Health Insurance - Why So Expensive?

Yesterday’s post was a long one so you deserve something a little more entertaining. The link below is to an article on the Consumer Reports web site. On the left side of the page there’s a number of articles you can read that you’ll find interesting. The articles will give you a clue to why health insurance is so expensive. Enjoy the articles.

http://www.consumerreports.org/cro/health-fitness/health-care/medical-ripoffs-11-07/overview/medical-ripoffs-ov_1.htm

Hillary Clinton: The American Health Choices Plan

The title of Hillary’s plan and the graphic above copied from the graphic on Hillary’s website points out her emphasis on expanding health insurance choices. The choices are to keep your existing coverage through your employer or your own individual coverage, choose from the same private health care options that members of congress have as part of the Federal Employee Health Benefit Program, or choose a quality public plan option similar to Medicare. The plan calls for the federal government to become a provider of health insurance. The idea is that the competition will encourage the private insurers to offer better plans at a lower cost. Personally I believe that the government needs to stay out of the business of health insurance. It’s another bureaucracy. Competition is healthy but I think it needs to be between the private insurers. Possibly the insurance companies aren’t willing to compete. If that’s true, it sounds like price fixing is occurring which is against the law.

The second part of the plan calls for lower premiums and increased security. Lower premiums will be realized by removing hidden taxes, better lifestyle choices, and focusing on efficiency and modernization in our present health care system. Increased security will be legislated by ensuring that job loss or family illnesses wouldn’t lead to a loss of coverage or high costs and an end to unfair health insurance discrimination “by creating a level-playing field of insurance rules across states and markets, the plan ensures that no American is denied coverage, refused renewal, unfairly priced out of the market, or forced to pay excessive insurance company premiums.” This part of the plan is common across all the plans. There’s little or nothing that could be argued about here. What interests me the most is unfair discrimination. As far as I’m concerned, unfair discrimination is redundant. Discrimination is unfair and it’s against the law everyplace but in insurance. We’ve tolerated it from our insurance companies long enough.

The third part of the plan, promote shared responsibility, is the main emphasis of Edward’s plan. The participants in Hillary’s plan are insurance and drug companies, individuals, providers, employers, and the federal government. Insurance companies will be required to end discrimination based on pre-existing conditions, drug companies will offer medications at fair prices, individuals will be required to purchase health insurance, providers will work with patients and businesses to deliver high quality, affordable care (no more $20.00 aspirins), and employers will help finance the system. Large employers will provide health insurance or contribute to the cost of coverage. Small businesses will receive a tax credit to continue or begin to offer coverage. The federal government will ensure that health insurance is affordable and never a burden on any family. I agree that shared responsibility should be a cornerstone but I’m not sure that employers should continue to be the first line of defense. Think of the cost savings to companies who don’t have to pay for administrating an insurance plan. What if they paid their employees the amount the employer paid into the plan and allow the employee to purchase their own insurance. Employers don’t assist with house or car insurance so why do they need to offer health insurance. I think it’s been a bad practice that we need to end.

The last two parts of the plan are to ensure affordable health coverage for all and institute a fiscally responsible plan that honors our priorities. Affordable health coverage will be realized by providing tax relief to ensure affordability, limit premium payments to a percentage of income, create a new small business tax credit, strengthen Medicaid and CHIP, and launch a new tax credit for qualifying private and public retiree health plans to offset a significant portion of catastrophic expenditures. A fiscally responsible plan that honors our priorities comes from modernizing the heath systems and reducing wasteful health spending, a new tax credit to make premiums affordable, and making the employer tax exclusion for health care fairer.

The plan has a lot of positive points but again the plan calls for too much bureaucracy. There isn’t any reason the government can’t be a watch dog ensuring that everyone plays fair and providing tax credits where necessary.

Caught in the Health Insurance Web

Today I was preparing to post an overview of Hillary Clinton’s health care plan when I came across this letter.

http://ihcrp.georgetown.edu/ahpfiles/victimjanicestatementfinal.pdf.

It’s about a woman’s experience with a health insurance company that turned out to be doing business illegally in Florida. That’s not the reason I’m suggesting you read the letter. The story is about what happens when you have or get a serious medical condition. There are multiple preexisting health conditions that can cause an insurance company to refuse you insurance or not cover any expenses related to your preexisting condition. I know that most people don’t have preexisting conditions so you may think this doesn’t apply to you. That’s wonderful but it’s not realistic. There's a good chance that cancer or diabetes will affect you or someone in your immediate family. That's what this story is about.

Let’s be Scrooge for a moment. You can remove yourself from the concern related to immediate family members. You can divorce a sick spouse or wait long enough and a child who gets sick will grow up. If you’re the one who gets sick, well, too bad. Scrooge may sound heartless but how is our treatment of people with preexisting conditions any different. There is a solution and that is to have group insurance available for everyone and the groups are large enough to spread the impact.

If a group has 10 insured costumers with no medical concerns and one with a preexisting condition, the costs are affordable for everyone. Of course those without any concerns will pay a little more but what kind of world do we want to live in. After reading the letter I hope you can appreciate the hopelessness so many feel. For some it’s a preexisting condition and for others it’s just good old poverty. Not all of us work for an employer who can afford our health insurance. Those days are becoming more unlikely every day. Tomorrow we’ll get to Hillary.

Business and the Left?

