Wednesday, March 29, 2017

HR676, Health insurance, broadband and the public option

There is a story floating around that Bernie Sanders will introduce a single payer plan in Congress. That story is being pushed by Politico, but there are scant details and plenty of other distractions in the same article. It is a wonder why Sanders does not just put his weight behind HR 676, the Improved and Expanded Medicare for All Act. Yes, it's still in the House, and he's in the Senate, but he's one of the most popular politicians in the country. He could bring HR 676 to national attention and gather support for the same. But he has not done so, at least not yet.

Health Over Profits has a story the one that seems to explain why Sanders has not touched HR 676. From the article:
Right before our eyes, we are seeing the transformation of single payer Bernie Sanders into public option Howard Dean.
During the 2016 Presidential campaign, Sanders took off like a rocket, fueled by the promise of a single payer, Medicare for All single payer system.
His single payer plan paralleled HR 676, the single payer bill in the House of Representatives that now has 72 co-sponsors.
HR 676 is the gold standard of single payer bills.
It would deliver one public payer, no deductibles, no co-pays, lower costs, everyone in, nobody out, no more medical bankruptcies, no more deaths from lack of health insurance and free choice of doctors and hospitals.
That was the promise of Bernie Sanders during the 2016 campaign.
But since then, Bernie Sanders has endorsed Hillary Clinton for President.
Then become part of Senator Chuck Schumer’s Senate Democratic leadership.
And this weekend, Sanders has been telling people he will introduce health care reform legislation in the Senate within a couple of weeks.
But it’s not going to be a companion bill to HR 676.
Health Over Profits has found a logical progression in the actions and statements of Bernie Sanders, an apparent drift away from a part of what made him so popular in the election last year to the position that he has taken now. There is no obvious reason for him not to endorse HR 676. Unless he has become a captured regulator.

Setting his motivations for his changing posture aside, that means it's up to us to encourage him, even implore him to co-sponsor and promote HR 676 (or a Senate bill identical to it). We should keep our eyes on the prize as a public option might only confuse and distract voters and consumers. Yes, a public option could help, but we already have that in the form of Medicare. It's just the Medicare is restricted to people over 65. The rest of us are left with private plans that treat health as a profit center commodity, not a public good.

Public health is not a commodity because it varies with the person and a person's behavior. Consider how we treat our cars. A car is a commodity. My health is not.

I have a car that has a little light on the dashboard that tells me when to take it in for maintenance. I also have a sticker on my window reminding when to take it in, by mileage or date, whichever comes first. The car has sensors that measure the health of the oil in the engine. When the sensors determine that the oil life is 15% or less, I see a light indicating maintenance required.

Changing the oil in a car is the single most important maintenance to be performed for the engine. Take care of the oil, and the rest of the engine stays clean. Pass on changing the oil and every part that requires lubrication begins to see contact with other parts. Bearings see contact with journals, pistons see contact with cylinder walls and things begin to break down from there. Keeping the oil changed when needed is the most important task for maintaining engine life, and that's the path to 250,000 miles on an engine.

People may not be machines, but with regular maintenance, other costs go down. Catastrophic costs are minimized. Regular doctor visits allow us to keep bigger problems in check and increase awareness about the health of our own bodies. Regular doctor visits also allow us to develop historical records (just like taking our car to the same shop over the life of the car), to see our progress. A body in poor health also has an effect on the mind. Allow a body to fall into disrepair and we may find we make poor decisions based on poor judgement based on a brain that is not operating in the best environment. Universal health care makes regular maintenance a breeze.

Under current conditions, people are often afraid of going to the doctor or getting that health screen because they're afraid of a catastrophic cost. They're afraid of losing everything else to health care. Who profits from this system? The shareholders of our largest insurance companies and health care providers. Health insurance companies and health maintenance organizations also have far greater influence on public policy than the average person. They will fight tooth and nail to keep the profits flowing. And thanks to decisions like Citizens United, they will use their profits to influence Congress away from universal health care. To those who profit from the system and use their money to keep it the same I say, "I want to buy your products, not your politics".

There are a few problems that incumbent interests have with universal health care. The first is accountability. A single government agency subject to political oversight, collecting data on money spent and outcomes, will make it much easier to keep insurers and hospitals accountable. Empirical evidence will show us what works and what doesn't.

The second issue is negotiation. While hospitals, medical device makers and drug companies can negotiate differently with different insurers, different insurers may not be privy to the negotiations running in parallel. In other words, one insurer can never know for sure if another company got a better deal on a product or service. With a single payer, universal health care system, there is no "hide the ball" game to play between the insurer and the provider. Attempts to negotiate will be based on evidence of performance for all Americans, all hospitals, all practices.

There will still be private practice of medicine, but in HR 676, there is one payer, one set of standard forms to complete, and 535 necks to grab in November if things are not done right.

I also notice that doctors are not exactly having a smooth ride, either. Check out this article from Dr. Cathleen London of Milbridge, Maine. She outlines the game of the insurance companies, always moving the poles, always hiding the ball, denying claims without cause and stiffing her on payments. This is a doctor on the front lines, who can see what is happening and says, without equivocation, the games insurance companies play have little if anything to do with Obamacare.

In other words, when people claim that the games insurance companies play are a result of distortions in the market as a result of Obamacare, they are exaggerating at best and lying at worst. After describing a bureaucratic nightmare with an insurance company as a health care provider, she wrote this:

"This is not the fault of Obamacare, which stopped the most egregious problems with insurance companies. Remember lifetime caps? Remember denials for pre-existing conditions? Remember the retroactive cancellation of insurance policies? Returning to that is not an option."

