SiCKO presents a dramatic portrait of what's wrong with America's healthcare system… and clearly there is a lot wrong. But it is by no means a fair or balanced documentary. It says nothing of the problems endemic in socialized medicine. It doesn't mention the people who die waiting in line for treatment in Canada or England, or who come to the US because they can't the treatment they need in their country. It doesn't mention that the US is the leading innovator in medicine, and we have the best healthcare in the world for those who can afford it. It doesn't mention the fact that healthcare is rationed in other countries, and that it may take months to get an appointment or a treatment. It doesn't mention the cripplingly high taxes required to pay for these systems, which drag down the economies of these countries.
The US system has many problems, and desperately needs reform. We need very badly to increase the number of people who are insured, both for their benefit as well as for the benefit of the presently insured, who often pay for the emergency care of the uninsured indirectly. We need to make changes to the insurance system as well. Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.
However, I am strongly opposed to the idea of federal government provided, single-payer universal healthcare. Here’s why:
1. To achieve “universal coverage” would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government does a poor job of improving quality or efficiency. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention. Government is bad at just about everything. It is inefficient, slow, and incompetent because it has no competition. I really do not want the people who run the DMV or the IRS to be in charge of my healthcare. I do not want beaurocrats making decisions about what services I should receive. I do not want more of my hard earned money being stolen from me through taxes. As a libertarian, more often than not I see government as part of the problem, rather than the solution to our problems. Any government beaurocracy will only become larger, more powerful, more bloated and inefficient, and more costly over time. The examples are so obvious I don’t need to name any.
2. In a free country, people should have the right to refuse health insurance. If they do, they should reap the benefits or suffer the consequences of their choices.
3. If governments must subsidize those who cannot afford medical care, they should be free to experiment with different types of subsidies (cash, vouchers, insurance, public clinics & hospitals, uncompensated care payments, etc.) and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.” This is best done at the state level. The constitution does not give the federal government the authority to manage healthcare. Letting the states try experiment with different policies and systems will allow us to discover the best solution far more quickly than if we impose a single policy on the entire nation at the federal level.
Here is what I think we should do instead:
1. Subsidize healthcare for the very poor and children of poor families (we already to this through Medicaid… the system may need some tweaking). These are the people who truly cannot afford to buy their own insurance or healthcare.
2. Everyone else who can afford to buy their own insurance should be strongly encouraged do to so, but not forced to.
3. Get employers out of the business of providing health insurance. It makes no sense. We are the only country in the world where employers are expected to provide health insurance. Why should they? The system is a relic of the WWII era when the government imposed caps on wages, so employers found other ways to attract and retain the best employees. In order to change this, we need to fix the tax code so that there is no longer a tax incentive for insurance to be provided by employers. The best way to do this is to make medical expenses and the cost of buying your own insurance tax deductible. Then your employer could simply give you the money they currently spend on insurance as an increase in pay, and you could decide how to spend it for yourself.
4. Make insurance more portable, so that if you lose or change your job your insurance is not affected. This requires getting employers out of the healthcare business.
5. Convert our paper-based medical records system to a digital system. This will improve efficiency and reduce errors, saving both money and lives.
6. Reform the legal tort system so that fear of malpractice lawsuits and the cost of malpractice insurance no longer drives up the cost of healthcare. Bringing down the cost will enable more people to buy their own insurance.
7. Change the way most Americans think about health insurance. Insurance, in the true meaning of the word, is intended to cover major unforeseen expenses, not small regular ones. Yet in the past few decades, we have seen the system evolve to the point where we expect our health insurance to fully cover the cost of every runny nose and checkup. The problem with this is that people have no incentive to shop around, turn down services, or minimize the cost of their healthcare. When somebody else is paying the bill, why are you going to say no to anything? This is a big reason why healthcare costs keep going up. If you have insurance that only covers the major, unforeseen expenses, you will make much better decisions about what services to get and what services you don’t really need. You will also be more inclined to shop around for less expensive treatments or medication. This will lead to tremendous savings.
Look at this another way. Your car insurance doesn' t cover the cost of oil changes, and your homeowner's insurance doesn't cover the cost of fixing a leaky faucet. If they did, it would drive up the cost of these forms of insurance as well. People would go to the most expensive mechanic or hire plumbers to do all kinds of unnecessary work, since they wouldn't be paying the bills. Our system has evolved from healthcare insurance to healthcare cost insulation, and that is one reason it's so expensive.