It's not just politicians promoting universal health care. Business leaders are taking up the cause as well. Take a look at this article. It’s worth the read.

http://www.nytimes.com/2007/04/01/magazine/01Healthcare.t.html?pagewanted=1&ei=5090&en=636bdc6bb678c4f2&ex=1333080000&partner=rssuserland&emc=rss

The Edward's Plan

John Edwards titles his universal health care plan Universal Health Care Through Shared Responsibility. The responsibility for providing health care will be shared by business, the government, and the individual. John calls our health care system a broken health care system. He points to four major problems with the system: 45 million uninsured Americans, spiraling health care costs, a fragmented system of insurance, and inconsistent quality. John’s plan points out the following.

The 45 million uninsured doesn’t take into account the tens of millions who are at risk every day of losing their health insurance. It’s estimated that one in three Americans is without insurance at some point over a two year period. Many Americans will find their insurance canceled when they have a major illness. Half of the bankruptcies in this country are the result of medical expenses and two thirds of those people had health insurance.

For the past 50 years, health care costs have grown faster than wages and over the past six years health insurance premiums have grown by nearly 90 percent. In the past year, one in four Americans has a family member who has had difficulty paying medical expenses and more than 25 percent of the low and middle income families with credit card debt have charged medical expenses.

The job based system of health insurance works for most of the insured in America but of the 45 million without insurance many are small business entrepreneurs, part time workers, and independent contractors. Many of those insured are in danger of losing insurance if they change jobs. Those buying private health insurance are denied insurance or pay much higher premiums based on age, medical history, specific drugs they are taking, or their job.

We spend twice the amount for health care as the average for other industrialized nations yet we rank near the bottom of the list in areas such as healthy life expectancy and infant mortality rates. In 2005 we had fewer physicians and nurses per capita than the average industrialized nation and despite the fact we have excellent doctors and nurses, patients receive optimal care little more than half of the time. The system is broken.

John’s solution is to maintain the employer based system we have today, institute new Health Care Markets, and expand Medicaid and State Children’s Health Insurance Program (SCHIP). To quote John’s plan concerning the Health Care Markets, “The U.S. government will help states and groups of states create regional Health Care Markets, non-profit purchasing pools that offer a choice of competing insurance plans.”

The responsibility of businesses will be to offer their employees a comprehensive health plan or contribute to the cost for the employee to purchase insurance through a Health Care Market. The responsibility of government will be to offer new health insurance tax credits to those who have to purchase insurance through a Health Care Market, expand Medicaid and SCHIP, require fair terms for health insurance from insurance companies, and secure the present system of public hospitals and community health centers. The individual’s responsibility is to purchase insurance for themselves and their families.

There are a number of other initiatives such as help doctors deliver the best care, invest in preventive care, and improve productivity with information technology. This is a well thought out plan but there are a number of points in the plan that concerns me. At the top of the list is expanding Medicaid and SCHIP. Whatever the problems it’s a least refreshing to see there’s a serious effort to bring our health care system up to the level of the rest of the industrialized world. Franklin Roosevelt wanted to institute a program during the time he was trying to get Social Security passed by congress. He decided it might interfere with his desire for Social Security. Over 60 years later we’re still trying.

I want to point out that I started with Edwards because he was the first candidate to offer a solution. It doesn’t mean I support or endorse John Edwards or any other candidate. The last Democrat I would have voted for was Robert Kennedy. This blog is not a political blog but the issue of universal health care has become a political issue. When we recognized the need for a national highway system it didn’t become a political issue. In that case, we copied the Germans. Maybe we need to do it again.

Universal Health Care - How We Got There and Where We Are

In the September 21, 2007 issue of the New York Times there was an interesting article by op-ed columnist Paul Krugman titled Health Care Hopes. The New York Times and Paul Krugman may be unbiased in their regard to political parties (wouldn’t that be novel) but whether they are or not the article rings true and gives us an idea of how universal health care became such an important issue in this campaign and where each party stands on the issue.

The following (long) excerpt from Paul’s article describes how we got to this point. Click here to read the entire article.

“To see how much things have changed, consider Hillary Clinton’s evolution. Just 15 months ago, The New York Times reported that “her plans to expand coverage are tempered and incremental,” and that “she continues to shy from the ultimate challenge: describing what a comprehensive Democratic health care plan would look like.” Indeed, when she was asked how costs might be controlled, she demurred: “It depends on what kind of system you’re devising. And that’s still not at all clear to me, what the body politic will bear.

But that was then.

John Edwards broke the issue of health care reform open in February, when he proposed a smart and serious plan for universal health insurance — and bravely announced his willingness to pay for the plan by letting some of the Bush tax cuts expire. Suddenly, universal health care went from being a distant progressive dream to something you could actually envision happening in the next administration.”

I’ve said all along that it would take someone who had the strength of character to get universal health care moving in this country and John Edwards appears to have what it takes. I’m not suggesting that he’s my choice for president but he certainly has the attributes I believe our next president must have.

We’ve all heard of the polls that politicians take before they take a stand on any issue. Whether we agree with Bush or not I doubt he spends much time agonizing over the polls. Reagan wasn’t all that interested in polls. I’m not so sure with Hillary. Fifteen years ago she was willing to step up and offer a universal plan but she got burned. Now she’s running for office. I’m concerned when a politician believes in an issue but is afraid to step up when they have the opportunity.

