POW #68 – Berlin Wall

They say that you’ll always remember when…

I remember watching thousands of East Germans pushing through the holes in the Berlin Wall on the evening news.  And I recall Mr. Megargee telling us how important this was to our world.  But of course, I didn’t realize the enormity of the event until much, much later.

We saw pieces of the Berlin Wall at the Newseum this past year:

Saturn Returns

Two thumbs up for Noah Haidle’s play, Saturn Returns at South Coast Repertory.

On a whim, @PadrePablo and I decided to get rush tickets.  It’s only the second time that we’ve seen a show at SCR.  The first time we saw a preview showing of Hamlet.  We’re both 2 for 2 and impressed with the caliber of plays right in our own backyard.

The story follows Gustin Novak through three phases of his life: at 28, 58 and 88 years young, though not chronologically.  At each stage of his life you see Gustin interact with a different woman who brings equally different meaning to his life: Loretta, Zephyr and Suzanne.  Each of the different relationships is a reaction to an experience he’s had throughout his life in a small Michigan town.  “Saturn” is a reference to the nearly 30 years that it takes for the planet to make one orbit around the sun.

The three female characters are brilliantly and uniquely played by one actress, Kristen Bush.  And each Gustin, (Nick Ullett at 88,  Conor O’Farrell at 58, and Graham Michael Hamilton at 28), plays a stubborn, hardened, and simultaneously gentle father and husband.  I laughed, cried, giggled and scoffed.  Saturn Returns is a story full of emotions and keeps you completely entertained for the full 80 minutes.

Turns out it was the preview evening.  But as fresh off rehearsal as the cast was, it was a great show and worth every dollar.

With Opera Pacific having folded half way through the last season, I often worry about SCR’s fate too.  But if they continue to feature well-written and well-played scripts like Saturn Returns… I don’t think there’s much to worry about.

The play runs through November 22 at SCR.

POW #67 – Fall Foliage

Behind almost every XKCD comic, there is a true story about @PadrePablo and I… or at least we can relate in a funny way.

If a picture paints a thousand words, then the smirk on @PadrePablo‘s face paints a whole lot of patience as I took some 150 photos of leaves in the Shenandoah Valley in Virginia.  See the full set on Flickr here.

Health Care: Economic v. Political Forces

[This post is part of several that are my lay attempts at applying the economic and social interest theories to my assumptions, and pragmatically evaluating the options.]

As GDP increases, medical care will undoubtedly increase as well.  So it’s apt time that we take a look at health care reform.

What motivates government?  Why do we have the health policies that we have? How likely is it that we’ll have a different health policy in the future?

I think these are points that we don’t consider everyday, and understanding how we got to where we are today is important.  And part of understanding history is knowing about the factors that fall under the two largest forces driving the debate  – economic and political interests.

Economic Forces include:

• Demands for care.  The demands are dependent on prices of services, insurance costs and the economy.
• Costs for providing care.  For example, as technology increases, costs will increase too.
• Market structure. Competitive markets = lower price increases and more choices. Antitrust policy is important here.
• Incentives. Depending on the types of economic incentives available, all of the above are affected.

Political Forces also include:

• Demands for care.
• Costs for providing care.
• Market structure.
• Incentives.

In an economic market, companies compete against other similar companies.  Under political influence, these competitors become allies because collectively companies want to make sure that public policy does not increase costs. These public policies affects both finance and regulations.

Health Care Rant

For several years I’ve waited for our country to entertain the health care reform issue.  Now that it’s here, I’m both excited and frustrated.

Excited that we are finally talking about it. Frustrated that I don’t feel anyone is taking a practical look at it.  I hate politics because it’s a game played by finding faults in each others plans, rather than building on each idea or proposal to reach a sustainable solution.

I’d never survive in politics.

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I’m not an economist, health care provider or policy analyst. I don’t completely understand the proposals under the health care bill.  But from a lay perspective, I believe there are a lot of assumptions being made by people (myself included) that could be better thought out to have constructive debates about the hot topic.

I lean neither left or right.  I lean towards the most practical and sustainable solution based upon the information I have at any given time on any given subject.  And of course I am driven by self-interest…  I don’t believe that anyone can claim not to be driven by even the slightest self-interest.

Here’s the issue with individuals and the debate around health care… most people don’t understand.  We generally operate under one of two (or both) broad assumptions that shape our views:

1. The government will nationalize health care, which will unfairly raise my taxes.
2. Private insurance premiums are skyrocketing exponentially, so we need to find an alternative.

You can surmise where the left and right sit on the above statements.  What neither side seems to acknowledge and agree upon is that regardless of the outcome of this debate, tax-paying and law-abiding citizens will always pay for themselves AND others.

In the first scenario, we pay the premium via income taxes.  The risk is spread across the entire American population whereby the healthy pay for more than they use, and the sick use more than they pay.  The idea is that you are investing for the future when you will inevitably get older and need more care.  In an ideal world, you eventually end up using what you’ve paid out in your lifetime.

In the second scenario, we pay the premium via employer/ee insurance contributions and co-pays.  What we fail to remember – or don’t even realize – is that our out-of-pocket premiums pay into a “pool” or community where the risk is spread out as well.  The difference with the risk pool in self- or employer-paid health insurance program is 1) in the risk variables, which include size of your company, average age of employees, etc. and 2) the term of coverage – which ends when you stop realizing your benefits (e.g. you quit you job).

In scenario two, a healthy person may never realize the amount that s/he or their employer contributed.  This contribution is simply a private tax exercised by the employer that most employees would be able to pocket if health care were not a benefit. And unless written as a retirement benefit after vesting with a company, there is no lifetime payout.  Because the private tax is marketed as a “benefit”, people have to come believe that it is an entitlement.

Then there are those that are risk averse and won’t pay for any insurance, or those who are independently wealthy enough to pay for medical costs out of pocket.  These two populations represent only a fraction of a percent, so I’ll ignore them here.

The bottom line is, we all pay – whether you call it a tax or benefit. The solution that we pick should be based upon where the most efficiency lies.  Unfortunately, there are no clear lines that define the efficiencies.  Everything is a fuzzy give-and-take, as you’ll see below.

What the health care issue drills down to, is really the debate between economic theorists and social interest theorists.  These theories are a little less defined by party lines than the original assumptions, though heavily influenced by the population that is able to take collective action, such as labor unions, PhRMA and the AMA.

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Subsequent posts are my lay attempt at applying the economic and social interest theories to the assumptions, and pragmatically evaluating the options.

Health care undoubtedly needs reform.  I don’t know how to do this.  But I do know that any new policy should:

• Cover all minors.  They have no control of their situation, and it’s in society’s best interest that we take care of them and mitigate future health care disasters.
• Cover all elderly.  They’ve paid their debt to society and we owe them the respect… particularly the lost generation.
• Protect small businesses.  The U.S. has always been a land of opportunity.  And to price someone out of pursing their dream because they can’t afford health insurance goes against the founding principles of our country.  Look at Mr. Jobs, Mr. Gates, even Mr. Buffet.

Whether we solve the health care disaster with wine and golf taxes or limiting excessive and unnecessary procedures, whatever… I do hope we reach a good, sustainable solution that will easily transform our culture for the better over the next generation.