8. Studies show that many treatments provided today are a complete waste of money, either because they are ineffective or completely unnecessary. Doctors today have an incentive to provide ineffective and unnecessary treatments for two reasons: a) to cover their asses so they don’t get sued if something unexpected happens, and b) because they make more money by providing more treatments. In order to reduce the number and cost of unnecessary treatments, we need to give patients the means and the incentive to become involved in these decisions.
When you go shopping, do you let the shopkeepers decide what you're going to buy, and then just whip out your credit card every time they ask you to buy something? Of course not! So why do that with doctors?
9. In order to make #7 and #8 work, we need to make information about the cost and effectiveness of various treatments more readily available to healthcare consumers, so they can make informed decisions. This can be done be forming an organization whose purpose it is to impartially evaluate and rate the benefits, risks, and costs of various treatments and publish that information on a web site. This will help people decide what treatments to spend THEIR money on and what treatments aren’t worth it.
10. Come to grips with the fact that as technology advances, companies will develop treatments for more and more diseases. Eventually, it may be possible to cure nearly anything, and to keep someone alive indefinitely, for a cost. In some cases that cost will be extremely high. Research is expensive, and some diseases are rare. We cannot and should not expect society as a whole to pay an unlimited amount of money to keep someone alive. What would happen if any illness could be cured for $10M? Would we expect insurance to pay $10M every time someone gets old and develops one of the inevitable diseases of old age? Clearly that is unworkable. Therefore, in the coming decades we will have to wrestle with the unpleasant decision of how much we are willing to spend on each person’s healthcare when technologically, the sky’s the limit. I, for one, do not want the government to make that decision. I think it is best left up to each individual to decide how much to spend on their healthcare.
For further reading, I recommend these:
http://www.weeklystandard.com/Content/Public/Articles/000/000/013/760hoavn.asp
http://www.amazon.com/Crisis-Abundance-Rethinking-Health-Care/dp/1930865899/ref=pd_bbs_sr_1/102-1542867-4157759?ie=UTF8&s=books&qid=1183572929&sr=8-1
http://www.amazon.com/Healthy-Competition-Whats-Holding-Health/dp/1930865813/ref=pd_sim_b_1/102-1542867-4157759?ie=UTF8&qid=1183572929&sr=8-1
Tuesday, June 19, 2007
Jury nullificaition: a juror's right to judge the law, not just the defendant
Most people have never heard of it. Most jurors are deliberately kept in the dark about it by judges and attorneys. But jury nullification is a powerful tool that every prospective juror (every US citizen) should be aware of. If you are called on to act as a juror in a trial, and you feel that the law being used to prosecute the defendant is unjust, you can (and should) return a verdict of not guilty, even if the defendant is clearly guilty of violating that law.
Many judges and attorneys hate it, and refuse to inform jurors of their right to nullify unjust laws, or even acknowledge it in court, because it diminishes their power over the jury and the defendant. But this power is important because it is, in effect, a safety valve which can prevent the powerful from victimizing the weak through unfair, immoral, or unjust laws.
I think drug laws a perfect example of of why we need jury nullification. Tell all your friends about it!
en.wikipedia.org/wiki/Jury_nullification
Many judges and attorneys hate it, and refuse to inform jurors of their right to nullify unjust laws, or even acknowledge it in court, because it diminishes their power over the jury and the defendant. But this power is important because it is, in effect, a safety valve which can prevent the powerful from victimizing the weak through unfair, immoral, or unjust laws.
I think drug laws a perfect example of of why we need jury nullification. Tell all your friends about it!
en.wikipedia.org/wiki/Jury_nullification
Sunday, May 27, 2007
Bottled water is one of the biggest scams ever perpetrated in America.
Over the last 20 years, an $8 billion industry has been created by convincing people that tap water is unhealthy and tastes bad.
People constantly discuss and complain about the price of gasoline, but I've never heard anyone complain about the price of bottled water. The fact is that at a typical price of $0.99 for a 1L bottle of water ($4.00 per gallon), bottled water costs more than premium gasoline. How absurd! Especially when you consider that tap water costs about $0.001 per gallon (that's 4000 times less!). Unlike gasoline, which is very expensive to produce, bottled water costs virtually nothing to produce. Bottling and transportation cost a few cents per bottle, but the real reason it's so expensive it that suckers are willing to pay for it. All that money goes back into the company's marketing budget, or comes out as profit.