A man I respect very much said that he agreed with a lot of what Hillary is talking about but he’s afraid she’s become too much a part of the system, too unwilling to take a chance. I’m not sure who she is but at least she got on the wagon when John Edwards didn’t get his head handed to him on a plate.

What does Paul Krugman have to say about the Republican’s plans for health care? Read the following.

“There won’t be a serious Republican alternative. The health care plans of the leading Republican candidates, such as they are, are the same old, same old: they principally rely on tax breaks that go mainly to the well-off, but will supposedly conjure up the magic of the market. As Ezra Klein of The American Prospect cruelly but accurately puts it: “The Republican vision is for a world in which the sick and dying get to deduct some of the cost of health insurance that they don’t have — and can’t get — on their taxes.”

But the G.O.P. nominee, whoever he is, won’t be trying to persuade the public of the merits of his own plan. Instead, he’ll try to scare the dwindling fraction of Americans who still have good health insurance by claiming that the Democrats will take it away.

The smear-and-fear campaign has already started. The Democratic plans all bear a strong resemblance to the health care plan that Mitt Romney signed into law as governor of Massachusetts, differing mainly in offering Americans additional choices. But that didn’t stop Mr. Romney from denouncing the Clinton plan as “European-style socialized medicine.” And Fred Thompson claims that the Clinton plan denies choice — which it actually offers in abundance — and relies on “punishment” instead.”

I hate the use of fear but in these days of sound bytes it’s become popular or is it easy. I'd rather a politician who isn't afraid to describe their position at length. There are plenty of forums to use today so there's no excuse not to. By the way, Mitt Romney signed the universal health care plan in Massachusetts but he wasn't the archietect. We'll talk about that soon. Next we’ll be talking about John Edward's plan. I’ll close with the last few sentences from Paul Krugman’s article. As you read it, think about what it takes to do what’s right not easy and note the polite use of the word determination.

“It’s good to know that whoever gets the Democratic nomination will run on a very good health care plan. What remains is the question of whether he or she will have the determination to turn that plan into reality.”

Health Insurance and Diabetes - They Don't Mix

Today I read a post on a blog site I read every day. The title of the post is So this is highly disturbing…. The blogger, Wil, is the coordinator for a community health center in Northern New Mexico. The post is about a patient of Wil’s that’s passed over for a job because he’s a diabetic. They were concerned with the impact his disease might have on the cost of their health insurance.

The company is a small nonprofit so I understand their concern. HIPAA requires group health plans to cover all eligible employees, regardless of health status. I support HIPAA but I understand the consequences. HIPAA solved many problems but it didn’t go far enough. We make patches but we’ve yet to look at the entire problem and fix it. Massachusetts decided to solve the problem and came up with a solution. Other states have done the same. I see the leaders in those states as people willing to do what’s right not what’s easy or popular.

Read Wil’s post and you’ll read about one of the ugly realities of the health insurance industry. This and every other inequity must be resolved.

Concerns About a Universal Health Insurance Plan

I’ve spent a lot of time talking with people about my desire to see a national universal health insurance plan adopted in the US. Almost everyone has voiced the same concerns.

• We don’t need another government program that’s inefficient and expensive.

• We don’t want a program that causes “good” doctors to leave the system and only offer their services to those who can afford to pay.

• We don’t want a program that creates long wait times for treatment.

• We don’t want to affect a system that provides millions of people with the most advanced health care in the world.

I couldn’t agree more that these are legitimate concerns but it shows a lack of understanding of the universal health insurance plans being proposed by the presidential candidates and the plans now in effect in states such as Massachusetts.

Yes, we don’t want another government program like Medicare and we don’t want a national health care system like the one in Canada. Canada’s public health care system does have some positives but I think we can all agree that it would be a disaster in the US. We need to keep our system but we need to make more affordable and equitable.

In the US doctors are, for the most part, paid handsomely for their services. Of course, they may be better off to pursue a career in professional sports, music, or entertainment but most doctors didn’t choose their career based on the paycheck. I’ve never met a doctor that didn’t feel it was a calling but the reality is that doctors do expect to earn a higher than average income. Changing the source of compensation and the amount that doctors are compensated for their services should never be tolerated.

We’ve all heard that the average Canadian has to wait weeks for treatment. The long wait times are due to a shortage of doctors in Canada. According to an article in the Canadian Readers Digest the shortage of doctors “is partly rooted in a 1991 report commissioned by the provincial deputy ministers of health. In that document, Morris Barer and Greg Stoddart, two health economists, predicted that Canada was facing a physician surplus. In response, provincial governments, scrambling to save money, cut first-year enrollment to Canadian medical schools by about ten percent. Dr. Andrew Cave, an associate professor in the Department of Family Medicine at the University of Alberta in Edmonton, says, “Despite the predictions of the gurus ten years ago, in fact, we need more doctors.” Long waits for treatment isn't an automatic result of universal health insurance.

We do have an advanced health care system. Much of that is the result of expensive research and development. Those responsible for this technology know they will be compensated for their efforts and they work hard to provide us with more advanced technology every day. We have the best medical technology and we also have the most expensive healthcare. No one wants to be without the technology but the expense is creating a crisis.

