A plan to make healthcare reform popular

Photo by Lauren Nelson on Flickr

There is pretty widespread agreement on the need for reforming our healthcare system.  There is much less agreement on how to achieve the desired results of universally accessible coverage and affordable costs.  Much of the angst exhibited during the debate over the new healthcare reform law as well as the repeal and reform again position of the GOP’s new Pledge to America is rooted in everyone’s fear that reform will break what already works.

However, the notion that what we have already works is somewhat of a facade.  Granted, there are ample horror stories of people who lack coverage, whose policies have been canceled, or who are dying because they can’t afford the treatment they need.  While that’s a tragedy in its own right, the horror doesn’t impact a significant enough portion of the voting population to drive change.  The reality is that people are generally happy with the care they receive, and while they’d like lower costs, cost is not a major pain point in their financial lives.  Perhaps that is the key point to address in order to get action and cooperation towards real and substantive reform.

Post WWII labor and tax laws created the uniquely American system of getting healthcare primarily through employers.  The result has been that the majority of the cost of healthcare insurance is completely hidden from us as employees.  Let’s change that.

While it may be tough to get this program to roll out correctly, in principle we need to legislate that every employee have his wages increased by the amount that the company is contributing to the employee’s health insurance.  It would also be necessary to provide a payroll tax credit for the employers for that same amount so that companies’ would find this change tax neutral.  Also needed is a tax code change for individuals such that health insurance premiums are deductible on your income tax. This should also be tax neutral as you are not currently charged tax on employer or employee contributions to healthcare.  At this point, everything should be financially equal to the system as it exists today.

Now, as an individual, you get to go shop for healthcare insurance much as you would for car insurance.  Buy whatever policy suits your family’s needs.  Keep in mind that the average cost of a family policy today is about $14,000/year.  Even allowing for new competition driving rates down, your family can still expect to write a check for about $1000 every month to pay your healthcare insurance premium.

Even given that your wages are now higher, it would be a reasonable bet that the visible and widespread financial pain of families now paying what amounts to a second mortgage payment for healthcare would inspire a call for government intervention that would make either party’s current plan look like an exercise in rearranging deck chairs.

We don’t need better ideas for reform as much as we need better light on the current situation.

Luddite politicians

We all remember Senator Ted Stevens trying to explain the Internet as a “series of tubes“.  And the Supreme Court’s recent faux pas while trying to get a handle on this text messaging thing.   Well it turns out that technophobia isn’t a new phenomenon in Washington.

Back in 1930, the Senate tried to ban dial telephones because they felt it was inappropriate and wasteful to do the work of operators themselves. The resolution, which passed, read:

Whereas dial telephones are more difficult to operate than are manual telephones; and Whereas Senators are required, since the installation of dial phones in the Capitol, to perform the duties of telephone operators in order to enjoy the benefits of telephone service; and Whereas dial telephones have failed to expedite telephone service; Therefore be it resolved that the Sergeant at Arms of the Senate is authorized and directed to order the Chesapeake and Potomac Telephone Co. to replace with manual phones within 30 days after the adoption of this resolution, all dial telephones in the Senate wing of the United States Capitol and in the Senate office building.

At the time, they stated a hope the telephone company would take a hint and give up nationally on this foolish roll-out of phones people had to dial themselves.  The horror.

So yes, let’s listen to these guys on technical issues like ACTA, broadband initiatives, intellectual property laws, and cyber-security. At least we can take solace in knowing that being a Luddite is apparently a longstanding job requirement.

Senior Senators impose their views on young soldiers

John McCain
Photo by Geoffrey Chandler on Flickr

The repeal of Don’t Ask Don’t Tell was shot down in the Senate yesterday.  Republicans stood unanimously, with the aid of two Democrats, against allowing the defense authorization bill to come to a vote on the floor while it contained the proposed repeal of the military policy.

The repeal of DADT was part of Obama’s 2008 campaign platform, and is supported by both Robert M. Gates, the Defense secretary, and Adm. Michael G. Mullen, chairman of the Joint Chiefs of Staff as well as 60% of the American people.  The policy was initially created to preserve morale among troops who wouldn’t be comfortable with gays in their ranks.  Yet is this really still an issue, and does it even matter to the Senate if it is?

On the one hand, the pentagon has yet to complete its study on the impact of lifting DADT.  They are currently scheduled to release that study before the end of the year.  In the mean time, it seems the real issue here may simply be age.

