Friday, July 31, 2009

Rising Tide SWAG

It's Rising Tide Time Again and we going have a great one there are lots of other posts about the panels and the Keynote Harry Shearer.

But I know the most important part is the Great T Shirt designed by Greg Peters. Hurry on over to the Rising Tide Web Site and Register and order your T shirt.

See you there!

Thursday, July 30, 2009

Presumed Prejudiced

I've been watching the circus surrounding the incident between Professor "Skip" Gates and a policeman. It has been a circus. So far as I can tell the only winner has been Blue Moon Beer.

They've gotten a ton of free publicity out of it and probably only donated a few cases of beer to the White House. Nobody seems the slightest bit mad at them.

Every time one of these dust-ups occurs I wonder what really happened. I don't suppose anyone will ever really know or care. Everyone seems to have retreated behind their own preconceptions. Facts hardly matter.

I wonder why everyone presumed the basis of the incident was racial? How can anyone know. As far as I can tell no racial slurs were used by the policeman and all of the radio recording seem calm and even in tone.

Recently one of my friends who tends bar at a very well known place frequented mostly by tourists was upset because a patron accused her of being racist. She didn't place the change in the patrons hand, which was somehow racist. She never places the change in my hand either. That notion seems a little off the wall. Don't most people in bars (unless it's very crowded) place the change on the bar, with the receipt. In some of the nicer bars they put the change in a nice vinyl American Express folder. This middle aged African American patron went off, my friend was both upset and angry at what she considered an unfair accusation.

Earlier this week I flipped on to WRBH, Radio for the Blind and Print Handicapped. They were reading something about the shootout between NOPD and The Black Panthers in the Desire Projects back in 1970. It was written pretty much from the Panther Perspective, complete with Maoist rhetoric. How much has changed since then?

I wrote about an incident She was involved in. I'm still not sure if it was racial or not.

I don't consider myself prejudiced but maybe some other people do. I do know I can be curt, abrupt and have been called an asshole. I like to think of myself as an equal opportunity asshole. I think everyone has a right to be an asshole at least sometimes. But it doesn't really matter if it's a right or not, virtually everybody is one sometimes anyway.

I wonder at the unerring ability of some people to look into the content of a someone's character and see whether the other person a racist or an asshole or a racist asshole on the basis of limited, if any interaction.

Sunday morning I typically listen to as many of the Sunday morning shows as I can. I especially like ABC's Sunday morning with George Stephanopoulos. They have the best, most articulate panelists for their round table. There are only two regulars I can't stand Sam Donaldson, who comes across as an over bearing bully and Arianna Huffington who seems to come each time with a 3 x5 index card with one answer for all questions (last week it was a public option). She seems to me about a smart as Veronica White. I do especially like the Louisiana Contingent Cokie Roberts and Donna Brazile.

In any event this Sunday l'affaire Gates came up. After suitable platitudes about Race in America. Donna Bazile described how here brothers were taught to act if confronted by police. They were told keep their heads down, not to argue and to do what they were told. That's pretty much what I was taught. I may have missed something subtle here.

The discussion started me thinking about my interactions with Police Officers.

I haven't had a lot of run-ins with police in my life but I have had a few, especially when I was younger. Once on a road trip in college with several of my buddies we were pulled over by 3 Mississippi Highway Patrol cars and held at the point of several shotguns on a dark road for a good long while (probably not as long as it seemed at the time). Seems they were looking for armed robbery suspects driving a similar car. I was very polite, after I started breathing again.

Another time I was confronted the by the NOPD at gun point during Mardi Gras. Seems they thought we were trying to break into our car. My friend who's car it was had dropped his keys trying to unlock it. There was a lot of yelling, screaming and hands against the wall kind of stuff.

More recently I've been pulled over for driving a red car.

Post Katrina I was followed into my driveway by a police man. I was sure relieved when he turned on the blue lights. I shook his hand and told him to keep up the good work. I thought I'd written about that incident and others living in the wasteland, but I couldn't find it. I reread nearly the entire first two years of this blog looking for it. I left out a lot of stuff.

I often wonder how many "racial" incidents are just another person being an asshole, not a racist. Now if the person is spouting racist language or otherwise being obvious (sheets swastikas etc) then you can skip it, the conclusion is pretty clear. I wonder if people should first consider that as Freud said sometimes and asshole is just an asshole.

In our political life here in New Orleans the charges of racism are frequent, vicious and often calculated to protect a favored few disadvantaged millionaires from scrutiny. These are offensive to many people of goodwill and dishonor the memory of those who struggled and died for racial progress. Worst of all they divide a community that desperately needs to be united.