None of the top presidential contenders is suggesting a national plan funded by taxes and administered by the federal government. None of the state programs are funded by taxes and administered by the state. I will write a number of posts about what the presidential candidates are proposing and what one state, Massachusetts, has done. Keep in mind that a national universal health insurance plan would not change the system we have now. It would change how many people contribute to the pool of cash that funds our system. If that’s a negative, I would like to hear why.

Top End Handcycles

Today Cheryl and I went to look at handcycles. We went to Pinellas Park, Florida the home of Invacare Top End handcycles. I tested two cycles and looked at a third. The first one we looked at was the Top End Excelerator. This cycle is designed very much like an adult tricycle. The cycle has a normal sitting position which is very comfortable. What a feeling of freedom. I haven't been on a cycle since I was about four years old. This cycle has a top speed of 15 miles per hour. After about 10 minutes of practice, it's like you've always been riding a handcycle. Considering the riding position and the height; this is probably the most appropriate cycle for me.

The next cycle I tried out was this yellow low slung model; the Top End Excelerator XLT. The XLT is much lower and your legs are straight out. Steering was a little different because your feet are in stirrups attached to the hub on the front wheel. This bike is faster and it felt great. When I'm ready to race I would consider this cycle.

The last cycle we looked at was the orange model you see to the left. It's called the Top End Force. This is for serious racing. Would I like to own this one? Don't be silly. Of course I would. Both the XLT and the Top End Force are very sexy but the Excelerator is more practical for the Ride to Tallahassee and isn't that more important????????

Book Title

My plan for the book title is Whatever it Takes. This title has a special meaning to me as it comes from the inscription on the key fob one of my daughters gave many years ago. Whatever it Takes would be a great title for an inspirational autobiography but unfortunately there are so many books with that title I’m not sure we need another.

Some samples:

Whatever it Takes: How Professional Learning Communities Respond When Kids Don't Learn

Whatever It Takes: Illegal Immigration, Border Security and the War on Terror

Whatever It Takes – “A compelling novel depicting what happens when Butch and Zig Steel, carrying a 25 year grudge, finally gets their chance to unleash hell upon an unsuspecting prey.”

Whatever It Takes – “A book for anyone who knows where he or she wants to go and are willing to do whatever it takes to get there. This coffee table book contains motivational quotes and stories to inspire and celebrate your commitment to excellence.”

I’m not sure I want to abandon the title Whatever it Takes but I do have another idea. In high school there was a young man that had a special way of getting my attention. He would yell, “Hey half-a-man!” My usual retort was, “What part of me you consider a man is twice the man you are.” It got to be a joke and he finally lost interest. I have a very thick skin so, if anything, the comment was a little inelegant but it wasn’t intended to be malicious. Cheryl and I spoke about it and we came up with a sub title of “What makes a man a Man.”

So, what do you think? Keep the original name or strongly consider Hey Half-a-Man!

An Accomplished Hand-Cyclist

Got to be losing my mind. I thought for sure I mentioned Kelly McCall in one of my posts. Can’t find any mention of her. Kelly pedaled a hand-cycle in the American Lung Association’s Big Ride Across America 2007. You can find her at http://members.cox.net/mclieb/index.mht . My Ride is going to be all of 400 miles. Kelly went a measly 2,500 miles. That's two THOUSAND five hundred miles. I'm beginning to feel a little under whelmed with my goal. Actually, I'm not raising money. It's the message not the distance in my case. Kelly raised over $7,500 dollars for the American Lung Association!

Kelly couldn’t spend a lot of time with the other riders because they were on foot pedaled bikes and the hand pedaled bikes are at a disadvantage. Because she couldn’t keep up, Kelly had to provide her own support vehicle. The Lung Association was reluctant to allow her to participate until she said she would get her own support vehicle. I can understand the reluctance. The Lung Association would be concerned with Kelly’s safety and the Association's budget is small for these fund raising events. Every dollar they spend on the event doesn’t go into research.

Kelly said that the drivers of the cars and trucks sharing the road with her were, for the most part, very polite but there were a few times that she had to “bail” off the road to avoid getting hit. One of the most difficult parts had to be the three flat tires she had on the trip. There was a lot of debris in the bike lanes and road shoulder. I’m impressed with her accomplishment. I don’t have six weeks to travel but, if I find people are paying attention and the Ride is making a difference, I’ll just have to keep going. I’ll head for Washington, DC. We’ll see what happens.

Check out Kelly’s site. She’s quite a lady.

Links

There’s something new on this site. To the right you’ll find two link lists to sites with information regarding health care and diabetes. The health care sites posted give you an overview of the different plans suggested and some reasons why we need universal health care.

The diabetes sites are the sites I read and comment on almost daily. Being a diabetic is a full time job and learning how other people are handling their disease and what new products or treatments are available is extremely important. I’m posting these links here because the act of posting the links shows support for those sites. I hope they support universal health care and someday post a link to this site.

I’m keeping this one short so that you might take a few minutes to visit some of the sites I posted. Got a lot to tell you about so see you tomorrow.

An Answer

Rose, who has been commenting here, wrote a comment to my last post as I was writing today’s post. The comment was a question. Today’s post is the answer. Good timing.

Brian Miller from Lee County government called and said I have to observe the rules that apply to the other vehicles on the road; specifically bicycles. There might be some bridges that I won’t be able to cross because they don’t have a lane for bicycles. In this case, the cycle goes in the car and we drive it over.

