A Modest Proposal (on U.S. Health Insurance)
By · CommentsThis is a guest post by Hank Keiser, an accounting and hay-farming expert (don’t laugh, you need both in the farming biz today), who has a great idea on how to resolve two thorny issues with one bold stroke.
If you will give me 5 minutes of your life, I will give you a health care plan that will work.
When U.S. taxpayers bailed out AIG, we got 80% of the stock in return. We own the corporation. Why not make it work in the best interests of the shareholders?
AIG is licensed to sell insurance, through its subsidiaries, in all 50 states. Why not sell health insurance that covers pre-existing conditions, is not employer dependent, and does not drop you (or jack your rates) if you need to use it?
Isn’t that what just about everybody wants? Wasn’t that the original intent of Mr. Obama’s plan, before it got turned into a Christmas tree by the Senate?
Doesn’t this cut the legs out from the opposition’s arguments? After all, this is not a tax-driven, big-government piece of legislation.
It has zero negative impact on the deficit, is provided by a corporation, not a government agency, and requires absolutely no legislation to enact.
In fact, it’s pure (if there is such a thing) capitalism at work – without the greed factor.
AIG doesn’t have to pay dividends, so it can plow any operating profits back into the business. It doesn’t have to pay bloated salaries, bonuses, or country club fees. It will operate with a lower overhead, hence it can charge less. Much less.
You start off by moving the management of Medicare to AIG, then all Federal government employee health insurace, then state and local government employee insurance, and finally private group and individual health insurance, all under the umbrella of a corporation. A corporation owned by the taxpayers, providing a competitive product in the marketplace. A corporation that would manage the insurance of maybe 200+ million people. That’s a pretty big pool to spread the risk.
There is a huge political upside to this – it doesn’t have to be legislated. It doesn’t care if you are a citizen or not. If you want a plan that restricts coverage for abortions, there will be other providers out there who will compete for your business.
And it is bullet proof – no bank, no financier, no corporation, no tea-bagger can scream socialism, because it is not socialism. Nobody on Wall Street turned down TARP money when it was offered, none of AIG’s creditors lost a penny in the settlements they received.
Oh, we promised not to interfere with AIG’s management when we bailed it out? Too bad, promises are broken every day on Wall Street. If you can dish it out, then you can learn to take it.
Who loses? WellPoint, Cynergy, et al. And Joe Lieberman – he loses big. Real big.
No one is saying WellPoint and the rest can’t offer health insurance that is better than this plan. After all, they aren’t being legislated out of business.
They are just going to confront honest, open competition for the first time from a publicly chartered corporation that we had stuffed down our throats because it failed to price risk correctly.
Health Care Storytelling
By · CommentsIn all the sturm und drang over the US health care system in the last couple of years – and the last many decades – one voice seems to be largely missing in the discussion.
We’ve heard from health care providers – hospitals, doctors, et al.
We’ve heard from insurance companies.
We’ve certainly heard from politicians.
We have not, however, really been hearing from patients, unless some disease sufferer with a story to tell to support the POV of a health care provider, an insurer, or a political position gets trotted to the microphone to tell his or her story.
As social media rises as the brave new communication platform for any and all global-village ideas and events, health care is starting, sloooooowly, to dip its toe into social networking as a tool to get their message out. What we have not seen, though, is a lot of listening, other than the usual suspects listening to (and yammering at) each other.
There are a number of community sites that have grown up around specific conditions and issues – Fran Drescher’s Cancer Schmancer community and Lance Armstrong’s LIVESTRONG efforts around cancer spring to mind.
Microsoft has launched MyHealthInfo.com, and Google’s got Google Health.
Patients are out there: on Facebook, on Ning, on Twitter, and other online community sites like SparkPeople.com. However, less than 20% of doctors are currently using technology to manage their patients’ medical records – given that resistance to technology, combined with the strictures of HIPAA (which I swear must mean Health Insurance Paying All Attorneys), it’s easy to see why the health care industry seems to be MIA in the Web 2.0 world.
