remained in a job they disliked. That borders on involuntary servitude, aka slavery. The cost of medical care (even with health insurance) is one of the three major causes of personal bankruptcy, (the other two are loss of employment and family break up) I believe it is a good thing that lifetime limits has been eliminated. I believe it is a good thing that those who are unable to afford health insurance can now be covered.

I believe the health care bill also does some neutral things. I believe that health care costs need to come down. I recognize that shifting the cost elsewhere is not the same thing as reducing the cost. That is at best neutral and at worst negative as the true costs remain hidden. I was intriqued by a study by a Professor at Arizona State University who specializes in health policy. After researching the health care systems in all of the industrialized nations, she discovered that the percentage of people in each nation who liked the system they were under was the same for all systems and the same was true of the percentage that did not like the system they were under. Each system has to deal with the issues of cost of care, quality of care, and availability of care. A change in one of these affects the others. The balance between them may tilt one way or another. An action which will benefit one of the factors will reduce one of the others. Each action will delight one group and disappoint another but it all stays in balance for the entire country.
This is similar to when I was a boy with a paper route. Each day the papers came at the same time and it would take me an hour to deliver the newspapers. I experimented with different methods to cover all of the streets on my route. When I would make such a change I discovered that I got big tips and thanks from those who got their paper earlier. When I went on a different street first I would get a tip and thanks from the ones on that street. Either way the time I took to do it all did not vary. On the whole, I believe the same will happen with health care.
I see a significant negative with the passage of the health bill and this is what it is. The momentum to correct problems in the health care delivery process has stopped without addressing the most significant issue. That issue is that there has been confusion in health care over who the customer is. The customer is the one that pays the bill. In health care that is the insurance companies, not the patient. If the patient was the customer I believe health care would improve and costs would decrease. See this article from The Harvard Business Review:

http://hbr.org/web/extras/insight-center/health-care/will-disruptive-innovations-cure-health-care

Another problem is that prepaid health care is masquerading as health insurance. Insurance is used when there is a high cost risk which will occur in a population. It cannot be determined which member of the population will incur the cost. Insurance spreads the cost of the risk among a large group. That way the large potential unknown cost becomes a known cost, the cost of insuring against the loss. Such a program does not cover the routine and the expected anymore than my auto insurance covers the costs of brakes, oil change, and replacing windshield wipers. Yet health “insurance” asks me just to pay $10 or $25 when I visit the Dr. (True he only sees me for three minutes and 15 seconds so those add up over the course of the day.) but that really isn’t insurance.

I have also found these additional articles on health care to be of interest,
http://hbr.org/web/extras/insight-center/health-care/why-innovation-in-health-care-is-so-hard
http://hbr.org/web/extras/insight-center/health-care/redefining-competition-in-health-care
http://blogs.hbr.org/cs/2010/03/health_care_of_the_future.html
And just for perspective.
http://www.theatlantic.com/magazine/archive/1969/12/how-good-is-government-medical-care/6085/

Friday, March 12, 2010

Just Sayin...

I was reflecting on some of the sayings that have come up at different points in my life and have stuck with me:
1. In the First grade, after taking a longer than normal time to walk home(I reversed course every time I saw a dog, my sister had been bit by a dog that summer and I had heard about rabies shots) My dad get a saying which ended up being posted on my wall,

"Courage is not the absence of fear but the master of it."

2. When I was in college I ran across a quote which I copied and put on the wall of my room. It went something like this:

"There is no substitute for the first rate person, 10 second rate people cannot replace them"

3. I worked and worked to get our family to develop a family mission statement. I finally drafted one myself and it has remained largely ignored. Except my daughter, when she was working at a company doing engraving had it engraved on a plaque and gave to me for Christmas.

"An Andrews is patient. An Andrews is kind and envies no one. An Andrews is never boastful nor conceited, not rude or indecent, never selfish and not quick to be resentful or take offense. An Andrews keeps no score of wrongs, does not gloat over other person's problems, but delights in the truth, the eternal potential of ourselves and others. There is nothing an Andrews can't face. We are loyal, we believe in one another, We expect the best of one another. There is no limit to our faith, our hope, or our endurance. Our love will never fail! We will be valiant. We will have joy and have fun.

4. I have been teaching a class on Family finance. One of the lessons is on goal setting and has this quote from Will Durrant's Story of Philosophy. It ow adornes the fridge.

We want to know that the little things are little, and the big things are big, before it is too late; we want to see things now as they will seem forever--'in the light of eternity.'

So there you have it, the sayings and accumulated wisdom I have picked up through the years