There are two more tasks that I need to add to the task list. One is writing a position paper describing why I believe we need universal health care (UHC) and what UHC should look like — how it’s administered and funded, etc. The other task is lining up a list of civic organizations to make a presentation to about UHC.

The presentations will give me an opportunity to feel comfortable with speaking about UHC and I’ll discover if I’m addressing the concerns the public has with UHC. The more Cheryl and I discuss this project the more excited we get. I want to have a team that’s as excited as we are. After this project’s over and we’ve succeeded, I’ve got more — gotta wear out that cycle.

On Track

My friend who works for the Lee County Sheriff’s department said I should call the sheriff’s department to ask about obtaining a permit for the Ride. I’m calling it a Ride for now because I’m not very creative — it’s the best I can do. I called the sheriff’s department this morning and spoke with the desk sergeant. He wasn’t aware of any permit requirements and suggested I call the Florida Highway Patrol. I spoke with a woman at the Florida Highway Patrol who said I wouldn’t need a permit but I couldn’t have an automobile follow closely behind me at a rate of speed slower than the prevailing traffic. It would be considered a hazard.

She also said there might be an ordinance in Lee County that would prevent the use of hand-cycles on bike paths. I thought that was interesting; can’t ride a bike on a bike path. I understand the concern. The hand-cycle is very low and they’re wider than a standard bike. She suggested I call Lee County government and ask about an ordinance then she gave me the number. The woman I spoke with at Lee County government said there’s no such ordinance but I should speak with a particular gentleman in the office to determine if he was aware of any problems I might encounter while cycling through Lee County. I called the gentleman and left him a message. The search continues.

I Need a Team

The walk/pedal to speak out in favor of universal health care will require a lot of preparation. I’ve left a message with a friend who works for the Lee County Sheriff’s department to ask about gaining permission. There may be some obstacles. The activity of walking or hand-cycling to raise awareness on our roads could be considered unsafe. Walking or cycling on most streets is legal but I'll need a car to follow closely behind me to ensure some level of safety. How would that be addressed by the local sheriff’s department? I think I’ll have the answer to that soon.

The other tasks I need to complete before setting out are being sure I’m Mister Know-It-All on universal health care, getting in the proper physical shape, and getting a lot of practice using a hand-cycle. I’ve been spending a lot of time learning all I can about universal health care; that’s ongoing. I haven’t started the getting in shape part yet but I'm on a diet. I’ve lost a few pounds so far. I need to start the process of getting in shape. I think I can kill two birds with one stone here. I can use the hand-cycle to get in shape and I’ll be well practiced by the time I’m ready to go.

While I’ve been waiting for the call from my friend, I’ve been thinking about what to call this walk/pedal. It’s not a protest or a walkathon. It’s not a march or a demonstration. So what is it? My goal is to raise awareness of the need and viability of universal health care. So what I need is a name for what I’m doing and I can’t call it a walk-a-pedal. If you’ve got an idea, write a comment here. Also, I need a team to help me plan and get this underway. I know I haven't come close to listing all the tasks that need to be accomplished before I hit the road. If you would like to be part of the team, let me know. There’s a lot to do so let's go.

Obedience

I’ve spent my life speaking to God but very little time listening. I’ve always felt confident that I was making the correct life choices. I remember so vividly asking God to perform a miracle and cure my legs. When I became diabetic I thought it was a display of God’s humor. I looked up and said, “Okay is this your way of changing my focus or have you just gotten tired of the same request.” God and I never had a conversation. I did all the talking and until recently no listening.

For the third time in 10 years, I’ve found myself out of work. Actually I’ve been out of work a lot in my career but that’s typical when you work for small high tech companies. Many fail or get bought out and move. This time is going to be different. Eight years ago I started writing the book I’m writing now and I never got very far. This time I started and decided to stay with it. That was eight months ago. Six months after I started the book I got the phone call that my services weren’t needed.

My first reaction was to start looking for another job. In fact, I had already started the process months earlier because the company I worked for had been bought out by a French company and I had a suspicion that the company would close the US operations. Once I got serious about looking for work some opportunities came available. One was very promising but the position is in Massachusetts and we’re not ready to leave Florida.

One day Cheryl said to me, “What are you doing; how many times do you have to be hit on the head?” Of course, that got my attention. I decided I better ask some questions. It’s bad enough I have selective loss of hearing but to completely ignore my wife; not a chance. What Cheryl was suggesting was that God might have been trying to get my attention AGAIN and maybe I ought to pay attention. I stopped talking and struggling and listened for a change. What I was hearing was that I needed to stop and start looking for a literary agent.

Now I’m not saying I stopped looking for work. The agency responsible for unemployment compensation might be listening. What I am saying is that I’m staying on course. I will get the book published and I will listen rather than do all the talking. For the first time, in many many years I feel like I’m being obedient. Now I know why my head hurts.

Ouch!

Deception

I love marketing. My first experience with marketing was accidental. It all started in the year 1960 or 61. Our Boy Scout troop was going to summer camp and I wanted to go just like all the other scouts. The problem was that the cost for the two weeks at camp was substantial and would have meant some serious sacrifices for my parents to afford to send me. My parents had already sacrificed a lot and I wasn’t so sure I wanted to bring this home to them. Then the scoutmaster had another announcement that was the answer to my problem. One of us scouts was going to go to camp at no cost.

