Socialized Medicine? Let’s Do the Math (or at least make some conservative estimates)

With our health infrastructure crumbling, 50 million folks without health insurance, and a growing sense of urgency, you frequently hear about the evils of "socialized medicine." So I thought, let's take a closer look. Let's do the math, and see just how bad we'll get ripped off if we nationalize health insurance and adopt a single-payer insurance system like what France or Germany or Sweden or Japan or some other backward, socialist liberal country does. Sure and if we do, our health system will go right down the tubes and be like theirs, huh?

Oh, wait. Their systems are all rated LOTS better than ours. Though we do pay about 2.5 times as much, per capita.

For simplicity's sake, I'm just going to figure this as if we expanded Medicare to include everyone. After all, we've already got socialized medicine, which by law is required to try to make itself competitive with private insurance. This is tough, since Medicare operates at about 3% overhead, and private insurers operate at 12% t0 30%. So, by law, Medicare is not allowed to negotiate drug prices, it excludes a huge number of people based on age and ability, and they've got tons of complicated, stupid paperwork that drives health providers nuts and makes them hesitate to accept Medicare patients.

So, my employer pays about $6.35 per hour that I work into private health insurance. Under Medicare, I'd save, conservatively, 10%. (6.35x.1=.635) So, right off the bat, I get a 64 cent raise. Cool.

Then the math gets more complicated. For instance, I know that there will be 50 million more people with health insurance, but how many of them would be taxpayers? I don't know the details well enough – does that number include kids and workers, or just workers? Either way, it's going to spread the premium base, and so bring down the cost. Let's call it another 10 cent reduction in my share. Now I've got a 74 cent raise.

But folks that are uninsured now will have access to regular checkups and wellness programs, so overall emergency room costs will go way down. I don't know how to account for this mathematically, either, so let's conservatively take another 10 cent reduction in my share. And my raise is up to 84 cents.

And what if we allowed Medicare to negotiate drug prices? I wonder how much that would save? I don't know, but it's bound to be significant. Let's say that savings reduces my share another 10 cents. I'm nearing a dollar! (And that's not even counting if we allowed Medicare to negotiate the cost of procedures.)

So what if the paperwork problem were fixed, which should be pretty basic since Medicare wouldn't have to exclude everybody who is young and healthy. That would reduce the costs to providers, so Medicare wouldn't pay as much – say, 6 cents.

Wow! A dollar raise! Just for socializing medical insurance!

What would your raise be?

And how cool would it be if every kid had health insurance? (Real cool, in my opinion.)

Of course, that doesn't account for the fact that the money I pay into Medicare taxes currently goes to cover the oldest, sickest people around – in other words, by adding young, healthy people to the premium pool, my current taxes would go down.

How would this affect health providers? Wouldn't they be totally demoralized by getting paid by a socialized insurance program? Doctors would flock across our borders to work in Canada and Mexico and …

Oh, wait. Yeah, they probably wouldn't. They'd just have an easier time with paperwork. (Believe me, any fix of this nature is not complete without fixing the Medicare paperwork nightmare.) And their liability insurance would probably go down a lot. So their overhead would go down, further reducing costs, and even if their pay got reduced through negotiations, the savings in insurance would likely mean increased take-home.

But you couldn't pick your doctor, right?

Why not? They're all getting paid by the same insurer. Seems like having a license to practice medicine automatically puts them into the preferred provider pool, which means you'd have more choice of which doctor to use.

But there has to be some downside to socializing medical insurance. Right?

Well, it would mean increasing taxes. My share of that would be $5.35/hour (worst case scenario). Which still leaves me a dollar per hour more in discretionary income. I'm actually okay with that. (Some employers might not want to pay out all of their savings on health insurance to wages. So, join a union!) Only Republicans are so anti-tax they'd rather spend lots of money on inefficient private systems and reduce take home wages than surrender their ideology.

