"Universal Health Care" - Pelosi

Figuring that someone needed to say something reasonably coherent (and, for me, not terribly wordy...) about the whole "universal healthcare" debacle, I've just sent this message to Speaker of the House Nancy Pelosi.

Will it help? Probably not. But, taking the effort and having it fail is certainly better than not taking any effort at all. I'll probably write something similar to President Obama, and I'll put that up here as well.

----- SNIP -----

Speaker Pelosi -
I've been hearing much in the news of late about the "universal healthcare bill" being tossed around in committee, and I'd like to take a moment to weigh in with the comments of a constituent:

1) I find it worrisome that not only is the wretched thing some 1100 pages long, but everyone seems to be in a hurry to pass this thing. Has anyone actually read it all the way through? If not, why are we trying to accelerate a vote on it? How can anyone, in good conscience, vote on something they haven't even read, much less understand?

2) Why are so many pages needed to describe what needs to be done? I'm writing technical books that are considerably shorter than that, and I've got engineering texts that go into much greater detail on subjects in fewer pages - and give a better understanding of the topic at hand (I must admit, I've not even read the thing yet - legislative language tends to be a cure for insomnia for me. However, this sort of thing is what you and your colleagues are paid to do - so you should be able to read it, and you should be provided with the opportunity to do so.)

3) I've also been given to understand that there is to be no tort reform in this bill. Pity that - tort reform would be one of the single greatest things that could be done to bring medical costs down overall! Raise the bar for a malpractise suit to proceed (have a panel akin to a Grand Jury that hears the initial merits of the case, and decides whether or not true malpractise actually occurred, for instance;) and the cost of malpractise insurance should drop sharply. Considering what a malpractise policy typically goes for, this would be HUGE.

4) Streamlining the FDA approval process for new drugs (or - and possibly more importantly - the manufacture of ALREADY ESTABLISHED generic versions of drugs on the market) would work wonders for bringing the costs of prescriptions down. I'm on several due to a massive physical trauma I sustained in NOV2005, and they're expensive even with insurance (seeing the "Your Insurance Saved You:" line on the receipt worries me greatly... Most of this stuff is second-tier or third-tier on the schedule for our insurance plan.) Pharmaceutical companies seem to be willing to work with patients if asked. Medicare recipients can get supplemental coverage (through AARP) for a reasonable cost to bring their prescription costs down to effectively nothing out-of-pocket at the pharmacy. If the FDA simplifies their approval process for generics (simply making the manufacturer hold to quality materials and proper manufacturing processes, instead of having to do pretty much the entire process over again,) then MOST OF US would be able to get our prescriptions covered fully or nearly fully by insurance.

5) Make it easier for service providers to deal with insurance companies, and vice versa. Perhaps have the fixed "Medicare negotiated rate" paid out by any insurance company - this should effectively eliminate overbilling as a negotiation tool with individual insurance companies, and should help to get more providers "in network" for various insured persons using an employer's plan.

6) I've also read in the news how some of your colleagues are considering fining people for NOT carrying insurance under the new plan. I'm not so certain this is a good idea - allow me to modify it slightly:
- There are people who don't carry health insurance in general, paying out of pocket (OOP) for their physical every year or so instead. Why? Because they're reasonably healthy, and paying OOP for the annual (or so) checkup is cheaper than carrying a regular healthcare plan.
- Many of these people have a catastrophic medical coverage plan ("cat coverage",) which covers them in the event of a massive trauma or illness.
- There are also people who, I am sure, WILL NOT BE ABLE TO AFFORD any insurance plan. I'm sure you've heard the phrase "working poor?" There are more of them than you probably think. If they can't afford coverage, how will they afford to pay the fine for not having it?

Offer a "cat coverage" plan for the healthy, since that's really all they need.

For the "uninsured" who end up going to the ER at a County hospital for even a mild case of the sniffles, perhaps having "neighbourhood clinics" for that sort of thing will bring the ultimate costs down, reduce the billable expense, and perhaps enable low-income people to be able to actually pay AT LEAST SOME of their billable expenses, or carry coverage that can cost less due to the availability of a clinic? The clinic may be located near an ER - anyone who gets triaged as "non-critical" would then be sent to the clinic, rather than treated in the ER. This would also free up ER resources - having been a trauma case a few times myself, and being a caretaker for an end-stage emphysema patient (my mother-in-law,) this would be a good thing for me. I see people in the ER that I would like to honestly check for malingering, myself.

I place myself at your disposal for further discussion. However, I feel that further discussion IS necessary - with whomever, but preferably with constituents who actually have to DEAL with this sort of thing - before action be taken. Rushing this sort of thing through committee, through voting, and for the President's signature can not possibly be a good idea.

However, if you and your colleages are in such an all-fired hurry to pass this, please allow me to offer a couple of options:

1) ALL CITIZENS go on Medicare. Yep - including you and your colleages. That should handle any perceived disparities in the system (and probably get Medicare sorted rather quickly to boot.)