Every spring there was a Boy Scout Jamboree held at the local coliseum. It was an exciting time with all the troops in the area participating in a demonstration of our many skills. This year we were going to stage a real honest to goodness attack on a wagon train by a group of wild Indians. We were going to use all our skills to build the wagons and horses. The wagons would be miniatures of the real thing and the horses would be plywood cutouts that the riders held onto. The planning and preparation would take months.

The problem was that the jamborees were not well attended. A lot of parents and some relatives but that was about it. The scoutmasters wanted to see a larger audience so that the whole affair would be more spectacular. They had visions of filling the coliseum. For us scouts, it would be a moment to remember. To get more people at the jamboree, a contest was going to be run. Every year the scouts sold tickets to the jamboree. This year the scout who sold the most tickets would go to camp free. I was pumped. This was my opportunity to unload the burden from my parents. I immediately hit the streets knocking on doors. I discovered that everyone would buy at least one ticket from me. What a salesman.

My cousin Fred followed me on one of my sales trips and he said after five or six sales, “Hey you could sell anything.” I said, “Yes I can.” Then he told me why. He said, “Those people don’t have a chance with you being on crutches.” I came to the conclusion that Fred was right so we just kept knocking on doors. When I finally turned in my sales I sold more than three times as many tickets as my nearest competitor. I won. Now I think that was a little deceptive. I wasn’t lying to anyone. The jamboree was a spectacular event that year. The problem was that many of the people who bought a ticket didn’t get any value for their outlay. They weren’t going to the jamboree and I knew it but that didn’t stop me from selling them the ticket.

There's an example of deceptive advertising that really gets me angry. I’ve seen it in print and on television and now I've found it on the Internet. Actually this example isn’t quite as bad as the others because it tells the whole story. The American Diabetes Services has a web site where they provide low cost and free diabetic supplies. There’s an article on the site titled New Advances in Pain-Free Testing for Diabetics. An excerpt from the article says the following.

“For many people living with diabetes, frequent testing of blood glucose levels can be the most valuable tool for maintaining control of symptoms and avoiding long term complications. New advances in pain free testing, including painless glucose monitors from many manufacturers, make pricked fingers and drawing blood a thing of the past.”

Now isn’t that exciting. That’s what I’ve heard on television and I’ve seen in print advertising. I was excited the first time I heard the message on television. Twenty five years of drawing blood four plus times a day was over. If you read on, the article says.

“Alternative site monitors allow the patient to replace finger sticks with blood draws in less sensitive areas of the body such as the forearm and thigh.”

Watch for the television commercials. This last part either isn’t mentioned or it’s so subtle you wouldn’t notice. Less sensitive areas! What a ruse. I’m marketing myself to agents with an honest query letter. Now I wonder if I should make some changes. Let me see. The most successful salesman the world has ever seen writes about his easy to use methods. It's got a chance.

Getting it Write

My sister Donna read the first three chapters of my first book and she enjoyed them but I enjoyed most her comment “you made it sound too easy.” Her comment to my last post was “It's a good story, if you admit you had some problems.” I went back and read the chapters and she’s right. I haven’t said too much about what I was feeling emotionally and physically. Much of what I experienced I don’t care to relive but Donna’s right. My defense was humor and the chapters reflect that.

If the idea is to inspire, than the reader has to experience what I experienced; the struggle and the success. The hardest part of writing is painting a picture with words that draw the reader in. I was a technical writer for a number of years and I’m very successful with that style of writing. Being a lot more touchy feely is an exercise. I find myself rewriting and rewriting. I’ll get there. I’ll have to share some of my rewrites here to get your comments but I’m not quite ready yet.

This reminds me of Good Morning America when they have a story about someone who wrote a book and they have a portion of the book online for us all to read. If you haven’t figured it out yet, all those fun shows in the morning and late night talk shows are a marketing tool. I hope I never get accused of that. My motives are always of the highest order. They are!

A Response or Two

Yesterday I said at the end of my post that I hadn't got any responses yet to my first five query letters. Right after I completed the post the mailman came and there was one of my self addressed stamped envelopes (SASE) in the mail.

I felt like Charlie in Willie Wonka opening the candy bar. You know don’t you, Charlie had to open more than one bar before he got the golden ticket.

I opened the envelope and inside it looked like the agent had sent my letter back????? I took the letter out and flipped up the top of the letter and sure enough it was my letterhead. I didn't see anything other than my letter. Then I opened the rest of the letter and there it was, a circle around a word, and a line coming off the circle to some words.

My heart was in my throat. I was sure that it was a note saying I had misspelled a word. I've been told that's a death sentence for a query letter and I sent out five of that letter. Well, it wasn't a misspelling. The agent circled the word autobiography. She wrote that she wasn't doing any autobiographies at this time.

Today I got another one. This time it was a form letter saying how I must know that publishing is a difficult business and the agent didn't "feel strongly enough about the work." I was happy to see that I'm one more response closer to getting that golden ticket.

Healthcare Elsewhere (and here)

I’ve been busy reading the information on the Internet about healthcare systems and I’ve come to a conclusion. None of the healthcare systems are perfect. What’s great for us is that we have, for the most part, a private, voluntary system in which insurance is provided primarily through employers. That type of system is a great framework from which to build a universal system. Fortunately we weren’t the first to have a universal system. We lag way behind countries such as Canada, Great Britain, Germany, France, The Netherlands, and Japan. The fact that we lag way behind is a plus. We can learn from the mistakes of those who went before us. We even have many states that have instituted a universal system. What a gold mine.