For the past 30 years or so, we've been bombarded with the myth that government efficiency is an oxymoron. It's true that government is typically incompetent and inefficient in producing goods and moving them around. But in fact government does excel in certain efficiencies, and one of these is insurance. Social Security, for instance, is an enormous program; yet it operates at under 3% overhead. Medicare is the biggest health care payer in the nation, yet it has by far the lowest overhead of any health insurance company. Continuing down our course of blind ideology to support a myth that the "free market" provides the best service in all situations and circumstances, while the data, both from our own nation and from the rest of the world, proves otherwise is worse than stupid. It's insane. When it means withholding health care from sick people and kids, it's cruel and unjust.

It's also very, very expensive.

Repudiation

There are aspects of the language that Keith Olbermann uses in this video that I don't care for, but I respect what he says.

The history of this nation is clear. That history shows that the McCain/Palin campaign, whether intentionally or not, is inciting violence. They are putting Mr. Obama's life in danger. And that is, in my opinion, far worse than the warning Mr. Lewis recently issued, that that is exactly what McCain is doing.

If I were not already an Obama supporter, this would make me one.

I truly hope that the American people will rise up and repudiate the McCain/Palin ticket on November 4th. We are a better nation than this.

Peace.

Obama & McCain – Debate Dizziness

I listened to the debate between Obama and McCain last night just enough to get thoroughly disgusted. It didn't take long.

First there was the issue of taxes. I was disappointed to hear Obama say that he disliked them. It sounds like he's bought into the Republican meme that "taxes are bad, and everyone hates them." I've blogged on this before. It's true that the federal government misspends a huge amount of taxes (the military budget), but taxes themselves are good things, they're really cool, and every year I enjoy writing out the check to the state (though not the feds – see above). This distaste for taxes, born in the myths of the Boston Tea Party and Republican wet dreams of drowning government in the bathtub, is what got us $10 trillion in debt.

So both candidates are going to cut taxes left and right (though at least Obama would raise them on the wealthiest Americans). And balance the budget. Uh, huh. This Republican fantasy has been around for 30 years now, and it's time to get over it. Try it in your personal finances. It doesn't work. If we want to either "fix the problems" this country has, or create the country we want, it's time to raise taxes and cut spending, and the place to start cutting is the military budget – half of the entire world's. I believe in a strong military. So let's cut the military budget by $300 billion, so that we'll have the biggest, most expensive, best trained military in the world. We can start by withdrawing garrisons from dozens of countries around the world, and eliminating Star Wars.

Second, both candidates are fixated on "solving our problems." I bought into this mindset recently, so I can't criticize too much here, but it's recently become clear to me, through watching people like Kristin create her life, and now reading The Path of Least Resistance, by Robert Fritz, that that mindset will not get us where we need to go. We need to switch that mindset to one in which we ask ourselves, what kind of country would we like – and then set out to create it.

Think about that for a second. How would it be if, instead of saying, "Omigod! Look at this horrible economic meltdown! We've gotta rush around madly and fix it right now!" we said, "Okay, what kind of country do we want to create? Let's figure that out, then we'll look at our current economic meltdown situation, and figure out how to create it from here."

Which mindset do you suppose is going to get a better end result? And have more fun getting there?

As Douglas MacArthur once said, "There is no security on this earth. There is only opportunity."

Of course, even with my disappointment with Obama, my support for him remains unchanged. He's obviously less delusional about taxes than his opponent, he's definitely more creative, and he'll select Supreme Court justices far superior to those McCain would choose. If anything happens to him, his vice president is at least competent. And I would SO much prefer that Obama get that 3 a.m. call on the red telephone!

(As an aside, this quote from MSNBC's debate coverage really floored me: "The financial crisis — an unforeseen and unimaginable event, ..." Anybody who's spent any time studying history - especially the economic policies of Coolidge & Hoover - should have been expecting it. Likewise anyone who's studied economics (at least, who's been reading Krugman instead of Friedman). Lots of us were. A guy named Kunstler wrote a book more or less predicting it a number of years ago, called The Long Emergency. Well, perhaps the writer was stuck in a Fox News information vacuum....)

Teaching Tolerance

This post by Riftgirl is one that I highly recommend everyone read - especially if they have any kids or grandkids who are or will be in school.

