Best For America?

I received an email that was sent to her friends list by a good friend of mine who is very concerned about what she insists on calling “Obamacare.” She had a list of questions about the Affordable Care Act (ACT) ending with the question: “Is all this going to work out and be the best for America??????”  I dare to say her concerns reflect those of a great many other Americans an alarming number of whom seem to have pushed the panic button and are convinced we are on the verge of Armageddon.

Now I don’t claim to be an expert on the Affordable Care Act. By no means. But I can read and I have checked a number of items. In spite of the glitches that have shown up in the early days — inevitable some would say — there are a number of questions that have yet to be answered. But, on balance, it would seem that the Act is a good idea though it has a great many rough edges yet to be ironed out. We must remember that this country is one of the very few “developed” nations with inadequate health care. Indeed, according to a recent story on PBS, health care costs in the United States are the highest, per person, in the world. And, despite the fact that for those who can afford it the care is outstanding, it is not clear that as a nation we are getting the most for our money. As the story relates, in this country

  • There are fewer physicians per person than in most other OECD countries. In 2010, for instance, the U.S. had 2.4 practicing physicians per 1,000 people — well below below the OECD average of 3.1.
  • The number of hospital beds in the U.S. was 2.6 per 1,000 population in 2009, lower than the OECD average of 3.4 beds.
  • Life expectancy at birth increased by almost nine years between 1960 and 2010, but that’s less than the increase of over 15 years in Japan and over 11 years on average in OECD countries. The average American now lives 78.7 years in 2010, more than one year below the average of 79.8 years.

The ACT is designed to lower costs and extend health care to most, if not all, of those who could not otherwise afford it. This, it seems to me, is a lofty idea and the overriding principle that should always be kept in mind when weighing costs and benefits. In the end, what matters is what kind of country we want to live in: one that worries more about the businesses that might suffer because of the enforced costs of extending health care to employees or one that cares about its citizens and their health regardless of the monetary costs.

We know, for example, that a great many young people who would otherwise have no health insurance can now be included in their parents’ insurance — until they are 26 years of age. My understanding is that thousands of young people are now covered who were not covered previously. And given the growing number of young people who are unable to find employment, this is an unmitigated blessing. Further, Medicade coverage is extended under this plan, thereby allowing a great many of the poor and elderly to receive care that they were not able to receive previously. In fact, the number of uninsured under this plan will be reduced by 32 million, a fact that cannot be ignored.

The number of states that have opted out of their commitment to the ACT has reduced estimates of the eventual financial benefits to the nation from $200 billion to $84 billion. Still, every little bit helps when it comes to the budget deficit. Despite the benefits in the form of a reduction to the national debt, however, there will be costs to small businesses — which concern my friend — and these must be factored in, since the Act requires that businesses employing more than 50 people must provide them with health care. This has resulted in all sorts of shenanigans by companies — cutting the hours of their employees to reduce the number of full-time employees, refusing to employ more than 49 full-time people, and the like.  The fact that small businesses that operate on a low profit margin will be required to assist their employees in paying for their health care will, in fact, place a burden on those businesses and in the end force some of them to close down, and it does appear to be the weakest link in the Affordable Care Act.  But, given the fact that an estimated 200,000 small businesses closed down during the recent recession, it must be admitted that small businesses are a risk and always have been and one suspects that with careful planning and intelligent cost-cutting fewer will go under as a direct result of the ACT than have been predicted by the knee-jerkers among us. In any event, one must wonder why a federal mandate is required to insist that employers take care of their employees’ health needs, which many regard as one of our basic human rights. In any event, the plan has generated more heat than light among the fearful due to its complexities.

And there’s the rub. My friend’s email stems from her fear that this plan will bring America to its collective knees. She starts with FDR’s famous quote that “the only thing we have to fear is fear itself,” which is a good thing to keep in mind. Any plan this encompassing that involves inevitable glitches and also involves controversial elements such as mandatory contraception will raise the hackles of the nervous element among us — and that element is growing as those who have political axes to grind have learned how easy it is to control the population through fear — of terrorists, or increased taxation, or sex education in the schools. But as I said above, it comes down to what sort of country we want to call our own: one that cares about the health of its citizens or one that cares more about “the bottom line.”


Long Life and Education

What a strange people we are. We apparently need reasons to pursue education — as though training the mind to be more perceptive, critical, and insightful needs to be justified. We have for years tried to send our kids off to school with the promise that getting an education will guarantee them a good job and more income in their lifetimes. Recently, however, that line of reasoning has come a cropper. It appears that the jobs aren’t there and we now find PhD’s working as greeters at Wal-Mart. Whatever!

But lately there’s a new reason to get an education. We are told that educated people live longer, as an interesting Yahoo News story reveals:

If you want to know how long you will live, you might stop fretting over genetics and family history and instead look at your educational achievements. Education is certainly not the only variable associated with longer lives, but it may be the most powerful.

