What’s Their Deal With Health Insurance Anyway?

It feels odd to write about anything else now that a senseless, malevolent being has taken control of the White House, but here goes anyway:

Four years ago, Dr. Ben Carson, who is expected to be the U.S. Secretary of Housing and Urban Development in the new administration, compared the Affordable Care Act to slavery:

“You know, Obamacare is really I think the worst thing that has happened in this nation since slavery,” Carson … said … in remarks at the Values Voter Summit in Washington. “And it is in a way, it is slavery in a way, because it is making all of us subservient to the government, and it was never about health care. It was about control…”

“And why did [the Obama administration] want to pass it so badly? Well, as I said the other night on television, Vladimir Lenin … said that socialized medicine is the keystone to the establishment of a socialist state.”

As we might expect, there is no evidence that Lenin said any such thing. The “socialized medicine” quote attributed to him by Carson and others was fabricated for a 1949 brochure issued by the American Medical Association. That’s back when the AMA was fighting President Truman’s proposal for national health insurance (and years before they opposed Medicare). But Carson telling that tall tale helps explain why the Republican Party is so opposed to the Affordable Care Act.

The ACA requires individuals to have health insurance (or pay more income tax) and employers of a certain size to offer health insurance to their employees (or pay more income tax). It also requires that health insurance plans meet specific requirements in order to qualify as health insurance for purposes of the law. So that’s one reason Republicans want to repeal the ACA. The law requires that we do something for our own benefit or for the benefit of others. It limits our freedom to do whatever the hell we want. That makes it a prime example of government overreach, or what the right-wing calls the “Nanny State”.

But since Republicans are forced to buy insurance for their houses and cars without making a fuss (let alone bringing up slavery or Nazi Germany), being forced to buy insurance for their bodies (or their employees’ bodies) can’t be the only reason they’re against the ACA.

A second reason is simply political. After decades of trying, a Democratic President finally got a bill passed that takes us closer to universal health insurance. But whatever Obama was for, the Republicans were against. They immediately labeled the ACA as “Obamacare” to help convince right-wingers to oppose the law, even if they didn’t know what the law did (and even if the law would improve their own lives). 

That’s despite the fact that the ACA adopted the conservative approach to universal healthcare that Republicans had been advocating since the 1970s. It’s pretty amazing. A letter to the editor in The Chicago Tribune tells the disheartening story:

Obamacare is virtually the same privatized mandate plan [the Republican Party] pushed since President Richard Nixon first proposed the National Health Strategy in 1971, then again in 1974. Then the GOP revived its privatized mandate plan again in 1993 with … the [HEART] act … an alternative to the [Clinton] single-payer plan… 

Obama — as a compromise to have basic health reform passed — used this same GOP blueprint with one significant change: adding a public option alongside the GOP’s privatized mandate plan … 

Eventually the public option was stripped out of the 2010 ACA bill as a further compromise to attract bipartisan support for the bill, leaving in its place the very plan that the GOP wanted and pushed for decades. Unfortunately, the ACA did not receive a single vote from the Republican Party that created the plan’s primary concepts as an alternative to a single-payer — “Medicare for all” — type of system.

No wonder the Republicans have had so much trouble coming up with a replacement for “Obamacare”. The law they’re so against is the law they used to be for.

A third reason the Republicans oppose the ACA is that it’s the kind of Robin Hood economic redistribution Republicans hate. It takes from the rich and gives to the poor. Paul Krugman explains in a blog post called “Health Care Fundamentals”:

Providing health care to those previously denied it is, necessarily, a matter of redistributing from the lucky to the unlucky. And, of course, reversing a policy that expanded health care is redistribution in reverse. You can’t make this reality go away.

Left to its own devices, a market economy won’t care for the sick unless they can pay for it; insurance can help up to a point, but insurance companies have no interest in covering people they suspect will get sick. So unfettered markets mean that health care goes only to those who are wealthy and/or healthy enough that they won’t need it often, and hence can get insurance….

The thing is, however, that guaranteeing health care comes with a cost. You can tell insurance companies that they can’t discriminate based on medical history, but that means higher premiums for the healthy — and you also create an incentive to stay uninsured until … you get sick, which pushes premiums even higher. So you have to regulate individuals as well as insurers, requiring that everyone sign up — the mandate. And since some people won’t be able to obey such a mandate, you need subsidies, which must be paid for out of taxes…

What [the Republicans] are left with is … voodoo: they’ll invoke the magic of the market to somehow provide insurance so cheap that everyone will be able to afford it whatever their income and medical status. This is obvious nonsense [but] it’s all they’ve got.

The redistribution is related to a fourth reason they’re against the ACA and it might be their biggest reason of all. Not only did the ACA impose fines in the form of tax increases on taxpayers who wouldn’t buy health insurance, it included a separate, relatively large tax increase on the richest Americans. As everyone knows, that‘s anathema to Republican politicians. Repealing the ACA, therefore, would mean a big tax cut for the Republicans’ favorite people. From Slate:

One of the core, very simple things [the ACA] did was raise taxes on the wealthy in order to fund subsidized health care for more Americans. Couples earning more than $250,000 saw a 0.9 percent increase in their top Medicare tax rate, as well as a new, 3.8 percent Medicare surtax on investment income.

