Showing posts with label Healthcare Costs. Show all posts
Showing posts with label Healthcare Costs. Show all posts

Tuesday, October 12, 2010

The Fence I'm Straddling has Barbed Wire - Ouch!

Sometimes it's hard to be a liberal however one likes the meaning of the word. It is equally hard to be a conservative with respect to wanting to conserve institutions that work and get rid of or modify the ones that don't, which is, by the way, the true meaning of conservatism, or at least a truer meaning than the one touted by so-called conservatives nowadays in the radical Tea Party and its radical friends. David Brooks is usually "too" conservative for me, although I don't see him as a radical, but in this Op-Ed Columnist - The Paralysis of the State - NYTimes.com, I can't disagree with him. I'm straddling the fence again and I'm uncomfortable.

As a general rule, I hate union busting for a couple of reasons. First is that unions have been somewhat successful in making sure the everyday worker is paid a reasonable, living wage or at least paid a wage that is not less than the wage of ten, twenty or thirty years ago. Unions built the middle class, and it is the middle class that has driven America to a level of prosperity that so-called "management" would have never been able to do. Management, as I interpret it to mean, are those CEOs that pay themselves multi-million dollar bonuses and stock options, and other ridiculously expensive benefits. The middle class built America because the middle class had "Purchasing Power." Well, all of that turns out to be only half true. Management, it seems, according to a recent report that I've forgotten where to find, has managed to sell us hocus pocus, voodoo capitalistic ideals that management knows best over the past forty years and so the everyday Joe worker has not really seen an increase in wages since the 1970s, if you count inflation. Perhaps I heard that from Robert Reich, who seems to have his facts and logic together. So, it makes sense to me to "redistribute" a little of the top wealth back to the middle class and the poor through tax changes, i.e., tax the rich and not the poor or middle class - that is if you want them to buy anything.

There are some cases of union busting that simply fly in the face of all reason, and that's what I hate about union busting. Take the case of Gibson County's Commissioner Bob Townsend's attempt last year. As I understand, the Gibson County Local 215 employee union is now operating without a contract, so he was somewhat successful. If Townsend had made a reasonable attempt to bargain with the union, I probably wouldn't have said a word, but he didn't. In fact, there was every appearance of graft, favoritism and corruption at the center of it. The fuss was all about the County's health insurance policies, purchased through the so-called "city and county" insurance agent, the one and only John Dyer, for non-union workers and the "group" insurance policy purchased by the union . I suspect that the group policy is the better and less expensive policy, because group policies usually are. But, Dyer, it seems, has the sole right to sell the City of Princeton and Gibson County their insurance policies. Was he the only agent in town? How about competitive bidding? The other troubling aspect in the comedy skit was the Princeton Clarion, the newspaper. While there was trouble in River City, the Clarion said not one word other than reporting, verbatim, what was said at an "open and public" County Commissioner-Employee meeting that included both union and non-union people. It didn't "investigate" one iota of the situation. Instead, it reported on a lost dog and the November garage sales and other such articles, and lamented on the coming of Winter in its Op-Ed pages. Big deal! Later, after I joined Facebook and befriended the Clarion, I learned that the Clarion is basically a Tea Party newspaper and it won't investigate nor print anything contrary to Tea Party views or the shenanigans of Republican administrations. In other words, anyone reading the paper will never know about hanky-panky at the County seat. That's usually the case in union busting, it's all rigged against the worker and for the rich managers, including newspaper publishers. If I lived there, I'd send Andrea Howe, the editor, an email every day telling her the "what for." And, I would keep sending them until she either quit or got off her ass and did some real investigating. I sent her a couple anyway. She didn't respond when I asked a few pointed questions.

But, David Brooks, and the study he cites, has a point. When unions become too big and begin to have enough influence to elect their bosses, then we need to worry. That the unions have become big enough for states to pass laws that give them 90% of their working salaries for retirement is outrageous. When did we ever believe that we can afford that? But, the real question is, why wasn't there a BIG STINK raised when it happened? Where were the newspapers and news media back then? Silent, like the Princeton Clarion is on the Gibson County back-room favoritism, wheeling and dealing with John Dyer.

The other "real" question is what is the most significant "cost" that makes a high pension necessary in the first place? What makes the unions scream so loud? The answer is: HEALTH INSURANCE. And, the real point to that is that perhaps we could pay Joe worker a real, honest-to-goodness wage if we didn't have to pay the outrageous Health Insurance Blackmail. Then, taking the next reasonable step in that argument, there is the one thing that we could do that would punch the Health Insurance Companies squarely on the nose: Pass the Public Option law and circumvent the Insurance Companies entirely. But, that too is a Republican No-No vote. Go figure.

So, from union busting, graft, favoritism, corruption, health insurance loving, bug business loving to not investigating and reporting those things by right-wing news media, I still see Republicans as the Party Without A Clue, but I have to agree that powerful unions are just as dumb and greedy in their demands on taxpayers. That barbed wire on the fence I ride sometimes hurts.

I guess we could go one step farther, too, and that is to ask: How did we come to a time when Unions and Corporations have so much clout in our elections as to elect the people who will return favors? I guess we could take that to the Supreme Court case: Citizens United v. the Federal Election Commission. Wonder who bought the five Supreme Court Justices who made that decision and, by the way, changed the law? Are you really thinking they were not paid for? If so, you're delusional.

