All In

The problem with part-time solutions..

Health care. Arg, so many things are working against this one. Compromise is not always a good thing. Lets count what is going wrong: premiums are up (double digit up). Families are dropping off, and companies are reducing the number of people covered. While I have my nice cadillac benefits, for the moment (not even for the biennium, I don't think those nice union-negotiated-contracts exist for us management service dweebs). No guarantees here, and the secret budget the current Gov is working on (does not need any messy state agency help! ok then!) we shall see.

Just today someone I work with jumped ship. Announced his retirement effective the last day of the month. Effectively giving 3 days notice. Now he's probably been there 30 years or so, this is actually *not* uncommon, though I cannot imagine it. I've been there nearly 3 years. For me, 4 years is a work record. One of the proposed PERS pension reforms would have reduced his benefits 20%, so yes a sensible decision.

What else is going wrong with health care - the cost of medicine is up. The spectrum of cspan callers-in is wide. Today someone calling in representing the widows of the nation. She has seen no cost of living increase in social security payments for 2 years running. And the cost of her medicines continues to go up. She sounded angry, but also tired, also hungry, also very frustrated, also anxious. If you listen to the radio hours a day you can learn to recognize these things in voices. Or, like, which senator is speaking. Now, if pharmaceutical companies didn't spend 20% or is it 50% of their budget on marketing directly to consumers, maybe they could actually deliver sensibly-priced drugs that people actually need. Right now none of those adjectives is true.

What else - doctors. The number of doctors is not keeping up with demand, as the baby boom crowd ages and needs (or is told they need?) medical care. I ask whether they need this, since I have a 90-year old neighbor who does not have a doctor. By now he is probably 92, and he is still out trucking around. Maybe that is the key to a long healthy life - do not have a doctor, do not interact with the medical establishment. Just wondering.

Part of the doctor supply issue may be that Medicaid and even Medicare rates do not keep up with their costs. Thus doctors do not want new Medicaid and Medicare patients. Making it hard if you don't live in a metropolis, but in some Eastern Oregon town, say. Despite all the tax incentives and expenditures out there to lure medical professionals to these rural areas. Note to self (and to anyone else out there): look up the most recent Tax Expenditure report. A useful and insightful publication, published by the State Department of Revenue. Whatever else they do that you might not like, they do make a vast range of data available to the average citizen.

Doctors are also beset by medical malpractice rates. And high loan fees from their education..

That is Part 1 of how a half-way compromise solution ends up satisfying no one. The Next Health Care Solution will have to be All In. None of this part-way stuff. Go for it, Obama! Full scale national health insurance, like a real developed industrialized nation. Do we still qualify as one of those?