BACK TO THE FUTURE

We hear that W is proposing a new approach to health care. He wants to increase the use of Medical Savings Accounts. The citizen (or her employer, if she's lucky enough to have that kind of deal) puts money into the account tax-free, for ordinary day-to-day health expenses, and buys a large-deductible insurance policy to cover "catastrophic" medical expenses. The premium for that policy may or may not also be tax-deductible.

The advantages of such an arrangement are: (1) that it will be "portable" and available to people whose employers don't provide benefits, or who are self-employed or unemployed or have just lost a job, and (2) that it brings market forces to bear on the medical industry--that is, if the patient has to pay for a doctor visit or a lab test, s/he is likely to choose the least expensive one, and thereby encourage the medical industry to restrain its price gouging.

What nobody on either side of the discussion of this plan seems to notice is that it is almost exactly what we had in the 1950s and early 1960s. In those days, if you had health insurance on the job, it covered only inpatient hospital care--not doctor visits, inoculations, or prescriptions. But those, and all other medical expenses, were tax-deductible.

Why did we give up that system? Two major reasons: if preventive care comes out of the patient's pocket, s/he is not likely to get much of it, which makes the eventual consequences of not getting it very expensive. And if only care given in a hospital is covered by insurance, more and more procedures and tests will be done in the hospital. That's how market forces really work in the health market.

That doesn't mean the average medical consumer is a free-loader trying to get something for nothing. It does mean that, once s/he has paid a health insurance premium, s/he will do everything possible to make sure that s/he gets health care only in ways that are covered by that premium.

And remember, back then, health care was both cheaper and simpler. Doctors still made house calls. And charged ten dollars more for a house call than for an office visit. Both doctors and hospitals regularly wrote off the bills of uninsured or medically indigent patients. The medical industry really was restrained in its pricing by market forces, and always had been. Now, after 40 years of unrestrained price increases paid without question by private insurance and governmental agencies, the total cost of health care is far beyond the means of all but the richest citizens.

Arguably, we are getting more for our money (or the money of whoever is actually paying.) Chronic and degenerative diseases that our grandparents just lived with and eventually died with are now treatable, and those treatments give many of us almost ten more years of active and useful life. If we go back to the health insurance system of the 1950s, does that mean going back to the health care system of the same era? Are we really willing to do that? Let's give this some thought.

FAREWELL TO KIRIBATI

Kiribati is a small nation in the middle of the Pacific, consisting of a bunch of atoll islands, none of which is more than 6.5 feet above sea level. At the current rate of global warming, the entire nation will be swamped within the next decade, if not sooner.

For the rest of us, global warming is a more mixed blessing. Mr. Dissociated has decided we need not worry about retiring in Florida or Arizona, because by the time we're ready to retire, Chicago will be growing its own palm trees. On the other hand, people living in Europe may find themselves buried in the snow if global warming shuts down the Gulf Stream current which now warms that continent.

But Bush's spokesman says, "We will adapt, as we always have." If he means homo sapiens, so far we have always adapted, but then, we have occupied this planet for only a flicker of the time spent here by, for instance, the dinosaurs. And, as we all know, they didn't do such a great job of adapting. The Bushman's pronouncement reminds me of the old joke about the rabbi notifying his congregation of an impending flood by telling them, "We all have thirty days to learn to breathe under water."

In the meantime, anyone who wants to see Kiribati should buy tickets immediately, and then get trip insurance in case the airport floods out before the flight arrives. Happy landings.

A MORAL DILEMMA

I have recently started reading all the blurbs that go with my blogspot subscription. One of them offers me a chance to get advertisements posted on my blog and get paid for allowing them. It's an interesting thought. They promise ads that bear some relationship to the content of the blog. Not sure what that would entail here on DP. It might even be interesting to find out what the adsters thought my blog was related to. If anything.

But why on earth should I subject my loyal readers to commercials? I'm not quite that broke, and the blog itself doesn't cost me a cent. And, even more to the point, advertising on my blog violates my principled objection to what advertising is doing to our culture.

The stalwart conservatives who managed to get "The Book of Daniel" pulled from network television last week seem to have no trouble at all letting the free market advertise cures for genital herpes and erectile dysfunction during prime time. The pundits who loudly deplored Janet Jackson's wardrobe malfunction have no problems with advertisers using women's mostly-undressed bodies to sell cars, liquor, and vacations. Not only does advertising debase our appreciation of the human body, it debases our relationship to communications. We expect advertisers to lie, and that gets us in the habit of assuming that everybody lies, and everybody is entitled to lie. Which in turn gets us in the habit of ignoring everybody who tries to tell us anything, including the purveyors of some very useful information.

For instance, even though most people who get arrested have had the opportunity to hear the Miranda warnings at least 1800 times on assorted cop shows before they are old enough to be prosecuted as adults (do the math yourself!), most of them still don't know that "you have the right to remain silent, etc." means "shut up until your lawyer gets here," and instead they spill their guts. Apparently what they learn from the cop shows is not the fine points of the Fifth Amendment, but that only guilty people call lawyers.

