Tuesday, August 4, 2009

Cash for Clunkers

The CARS program, more affectionately known as "Cash for Clunkers," is gaining more opposition as it shows more success. let's be real here, this is a stimulus plan for the American Car Companies, and certainly it is doing that. Ads around where I live show that with the rebate, one can get an economicaly car for a damn good price; one dealer is doubling the bonus...taking 9k off the price. I checked today to see if my "clunker" a 91 Plymouth Acclaim qualified (it doesn't).

Interesting that Fox News slams the program as early claims are that the average mpg of vehicles traded in is 10 mpg less than what people are driving away with.

some of the controversy comes from the destruction of the cars. This takes energy (as does building a new car). yes, these criticisms are accurate, but then let's be honest and all recycling is just down cycling, not true recycling. These criticisms are coming from fairly radical environmentalists. If we narrowly look at just transportation, the savings in mpg, assuming that people will not double their driving due to the increased mpg, we are saving gasoline. Some people will undoubtedly drive more, just as people who switch to compact flourescent bulbs, leave the lights on longer since cost is the driver, not energy consumption

Addendum to previous post

In my newspaper essay I complained about poor journalism around the healthcare debate. Finally somebetyer journalism. This week's Time has a chartehst shows how major features of the proposals would effect people in different demographic groups; both ppsitives and negatives. The chart also outlines the major players in the debate like insurance companies, docs, and others this is much better .

Monday, August 3, 2009

Specifics of Health Care Reform Need Examination

Previously published in the Terre Haute Tribune-Star, 8/2/09

What does health care reform, education reform, and campaign reform have in common? Other than repeated attempts to “fix” without much success, public opinion on these topics shows similar patterns. Significant majorities of people polled agree that the present system is broken, that reforms are needed, but those same people also report their health care plan, their local schools, and their elected officials are fine. In short, my situation is fine but everyone else’s is fouled up. Recent polls on the current run of “health care reform theatre” indicate Americans don’t want to pay for health reform. Such is the behavioral effects of payroll deductions.

How should policy makers understand such polls? Without specifics, it is very difficult to make sense of them. Polls show significant proportions of Americans think the system needs changing but at the same time “don’t change my situation.” No wonder opposition to any change is so effective. All the opposition has to do is to scare people into thinking that their situation might change and reform is defeated. The only way to break the logjam is to focus on specifics. Specifics, however, are often difficult to find.

I’ve spent quite a bit reading the “America’s Affordable Health Choices Act of 2009.” This is the House’s version of health care reform. The Bill is 1028 pages long. I’ve read about a quarter of the bill. I’m a reasonably informed and literate person. I am having a very difficult time trying to understand exactly what this bill is going to do. Oh, the House committee makes it easy with fact sheets about what is contained in the bill, but other than the claims made, it is very difficult to see how those claims will be achieved.

Some features are easy to see: the bill, if enacted, would extend coverage to most of the uninsured. The dreaded exclusion of previous existing medical conditions would be gone, and there will be a public option health care plan modeled closely on Medicare. Polls could be done on these specifics: do you support or not support ?

Other aspects, like cost savings, are more difficult to understand. How the plan creates savings is complex. Extending insurance coverage to everyone will save money because fewer people will use the most expensive options for health care…..the emergency room. Okay, that sounds like it will work. Beyond that, I don’t get it. Taxing the richest families among us? There is not enough money there to put much of a dent in the cost of extending coverage to all. And, there are added costs. The administration of who is in, the additions to the tax code, the extra regulation of business, the new bureaucracy that will be created to oversee the public option and so on makes me wonder if the “savings” will even cover those new costs.

Few are going to read this bill. I wouldn’t except I decided to write this essay. So, we informed folk rely on journalists and advocacy groups to inform us. The pro groups and pro journalists pretty much just repeat the fact sheets the House committee has prepared or White House talking points. Journalists don’t provide much critical or objective examination of the proposed changes. They prefer to focus on the political machinations instead. And the anti groups and anti journalists rely on fear of possible unintended consequences (or secret conspiracies) like ending all private insurance or the dreaded “socialism.” There is nothing in the bill’s first quarter that suggests the government would hire doctors and open up separate health care facilities for people, even on the public option. The model is Medicare, not the VA. (The VA is a version of socialized medicine.) Even in countries with single payer systems like Canada and Great Britain, private health insurance, for those who can afford it, flourishes.

No doubt there are more specifics in the remaining 750 pages of the bill I didn’t read. Based on what I did read, I (and my family) would benefit from ending the practice of excluding previously existing medical conditions and having the right to choose other than what our employers offer. (That one of us has Anthem, choice would be welcome given the local situation with Union Hospital). These are two specific parts of the House plan that I suspect would be very popular if pollsters asked the right questions and journalists reported with more depth and a little more complexity
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