If it is true this is good news indeed for those who have stuck it out in school, especially since they may find themselves financially strapped. However, there are a couple of problems with this story and the reasoning behind the conclusions drawn by the author.

To begin with, it smacks of “false cause,” the fallacy that reasons from a coincidence of events to a causal relationship: it has rained every time I put out the trash, therefore putting out the trash must be causing it to rain. Yeah, right! Believe it or not, people actually buy into this line of reasoning. In the case of length of time in school (which we wrongly equate with being educated) and length of life, there could be a great many other factors that enter in that lead to a longer life — perhaps, as suggested, the kinds of lifestyle so-called educated people live. Perhaps they know enough to stay away from the kinds of foods that cause cancer and heart attacks. But whatever we factor in, the leap from A to Z is huge. Education, in itself, cannot possibly lead to a longer life — it may not even be the most “powerful” factor in the equation.

But more important is the consideration I raised at the outset of this blog: assuming that this is suggested as a reason to pursue an education, why do we need such a reason in the first place? Given that education properly conceived means the ability to use one’s mind, one would hope that everyone in this country, if not the world, would want as much as possible. But we do confuse schooling with education when there are a great many people who are well schooled who are horribly mis-educated — they may be well-trained to do a particular thing, but they cannot use their minds and are captive of every intellectual fad that passes their way. And there and a great many who never went to school and who are positively brilliant — like Eric Hoffer or Abraham Lincoln. What these people did was read copiously and explore the world around them: they kept their minds open and examined every passing notion to see if it was worth holding on to. Education should help us achieve these goals, but it may not.

In a Republic like ours it is essential that all citizens acquire the capacity to use their minds, to know whether or not they are being led astray — keep an open mind, stay on top of what is going on around them, and think their way through all the nonsense to see if there is a kernel of substance at the center. Education properly pursued will assuredly lead to this end; but it is not the only way to get there. And even when schools do their job and lead us down the path to an education, it does not stop there. Education properly conceived, lasts a lifetime. If education also leads to a longer life or a better job, so be it, but neither of those should be the goals.

Those Annoying Regulations

I wouldn’t be a politician for all the tea in China; they can’t win for losing. A case in point is the matter of regulations. Obama is criticized by the conservatives for being “regulation-happy” when according to the Office of Information and Regulatory Affairs he has been responsible for fewer regulations than any president since 1992 — a fact which brings criticism from the political left which thinks there should be more, not fewer, regulations.

Even more interesting is the fact that in an election year large numbers of regulations that have been passed simply sit somewhere in an office in Washington “wrapped in red tape” “under review” waiting for “experts” to move them along. They are in limbo and aren’t part of the warp and woof of our political world. They have been passed but haven’t yet been passed, if you catch my drift. This year, for example, a number of so-called “expensive” regulations — those that might reduce the profits of the large corporations and further weaken the economy (along with some that are regarded as “controversial”) simply gather dust waiting further review, even though they have been passed and approved. These regulations, according to USA Today (July 27, 2012), include such things as “four rules required under last-year’s updated food-safety law.. .[including] improved controls at food processing facilities and stricter standards on imported foods.” In addition, waiting activation are regulations to reduce exposure to silica dust, regulations to require rear-view cameras in automobiles, and the like. Some regulations would appear to be essential to our health while others seem a bit esoteric and even pointless. But they have not been activated because this is an election year and someone might get upset — someone with a fat check book. This tells us who carries weight in Washington, in case we were in doubt.

Liberals want more and tougher regulations and see the important ones gathering dust and complain loudly. But they carry little political clout so their collective voices are not heard. The corporations do not want the “expensive” regulations passed — such as the regulation to reduce silica dust — because they will cut into profits and therefore hurt the economy. This is the familiar argument that regulations (the result of an overgrown government) cut into profits resulting in cut-backs and “downsizing” (not to mention outsourcing) and the economy is further crippled. Here we have the old bifurcation fallacy: either jobs or the economy. I have discussed this error here and here. Despite the fact that it is a flawed argument, it is heard, of course. This is most interesting: politicians have determined that the economy is more important than health and human welfare. And apparently we agree with them because we keep electing the fools.

Until the regulations have been fully “reviewed” and approved they cannot be put into effect even though passed by the Congress. And since the mid-term elections the current  Administration has been reluctant to pass along many regulations and the best guess is that it will be quite a while — at least until after the elections — before the regulations are put into effect, especially the “expensive” regulations. And this despite the fact that regulations that are pending could help improve our quality of life and reduce health risks, such as heart and respiratory problems that result from poor air quality.

We need to reconsider what we mean by the word “expensive.” Some things may cost money, but even when it is a great deal of money it is cheaper than poor health and early death from causes that could be eliminated or reduced through government regulations — especially those that have been passed but are “pending” until further review — i.e., until it becomes politically expedient to move them along.