Monthly Archives: August 2009

On Health Care, Give the US Competition with a Public Option

Since the United States has been so obsessed with free markets, democracy, and business competition, it is time that the health care systems gets a good dose of competition from these United States in the form of a public health care and insurance option for any citizen or legal resident of these said States.
Given all the hysteria from various corners and pressures from lobbyists, the various Congress Critters and Administration folks seem to have lost heart and have caved to a reform bill that is unpalatable by most.
Last week while having dinner with my mostly Republican family, a hue and cry went up about health care reform. I expected various members of the family to bash Obama’s health care plan, which they did, but not for the reasons I expected. Several folks at once cried out, “What happened to the public option?”
After discussing all the various perspectives, everyone but my 89 year old Grandma agreed that the US needed a public health care option to be opened for all who wanted one. Two of my aunts agreed with me that the Irish way of public health care for all and extra private supplemental care for those who want to pay for it was an excellent way to go.
When I lived in Ireland, I purchased private supplemental health insurance from VH-1 for €10 a week, which at 2005 exchange rates worked out to be about $54 per month. This supplemental health insurance would give me a semi-private room if I ended up in a hospital plus other options for picking the doctor of my choice. Right now, I pay $297 per month to Kaiser Permanente for health care and I have no idea what my hospital coverage is if I would need it other than I have a $100/day co-pay.
I felt more confident in Ireland with the public health care and my supplemental healthcare than I do now with Kaiser. I am reluctant to go to Kaiser and in the last three years have only been 5 times in total, twice for my migraines, once for an ear ache, and twice for travel shots & booster vaccinations, otherwise I have avoided the Kaiser doctor like the plague. I have paid out of pocket to see an N.D. about my allergies & migraines, as Kaiser in SoCal does not cover ND’s although they do in their Pacific Northwest territory.
I am willing to pay out of pocket to see a doctor that is willing to explore the real causes of my migraines as the ND was and the doctor at Kaiser was not. The Kaiser doctor did not want to listen to my ideas of what I thought my migraine triggers were, but instead after 2.5 minutes prescribed a $125 co-pay medication and shuffled me out of the office. This is a minor problem to have compared to the large minority of people who do not have any health coverage or are under insured.
Let’s not even speak of all the small businesses that will never be started because folks are too afraid to lose their insurance if they leave their job to start a new business or the current small businesses who can’t afford to hire more people because they want to provide insurance but can’t afford it.
Tonight I decided that I would send emails, via their websites, to the President, my Congress Critter – Dana Rohrabacker (R-CA), and my two Senators’ Dianne Feinstein and Barbara Boxer (both D-CA). I tailored each letter to the political type human and here is an example of what was sent:

Dear Senator Feinstein,
I am writing as I am very concerned about the health care legislation that is currently going through Congress, as it does not have a public option. I am concerned that true reform is being squelched by the insurance company lobbyists.
For a variety of reasons – humanitarian, reduce costs, increase competition, and others – we need to provide a public health care option along side of the private health insurance and health care systems currently in place.
Not only do all people within the borders of the US need access to affordable health care, but we need to keep costs down. A public option would increase competition and access.
Thank you,
Jenifer Hanen
Seal Beach, Calif.

Regardless of how your hopes and thoughts in the US health care debate, here below are some good blog posts to get one thinking, after you have done some thinking, please do write your Congress Critter:
Matt Haughey on The entrepreneurial case for national healthcare
BLDGBLOG on City of Fees and Services
William Blim of 3 Quarks Daily on Will Someone Rid Me of Private Health Insurance?
Adam Greenfield on On systems, and what they do

Tidbits :: Monday, August 24, 2009

BLDGBLOG on City of Fees and Services: “Indeed, the bizarre irony for me throughout all of this has been that police officers, fire crews, and members of the military are all, to use this language very deliberately, the most socialized subsector of the U.S. economy. That is, they are paid through what many people would call “government hand-outs.” On the other hand, it is these very social positions that are often held up – by these same critics – as triumphant examples of national service and personal heroism. Indeed, it is not entirely inaccurate to say that The Greatest Generation was a generation of near-total tax-funded employment.
If the recent health care debates are to be believed, doctors are not subject to this same sense of national appreciation; they are mysteriously yet fundamentally unlike the police, we are meant to believe, offering services that only private money can afford. But where is the line between private health (diabetes) and public safety (tuberculosis) – and when might this solidify into actual government infrastructure?”
Michael Blim on Will Someone Rid Me of Private Health Insurance? : “Once a mistake is made and a bill made up, the paper chase begins in earnest. It is then that one uncovers the fact that unlike in the Wizard of Oz, there is no one behind the curtain. The hospital in a show of dauntless efficiency sends me one bill for everything they do to me. It is a complete sham. There is no unified billing service at the hospital. Every service simply dumps its bills into a big computerized hopper in the Ethernet, and a sum with unintelligible notations is derived and duly sent to the patient. I call to ask each service if it recorded a co-pay non-payment. Recently I made the rounds among the services billing for the podiatrist, the orthoticist, the physical therapist, the surgeon, and the family doctor. Sometimes it’s like bingo, and several of the services made claims for the “missing” $15 co-pay. Each service demanded documentation that I paid the co-pay, but even if one of the billing problems is resolved, the clearance never seems to stop the unified billing service from sending out another bill, this time with a dunning notice attached. One of the services refused to believe that I had not cheated them out of the $15 – this on a bill for a rotator cuff repair in which the hospital grossed thousands of dollars.”