Drink bottled water because you think it's healthier? Think again. Many reports have shown that bottled water often contains as much gunk as tap water, plus chemicals from the plastic bottle. www.organicconsumers.org/foods...3.cfm. In most cities, the very small amounts of chemicals in tap water have no ill effects. If you're concerned about health, you'd be better off saving the money you spend on bottled water and spending it on better food, a gym membership, or a relaxing vacation.
Drink bottled water because you think it tastes better? Think again. In blind tastings, most people can't tell the difference, or rate tap water's taste as good or better than most bottled waters. The fact is, people taste what they expect to taste. If you buy a fancy bottle of expensive water and expect it to taste great, it will! If you think tap water is yucky, it will taste yucky to you. Try this yourself - buy several brands of bottled water, fill identical, numbered cups with each brand, plus one with tap water, and have a friend set up a blind tasting for you. Be sure to leave the cups of water out for a while so they are all at the same temperature, and be sure that your friend does not know which one you're tasting if he watches you, to avoid subtle hints or influence you might pick up from him. I've tried this on a few people and they are always very surprised by the results. Of course, if you have bad plumbing or live in a city with really bad tap water, your mileage may vary. But if you don't like the taste of your tap water, get a filter!
A lot of people who drink bottled water consider themselves to be environmentally conscious. But how environmentally conscious is it to schlep water (which is very heavy) half way around the world, when we have perfectly good water right here? And how enviornmentally consicious is it to use up billions of plastic bottles every year? Even if you recycle them, a tremendous amount of energy is consumed in manufacturing, transporting, and recycling them.
For the biggest suckers, there are "ultra premium" bottled waters that are super purified and/or processed with some sort of voodoo that's supposed to improve it. One example is Penta water: www.pentawater.com/. This crap claims to be processed in a way that creates pentagonal molecular clusters of water molecules, which increase hydration. This is pure fiction with no real scientific basis, intended to con suckers who lack the scientific background to realize that these people are lying.
America has some of the safest and best tasting tap water in the world. Don't fall for the marketing hype and health hysteria perpetrated by the bottled water companies. Get a filter if you have bad tap water, but don't waste your money on bottled water.
People constantly discuss and complain about the price of gasoline, but I've never heard anyone complain about the price of bottled water. The fact is that at a typical price of $0.99 for a 1L bottle of water ($4.00 per gallon), bottled water costs more than premium gasoline. How absurd! Especially when you consider that tap water costs about $0.001 per gallon (that's 4000 times less!). Unlike gasoline, which is very expensive to produce, bottled water costs virtually nothing to produce. Bottling and transportation cost a few cents per bottle, but the real reason it's so expensive it that suckers are willing to pay for it. All that money goes back into the company's marketing budget, or comes out as profit.
Drink bottled water because you think it's healthier? Think again. Many reports have shown that bottled water often contains as much gunk as tap water, plus chemicals from the plastic bottle. www.organicconsumers.org/foods...3.cfm. In most cities, the very small amounts of chemicals in tap water have no ill effects. If you're concerned about health, you'd be better off saving the money you spend on bottled water and spending it on better food, a gym membership, or a relaxing vacation.
Drink bottled water because you think it tastes better? Think again. In blind tastings, most people can't tell the difference, or rate tap water's taste as good or better than most bottled waters. The fact is, people taste what they expect to taste. If you buy a fancy bottle of expensive water and expect it to taste great, it will! If you think tap water is yucky, it will taste yucky to you. Try this yourself - buy several brands of bottled water, fill identical, numbered cups with each brand, plus one with tap water, and have a friend set up a blind tasting for you. Be sure to leave the cups of water out for a while so they are all at the same temperature, and be sure that your friend does not know which one you're tasting if he watches you, to avoid subtle hints or influence you might pick up from him. I've tried this on a few people and they are always very surprised by the results. Of course, if you have bad plumbing or live in a city with really bad tap water, your mileage may vary. But if you don't like the taste of your tap water, get a filter!
A lot of people who drink bottled water consider themselves to be environmentally conscious. But how environmentally conscious is it to schlep water (which is very heavy) half way around the world, when we have perfectly good water right here? And how enviornmentally consicious is it to use up billions of plastic bottles every year? Even if you recycle them, a tremendous amount of energy is consumed in manufacturing, transporting, and recycling them.
