Public Option in Health Plan

I clearly support universal health care with single provider (funding mechanism) as in Medicare. I am convinced that this is not only a fair system but it is also a cost-effective system.  Dr. Steffie Woolhandler represents one of many physicians who are convinced that this is the only way to implement the required changes in the health care system.  However, it is clear that this level of reform is too much to expect from our Congress.

More palatable, but still toxic to some, is a public option that would be available to those who do not want to purchase their health insurance from a private company (where overhead is 31% versus 3% for Medicare). Reasons are not easily explained rationally. They seem to be simply against the public option because they want to support the insurance industry. Thankfully, there are many who advocate for the public option, e.g.,  NY Times and Paul Krugman.

A Film: August Evening

I am not an expert on films, but "August Evening" deserves a word because of its brilliant filming.

Somewhat akin to other cinematography that allows pictures to convey meaning, this rather simple if sad story of a illegal Mexican man and his family requires little action or words to convey the emotion involved in their tragic circumstances. Quiet but strong, the film focuses on the sounds of nature, the landscape, the evening skies, the sad faces to bring your own feelings to the forefront.

It was a beautiful film.

High Costs of Health Care

I just finished reading the well-publicized article in the New Yorker that focused on McClellan, Texas, where the average cost of health care per person ($15,000) which was $3,000 more than the average per capita income!  This study contrasted McClellan with a neighboring city (El Paso) as well as other organizations, e.g., Mayo Clinic, and states, e.g., California.

While other studies convinced me that the high costs of medical care were attributed to useless new drugs and  medical devices, this article brings to bear physicians in some areas see medicine as a source of increasing revenue. Quantity trumps quality, since the high costs of care do not correlate with better outcomes. 

Even though the evidence is clear, the author admits the difficulty in promoting models of collaboration and shared revenue to promote quality of care. Whether the government or private insurers fund health care, the evidence indicates that there is no difference in array of different costs. In short, unless physicians can see medicine as primarily a service to people without consideration of improving their levels of income, there will be a problem in the level of health care costs.

Rationing Health Care

Rationing health care is being discussed as inevitably related to new legislation that will raise the costs of health care. Sure, it will, but the important aspect of the debate is not that rationing will occur, it already is a reality. Rationing is inevitable; the issue is how rationing occurs and who "suffers" the consequences of the system. 

David Leonhardt has pointed out this reality.  I advocate a system where everyone is included in the basic system. There is a common good aspect of care that is critically important. Our brothers and sisters deserve access to care on a reasonable basis. However, I appreciate that at some point, there is a need to limit care in some form or other. Admittedly, this gets into difficult territory, but I do see ways to minimize the pain. Many medications are produced with no evidence that they generate better results than cheaper and older drugs. Same with medical devices. Technology  can invent various iterations of the same type of drug or device that will raise new revenues for stock holders but result in no better health for the consumers. 

Even with these changes, I do not see how we can have universal health care without additional taxes, something that seems appropriate. We need to share the pain involved in a plan that we give us all a chance to share in the this nation's health system.

Capitalism: It's Great If Actions Based on Ethics and Values

Fareed Zakaria has become special to me over the last year. His knowledge appears to be broad-based and his perspectives seem very balanced (more than mine!).

In a recent article on capitalism, he captured the many positive aspects of capitalism as well as pointing out the necessity that those who are in positions to succeed, base their actions on appropriate ethics and values.  In short, all the regulations in the world (albeit, I do support regulations being drafted by the Administration) will never ensure that financial disasters will not occur. People have to be behave ethically. None of financial instruments proven to be implicated in the current mess were used illegally. Few will be found guilty of crimes (some may have occurred secondary to fraudulent deals with unsuspecting customers), but many will fail the tests of common sense and values based on sober ethics.

"Confronting Power and Sex in the Catholic Church" by Bishop Geoffrey Robinson

Bishop Robinson is from Australia. He was a relatively conventional bishop until he was appointed by the Australian bishops to head a group that would deal with the sexual abuse scandal that erupted in Australia (as in many other nations). His involvement with victims helped him to see clerical sex abuse within a larger context. He eventually come to an understanding of the problem that forced him to resign his position as bishop while remaining active in the Church, i.e., he remains a bona fide bishop but has no responsibilities as a pastor in a diocese.

His book is written with good theology but also in a pastoral tone. He is not so much protesting as pleading for the bureaucracy of the church to recognize the need for major change if it is to be faithful to the spirit and teachings of Jesus.

His vision of the church would include the following:

1. People would be encouraged to adopt a healthy relationship with God rather than one based on guilt and fear.

2. People would have increased trust in his/her conscience as the primary tool for adopting beliefs and behavior. Those in power would be responsible for convincing people of the validity of their teaching rather than warn them of the consequences of failure to follow certain edicts.

3.  Recognition that the church is called to serve the "Kingdom of God" which is more than the church. The church is the servant of the Kingdom of God.

4. Authority in the Church is subservient to truth. There is a need for the church to admit mistakes and errors. Infallibility is a major hindrance in such a reformation.

5. Recognition that the body is as relevant to spirituality as is the spirit. Sex has to be promoted as good.

6. There is a need for some form of democracy. Without spelling out how such a form of government would be achieved, it is clear that the views of people have to be incorporated into teaching and governing mechanisms of the church. This view would not so much minimize the power associated with the pope and bishops as much as incorporate this power within the inherent power of the People of God, the entire church.

There is nothing in this book that has not been discussed by many theologians. He is not presenting the material as original. He is framing his presentation as a method of trying to reach out to everyone that there is a need for major changes with suggestions regarding what such changes should be adopted.

Personally, I totally agree with his points of view but I do think that the time may have gone by when change could make a difference. If and when such changes would occur, I have afraid that it would be considered too late for most.