2) ALL CITIZENS go on whatever plan you have. It must be good - I'm sure Senator Ted Kennedy never even saw a bill for his medical treatment before he expired (I had to fight to get a bill dismissed as "Paid By Insurance" after my trauma four years ago. Not fun to do. Took only two months.)

Either one should put everyone on an equal footing and make access to healthcare more "universal" than it is now. I'm sure most of American would prefer the second option - especially those of us who are tired of fighting with insurance companies.

I certainly shan't argue that something does need to be done. However, it should NOT be done in a hurry, it should NOT be made overly complex, and it SHOULD be carefully thought-out and discussed out in the open - and made relatively equal for EVERYONE. A line from Orwell comes to mind whenever I see a news blurb on this: "All animals are created equal, but some animals are more equal than others."

Shaving...

I got tired of the King Gillette model - which, with my beard, costs a good deal of money.

"My beard?" Yeah. I can't use an electric - it would hurt less to get my face waxed, or even pluck it clean with a pair of tweezers one whisker at a time. So, that's out (tweezers are cheaper than an electric.) I could probably scrub pots with my chin, if I thought I needed to (and if I needed something more aggressive than Scotch-Brite or Brillo pads...)

I used to use a cartridge blade razor - but those cartridges are spendy. And, I can only do about a one-inch pass before I've clogged the blades and have to clean them out (usually with a toothbrush.) Yes, I shave in hot water, and I try to soften things up first.

I got to pillaging around looking for something else, and managed to find a straight razor handle that took a replacable blade. In fact, it takes a half of a blade - you take a conventional double-edged safety razor blade, snap it in half, and insert one half into a slide-out carrier. Change the blade by sliding out the carrier and using the other half of the blade.

Seven bucks for the razor, and it came with a box of ten blades (total of twenty, once you snap them in half.)

Now, I'd used a Gillette Mach 3 - and only shaved on Fridays, weddings, funerals, and court. Considering I could only use a cartridge about twice before it was shot, and throwing away a cartridge for that razor amounts to throwing away about four dollars, it was getting old rather quickly (I got the Mach 3 as a sample - just as I did the Sensor Excel, and a couple of razors before it.) I hadn't used a straight razor in a number of years, so it took a little bit of practise - mainly to avoid gouging myself.

But, I've noticed something: shaving has become less of "an onerous task" and more "something I enjoy." I don't shave every day, but I now shave on Mondays and Fridays - plus weddings, court, and funerals.

Why? There are a couple of things I can think of:

1) While it did take some practise (a couple weeks' worth) to get back into using the thing, I find it easier to use than a cartridge razor. Hell, I can clear-cut a full beard with a straight, if I feel like it! Yeah, I sometimes snag moles and blemishes, but that can be handled.

2) I don't get shaving bumps anywhere near as badly with the straight than I did with the Mach 3. The Derby blades I'd gotten with the straight were OK, but the Lord blades I'd bought to replace it (stainless ground in Egypt) are much better! The Middle East and Northern Africa really understand blades - almost as well as the Japanese.

3) It's a return to an old-fashioned, purely physical skill. That, more than anything else, is probably why I enjoy it so much.

You see, when I was a kid in Indiana, one of the greatest joys I ever had was learning yet another purely physical skill. Little involvement of the brain - it was just there in a supervisory role, and could pop off for lunch if it wanted to without interfering with what was going on, most times. Yah, some things it had to stay around to watch - but it could think about other things (usually several other things) while it was watching what the body was doing. This is what I mean by "purely physical." Sharpening a knife is a purely physical skill. Whittling is, most times, a physical skill. Riding a bicycle, roller skating, and the like are all physical skills.

And shaving, using a single bare blade, is a physical skill. And, using the single bare blade is more comfortable all around than using a cartridge blade, believe me! I'd honestly suggest that any man who doesn't have palsy at least try a straight razor - what you find out may surprise you!

I'll probably eventually assemble a "real" straight razor kit - good hollow-ground Solingen blade perhaps, strop, brush, shave cup, and the like - but this will work for the moment (and it got me set up to save a bunch of money on shaving for an initial outlay of about ten bucks.) I get one shave out of a half-blade, but I don't throw them away (they're stainless, they go in the cannister for recycled stainless steel...) and they're only about seven cents a shave anyhow. I pay half as much for fifty double-edge blades (of better quality!) than I did for four cartridges.

And, I don't dread shaving anymore. Sounds pretty win-win to me!

I'll have to see what other skills I can renew that are considered "old-fashioned." I can already navigate effectively using a map and compass (on-road or off,) and resolve my position closer than can be done with a GPS device - typical CEP (Circular Error Probable) with a GPS is something around fifteen metres, while I can usually nail myself down to within a half-metre. All by knowing how to read a variety of maps, being able to use a compass, and knowing the length of my pace... Map reading is becoming a lost art - but it's bloody useful! The batteries in a GPS can go flat on you. In your head? Not so much. And, a compass doesn't use batteries in the first place!