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This is What Democracy Looks Like

Today's Note From a Madman

Wednesday, November 15, 2006


On the Road to Vietnam (Finally)

President Bush is making his first trip ever to Vietnam. On could only assume that he hadn't visited this major manufacturer of cheap imported goods until now because he was politically afraid of what people might say. Of course, that won't stop me.

(Must I really come up with jokes for this, or can you all just make up your own?)

Here are George Bush's reasons for going to Vietnam now:

-Better late than never
-"I just got the letter from my draft board and I'm ready to serve,"
-He believes his own cowboy-hype and wants to "git Charlie"
-He's looking for the bodies of those who went instead of him or Vice President Dick Cheney
-He heard that drug use was rampant and wanted to know if he was too late to take his "toke" on the "doobie"
-"Hookers and drugs? That's for me!"
-He plans on taking a boat trip on the Mekong Delta, then, as president, present himself a purple heart and silver star
-He heard that the Hanoi Hilton had a great breakfast buffet

-Noah Greenberg

The Heath Care Trap

Small businesses (as defined by firms with less than 500 employees) employ more than half of all private sector employees. But that's just the beginning. According to the US Census Bureau, small businesses are responsible for more than 45 percent of the US private payroll; are responsible for between 60 and 80 percent of all new jobs created, in each year over the last decade; contribute more than 50 percent of the private, non-farm gross domestic product (GDP); and employ over 40 percent of the new high-tech workers in the US.

So why aren't they treated better by the health care industry?

Many small firms offer only one health care package to their employees, that is, if they offer any at all. And it isn't by coincidence that small businesses are the ones screaming for some type of middle class relief as it applies to health care. after all, many small business owners and managers are members of the middle class themselves and are subject to the same restrictions that effect their employees.

Many small businesses employ much less than 500 people. For my example today, I'll be speaking of a small, but busy, IT consulting firm with approximately 20 employees. In a firm such as this, there is usually only one health care plan offered with high deductibles and hefty employee contributions. This creates many problems.

When a manager decides to hire an employee at a firm such as this, he (it could be a "she", I know) needs to weight the position being filled not only by the qualifications of the prospective employee, but by how much that employee will cost. A married person with a family might look at the position as a life-rime opportunity while a younger, single candidate might look at it as a stepping stone to a newer better job down the road. And this isn't something that is lost on the hiring manager. However, conversely a married candidate brings with them a heavier burden to the employer in the form of higher health care premiums, among other things.

Imagine that a manager needs one employee. After evaluating two similar employees, his choice comes down to a married person with a family and a single person with no dependents. Assuming that both candidate are equally qualified, and realizing that the married candidate will cost an additional $600-$800 each month for heath care coverage, who would you hire.

Now bring it one step further. Imagine that one of this employees children have a chronic illness which require doctor visits, hospitalization, various consultations, MRI's and other tests. Imagine that your firm has only one health care plan to choose from, as most firms do. What happens to you if your child's doctors aren't on that plan? Even if they offer a "better plan" from the same health care company, it's going to cost you, your employer, of both of you more than even that $800 each month. And with the diminished benefits, you're still shelling out big bucks because the insurance company's "usual and customary" doesn't come close to what the doctors charge.

Part of the Bush administration's idea for individuals is to "bargain" with their doctors for the cost of their health care. And it's true - most doctors will work with you in relation to payment. But the "extra doctors", like the anesthesiologist or a specialist called in for a last-minute test aren't in on the deal. They want their money, regardless of how much your insurance company gave them.

And it gets worse.

If you're the married employee, how would you like to go into a meeting with the owner of your firm seeking a raise, and having the additional cost of your health care used as the reason that you aren't getting the same raise that an unmarried counterpart is receiving? What are your options? As a person with a family, being the primary wage earner, you just can't up-and-leave. And. let's face it, the jobs that are out there for the middle class, even those high-tech jobs that used to look so safe, aren't yours for the choosing.

The middle class squeeze, as Lou Dobbs likes to call it, extends beyond the loss of middle class jobs. It extends into those middle class jobs that have stayed here. In just a span of ten years, health care costs for small businesses, and more importantly, their workers, have more than doubles. But what's worse is that the other health care costs, such as deductibles and out of pocket expenses that result from unrealistic "usual and customary" payments to doctors. Our pockets got squeezed along with the rest of us.

Health savings accounts, as presented by the Bush administration, are not the answer. They assume that the average American has the income that will allow them to set aside money for the future. With the loss of disposable income and the fact that, during the Bush years, the average American family is in a negative savings situation, that hardly seems like a valid argument. Added to the other fact that personal debt has risen, the squeeze is even worse.

"Choice" is a word that the Bushies like to throw around. They tell us that the current system of health care gives us a "choice" as to the doctors we see and the medical institutions we choose to use. This very system that the Bushies want to keep in place is the very thing which limits our "choice". And for the 45 million Americans without health care coverage, their only "choice" comes in the form of "charity".

Initially, we need to make health care portable, not from job to job alone, but from plan to plan. There needs to be put in place a system where you can bring a sick child to the doctor of your choice without taking out a second mortgage. But this is only a temporary fix until our nation realizes that the only real fix is a national health care plan where everyone is covered.

I've called the Bush health care plan the "YO-YO Plan": You're on Your own, and that his real health care plan's slogan is "Plan to stay healthy". After ridding itself of the current lobby system, our new congress ought to tackle what most other nations have already tackled: Our national health care system.

-Noah Greenberg

In response to, "(Tony) Snow is the single most capable person to be the mouthpiece of the Bush administration. He isn't have to 'buy into' the whole White House spiel. He was already there. But this last statement was actually my favorite. By saying 'I think I succeeded', he was putting the onus on Gregory to prove that he didn't succeed.
"One really gets the gist of the White House when reading, instead of watching, White House press briefings. But read at your own risk. It can be painful,"
Eddie Konczal writes:

I think I liked it better when Snow answered every question with, "Well, I'm the new kid on the block..."

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-Noah Greenberg