One of the reasons cited by health care providers for not using web tools to communicate with their patients is privacy concerns. That is a legitimate concern, but I think it’s being used as a smokescreen – there are plenty of security apps and protocols available that would allow a dialogue between doctors and patients without having the conversation become Twitter status updates.
How refreshing, even revolutionary, would it be to have a way to communicate with your doctor and his/her staff online? To log in, schedule an appointment, enter your blood sugar numbers or blood pressure, request a prescription refill, ask a question, get a referral, download your medical records.
The health care sector has been losing the trust of its customer base for a long time – gone are the days when doctors were looked at as elevated beings who knew way more than the average dude (dude, in this usage, is gender neutral).
Doctors can take some of the blame there, since they’re not batting 1.000 on calling out the bad apples in their bunch, and have, as a group, been acting as the supply-chain for the pharmaceutical industry more than is, um, healthy.
The pharma industry takes some heat on the trust gap, too, since they seem to be all about “ask your doctor” and not so much about “you’ll be able to afford this stuff”. And don’t even mention Celebrex or Vioxx…
These revolutionary web-enabled conversations would allow doctors and other health care professionals to start to build those one-on-one and one-on-many trust relationships that could actually bridge that trust gap. Even help us understand, manage, and maintain our health.
Patients need to take the lead here, I believe, because left to their own devices doctors, hospitals, insurers, and politicians will continue to talk at each other, and not listen to the ultimate consumer of health care: the patient.
That’s my story, and I’m stickin’ to it.
Looking for the Union Label in the 21st Century
By · CommentsAmerican, going against the tide of US carriers outsourcing aircraft maintenance to hangers in Mexico and Central America, has discovered a new partner in reducing costs and creating efficiencies: their own mechanics’ union, Transport Workers Local 514.
The only US airline that has not sent its jets to foreign hangars is American – they’ve continued to send them to their maintenance hangers in Tulsa, Oklahoma.
Wade Goodwyn at NPR told this story on the air on Tuesday, Oct. 20.
American’s maintenance crews have reduced the time an MD-80 spends in the hanger on what’s called a “heavy check” from 22 days to 12. Just in case you’re thinking that means they threw almost 1,000 people at the job, they didn’t. They’ve reduced the heavy-check crew from 700 to just over 300.
Good work, less time, fewer man-hours. Sounds like a business plan instead of a union work-rule, doesn’t it? Which is what gives me hope that trades unions in this country might enjoy a renaissance, with the highly educated and skilled workforce we still have in the US using those smarts and skills to create, and keep, good work for themselves.
What I love about the American Airlines story is this: it looks like there are still smart people in unions. I’ve wondered what had happened to the movement that fought so hard in the late 19th and early 20th centuries to make factory, construction, and agricultural work fit for human beings. Trust me, kids – at that time, in this country, it wasn’t. Read Upton Sinclair’s The Jungle if you have any questions.
The members of TW Local 514 have seen what’s happened to the rest of the wrench brigade in the US, who until the ’80s saw regular increases in wages along with a strong union membership base. The wasteland that is the skilled labor market in this country has virtual tumbleweeds rolling slowly down its dusty main streets – most of their jobs have been moved offshore to factories and machine shops where a good daily wage is, at best, one-quarter of what it is here.
But I digress. In my view, most unions had become anachronisms by the mid-20th century, after becoming fiefdoms for their leadership and what amounted to private wage-setting clubs for their members. If you disagree with me, I have two words for you: Jimmy Hoffa.
This story gives me hope that, with all the amazing new product ideas being born in basements, labs, garages, and corner suites across this country, there is likely enough sense between the ears of the skilled labor pool to want to bring those ideas to life. To look at what’s happening today as an investment in tomorrow, and probably next week, too.
A girl can hope. That’s my story, and I’m stickin’ to it.
Last Pitch Standing: Comedy Writing Tips for Speakers
By · CommentsI’ve been doing the short-form intro version of my “Last Pitch Standing” workshop pretty frequently of late.
Here are PDFs of the two handouts – they can get you started on opening your comedy writing chakras. If you’d like some personal coaching, you know who to call!
MightyCaseyMedia’s Comedy Writing Tips
Mighty Casey Media comedy worksheet
Make ‘em laugh!