In many ways we New Olreanians are like the Greeks and the Turks. Our food is the same, our music is the same, we drink the same things, we go to the same parades. People from elsewhere see the similarities and wonder why we can't get along. We seem to see only the differences.

I'm pretty sure a lot of people won't agree with my perspective, but then I'm an asshole.

Friday, July 17, 2009


Thanks to my friend Mark for making me remember this.

When I was a kid my grandparents lived in Melbourne Florida, just south of "The Cape".

Apollo 11 Launch

We would often watch the rocket launches from the beach. Once we watched a Saturn V take off from their back yard. You could clearly read the letters U S A on the side and see the tail of flame against a clear blue Florida sky. As is slowly rose straight up it gradually gained speed. We all silently stood and watched in awe. The house shook. We were 20 miles away.

It hard to believe it's been almost 40 years since I stayed up to watch fuzzy TV pictures of two guys in space suits jumping around.

Wednesday, July 15, 2009

Movie Trailers

One thing living in a FEMA trailer did was make me aware of travel trailers. Before I hardly ever noticed them anywhere. Now I seem them everywhere and all of the time. I even found one Saturday morning on TV.

Around my place Saturday morning is usually spent making breakfast, cleaning up, doing laundry and watching old movies in the background. I think it goes back to my childhood watching Roy Rodgers and Gene Aurtry on Saturday morning.

Usually I've seen the movies many times before, but recently I saw a movie I don't think I've ever seen or head of before Panic In the Year Zero.

It's a pretty tame drive-in movie feature of the time. It begins with a family starting off on a camping trip Mom, Dad, teenage Brother and Sister hauling a travel trailer.

Not long into the Journey there is a flash. Later they see an ominous mushroom cloud. The rest of the movie follows their efforts to survive as society breaks down.

The trailer is never really seen on the inside but it used to hide Mom and Sis, as well as store provisions. Along the way they encounter (and re-encounter) a hardware store owner, his wife, and a band of juvenile delinquents. The cast is pretty small. After setting up in a mountain cave, the hardware store owner finds the trailer and moves in. He then runs into Dad in woods, they plan to get together later. The delinquents attack the hardware store owner and loot the trailer. The family rescues another teenage girl from captivity. Sis is assaulted by the delinquents. They kill the bad guys. It has atomic war, juvenile delinquents, mild bondage, and moral equivocation, perfect.

Anyway it was a hoot and does feature a Kenskill trailer manufactured in California.

Wednesday, July 01, 2009

What is a Public Option?

I've been watching the Health Care debate with interest, but little understanding. Everyone seems to speak in a code only they understand.

As a small business we have provided our employees with 100% paid health insurance almost since the beginning of our firm. It isn't cheap and most employees don't appreciate it. Every year or so I have someone come and ask me to pay them in lieu of providing health insurance. There are a lot of reasons, some say they can buy insurance cheaper, some say they are covered by their spouses coverage, occasionally they say they would simply like more money. Unfortunately I can't do that. Because we are a small firm we can't get group coverage for only some of our employees, all must participate. I also believe in treating every employee equally so we provide the same benefits to everyone (including me).

It seems certain that the changes coming will upend medical coverage as we know it. Already the changes agreed to by the Republicans will cause a seismic shift. I'm not sure it is all good.

My understanding is the the insurance industry has already agreed it would support a universal mandate that includes "Community Rating". Rates would be set based on location and age, without regard to preexisting conditions. Already under The Health Insurance Portability and Accountability Act (HIPAA) group health plans and issuers may not exclude an individual’s preexisting medical condition from coverage for more than 12 months (18 months for late enrollees) after an individual’s enrollment date. Community Rating goes beyond that. Presumably groups would as still get a discount based on cost of administration and credit worthiness but individuals would also be able to buy insurance without regard to preexisting conditions. The rationale for the current situation is that some people would inevitably wait until they got sick to sign up for health insurance if coverage of preexisting conditions was not limited.

Many People seems to think a Public Option is necessary for universal coverage.
I question why a public option is necessary to achieve that end. I'd like someone to explain that to me, based on what the insurance industry has already agreed to.

It is possible to craft a system of universal coverage which does not require a public program. Under the system outlined above anyone would be able to get coverage at the same rate as anyone else in the age and location, without any exclusion for pre-existing conditions. The use of Community Rating would insure that pricing was not discriminatory. You should in fact be able to look up the cost on a web site and compare plans since no health questions would be asked or probably even allowed. Your age, zip code and possibly gender should be enough,

If on the other hand you mean by a "public option" (as I suspect some do), a taxpayer funded system which has no direct cost to the individual, then you can't. That is certainly the goal of some people. It is more that providing coverage.