I found a document titled International Healthcare Systems Primer prepared by Jessica A. Hohman at Miami University (Ohio) for the American Medical Student Association. The document put a lot of the information I had been reading in one place. You can read the document at http://www.amsa.org/uhc/IHSprimer.pdf . You can read more about universal healthcare at http://www.amsa.org/uhc/.

Reading the document I discovered that the major problem with universal healthcare plans in countries I mentioned is that the average person who needs to see a doctor finds themselves on a waiting list. The average Canadian has to wait weeks to see a doctor even for serious problems. I needed bypass surgery in 2000. I went to the hospital in the early evening with a heart attack. They stabilized me and did the surgery the next day. I’ve spoke with Canadians who had to wait several days before they had surgery. They were stabilized and waited in line.

I was surprised to find that Germany and France had the best systems. They still have problems. One which they all share is the rising costs because of our aging populations. That baby boomer bubble affects us all. Now there's a problem that will resolve itself. Some good news.

When we hear about these problems we recoil in fear at the suggestion of universal health insurance. Okay, lets all agree that any system designed by man will have problems. The space program has had serious failures but we got to the moon. What I’m saying is that we weren't a nation of people who stuck our heads in the sand with every problem. We solved the problem and moved on. We have a great healthcare system. It’s just that many people can’t afford it or they have to select an insurance plan that leaves them underinsured. It’s kind of like leasing a car that you can only drive 5,000 miles a year. Drive it more and you’re going to pay big time.

There is another reason that many people recoil and it has nothing to do with the inefficiencies of other systems. It’s the belief that we should remain a country in which government involvement in our lives is held at a minimum. Many people vehemently believe that and I agree but I have reservations about services such as healthcare. I wish I was articulate enough to describe what I believe but I’m not. I’ve been thinking about this issue being a moral issue and that we shouldn’t treat health insurance like merchandise and then I find it’s a point already made. The following excerpt from an article titled The Case for Universal Health Care on the American Medical Student Association web site says it all.

“At its root, the lack of health care for all in America is fundamentally a moral issue. The United States is the only industrialized nation that does not have some form of universal health care (defined as a basic guarantee of health care to all of its citizens). While other countries have declared health care to be a basic right, the United States treats health care as a privilege, only available to those who can afford it. In this sense, health care in America is treated as an economic good like a TV or VCR, not as a social or public good.”

Getting back to the document, International Healthcare Systems Primer, the following are some excerpts from the section about the healthcare system in the US.

“The US is plagued by high administrative costs, and studies have estimated as much as 31% of all healthcare costs in the US go to administration (Woolhandler, et al. 2004). Health insurance premiums continued to grow at unsustainable rates; from 2003 to 2004, premiums increased 11.2%, a much faster rate than inflation (2.3%) and wage increases (2.2%).”

“The increasing number of uninsured individuals and skyrocketing health insurance premiums continue to be the most visible problems within the US healthcare system.”

“The central challenge facing the US healthcare system is extending this excellent healthcare to all of its citizens, not just those who can afford it.”

“The US is a leader in groundbreaking biomedical technology and innovative life-extending procedures, and those Americans who are well-insured enjoy arguably some of the best healthcare in the world. Despite this, the US entered the new millennium with a healthcare system characterized by skyrocketing costs, administrative inefficiency, and significant health disparities by race and income. Perhaps most visibly from an international standpoint, the US remains the only industrialized country in the world without guaranteed healthcare for its citizens.”

Addressing this is so much easier than getting to the moon, you know, Whatever it Takes.

Now I think it’s time to put this to bed until I'm ready to hit the road. I need to do more than just write. I need to start planning for that walk/pedal. I’ll talk about the plans here and I’ll get back to some posts about the book; maybe even some excerpts of my own.

An Update

I've been doing a lot of research on healthcare systems and found some great sites. One in particular had a plethora of unbiased information. I'm finishing that post but the picture you see here really caught my attention. This is a hand pedaled cycle. Okay, it’s a high-tech, racing, hand pedaled cycle. Isn’t it beautiful? This one is a little expensive and not what I'll purchase. It cost $3,600. These cycles aren’t mass produced so the cost is high.

Anyhow, as I mentioned in my last post, the plan is to pedal and walk when I venture out speaking about the need for universal health insurance in the USA. It makes sense to pedal because if I walk every day I'll only get about four to six miles per day. It will take me a week just to get out of Fort Myers. These bikes can travel up to 30 miles per hour. That’s only for a very short distance because it’s all arm strength. The average speed will probably be 12 to 15 miles per hour. At that speed, I can cover some distance.

My youngest daughter and son-in-law said they will pay for a portion of the bike as a corporate sponsor. They own a web based business, miamibeach411.com. Check out the site. The more reasonably priced bikes cost around $2,000. Obviously, I’m going to put some miles on the cycle so I want to make sure I get a good one. The next challenge, after getting the bike, is getting in shape.

I believe an update on the book is called for now. I’m selecting the next five agents to send the query letter to tomorrow. It’s been a week since I sent out the first group of five and no word. I didn’t expect any responses by now but wouldn’t it be exciting to get a phone call in the next few days. I won’t even mind getting a form letter thanking me for my letter but no thanks. There’s a possibility I might get some advice from one of the responders. That would be appreciated.

