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"Everyone's Crying Peace on Earth Just as Soon as We Win This War" - Mose Allison
by John Lawrence
Note from the future: One of the last humans evacuating planet earth, Elon Musk, writing the last chapter of the human race from his space hut on the moon: "Well, I guess it's up to me to write the last chapter of human history. I personally was able to escape planet earth as temperatures soared into the 150s. People had been forced into caves deep in earth to escape the heat. However, the war in Ukraine still raged on. Each side was intent on winning that war. More and more resources were poured into weapons. The US defense budget soared into the trillions of dollars. Some of us more enlightened ones said, 'Wait, wouldn't it be more important to take that money and put it toward fighting climate change, our common enemy. Climate change is the enemy of both NATO and Russia. No, the power structure said, it's more important to win this war. As the fighters in that war were dying of heat exhaustion rather than enemy bullets, they were some of the last humans to hold out on the surface of earth. Air temperatures were buckling roads and railroads. Even tanks and drones were melting in front of their eyes. It came down to hand to hand combat as guns were useless in the severe heat. Soldiers got second degree burns just from touching anything metal. But the war raged on. Ukraine was promised a path to NATO membership at the end of the war, but the brush along that path was burning furiously. It's doubtful if Ukraine would have made it all the way along that path to NATO without burning up first."
Musk continued: "You know the human saga reminds me of the fairy tale about the frogs in a pan of water. The water temperature was gradually increasing, but frog A insisted on staying in the water until his frog army was able to defeat Frog B's army. He reassured baby frog that as soon as his side won, they would all jump out of the water and be safe. But first they had to win this war. But baby frog said, 'Aren't you devoting all your time and energy to winning the war when, if both sides cooperated instead, you could devote your resources to lowering the temperature of the water.' No, said Frog A. Frog B is despicable We want all this land. We're not going to cede any of it to Frog B's tribe. But baby frog insisted, 'Who cares who owns what land if the whole pan of water which is our collective habitat burns up while you guys are still fighting? Your budget for cooling the water is miniscule compared to your defense (offense?) budget. If you just got along with other frogs you wouldn't need such a large defense budget. You could devote that money to global water cooling. This is the only pan of water we've got!.' I assure you, Frog A said, that as soon as we win this war, we will devote all our resources to cooling this pan of water."
Musk continued, "Well the moral of the story is that the human race was not able to get its act together even when they faced a common enemy. Each year even after global temperatures reached 140 degrees in some parts of the world for 100 days at a time, neither side in the Ukraine war would stop fighting. In fact that war would have gone on for the next hundred years, but, unfortunately, earth would not have been inhabitable by humans for another hundred years. It was not more than a decade later when temperatures reached 150 degrees for days at a time in most parts of the world. All the glaciers had melted in Antarctica so sea levels had risen more than 10 feet inundating Miami, London, New York City, Tokyo and New Orleans not to mention many other less noteworthy cities. No one could get property insurance any more; the insurance companies all went bankrupt. FEMA had run out of money. Flash floods left hundreds of thousands homeless. Those who had bought those old missile silos in Montana were lucky. They were safely ensconced underground where the temperatures were cooler. People crowded into Carlsbad Caverns in New Mexico and Mammoth Cave in Kentucky. After these caves reached capacity a detachment of former marines stationed at the entrance shot anyone trying to gain entrance. Survivalist skills were highly in demand."
"As the last fighter on the battlefield in Ukraine died of heat stroke, NATO and Russia declared the war was over. It was undetermined who actually won. The path to membership in NATO for Ukraine was littered with dead bodies, many of whom had died from heat exhaustion. Ukraine itself was littered with tanks and other metallic weapons of war which seared the flesh of anyone foolish enough to touch them."
Trump Will Run on the Economy
by John Lawrence, January 20, 2020
What's not to like about the economy? Lowest unemployment in 19 years. The stock market is through the roof. Low income workers have made the biggest gains in wages. According to the Wall Street Journal: "The lowest-paid Americans saw weekly earnings grow more than 5% in the second quarter from a year earlier, more than the national median gain of 1.7% for all workers, according to a quarterly survey of households produced by the Labor Department. Workers with less than a high-school diploma saw their wages grow almost 6%, and younger workers’ pay grew almost 3%." So is trickle down really working?