In fact there are at least several current government systems which might be opened on a premium basis to those who cannot otherwise obtain required coverage.
  • Medicare, which provides for some co-insurance.
  • Medicaid which is "complete" coverage.
  • Public Employee Insurance (at many levels, usually provided by private insurers).
  • Veterans Administration
  • Tri-Care, the military dependent and retired military system.
Any or all of these can be opened to individuals or companies to purchase coverage.

I just looked up some figures Medicaid in Louisiana. In 2008 it covered just over 1,000,000 people out of a population of 4,400,000, that surprised me. The average cost per person was $6,760.00/per person or $563.00/month. That's about what my monthly premium is.

I tried looking up Tri-Care but couldn't find enough information. It's a $12 billion program but I couldn't find how many are actually covered. There are 9.2 million eligible. I know, for example, my brother (retired Air Force) and his wife are eligible but not enrolled because he has insurance through his job. My mother-in-law (My father-in-law was retired Navy) is covered but is also under Medicare.

Medicare covers approximately 44,831,390 people, as a result only around 1% of all elderly people don't have insurance. Medicare also $325 billion or $ 7,249/year per person or $604/month.

If what you are looking is a subsidy for those who "can't afford" insurance, that is very different from "a government option", as I understand it. Taxpayers already pay for almost a quarter of the people in Louisiana under Medicare and cover many more as government employees and retirees. I suspect that many who qualify (especially young people ) aren't enrolled.

One option could be to lower the qualifications for Medicaid or subsidize private insurance. It is already possible for some people to "buy in" Medicaid for a "premium" of $35/month. One option I thought of is to coordinate Government Employee coverage and Medicaid, enroll everyone else not on a private plan in it then collect a sliding scale of premium as part of payroll tax for those working. Extending free coverage to people on unemployment, although that would probably at least double unemployment taxes. The question here is how is going to be paid for.

Assuming the 44 million uninsured were added to Medicaid the cost would be in the range of $297,440,000,000/year based on the cost of the Louisiana program. That's $300 Billion Dollars, of course the uninsured tend to be relatively young and therefore healthy, some can afford to pay for coverage and some (like illegal aliens) will still not be covered.

Many people on Medicare who have a low income also qualify for Medicaid. But, Medicaid is also broken because some poor people may chose not to work (or work off the books, which is very common in some parts of this community) because they can't afford to lose coverage.

One of the chief arguments made by backers of the public option is that is will be cheaper, but it doesn't seem either of the two large government programs which cover around 90 million Americans are particularly cheap. Some studies advocating the public option make various comparisons but all basically fail to consider the coercive nature of the Medicare and Medicaid programs and the incremental cost of adding patients to an existing system. If government programs dominate those costs could shift dramatically.

I don't really understand all of the ins and out of it but government pricing of health reimbursement works something like this. The Government requires providers set rates based on covering the entire cost of treatment. It then requires providers to actually charge that to anyone who doesn't negotiate a better deal (i.e. people without private insurance AKA the uninsured). If a provider is insufficiently aggressive in pursuing those collections then they can lose government funds. If on the other had a provider serves a sufficiently large low income population they can qualify to be paid more money. That seems to me an implicit recognition of the inherent cross subsidy.

Those who say the Government could "use market clout" to "negotiate" lower rates are ignoring the actual method the government uses for reimbursements today. They set a rate and most providers (especially small ones) either take it or leave it. Since government patients represent a little more than 30% of all insured, that's a pretty big piece to pass on. So far the government has been pretty good at gauging how much they can force in cross subsidies, preventing mass defections. They are banking that the lower incremental cost of serving additional patients will encourage providers to honor the discount. Except for very large institutional providers no one sits across the table from a bureaucrat and discusses pricing. Even if they do the Government holds all of the cards.

Finally I wonder how this will impact employer coverage. I believe many companies will look at the "Public System" and dump private insurance. Insurance is a pain in the ass and simply paying larger salaries will likely attract employees, especially in middle income jobs. I'm not suggesting poverty level or minimum wage jobs but normal middle class jobs. I am talking about people making 30, 40 or 50 thousand dollars a year. The mean annual wage for people according to the BLS is just over $42,000. Many people at that income level could be eligible for health insurance subsidies, especially if they have families. This could be a windfall to both business and families, but it will be expensive and could make private insurance less available.

One of the reasons we maintain group coverage is to ensure that we have coverage. If I could buy individual insurance competitively, I could consider losing the headache of group coverage.

There is little doubt the health care system we have needs reform. But I'm apprehensive about the unintended consequences that will accompany any reform.

I do have one suggestion. If a public option is to be enacted, require all federal employees and officials (including Congress and the President) to be part of it. I'm pretty sure that would have a massive effect on the quality of the program.