Photo taken by Ms. Jen with her Nokia N95.

Mon 08.24.09 – Black cat watching Scruffy and Belle walking.

Tidbits :: Sunday, August 23, 2009

Adam Greenfield On systems, and what they do: “So from here [Helsinki], it would be easy to dismiss the “debate” on public healthcare unfolding in the United States right now as comedy in the
worst possible taste: the bad-faith flailing of an essentially unserious society, the civilizational equivalent of a Pauly Shore movie.
What serious polity – let alone would-be contender in the cutthroat
global market American policy has been so strongly dedicated to the
creation of over the last sixty years – would want to deny its citizens
and native industries every possible advantage? What kind of patriot
could possibly rest content with the notion that the poorest national
of, say, Trinidad and Tobago has better healthcare options than most Americans?”
“I began to wonder if iPhone ownership wasn’t like marriage in the ’50s,
everybody pretending they’re happy with their spouses but secretly,
behind closed doors, feeling awful and taking pills in the basement.”  Amanda Fortini, My evil iPhone,

Of Tools and Trolls

Fremont Troll by Roshan Vyas
Freemont Troll” by Roshan V on Flickr with a CC License.

I am honestly getting wearied by all the wars being waged online in the name of gadgets, devices, and software.
You love the iPhone? Good for you.
You love your Google Android G1/G2? Excellent.
Love your Nokia Nseries or Eseries? Even Better.
Are you a die hard WordPress fan? Fabulous.
Can’t believe that any designer or developer worth their salt doesn’t use Expression Engine? Hmmm… me neither, esp. since the EE folk throw a much better party at SXSW than the Automattic crew.
Are you Windows all the way? MacBook forever? Ubuntu for the win?
PHP partisan? Ruby on Rails raconteur? Django devotee?
Good for you. Good for your neighbor. And good for your perceived enemy.
First and foremost all of the above devices, software, dev frameworks, and operating systems are tools. They are tools to communicate, tools to create, tools to prototype, tools to view, tools to do business on and with, tools to publish, tools to build a system with, etc. etc. etc.
Depending on your usage, needs, culture, time frame, profession, and preference will determine which tool, device, software, operating system will be best for you. Maybe you have a try a few options to know which is best for you. Maybe you need time, maybe you need to discuss it with your friends online and in person. Maybe you need time to physically try the various options.
At the point where you have written or gotten excited about your new device/tool/software online is where the troll can come in.
For whatever reason, some folks want to go past a bit of teasing or a bit of good, honest debate with solid backup arguments to build their case; some folks want to troll. They want to mock, to drag a discussion or debate into a space that is no longer about sharing one’s excitement or learning from each other and into a space that is about bullying or badgering the other person into the troll’s point of view. A troll can and will argue beyond the point of normal communication and good manners to get their point across or lead the general discussion into a very fruitless place.
This is frustrating. Very frustrating. We have all been online long enough to know what is good manners and what is not. We all choose to use the tools we are using for a reason. If you want to convince a friend to try another tool, do it with persuasion, not with trolling.
It becomes even more frustrating when folks who are professionals in a field in and around technology become devotees to one product and are unwilling to explore the other options out there, esp. as the devices or software grows over time.
Recently, I had to unfollow a person that I liked on Twitter due to the fact that this person started many fights with anyone who was not an iPhone owner. This person chose to take any mention of any other mobile device as a time to point out the superiority of the iPhone, even when it was nonsensical and not on topic. The person would then pursue the argument with Direct Messages on Twitter that would attack one and one’s choices.
Love your iPhone that much? Good. I am very glad for you.
I choose to use Nokia Nseries devices for their cameras and moblogging abilities. As of the date of writing this blog post, the iPhone’s camera is not up to my standards. Sorry, but true. Please don’t send me Direct Messages on Twitter harassing me about using an obviously inferior Nokia, it is uncool and unworthy of our friendship or even mutual respect professionally.
Next year or the year after that there will be another device(s) or tool(s) that will excite everyone’s fancy. And just maybe it won’t excite yours or mine or someone we know, but maybe it will.
In the meantime, let’s all remember that these devices or software or systems are just tools, tools to accomplish what we want to do online or create with or communicate with. None of these tools are worth trolling for and thus breaking relationships over.
Instead let’s use these tools to create and communicate with in a way that builds relationships, communities, systems, and applications. We can respectfully choose to disagree, we can also attempt to persuade others to our point of view, let’s even debate, but let’s not troll over tools.