The Fed stands by to give more money to the rich if the economy shows a sign of faltering. The Big Banks are too big to fail. Unlimited prosperity, right? Except all this economic growth is adding to rather than subtracting from global warming. More people are traveling while jets are spewing more jet fuel effluent into the atmosphere. The automobile industry has a huge investment in fossil fuel cars. Every year more carbon dioxide goes into the atmosphere as oil still predominates in world markets. The American as well as the Chinese consumer economy is providing more middle class goodies each year which are tossed away creating more and more waste. Plastics are piling up in the oceans. More and more weedkillers are used to grow crops whose residues end up in human blood streams. Feed lot animals are fed a diet of antibiotics to make them grow quicker so they can be slaughtered sooner. This creates the situation in which they are not really useful for overcoming human diseases any more. The American way of life, which the whole world aspires to, is polluting the planet and despoiling the atmosphere, but it keeps the economy churning. Entrepreneurs are thinking up even more ways to sell us useless products and vapid entertainment.
The economy is predicated on waste, inefficiency and destructive weapons production including nuclear weapons. More and more money goes into the military-industrial complex to develop more and more expensive planes and battleships which are so complex they don't work half the time. But we are promised a computer fix after they alter a few lines of code. And all those people making a living off the military-industrial complex waste would be out of a job if peace broke out. All those people involved in the labyrinthine insurance industry would be out of a job if Bernie's Medicare for All came to fruition. The economy thrives on inefficiency and waste. If things were done rationally, so many people would be out of a job that the economy would grind to a halt.
Wall Street is not about to change its policy of promoting companies which seek maximum short term profits instead of sustainable growth that benefits all stakeholders including Mother Earth who in the final analysis is the most consequential stakeholder. But Americans and humans in general don't want to tighten their belts in order to save the planet. They would rather have short term profits and growth particularly if it can be tailored to fit into their lifespans. After their death all hell can break loose, but they won't be here to experience it. They had a good life at the expense of future generations. Ta ta, future babies. Trump will win because people care more about their present life than they do about the future generations of life on earth. Besides all those people in the military-industrial complex, which in the larger sense includes anyone who has ever been in the military, will vote for Trump because association with the military, whether pecuniary or not, represents masculine pride, virility and vanity. Ayn Rand would approve.
|
|
Type |
% of GDP |
Per Capita Cost |
|
Australia |
2-tier |
9.6% |
$ 4,798 |
|
Canada |
single |
10.6% |
$4,752.00 |
|
France |
2-tier |
11.0% |
$4,600.00 |
|
Germany |
mandate |
11.3% |
$5,550.00 |
|
Netherlands |
mandate |
13.3% |
$5,691.00 |
|
Switzerland |
mandate |
12.4% |
$7,919.00 |
|
UK |
single |
9.7% |
$ 4,193 |
|
US |
private |
18.0% |
$9,892.00 |
The Dutch total healthcare system is operated according to four basic related healthcare Acts: the 2006 Health Insurance Act, the Long-Term Act, the Social Support Act, and the Youth Act. The Health Insurance Act is the Dutch comprehensive Basic Healthcare Insurance package required for All and administered by private insurers.
I believe a credible variation to Sanders’ Medicare for All without insurers is a Medicare Basic Healthcare Option” (MBHO) for All. This would be a standard healthcare package contractually competed for by insurers, sold to the public and administered by private insurers. I see this approach, or some variation thereof, as a potential credible alternative to Sanders’ Medicare for All without insurers. The MBHO insurance plan is similar to the Dutch mandatory Basic Plan for All with one Big exception – it’s optional. It would be a marked improvement on Obama’s healthcare plan option which has been made worse by the Trump Administration’s changes. Despite that and other obvious weaknesses in Obamacare, millions of Americans are very thankful Obama’s plan is alive and doing well.