If Republicans have their way and successfully repeal the Affordable Care Act, those two taxes will be toast—which will mean a substantial break for some of the country’s wealthiest families. The liberal Center on Budget and Policy Priorities estimates that millionaires would see 80 percent of the benefits from those tax reductions. Based on the most recent IRS data, the think tank roughly projects that the 400 highest income households—which earned an average of more than $300 million each in 2014—would see a $2.8 billion annual tax cut, worth about $7 million on average per filer.

So that’s at least four reasons why Republicans want to scrap the Affordable Care Act:

1) It’s what they call the “Nanny State” in action. 

2) It was an important Obama accomplishment.

3) It’s the kind of redistribution Robin Hood was for and the bad guys were against.

4) It raised taxes, especially for the rich.

In conclusion, Republicans don’t necessarily want millions of Americans suffering and dying without medical treatment. Being concerned about that kind of thing is simply low on their list of priorities.

Learning to Deal with the Modern World (you know, the www)

Many years ago I created a Yahoo email account with an alias. I thought that was the wise thing to do in order to protect my privacy (as I said, it was many years ago). I still use it for junk email. For example, I give it to websites that don’t seem to deserve a lasting relationship.

Last week, I tried to look at the account and couldn’t. I was sure I had the correct password but Yahoo didn’t agree.

Unfortunately, they wouldn’t let me reset my password using any of the standard online methods. The reason given was that they thought my account might have been “compromised”.  Hence, I was told to contact Yahoo Customer Care.

Unfortunately again, the only contact information they provide is a phone number. If you have some time to kill, you can call it yourself (it’s 1-800-318-0612). The first recording you hear is the usual one about “heavy call volume”, but it goes on to say that the volume is so heavy that they may not be able to answer your call. Ever, I guess. 

If you choose to wait, you hear the usual announcements, including one that suggests that if you’re having a password problem, you might visit https://help.yahoo.com/identity, where you’ll be able to fix the problem and get on with your life. Being an optimist, I tried that, thinking it might be a special password handling page. The end result, of course, was that they told me to call 1-800-318-0612 (the “we may not be able to answer your call” number). This is the kind of thing you could do to a rat if you were a really mean psychologist and wanted to drive it crazy. 

What Yahoo means by “not being able to answer your call” is that after a while, if you haven’t hung up already, they hang up on you. 

But today I was invited to leave my phone number so they could call me back. They said there were 289 calls in front of me, but the average wait time was only 20 minutes and they’d keep my place in line. Since I’ve used the call-back feature with other companies and found it to be relatively pleasant, I gave it a try.

Unfortunately yet again, four hours passed and they didn’t call. I was beginning to think that Yahoo doesn’t really care about “Customer Care”.

Then I did what I should have done earlier: use Google (not Yahoo?) to search for “Yahoo email password problem”. It turns out they’ve had a few. But among the sad stories was a link to the famous Get Human site. Yet something else I should have done before! Why didn’t I remember to use Get Human?

Among Get Human’s helpful suggestions was to contact Yahoo via Facebook or Twitter. This is an option that hadn’t occurred to me at all. First, I went to Facebook. Although I didn’t try to get in touch with them that way, I did read some of the emotional messages people have left on Yahoo’s page. “I can’t get access to Yahoo email and we use it for our business and you don’t have an email address and never answer the phone!” and “I would use some other email but hundreds of sites already have my Yahoo address!” and “You should rot in hell!” (or words to that effect). One person even made the ultimate complaint: “Yahoo’s customer service is even worse than Comcast’s!”.

I then visited Twitter. Easily locating the official Yahoo Mail Team page (@yahoomail), I quickly fired off my own (brief) cry for help, being polite but not supplying any personal details, since I didn’t know where my tweet would appear.

Well, it was quite a surprise when someone on the Yahoo Mail Team responded within the hour. They sent a very nice message, inviting me to visit a certain link that would allow me to submit an incident report to their technical support group. Which I did.

Whether I ever hear from Yahoo or not, this experience wasn’t a total waste of time. First, I reminded myself to try Get Human as soon as things go bad this way. Second, I learned that big companies like Yahoo apparently pay more attention to the relative few who contact them by Facebook or Twitter than the hundreds of poor souls who call them up and then sit on hold listening to lame music, “Your call is very important to us” and, in Yahoo’s case, the occasional “Yahoo-oo-oo!” rebel yell. 

Lastly, I was reminded that our dependence on these massive companies for so much leaves us vulnerable. You can get an email address in a minute or two without spending a dime, build much of your life around it, and then have it disappear with no warning and for no apparent reason. Or keep lots of stuff on your hard drive or in the cloud and have that be “compromised” or become suddenly unavailable. People are working on better internet security methods, but there’s still a lot to be said for storing stuff the old-fashioned way, like on paper, and also for keeping your eggs in more than one basket.