So I guess for now you may continue reading this blog without being subjected to anybody's ads. You'll know the economy is bottoming out when I have to change my mind about this. Happy Muslim New Year (tomorrow, I think.)

STATE OF THE UNION

It's that time again. All of our favorite TV shows will be interrupted, delayed, or omitted altogether so that we can watch W try to explain the various messes he has gotten us into this year. I suspect I will be running the vacuum cleaner.

The Radical Right seems to think they have disposed of the President's opposition by branding them "Bush-haters." Makes them sound like the same sort of totally irrational blokes who can't stand tunafish or the color pink or dogs. But most of the people I know who are less than enamored of Bush don't actually hate him, they just wish he'd open his mind and close his mouth. Many of us sincerely wish him a long and happy retirement, beginning as soon as possible.

Would I cross the street to avoid shaking his hand? I'm not sure. I seem to be as immune to his fabled "charm" as I was to Reagan's. I may simply have been born with a deficiency in my charisma receptors. I have spent a lot of time over the last 20-plus years feeling like a tone-deaf person at a concert, unable to figure out what all the applause was about. It's not that southerners turn me off. In fact, real southerners, like Clinton and Carter, kind of turn me on. But W is a fake southerner, and that may be part of what fails to enchant me. (After all, I grew up around real southerners.)

So anyway, I won't watch The Speech tonight, but I'll pick it up online later. Watch this space for comments.

HAPPY NEW YEAR -- AGAIN!

Next Monday begins the lunar new year celebrated by the Chinese and many other Asian peoples. Mr. Dissociated and I have gotten into the habit of celebrating every New Year's day that comes along, because we need all the fresh starts we can get. Once again, we can make resolutions to change. Not just the usual trash about losing weight and exercising, but serious stuff, the stuff I would want to do if this was going to be my last year on earth (which last year nearly was.) For that purpose, giving up french fries just doesn't cut it.

On January 1, I resolved to give more money to panhandlers. So far I've been doing reasonably well, but could certainly do better. I know some of you out there may consider that either a neutral goal, or a downright bad one. Your mileage may vary. The religious tradition I come from tells us that everyone we meet, including street beggars, could be the prophet Elijah or some other celestial VIP in very effective disguise. The first time I ever saw a beggar was in South America in 1962. The first time I ever saw a beggar on an American street was sometime in the early '80s. I can't remember the last time I walked down the street in either the neighborhood where I live, or the one where I work, and didn't see at least one beggar. I toy with the paranoid fantasy that the panhandlers started out as out-of-work actors hired by the Radical Right to scare working people into accepting less pay and worse working conditions to avoid ending up on the street themselves. It certainly worked out that way. So for my Asian New Year's resolution, I think I'm going to come out of the closet about giving to panhandlers, and at least make their presence and needs something we can talk about.

Happy New Year!

QUESTIONS TO WHICH EVERYBODY SHOULD KNOW THE ANSWER

There's another cute little book of weird questions nobody ever thinks to ask for some very good reasons--I don't remember the author's name, but the title is also one of those questions: "Why Do Men Have Nipples?" I leafed through a copy at my favorite local bookstore today. The answer given was the usual thing about how the human embryo is basically female through most of its early development, etc. etc. Which is true as far as it goes, but geeze, doesn't anybody read the Iliad any more? If the author had bothered to do his classical homework, he'd know exactly what use male nipples are--they're ideal targets for spear-throwing. Not sure how you'd put a Darwinian spin on this, but it's probably worth trying.

THE GOOGLE SUBPOENA--UNCONSTITUTIONAL OR JUST PLAIN LAZY?

So the Department of Justice wants to subpoena a randomly chosen week full of Google's data, so they can figure out the chances that an ordinary person searching for anything other than porn will be led into a porn website by Google. This is part of a larger project involving other search engines who have already given DOJ what it wants. The point of the whole thing is to support the government's case for the necessity (and therefore the constitutionality) of a law restricting online pornography.

The proposed law, of course, is a crock. I applaud Google for refusing to give DOJ what it wants. I am not going to do any more of my searches on Yahoo until they grow a spine.

But what piques my curiosity at the moment is why DOJ feels it needs a subpoena (and a subpoena against a third party not involved in the proposed legislation at all) to do this research. If I were trying to get information like this for a client, I wouldn't subpoena a bunch of search engine proprietors, I'd just hire a bunch of ordinary people to run one search after another on the various search engines, and keep track of the results. If I had the resources of DOJ, I could hire a lot of ordinary people to do a whopping lot of searches and get a statistically significant result. So far as I can see, the only reason DOJ chose to use a subpoena is force of habit--if your primary research tool is a hammer, everything looks like a nail.

And frankly, I don't want the government to get in the habit of using a subpoena every time some flunky in DOJ wants to get the phone number of an attractive person s/he met in a bar last night.

FALSE HOPE?

Sorry to have been out of touch over most of the last two weeks--my computer has been in total disarray. Anyway, the Sago W. Va. mine disaster is still on my mind. If you can find it, take a look at Studs Terkel's comments on it in the Sunday Chicago Sun-Times, which are far beyond my poor power to add or detract. He says, essentially, that the only false hopes the miners have been dealing with are the hopes that the federal government would impose, and the mining companies would implement, effective safety regulations, and put the lives of miners ahead of profits.