The Dutch Basic Healthcare Plan for ALL, a ‘radical reform’ that took place with passage of the 2006 Health Insurance Act, has following key policy principles:
Access to quality, affordable Basic healthcare has no preconditions.
Standardization of a Basic coverage package is government set and required for All for comprehensive short-term medical services, hospital care and prescribed medications - vastly improving efficiency, quality and lowering system administrative costs.
Focuses healthcare policy on managed competition given the inherently imperfectly competitive nature of healthcare markets
The Health Insurance Act entitles all residents to a comprehensive Basic standard health insurance package at a standard premium/deductible cost – implemented by private, competitive health insurers and healthcare providers where quality, price, coverage are government oversight-controlled.
Insurance firms offering the Basic plan are not-for-profit cooperatives; profits made on the standard Basic plan are allocated to the reserves or they are returned in the form of stable, if not lower, premiums. Hospitals are also generally non-profit entities.
The Dutch hospital market has gotten increasingly concentrated through mergers the past few decades. Competition can lead to much-improved efficiencies, quality and accessibility if adequate alternatives are available to consumers and/or insurers. But studies have shown that on-going, unstoppable hospital consolidation enhances hospitals’ market power. That can undermine the objective of introducing more competition into the market. That’s why Dutch government policy focuses on regulating the hospital market and insurers, while also simultaneously introducing incentives for competition between providers and insurers.
In conclusion, I don’t see why a practical scale variation of the Dutch (or Canadian) universal public-private healthcare models cannot be achieved in our country by MEDICARE BASIC HEALTHCARE OPTION. If structured well, over time such a plan could potentially vastly improve our comparatively exceptionally inefficient, costly, poor coverage, non-standard healthcare system.
This Medicare Basic Healthcare Option (MBHO) would encompass following key policies:
A Basic standard optional insurance plan for All with no preconditions. The standard coverage package would be defined and set by Medicare.
Upgrades ‘not covered by the Basic Option would be the primary responsibility of insurers with oversight control by Medicare.
A standard national premium structure would be set for the Basic Option that is adjusted on a regional basis up or down by an average income and/or cost-of-living index.
The standard premium for low income people would be subsidized by Medicare.
Medicare would be the chief purchasing agent and awarder of regional contracts to providers/insurers who meet MBHO provisions on access, price, quality, medical services, hospital care, prescribed medications available to All who choose the Basic Option.
It’s incredible how talented and advanced our nation is in its medical research, in our precision-reaching of a planet millions of miles away, in our landing of a missile within one meter of the target thousands of miles away.
BUT, here we are … unable to come together on a quality, cost-effective, affordable Basic healthcare system for all our citizens! The Netherlands’ standard Basic Plan system for All is simple, with good coverage at a reasonable annual premium cost for every individual age 18 and above of $1,630 (euro 1,440) and the deductible is $435 (euro 385). This compares to a much higher U.S. average individual insurance cost … and for less coverage. Also there are no co-pays in the Netherlands on the Basic plan while they are considerable in the US.
I think Sanders’ single-payer Medicare Plan without insurers is the right thing given our deeply sick, complex, for-profit healthcare system. Unfortunately, this ideal solution appears to be politically impossible. Apparently it’s too big a step; there’s simply much resistance by many people who do not want their healthcare insurance plan changed. If the U.S. healthcare insurers and hospitals were mainly non-profit entities as is the case in the Netherlands, this resistance might disappear. Perhaps in this situation, Biden’s solution to seriously repair Obamacare is a credible first step - providing substantive changes are indeed made along lines, for example, of incorporating some of the best parts of Holland’s radically reformed 2006 standard Basic healthcare system.
Potentially considerable cost and quality improvements from a Medicare Basic Healthcare Option that standardizes quality, coverage and affordable prices for All. This would encourage more and more people of all income levels to eventually go for the Medicare Basic Healthcare Option. This in turn will expand opportunities to further improve provider purchase costs, coverage and quality. It’s important to note that Holland’s universal Basic Healthcare plan package covers at least 80% of all possible short-term medical services and prescription drugs needed for people of all income levels and health conditions. Upgrades like physical therapy or cosmetic surgery can be purchased direct from insurers at an adjusted premium.