Birthday Girl!

It's my birthday, and the full moon. So I'm taking a day off, sort of, from blogging. Just this little note, a celebration!

Peace, everyone! Be well.

Power and Racism

For about 30 years, I lived with and enjoyed privilege of which I was unaware. That privilege was white male privilege, and I took for granted that people would assume, in any social or economic interaction, that I was honest and worthy. When I walked the aisles of stores wearing a bulky coat, no one paid much attention. When I spoke to the tellers at banks, I barely had to show ID. When I applied for a job, I had full confidence that I would be assessed based completely on my competence and fitness for the job. I rarely hesitated to take the path to my destination I found most convenient, having confidence I would not be assaulted en route, even in a dark alley or midnight stairwell.

Gradually, I became aware that other people don't always have this experience. I witnessed the difficulty of a black woman to have her ID accepted at a bank. I noticed the way that store clerks or detectives watched black men in stores. I spent a very eye-opening pair of hours talking with a group of dark-skinned women in a Women of Color conference at the University. I read about hierarchical structures and the civil rights movement. I learned to recognize my own prejudices, acquired through assimilation into a dominant culture that is white and male. And I began my own transition.

Now the question has arisen, whether I consider the racist remarks of Rev. Jeremiah Wright as repugnant as the racism of David Duke, and Barack Obama's connection to that pastor as a warning bell of latent racist feeling.

Taken out of context, perhaps they are the same; but there is an inherent connection between power and racism. You cannot isolate racism without taking into account the power structure of the society that lies beneath it.

My ancestors owned the ancestors of Rev. Wright as if they were cattle. I've seen the photos of black men with their backs matted from neck to buttocks with scars from the whip. Slaves who ran away sometimes had their Achilles tendons cut, crippling them for life so that they could not run again. Or they were hanged. They were considered less than human – 3/5 human, to be precise. For two hundred and fifty years, this was their condition in America, and it was followed by another hundred years of Jim Crow oppression. Even today, a black man will spend ten times as much time in prison as a white man for possessing cocaine. He will be pulled over or stopped on the street for no reason beyond driving or running while black. Those are facts; you can look up the data if you like. That is simply the reality of our history, and to deny it or to assume that it has no affect on our current social structure is the height of naiveté.

(I'm not beating myself up over it. I never had a part in it, though, to my shame, I have at least twice observed racist actions without taking a stand against them – which is about as bad as participating. There aren't many people I admire more than Harriet Tubman.)

The power structure of our society is white and male. Again, look at our history. Women didn't even have the right to vote until the 1920's, just eighty years ago. We've had 43 presidents, and every one of them has been a white male. Even though white men constitute less than half of our population, they constitute the vast majority of our corporate CEO's and congressmen.

So when the country club puts up a sign that says "Whites Only," or "Men Only," it effectively shuts people of color and women off from access to power, to the policies and business agreements that affect their lives. It is oppression, and I find it repugnant.

On the other hand, when an American institution bars whites from membership to provide a safe place for a powerless group to organize and gather, can I honestly say that anyone is being barred from access to the power structures and economic activities that affect their lives?

I don't think so. The one is an attempt to prevent someone else from access to power, a means of stratifying society. The other is an attempt to gain power for oneself, a means of fighting for equality. I don't like it, and I believe it is not the most effective means, but it is not oppression.

It is this power differential that makes a comparison between the racist remarks of Rev. Wright and someone like David Duke irrelevant. They are completely different animals.

Which is not to say that I support Wright's views, or even fully understand them. I do not. It is only to say that I won't judge them by the same standard I would if they came from a white mouth. I won't line up the sheep with the cow to compare their meat and wool.

As for Barack Obama, I do not fear any aspect of racism from the man. He was hugely isolated from the very real though usually subtle racism that still permeates our society while he grew up in Hawaii, son of a white woman and an immigrant from Africa, and so did not assimilate those grievances with his mother's milk; at the same time, he has encountered and experienced racism in his work in places like Chicago, so he is not blind to it. While Obama sat in his pews, I suspect Rev. Wright spoke a whole lot more about black empowerment than white dismemberment, and since I'm all about empowering disempowered groups and individuals, I don't have a problem with that. I have not one iota of doubt that Mr. Obama will wield the power of the presidency with far more equality and even-handedness than his opponent would, and that he will judge people based on character over race far more reliably than Mr. McCain.