On one hand, I myself have spent a grim night waiting for news of someone close to me who had disappeared and was feared dead. I can't imagine what it would have been like to hear, first, that he was found safe, and then, that the first news was a mistake and he hadn't made it. It is something no one should have to suffer.

But on the other hand, can't we stop obsessing about how bad news is communicated, and look at the reality behind it? Twelve miners died, for pete's sake. Long after the families have gotten over the emotional roller-coaster of one night's miscommunication, they will still be grieving for the loss of the dead. Yes, the mining company's communications could have been better. But even if they had "done everything right" that dreadful night, there would still be 12 bereaved families, because the mining company had done so much wrong in the past.

MORAL EQUIVALENCY?

I'm just about to commit the ultimate journalistic sin--talk about a movie I haven't seen yet. So I apologize in advance, especially to the people who made Munich and those serious reviewers who have gone to the trouble of seeing it first. But the key term I keep seeing in other people's reviews of Spielberg's latest film is "moral equivalency." Spielberg either is or isn't (the reviewers have a hard time agreeing) saying that the Palestinian terrorists who murdered 12 Israeli athletes at the Munich Olympic games in 1972 were no worse than the Israeli intelligence agents who assassinated the terrorists.

The dispute over "moral equivalency" had its beginnings not long after the actual occurrences of Munich in 1972. That was roughly when an increasing proportion of the American and European Left began to see the Palestinians as "freedom fighters" and the Israeli government and its various military and civilian agencies as fairly close to fascism. It was also, not altogether coincidentally, right around when the US finally made a mutual defense treaty with Israel (1974, to be exact.) It was right around when the Know-Very-Little wing of the American Left began simultaneously denouncing Israeli influence on US foreign policy and denouncing Israel as a puppet of US imperialism in the Mideast. (Never before or since have I more deeply regretted my inability to draw--imagine a cartoon of two puppets, Uncle Sam and Moshe Dayan, for instance, pulling each other's strings!)

I don't know whether Spielberg's film espouses moral equivalency or not. I rather suspect not, judging from the large number of people denouncing it from both ends of the political spectrum. He must be doing something right.

But I'm not sure I am totally opposed to "moral equivalency", either. No, I don't believe the Israeli Army in any significant way resembles the SS. But, if I were a Palestinian civilian, I might have more trouble telling the difference. From the point of view of the average civilian in any war zone, it's hard not to see the soldiers on both sides, and for that matter their spies and secret agents, as virtually identical. As Joseph Heller's Yossarian said in Catch-22, "the enemy" is anyone who's trying to get you killed. In that WWII classic, Yossarian decided that the enemy was not only the Axis powers and their armed forces, but the Allied brass, who kept requiring his squadron to fly more and more missions when they obstinately kept coming back alive from the last batch.

And then there's the matter of theological equivalency. If you start with the premise that all human beings are made in the divine image, then all homicides are at least equally problematic, if not equally sinful. All homicides should impose at least an equal spiritual and emotional cost in decision-making beforehand and in trauma afterward. I hope this is what Spielberg is saying.

NEW BEGINNINGS

Once again, everyone around is resolving to smoke less, drink less, eat less, exercise more, and lose weight. Good grief, is this all we can worry about? Are we really doing everything else perfectly? Are we really as kind as we can be? Have we learned everything we need to know? Are we as grateful to those who care for us as they deserve? Are we doing everything we can for the communities we live in? Are our homes havens of peace and thoughtfulness? Honestly, if I thought I had mastered all these other virtues, I wouldn't care how much I weighed.

I want to start the new year with a vote of thanks to Faris Hasan, the 16-year-old from Florida, who took off to Iraq on his own savings in pursuit of a story for his journalism class and the truth about how the people of Iraq are living. Although his parents are Iraqi immigrants to the US, and he did get some help from a family friend in getting from Beirut to Baghdad, he doesn't speak Arabic, and basically operated entirely on his own. His parents, of course, are talking about grounding him until he qualifies for Social Security. It's hard to blame them. If my kid did that, I'd probably feel the same way. But bless his heart--he wanted to know what life is like for the people living in the country his parents left, the country our country is invading. And he used his own resources, at his own risk, to find out. I can't wait to read the journalism paper that comes out of this trip. Is there a special Pulitzer for teenagers?

California has too much water. Texas, Oklahoma, and New Mexico don't have enough. By comparison, the gray, damp Midwest is pretty lucky.

And, finally, there's the eavesdropping scandal. It doesn't have an official name yet. But President Bush has admitted to eavesdropping on private phone calls and emails involving US citizens on US soil. And now he wants a congressional investigation. To be specific, he wants a congressional investigation to find out who leaked this information to the NY Times. I'd kind of like to know too. Whoever it is deserves some kind of award. But somehow I doubt that's what the President has in mind for him, her, or them. The President seems to think the Leaker has made us less secure. I think he/she/they have made our freedoms more secure.