The U.S. battle is between Sanders’ universal single-payer solution without the high profit-making insurers and Biden’s serious repair solution to Obamacare working in cooperation with insurers and local communities in establishing a national standard Medicare Basic Healthcare Option. Even Canada’s so-called single-payer system works well with insurers who come up with market prices for good coverages that don’t vary wildly among provinces at a very competitive premium-deductible cost per individual or family that’s one-half the cost of a typical U.S. insurer.
We are buried in a brutally polarized political system – that’s demonstrating an outright deplorable incompetence in creating and playing politics with an insanely costly, poor standard coverage, super complex national healthcare system. The system is shamefully the most costly for less coverage compared to European systems and systems of economically advanced nations like Japan and Australia.
We could learn a lot from the quality, comprehensive medical coverage and affordability of the Netherlands’ standard Basic healthcare insurance package required for ALL … and generally approved by all citizens. I would say the same about Germany’s or UK’s, or Canada’s healthcare systems or any of the Scandinavian country systems. We Americans think we know it all … but we don’t, especially when it comes to the development and management of humanly fundamental social protection legislation for all Americans.
ADDENDUM II
ATTENTION : KAMALA HARRIS
I applaud your attempt to put forward a Medicare Option Plan that includes the insurers. Joe Biden is doing the same thing when he says significantly improve the Affordable Healthcare Plan, called Obamacare.
BUT, as I note in detail in describing the Dutch universal non-optional Basic Plan that an variation to that plan, like your and Biden’s options WILL NOT WORK unless following conditions are met.
The much needed scale of standardization in our complex national healthcare system will not be achieved without Medicare first defining one standard embracive coverage package that applies to all applicants and insurers. A transparent standard benefits package that insures comprehensive coverage - and profoundly simplifies the system. Insurers must accept that coverage package. They and providers (e.g., hospitals) deal with a single set of rules and billing procedures. A big plus with such a system in the Netherlands is that insurers and hospitals act largely as non-profit entities. This will be difficult in the states where healthcare for maximum corporate insurer profits is deeply imbedded. Even non-profit insurer firms in the U.S. have exorbitant salaries.
The individual monthly insurance premium and annual deductible costs should also be standard nationwide (or at least regionally). In the Netherlands, the premium and deductible costs for an individual 18 or older under the Basic Universal Plan are at reasonably affordable levels of $136 monthly and $435 annually, respectfully. And that’s for excellent coverage with no co-pays or playing the profit maximizing games of setting limits or exclusions under the standard Basic Plan for all.
The government should subsidize the premium cost up to, say, 70% (as does the Netherlands) depending on gross income levels below $35,000 per year. This could be funded by a small federal tax of +- 0.015% on everyone’s annually reported adjusted gross income.
Medicare should NOT accept insurers whose executive salaries are sky high – a perversely greedy condition that pervades every inch of our healthcare system (but NOT in Europe).
Insurers cannot retroactively revoke insurance based on errors in applying for the Medicare Option plan. Obama’s Affordable Care Act had an individual mandate - as does the Netherlands’ Basic Plan - that no-one can be rejected for plan coverage in any way, including a history of prior sickness. Not surprisingly, Trump’s administration has established numerous loopholes that undermine the insurance protections of Obamacare.
Our U.S. current private healthcare insurance system is primarily employment based and covers two-thirds of the population. Many people are happy with this but it comes with limits and exclusions regarding coverage and co-pays. And, most importantly, there is no standardization. So the premium and deductible out-of pocket costs still end up being extremely high vs. European plans. This problem and the insurer/provider being in business for maximum profit must be resolved in a clever way if a quality, affordable U.S. Medicare Option plan is ever to work successfully.
The potential purchasing and administrative cost economies where insurance firms play a role with central government oversight and control of a standard quality, pricing, coverage package are enormous – as proven by the Dutch, Swiss, and German systems. And unlike our Medicare Advantage health plans – where private insurers overbill Medicare in the hundreds of millions annually for sick patients who are not so sick or have reported medical conditions that cannot be proven - the profoundly simple, transparent EU healthcare systems don’t have such problems.