Dave

Saturday, July 31, 2010

A Root Canal, But I Digress

Yesterday at lunch with a good friend the subject of root canals came up. She said that while on a trip to Mumbai, India, she had to have a root canal on a painful tooth and she had it done in Mumbai. I sensed a tone of surprise when she said the dentist used the same modern equipment, was just as skilled and just as caring as she experienced in the US. She was thoroughly satisfied. And, the shocker? It only cost $150.00, total. "It paid for my plane ticket," she said.

What! My contribution to the discussion was that the cost of my root canal, in progress, is $1,350 and my share of that, after insurance, is $855, and that may not be all I pay. My dentist says I may need a "post," to firm up the tooth, that will cost another $345 out of my pocket since my insurance has capped out for the year. So, now that he has prepared me for another pocket-shock, I will probably "need" the post, since he suggested it, whether I really need it or not, primarily because I don't know any better and I've been sold on the idea for as long as I remember that dentists are "special," held to higher standards, expected to know the complexities of the human body (and teeth) and from all of their very expensive eduction they know what they're talking about. And, from there, the conversation digressed into why the cost disparity between a dentist here and a dentist there and why our costs in the US of A are so much higher.

I guess that you can guess how many turns the discussion could take, but I think dentists in America are overpaid. Can we say that "our" dentist are better trained than those in India? I don't think so. In Japan, a dentist's standard of living is middle class and not at all extravagant. Are they somehow not as good as ours? From the cost in India, it must be the same there; an Indian dentist must not have a high, extravagant standard of living because, if they did, the cost would be higher. I'm sure there are other reasons for the disparity, high insurance administrative costs for example, but US dentists do live extremely well, drive expensive cars, have the nicest homes and pretty much live the "good life." It is not a very hard job. It isn't "back breaking, laborious" work. The fact is, being brutally honest, I have to ask the question: just what is it that makes them "special?" How complicated is a tooth?

When all is said and done, a tooth is a pretty simple structure with a few layers of various materials, held in place by roots embedded in bone and a firm grasp of skin and tissue. That's it! Nothing more. One tooth is pretty much like the next. Google search for tooth structure and only one picture is returned; a crown, neck and root composed of enamel, denture, pulp, gum, bone, root canal, nerve, blood vessel, etc. Know one, know them all. What's the big deal?

I'd say that a dentist isn't much more than a glorified auto mechanic, and maybe, in terms of intelligence, less is required. An automobile is a complex piece of equipment, with new designs and technological improvements every year. A mechanic must never stop learning, or else they become obsolete in a year or two. What is there that a dentist must study every year? A new drill bit? A new digital x-ray machine? Nothing hard about that.

And, an automobile can't touch the complexities in computer programming! Try defining an "object," for example. Webster says an object is "anything that has a fixed shape or form, that you can touch or see, and that is not alive." But, that's not true! In the ephemeral and ambiguous worlds of cyberspace and programming, an object doesn't have a fixed shape or form and you can't touch or see it. But, a huge contradiction is that you can "know" it! It is true that it isn't alive - until you make it live. Try to wrap your brain around that definition! Talk about Zen Buddhism of unreal reality! This stuff will drive a programmer nuts and a non-programmer bonkers! Because in object-oriented programming, a programmer must "use" other "objects" that may or may not exist on your computer. There are hundreds of thousand of objects on your computer, maybe millions, and all could be at the beck and call of a programmer - if he or she knows they are there. If there isn't, or he/she doesn't know they are there, then the programmer has to "create," like a god, an object to use in the program. If that idea hasn't confused you, then try this one. Not only does the programmer have to create objects for the program to function, the object should be "polymorphic," able to take on numerous shapes and forms and "uses" yet still remain process specific, i.e., built to do finely defined functions, AND reusable in other programs if possible. Ha! That ought to make your head spin. Try to do that, Dr. Dentist!


All of this takes me back to another root canal I had done by Dr. Fry in early 2001, around the time I started my full-time computer programming job. Since it turned out that I have a knack for programming, I love the challenge and the logical thinking required and the infinite puzzle solving and especially the group of people the job put me with, and I was thinking of "after-hours" contract programming (I was, in fact, doing that for my previous company to help them transition to the new guy after I left), Dr. Fry asked me while I sat in his chair what I would charge to create him a web site. "$125 an hour," I said, the going rate for programming at the time, and in fact the rate I was charging my previous company. "Oh no!" he said, going nearly apoplectic, "that's way to much!" That just showed how much he knew about programming, i.e., very damn little. In fact, he was so disturbed by my quote that he broke off one of those mini-files in one of my root canals that finally, a few years later, caused an infection and I had to have the tooth pulled. That's why I'm seeing a different dentist for my latest root canal. Dr. Fry not only didn't know anything about programming, he apparently knew very little, or not enough, about dentistry.


So, what's the bottom line? It would likely surprise Dr. Fry that the average run of the mill programmer is worth four or five times their salaries to successful software companies. Microsoft and Oracle, for example, earn over three-quarters of a million dollars per year for each of their programmers, although they don't pay the programmers nearly that amount. Most programmers don't know that either. If they did, they would start forming unions to demand better wages. But, Bill Gates and Larry Ellison know it. What do you think made them so rich? How much do those brilliant programmers, such as Vaishali, Phil, Shivani, Mark, Dan-the-database-man, Namrata, Jeyasree and Barbara earn for their companies? Maybe two or three million each per year or more. They can make your iPhone talk while it does the Polka and your credit card safe and secure as it passes through those ambiguous secure socket object layers. Absolutely phenomenal!


We pay dentists way too much. Is there any other conclusion? They are only glorified technicians. Nothing more. Let's have them drive Chevies instead of BMWs. 


Dave