Update: Ok, they sent an email with a temporary password to my main Yahoo account. I clicked on the link and tried to create a new password. They didn’t like it because they said it was too similar to my account name. In fact, it wasn’t similar at all, except for sharing a few letters of the alphabet that were arranged differently. So I get past that hurdle and create a new password and then discover that I’ve now changed the password for my main account, not the account I was having trouble with. So I logged off that account and went to the troubled account and repeated the process, starting with the temporary password. That was easy. 

On Carrying a Camera Everywhere

There have probably been a billion words written on how most of us are now carrying a little camera with us everywhere and how that’s changing our lives for better or worse. 

But think of all the events that could have been photographed if everyone had a cellphone in decades past. We’d have more pictures of UFOs (but not flying saucers). We’d have more photographs of the Kennedy assassination and more views of Marilyn Monroe on that subway grate. From certain decades, we’d have many more pictures of people looking at themselves in their bathroom mirrors.

There was a story in the news today about an actress being handcuffed in Southern California after she apparently refused to identify herself to police officers. She wasn’t doing anything illegal at the time and wasn’t arrested. There are photographs of her in tears standing next to a cop, but not of what happened earlier. We’ll probably have to wait a while before it’s common to film every moment of every event that seems like it might be worth filming.

Anyway, I was walking into the grocery story this evening and stopped to take a picture with my phone. Future historians can study it if they want:

IMG_20140914_191214506

The Great Knee Defender Controversy

There are some issues on which everyone thinks they’re an expert. This explains why today’s New York Times article in defense of the Knee Defender has a couple hundred comments so far.

The Knee Defender was invented by a guy who was tired of people in front of him reclining their airline seats so far back that they made uncomfortable contact with his knees. You attach the thing to the tray table and it stops the seat in front of you from reclining. This made the news recently when a one passenger (a man, presumably tall) used the Knee Defender and another passenger (a woman, presumably not so tall) retaliated with a cup of water. The flight was diverted and both passengers were kicked off the plane.

Speaking as someone who is taller than average and has avoided coach only two or three times in his life, I can understand the motivation behind the Knee Defender. It’s bad enough with the limited legroom in coach without the person in front of you reducing your space even more. I’d never use the Knee Defender, however, because a more civilized approach is to communicate one’s discomfort to the reclining passenger in front of you, hoping thereby to evoke a sympathetic response. Also, life is too short.

Speaking as someone who doesn’t run an airline, I can also understand the motivation behind cramming as many passengers as possible into an airplane. There is efficiency (mostly $$$) at stake.

Nevertheless, if airlines are going to limit legroom, they need to limit how far back seats can recline. Otherwise they’re inviting conflict between their customers. Seats that can recline way back are an obsolete technology from a time when flying was one of those enjoyable experiences relatively few people ever had.

Of course, the airlines could simply rely on the common sense and common decency of their passengers. There are people who ask the person behind them if their reclined seat is causing a problem. There are other people who tell the person in front of them in a nice way that their reclined seat is too far back. People do these things.

But then there are other people who shouldn’t be allowed out in public. Many who responded to the Times article argued that they have a right to recline their seats as far back as they will go. If they’ve paid good money for a seat that can recline 30 degrees, they are damn well entitled to recline their seats 30 degrees, no matter what effect it has on the person sitting behind them. In effect, people (some of whom used their real names) made this claim: If an airline has given me the ability to do X, I have the right to do X.

Of course, most of us understand that “can” does not imply “should”. Airlines make it possible for passengers to throw water on other passengers, but passengers shouldn’t do that. Airlines also make it possible for their customers to lock restroom doors and occupy those rooms for hours at a time, but their customers shouldn’t do that either.

To be fair, the Times article these readers were responding to was a defense of the Knee Defender. So maybe they got carried away and went overboard when they wrote their unthinking responses. It’s clear, however, that although everyone may think they’re an expert on a topic like this, that isn’t really true.

The Future Gets a Little Closer

The British government has announced it will invest 60 million pounds to support the development of a “spaceplane”. This will be a spacecraft that can take off and land at an airport, just like a jet plane. But it will have the ability to escape the earth’s atmosphere, delivering passengers and 16 tons of cargo to space stations orbiting earth.

As planned, the spaceplane won’t need to carry lots of heavy fuel when it takes off, like today’s rockets have to do. It will use an extremely efficient engine that allows it to reach Mach-5 (five times the speed of sound) using oxygen from the earth’s atmosphere, and then use a small amount of on-board oxygen to reach Mach-22 in space. The technology has been proven in the lab. Now an actual spaceplane needs to be built and tested.

The article below suggests that the spaceplane technology might eventually be used to make regular air travel faster, allowing tourists, for example, to fly from England to Australia at an average speed of 2,500 miles per hour (i.e. fly 10,000 miles in just 4 hours). That would be 300 miles per hour faster than the fastest military aircraft, the SR-71 Blackbird, has ever flown (according to public records).

A futuristic passenger plane would have to accelerate and decelerate rather slowly, however. Otherwise your Aunt Sally and Uncle Bob would experience a g-force like an astronaut does.

It doesn’t exist yet (and isn’t expected to start flying until 2019), but it still looks really cool:

SkylonTakeOff

http://www.guardian.co.uk/science/across-the-universe/2013/jul/17/sabre-rocket-engine-reaction-skylon