Perhaps you and Joe Biden could merge the best of each other’s ideas and the brains of experts to significantly reform an Obamacare Option. This would include re-installing the provisions Trump’s Administration has taken away. Actions that constrain access to Obamacare and make it more expensive.
For a Medicare Option alternative, we should adopt in a constructive way the standard plan conditions and operating rules noted above that work so well in providing better coverage at a much lower cost in Canada and European countries with populations of 10 million to 70 million. Greatly reducing plan complexity, increasing plan standardization, scale purchasing of drugs and medicines, and equipment will deliver massive cost efficiencies and better healthcare coverage.
If we can’t take this first step as a precursor for a much, much broader public acceptance of a universal basic plan centrally controlled by Medicare, then we will likely remain a 3rd world country when it comes to comprehensive, quality basic healthcare at an affordable cost for the average American.
|
|
Type |
% of GDP |
Per Capita Cost |
|
Australia |
2-tier |
9.6% |
$ 4,798 |
|
Canada |
single |
10.6% |
$4,752.00 |
|
France |
2-tier |
11.0% |
$4,600.00 |
|
Germany |
mandate |
11.3% |
$5,550.00 |
|
Netherlands |
mandate |
13.3% |
$5,691.00 |
|
Switzerland |
mandate |
12.4% |
$7,919.00 |
|
UK |
single |
9.7% |
$ 4,193 |
|
US |
private |
18.0% |
$9,892.00 |
The Dutch total healthcare system is operated according to four basic related healthcare Acts: the 2006 Health Insurance Act, the Long-Term Act, the Social Support Act, and the Youth Act. The Health Insurance Act is the Dutch comprehensive Basic Healthcare Insurance package required for All and administered by private insurers.
I believe a credible variation to Sanders’ Medicare for All without insurers is a Medicare Basic Healthcare Option” (MBHO) for All. This would be a standard healthcare package contractually competed for by insurers, sold to the public and administered by private insurers. I see this approach, or some variation thereof, as a potential credible alternative to Sanders’ Medicare for All without insurers. The MBHO insurance plan is similar to the Dutch mandatory Basic Plan for All with one Big exception – it’s optional. It would be a marked improvement on Obama’s healthcare plan option which has been made worse by the Trump Administration’s changes. Despite that and other obvious weaknesses in Obamacare, millions of Americans are very thankful Obama’s plan is alive and doing well.
The Dutch Basic Healthcare Plan for ALL, a ‘radical reform’ that took place with passage of the 2006 Health Insurance Act, has following key policy principles:
Access to quality, affordable Basic healthcare has no preconditions.
Standardization of a Basic coverage package is government set and required for All for comprehensive short-term medical services, hospital care and prescribed medications - vastly improving efficiency, quality and lowering system administrative costs.
Focuses healthcare policy on managed competition given the inherently imperfectly competitive nature of healthcare markets
The Health Insurance Act entitles all residents to a comprehensive Basic standard health insurance package at a standard premium/deductible cost – implemented by private, competitive health insurers and healthcare providers where quality, price, coverage are government oversight-controlled.
Insurance firms offering the Basic plan are not-for-profit cooperatives; profits made on the standard Basic plan are allocated to the reserves or they are returned in the form of stable, if not lower, premiums. Hospitals are also generally non-profit entities.
The Dutch hospital market has gotten increasingly concentrated through mergers the past few decades. Competition can lead to much-improved efficiencies, quality and accessibility if adequate alternatives are available to consumers and/or insurers. But studies have shown that on-going, unstoppable hospital consolidation enhances hospitals’ market power. That can undermine the objective of introducing more competition into the market. That’s why Dutch government policy focuses on regulating the hospital market and insurers, while also simultaneously introducing incentives for competition between providers and insurers.