A Pew Research Study shows a strong correlation between age and views of DADT.  The 2006 study showed 72% of 18-29 year olds supported gays serving openly in the military.  Meanwhile, only 47% of those over 65 did.  It’s instructive to note the majority of those in military service fall into the younger group, while the majority of those in the Senate fall into the older group.

Further, conservatives are an older demographic than liberals.  This means that for conservative Senators, their votes are largely dependent on those least likely to want DADT repealed, and most likely to not be currently serving in the military.

It seems that DADT has much more to do with preserving the morale of the conservative voting base than it does with preserving the morale of the troops.

The expert dilemma: who should you trust?

Newspaper and Tea
Photo by by Matt Callow on Flickr

The Journal of Risk Research has published study results asserting a strong correlation between whom people accept as experts and whether or not the expert espouses a position the person agrees with.  In other words, people tend to listen to experts who tell them what they want to hear.

On the surface, this isn’t too surprising, and it would be easy to dismiss this as a natural tendency for people to be intellectually lazy.  After all, it requires a lot of brain power to analyze and refute contrary arguments (or a lot of emotional strain to keep from wrapping your fingers around the other person’s neck).

Yet there is a more complex issue underlying this phenomenon, and significant stakes to it in the political arena.  Many of the intractable issues facing us today have competing sets of experts advising two polar opposite strategies.  From economics to global warming, we are besieged with diametrically different expert opinions.  How are we supposed to decide who to trust?

The vast majority of us lack the domain expertise as well as the time to vet expert sources of information.  Is this scientist or this economist telling the truth or at least being honest about what is known versus what is speculation or prediction on his part?  We likely can’t tell from listening to the expert.

A secondary strategy used is to weigh the volume of experts.  If you have 20 people telling you one thing and 2 people telling you another, the best bet is to side with the majority.  But in a sea of 24 hour news, political action committees, and the Internet, it has become impossible to even gauge the volume.  There might be 10, 256 on one side and 6,857 on the other, but no one is going to bother to count.

So we’re left with trusting the source of the expert.  We are left having to trust that CNN or the NY Times has done their homework and is being honest.  But given that we all have particular trusted sources for news and information we go to time and again, this places an enormous amount of power in the hands of the information brokers and distributors.  Power that some are clearly abusing.

It may not be feasible to verify each expert’s credentials, nor even practical to count the experts on each side of an issue.  But it is reasonable to do your homework on your frequent sources of news.  Remember, caveat emptor is is still sound advice, even if all you’re buying is someone’s credibility.

GOP needs to watch more sci-fi

created by Tim Nichols

The Republicans brought their monster to life, and now it’s rampaging through the village as they watch helplessly.  Bringing the religious right into their tent seemed like a good idea at the time.  But outside forces morphed that animal into the Tea Party, and the GOP is now suffering the reality that it is they who are at the mercy of their creation.

Ronald Reagan aligned his party with the Moral Majority to bolster the GOP voting base.  It was a brilliant political plan that resulted in millions of southern Democrats and born-again Christians siding on the political right.  Republicans didn’t have a lot of passion around issues like Creationism, abortion, birth control, or sex education.  However, by adopting them as part of their platform, they brought in support from a large and passionate group of voters who really didn’t care much about the Republican pro-business agenda.  It was a win-win, and it redefined the party.  The new Republican fan base was a passionate and morally righteous group.  They had fire in their belly, but only for a fairly limited set of issues.

9/11 changed everything.  The attack brought an uprising of patriotic fervor that was stoked by the GOP into a national frenzy of desire for vengeance and justice as we marched into war.  Terrorism was positioned as a threat to all things American.  But that frenzy was not contained to the Republican core.  It spread widely and was fueled with abandon during the 2008 election season where fear, whispers of conspiracy, and racism flourished.  What started as primarily a religious movement had grown into a working class grassroots organization.  Yet it retained that passionate ideological fire and a renewed fear that the American way of life was at stake.

The Tea Party was born.  At first it was seen by the Republicans as an army they could use to rail against the evils of liberalism.  But as is so often the case, the slaves turned on their master.  After all, once all the soldiers start thinking everybody is out to get them, there’s little reason for them to worry about the guys across the battlefield until they’ve taken control of their own army.

Welcome to 2010, where the Republican officers are desperately trying to prove their allegiance to the Tea Party for fear of being fragged.  From Frankenstein to Battlestar Gallactica, any sci-fi fan worth their salt would have seen this coming from a parsec away.