This week I spoke with a man in town who is a published author. He gave me some suggestions on how to get the book published. He told me about a site called PublishAmerica http://www.publishamerica.com/ . That’s not the path I’ll take at this time but it’s an option. Well time to get back to the other post. See you soon.

The Problem

The National Center for Policy Analysis (NCPA) is a right-wing think tank. Below is a list of their principal issues as posted on the People For the American Way web site.

NCPA’s Principal Issues:

• A right wing think tank with programs devoted to privatization in the following issue areas: taxes, Social Security and Medicare, health care, criminal justice, environment, education, and welfare.
  
• NCPA describes its close working relationship with Congress, saying it “has managed to have more than a dozen studies released by members of congress – a rare event for a think tank – and frequently members of Congress appear at the NCPA's Capitol Hill briefings for congressional aides.”
  
• Right-wing foundations funding includes: Bradley, Scaife, Koch, Olin, Earhart, Castle Rock, and JM Foundations
  
• In the early 90s, NCPA created the Center for Tax Studies. NCPA’s website describes the inspiration for the Center: “Very few think tank studies are released by members of Congress.”

The NCPA is against legislation that imposes guidelines on private companies such as health insurance companies. Guaranteed issue and community rating are examples. I looked into other states such as Massachusetts that have guaranteed issue and community rating. The cost of health insurance isn’t a major issue in Massachusetts. That may be because they also have universal health insurance.

I’m not going to get any deeper into some of these issues such as guaranteed issue and community rating because they should be part of a universal health insurance program. I need to make a case for universal health insurance. I’m for universal health insurance not because it’s cheaper. It may be a little more costly for some. I’m for universal health insurance because it’s right.

Does anyone think Social Security was a bad idea? I doubt it. Does it have problems? Yes it does, but the problems are the result of legislators who allowed the fund to be raided. The number of baby boomers has also strained the system. It will be tough going for awhile and the baby boomer generation won’t be getting as much as they could have gotten if their numbers weren’t so great compared to the number of people contributing but Social Security is better than nothing.

You know, it would be a better system if everyone paid into it but you are aware that our members of congress don’t pay in and they don’t receive benefits. Years ago they devised their own retirement plan. What’s the problem? The problem is that there are too many people who believe they are above it all and there are too many who want to protect their station in life or wealth and have little regard for everyone else.

I would have loved to post some of the comments I saw on the Internet regarding universal health insurance, guaranteed issue, and community rating but both sides – right-wing and left-wing – have messages that contain so much hatred and biased information that I wouldn’t post it. They believe they’re right and everyone else’s ideas are [expletive deleted]. The middle of the road is being trampled. What we need are people who are interested in solving problems that effect our populace period. Too many people are without insurance and it’s a heavy burden for many. What should we do? That’s simple, find a solution.

As I said earlier, we need to populate our government with people who have strength-of-character. We need people who are willing to do the right thing for everyone not just for themselves, their constituents, or the special interest groups.

It’s time to start planning my walk or ride. Not sure if you saw that I may use a hand pedaled cycle for part of the trip.

Tomorrow we need to talk about universal health insurance in other countries. A friend has had experience with the systems in England and Canada and she isn’t impressed.

Guaranteed Issue and Community Rating

There's a web site I found with an interesting article about guaranteed issue and a mention about community rating. The site is at http://www.ncpa.org/w/w33.html . The site is by the National Center for Policy Analysis. They don't like guaranteed issue or community rating. Who is the National Center for Policy Analysis? I don't know; got to find out. I will be getting more information about guaranteed issue and community rating but I thought I would start with some negative publicity. I like coming back from a deficit. The article below is one of two articles on the site. This one is titled How Washington State Made Health Insurance More Expensive. Go to the site to check out the other article.

"State reforms intended to make affordable health insurance available to everyone have created a crisis in the market for individually purchased health insurance in Washington state, say insurance analysts.

Since 1994, Washington has required insurers who offer individual health policies to sell to any purchaser (called guaranteed issue), and it limits the waiting period for coverage of pre-existing conditions to three months. In addition, since 1995 the state has had "community rating," which restricts insurers from charging different premiums according to risk.

The effect of these reforms has been exactly opposite the announced intention of policy makers:

• Costs are higher, with six insurers sampled by the state Health Care Policy Board reporting an increase in the average cost per enrollee of 29.5 percent between 1993 and 1995.
  
• Premiums are rising faster than the national average; for example, most of the enrollees in Blue Cross of Washington and Alaska are paying 36 percent more than before reform -- with another 11.4 percent rate increase scheduled for 1997.
  
• Fewer people have insurance, with enrollment in the individual insurance market declining 13.4 percent among the five largest insurance carriers in 1996, partly in response to rate increases enacted in late 1995.

Costs are rising and fewer people are covered due to adverse selection -- meaning healthier people are dropping insurance coverage to avoid the increasing expense. For example, in the Pierce County Medical plan, the people who dropped their coverage in 1995 had average claims about 15 percent lower than those who stayed in.

Not only is insurance more expensive, say analysts, but consumers have fewer choices:"

I noticed in the article that people seem to drop out when their insurance cost goes up. That makes sense. I wonder if the initial increase was small and many dropped out which drove the cost up. I'll check this out. At least we all know the meaning of guaranteed issue and community rating.

I'm not moving to Washington anytime soon.