In conclusion, I don’t see why a practical scale variation of the Dutch (or Canadian) universal public-private healthcare models cannot be achieved in our country by MEDICARE BASIC HEALTHCARE OPTION. If structured well, over time such a plan could potentially vastly improve our comparatively exceptionally inefficient, costly, poor coverage, non-standard healthcare system.
This Medicare Basic Healthcare Option (MBHO) would encompass following key policies:
A Basic standard optional insurance plan for All with no preconditions. The standard coverage package would be defined and set by Medicare.
Upgrades ‘not covered by the Basic Option would be the primary responsibility of insurers with oversight control by Medicare.
A standard national premium structure would be set for the Basic Option that is adjusted on a regional basis up or down by an average income and/or cost-of-living index.
The standard premium for low income people would be subsidized by Medicare.
Medicare would be the chief purchasing agent and awarder of regional contracts to providers/insurers who meet MBHO provisions on access, price, quality, medical services, hospital care, prescribed medications available to All who choose the Basic Option.
It’s incredible how talented and advanced our nation is in its medical research, in our precision-reaching of a planet millions of miles away, in our landing of a missile within one meter of the target thousands of miles away.
BUT, here we are … unable to come together on a quality, cost-effective, affordable Basic healthcare system for all our citizens! The Netherlands’ standard Basic Plan system for All is simple, with good coverage at a reasonable annual premium cost for every individual age 18 and above of $1,630 (euro 1,440) and the deductible is $435 (euro 385). This compares to a much higher U.S. average individual insurance cost … and for less coverage. Also there are no co-pays in the Netherlands on the Basic plan while they are considerable in the US.
I think Sanders’ single-payer Medicare Plan without insurers is the right thing given our deeply sick, complex, for-profit healthcare system. Unfortunately, this ideal solution appears to be politically impossible. Apparently it’s too big a step; there’s simply much resistance by many people who do not want their healthcare insurance plan changed. If the U.S. healthcare insurers and hospitals were mainly non-profit entities as is the case in the Netherlands, this resistance might disappear. Perhaps in this situation, Biden’s solution to seriously repair Obamacare is a credible first step - providing substantive changes are indeed made along lines, for example, of incorporating some of the best parts of Holland’s radically reformed 2006 standard Basic healthcare system.
Potentially considerable cost and quality improvements from a Medicare Basic Healthcare Option that standardizes quality, coverage and affordable prices for All. This would encourage more and more people of all income levels to eventually go for the Medicare Basic Healthcare Option. This in turn will expand opportunities to further improve provider purchase costs, coverage and quality. It’s important to note that Holland’s universal Basic Healthcare plan package covers at least 80% of all possible short-term medical services and prescription drugs needed for people of all income levels and health conditions. Upgrades like physical therapy or cosmetic surgery can be purchased direct from insurers at an adjusted premium.
The U.S. battle is between Sanders’ universal single-payer solution without the high profit-making insurers and Biden’s serious repair solution to Obamacare working in cooperation with insurers and local communities in establishing a national standard Medicare Basic Healthcare Option. Even Canada’s so-called single-payer system works well with insurers who come up with market prices for good coverages that don’t vary wildly among provinces at a very competitive premium-deductible cost per individual or family that’s one-half the cost of a typical U.S. insurer.
We are buried in a brutally polarized political system – that’s demonstrating an outright deplorable incompetence in creating and playing politics with an insanely costly, poor standard coverage, super complex national healthcare system. The system is shamefully the most costly for less coverage compared to European systems and systems of economically advanced nations like Japan and Australia.
We could learn a lot from the quality, comprehensive medical coverage and affordability of the Netherlands’ standard Basic healthcare insurance package required for ALL … and generally approved by all citizens. I would say the same about Germany’s or UK’s, or Canada’s healthcare systems or any of the Scandinavian country systems. We Americans think we know it all … but we don’t, especially when it comes to the development and management of humanly fundamental social protection legislation for all Americans.
John Coltrane: One Down, One Up
(*****)
Dizzy Gillespie, Charlie Parker: Town Hall, New York City, June 22, 1945
(*****)
Monk and Coltrane: Thelonious Monk and John Coltrane at Carnegie Hall
Best album of 2005 (*****)
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