In short, I believe that Barack Obama, through his ancestry, heritage, and experience, is about as close as we're going to get to an ideal leader to finally break down the barrier of racism, bridge the gap between black and white, and bring Dr. King's vision to fruition. There are certainly positions of his with which I disagree – for instance, I don't think his health plan goes far enough, I'd like to see a commitment to cut the military budget by about three quarters, and I'd like to see him come out for marriage equality. Nevertheless, for the first time in my life, I will mark my ballot for president with joy, enthusiasm – and hope.

Arabs

Am I the only one, or does anyone else out there find this exchange from a recent McCain rally as disturbing as I do?

["I don't trust Obama," a woman said. "I have read about him. He's an Arab."

McCain shook his head in disagreement, and said:

"No, ma'am. He's a decent, family man, a citizen that I just happen to have disagreements with (him) on fundamental issues and that's what this campaign is all about."]

I think if I were an Arab, I'd be rather offended. As a European-American, I just feel very sad.

I know some Arabs and Muslims. My friend Noor identifies with Mohammed Atta about as much as I identify with Tim McVeigh or Bull Connor. The Arabs and Iranians I know are peaceful, honest, hardworking, "decent, family" people.

I give credit to McCain here for trying to correct the impression about Obama, and I don't think he was intentionally speaking out against anyone. Yet by choosing not to confront the comment about Arabs, he reinforced a stereotype that Arabs can't be trusted, and implied that they aren't decent, family people, as well.

But the saddest of all is that this attitude is common in my country. I am glad I'm not an Arab-American right now, but I want all Arab-Americans and Muslim Americans to know that I support you. I believe in you. I will speak in your defense. I will judge you by the "content of your character," and not by your religion, your ethnicity, or the color of your skin.

And right now, I grieve for my nation. I feel so sad to see this violent rhetoric split us apart.

Blessings upon you all, and on us. May there be peace.

Stuff and Poverty

Okay, back to the Peace Conference I attended about a month ago. It was a powerful event, and I met some rich and powerful people.

I met Marshall Rosenberg, who travels around the world mediating conflicts and creating peace. He chooses to live on a poverty income so that he doesn't have to pay taxes that support the Iraq Occupation.

I met Julia Butterfly Hill, who spent over two years living in a tree to save its life.

I learned about Mohandas Gandhi, who gave away all his possessions to live a life of poverty in service to his people.

I met Bonnie Tinker, who lives on her non-profit, and has been arrested many times in nonviolent demonstrations against oppression.

After the conference, as I drove to pick up my kids, I thought about that, and how I couldn't give up my stuff to live a life like that. I've got kids, for god's sake. A job. How could I give all that up?

Like a ray of light, I suddenly understood how I could. It was so clear that I exclaimed out loud.

I can surrender all my stuff in my heart, right now.

So I did. I gave up all my stuff; essentially gave it away. I don't own anything, I just use it. If I lose it, loan it, or have it taken away from me, I'll use something else.

I don't own my house. It's just where I live. If I lose it, I'll go live somewhere else.

I don't own my job. It's just where I serve right now. If I lose it, I'll find a better way to serve.

I don't even own my kids. I love them, sure, but if something happens to them that separates us, I know that they will be taken care of. And they're going to grow up and leave anyway. They're their own people.

A sense of freedom swept over me. What a celebration to have an insight like that! I realized in that moment that I am free. I can make decisions about what to do without fear. And that's pretty darn cool.

Now the only problem is how to keep that sensibility. I've had moments since when the cares of everyday life creep in and take that sense of freedom and choice away, but for the most part, it's been working. I still have that sense of possibility. I've still given everything away in my heart. I'm still free. And I've set an intention to keep that freedom and unattachment to my stuff.