For the biggest suckers, there are "ultra premium" bottled waters that are super purified and/or processed with some sort of voodoo that's supposed to improve it. One example is Penta water: www.pentawater.com/. This crap claims to be processed in a way that creates pentagonal molecular clusters of water molecules, which increase hydration. This is pure fiction with no real scientific basis, intended to con suckers who lack the scientific background to realize that these people are lying.
America has some of the safest and best tasting tap water in the world. Don't fall for the marketing hype and health hysteria perpetrated by the bottled water companies. Get a filter if you have bad tap water, but don't waste your money on bottled water.
Wednesday, August 23, 2006
Thursday, January 12, 2006
Vipassana
I just went to a 10 day Vipassana meditation course. I have to say that was one of the most gruelling experiences I've been through, but extremely worthwhile. I have a much better, deeper understanding of the nature of suffering (how it arises from craving and aversion) and how to get out of it, as well as a calmer mind.
I think some of what I learned can be applied to the development of Artificial Intelligence (as in, building a more enlightened AI so that it will be less likely to harm us). But I'm still trying to understand why an enlightened being, who presumably does not seek out pleasure or have an aversion to pain, would do anything. What motivates it do do one thing and not another? Why would it get out of bed in the morning?
Perhaps pleasure and pain are not completely eliminated as motivators in the enlightened ones, but a sort of feedback loop which leads to intensified craving and aversion is dampened.
I think some of what I learned can be applied to the development of Artificial Intelligence (as in, building a more enlightened AI so that it will be less likely to harm us). But I'm still trying to understand why an enlightened being, who presumably does not seek out pleasure or have an aversion to pain, would do anything. What motivates it do do one thing and not another? Why would it get out of bed in the morning?
Perhaps pleasure and pain are not completely eliminated as motivators in the enlightened ones, but a sort of feedback loop which leads to intensified craving and aversion is dampened.
Tuesday, October 25, 2005
Friday, August 26, 2005
The good and the bad about Tokyo
Things I like about Tokyo:
1. It's the cleanest city I've ever seen. There is not a spec of litter or graffiti anywhere. Not even a crack in the sidewalk, or a pothole in the road. Seriously.
2. No tipping. All advertised prices include tax, and tipping is practically uneard of. I really hate tipping, so this is cool.
3. Every toilet I've seen has a multifunction electronic bidet that will spritz your ass with water at the temperature and pressure of your choosing, at the touch of a button.
4. Great subway system.
5. All the cartoonish signs and ads make it look like the city was designed for kids
6. Very few homeless people
7. The taxi drivers wear white gloves, and the trash collectors wear uniforms.
8. Everyone is fit, nicely dressed, and ridiculously polite.
Things I dont like about Tokyo:
1. Everything is so frickin expensive
2. The streets and addresses are very disorganized and confusing, making it hard to find places (even for the Japanese). Some streets dont even have names, and the ones that do are not clearly marked. There is no logic to the layout. Addresses appear to be completely random, rather than sequential. Even the taxi drivers need a gps to find an address. It seems like a major problem, and I dont know why they dont fix it.
2. There's not much english, and I can't read japanese so it can be hard to figure things out.
3. It's hot as hell.
4. It's an extremely conformist culture.
1. It's the cleanest city I've ever seen. There is not a spec of litter or graffiti anywhere. Not even a crack in the sidewalk, or a pothole in the road. Seriously.
2. No tipping. All advertised prices include tax, and tipping is practically uneard of. I really hate tipping, so this is cool.
3. Every toilet I've seen has a multifunction electronic bidet that will spritz your ass with water at the temperature and pressure of your choosing, at the touch of a button.
4. Great subway system.
5. All the cartoonish signs and ads make it look like the city was designed for kids
6. Very few homeless people
7. The taxi drivers wear white gloves, and the trash collectors wear uniforms.
8. Everyone is fit, nicely dressed, and ridiculously polite.
Things I dont like about Tokyo:
1. Everything is so frickin expensive
2. The streets and addresses are very disorganized and confusing, making it hard to find places (even for the Japanese). Some streets dont even have names, and the ones that do are not clearly marked. There is no logic to the layout. Addresses appear to be completely random, rather than sequential. Even the taxi drivers need a gps to find an address. It seems like a major problem, and I dont know why they dont fix it.
2. There's not much english, and I can't read japanese so it can be hard to figure things out.
3. It's hot as hell.
4. It's an extremely conformist culture.
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