There are conservatives who would have us believe in the virtues and efficiency of private enterprise. But Dr. London's experience as documented in her article shows anything but that. The myth of the efficiency of private enterprise seems to stop at the border of the domain of health care. The Huffington Post noticed a curious thing about American health insurance companies. On average, they spend about 21% of your premium dollars on overhead and net profit. By overhead, if we're talking about CEO salaries, that might explain a lot. HuffPo compares that lofty overhead figure to Medicare at 1.5%. No health insurance CEO in their right mind would accept those numbers. But no health care CEO ever wants to see their insurance run as a tightly regulated utility.

Wait. I thought we were talking about health care, right? We are. But as the title of this article implies, there is another domain where the public sector kicks royal ass on the private sector: broadband. I know, I know. This is a huge segue, so bear with me.

Community Networks, a part of the Institute for Local Self Reliance, has documented more than 450 jurisdictions (towns, cities and counties) that have built their own broadband networks to compete directly with incumbent internet access providers, purely out of frustration with the big cable companies and telcos. The vast majority of those community networks are a success by any measure. Check out the story of Sandy, Oregon  (video), where the city figured out they could do what the citizens wanted for a fraction of the cost that incumbent providers were offering. For $60 a month, you can get gigabit service up and down, right there.

See? The public sector can actually offer better service than the private sector. It's just not that easy to find in the news because mainstream media has another narrative they'd like you to believe. Who buys advertising with mainstream media? Very large companies like Aetna, United Health Care and Blue Cross Blue Shield.

The legislation for universal health care has already been written. It just needs a lot of exposure to get Congress on board. I think we can make the pitch to them like this:

"I see that you're in a Skinner Box made by the biggest health insurance companies in the country. You vote their way, you get their money. I bet that makes it really hard for you to listen to constituents like me who actually live in your district. Vote for HR 676, get it on the President's desk, and you can spend less time in that Skinner Box if he signs it, because you won't have to call the health insurance companies to finance your next campaign. You could just rely upon people like me. How about that?"

If there was ever a time to call your representatives in Congress, now would be a good time to tell them about your fervent support for HR 676, just like I did.

Saturday, March 25, 2017

Political theater and distractions from HR 676, The Expanded and Improved Medicare For All Act

Once again, I see that the anti-Trump memes are becoming more and more severe, more radical and insulting. Now I'm not a Trump supporter by any measure, and I can understand the catharsis of making these memes. But I fail to see how they translate into public policy decisions that support progressive objectives.

What I do see is that in the days and weeks leading up to a crucial vote on the TrumpCare/RyanCare/WeDon'tCare bill? A lot of political theater about health care, including counting votes, lots of meetings, press conferences and overtures for the votes. Many of us are experiencing considerable angst regarding health care. So it is with a sigh relief that I see the GOP delaying the vote because they can't make the Democrats on the left or the selfish Freedom Caucus on the right, happy.

I could feel that angst myself. But instead of creating a new meme about Trump, I called the offices of both of my Senators and my Congressman, and let them know of my strenuous opposition to the GOP health care plan, and then I urged them to support and vote for HR 676, the Medicare for All bill currently circulating in Congress (they're all Republican, but at least I said something).

In case you're not aware of HR 676, this is the one that if passed into law, prohibits private insurers from offering health insurance that would compete with expanded Medicare, covers everything from preventive care, to hearing aids, eyeglasses and prescription drugs, and it's all financed with simple taxes that are easily calculated. If you want a tummy tuck or nose job, you're out of luck, but private insurance may be there for you if need be.

Under HR 676 preventive and catastrophic care would be covered. Nobody goes bankrupt. Everyone pays in, no one gets out. The risk is spread across the entire population. If passed as it is, it will be nearly impossible for business to externalize the cost of health care.

The entire point of this exercise is the struggle over who pays for it. Conservatives in Congress seem to be of the belief that business must be able to externalize the cost of health care onto the worker and consumer. Progressives disagree. Progressives, and I mean true progressives, hold that everyone must pay so that the costs and the risks are spread as widely as possible. This reduces the costs for everyone and everyone is covered.

More to the point, progressives understand that business seeks profits and one way to increase profits is to shift the cost of health care onto someone else. A universal health care system financed by taxes on all forms of income is the best way to make it possible. By imposing a small tax on all forms of income, the costs are spread thin enough that everyone can afford to pay into it.

Part of the reason why health care costs have been so high is that the health care industry, including the insurance industry figured out they could buy the influence they needed to avoid accountability. Let me give you an example of what I mean. Try estimating the cost of any procedure before you actually do it. I've done this. I needed to get something done, a surgery, and I called the hospital and the insurance numerous times and could not get a firm answer on my out of pocket costs for the surgery. It was not until the work was done and paperwork was processed that I was able to get answer. What kind of market is that? It's not a free market, it's an obscured market. This is a result of public policy decisions, not the free market, whatever that might be.

In a transparent market, we know what the costs are before we go in. We can do comparison shopping before we go in. The experience I had tells me that the costs are obscured by design and for a reason: to keep the patient in the dark. If the patient knew how much it would truly cost, including out of pocket expenses, the surgery would not get done. Worse, it allows the health care industry to land a debt on a patient. Interest on debts just means more money for the health care industry.

A universal health care system means that when any player in the system attempts to shift the cost burden upon someone else, everyone else notices. Properly designed, the cost of health care cannot be shifted upon someone else because everyone pays into it. All of the data goes into one system, generating statistics to show who is playing fair and who is not. A universal health care system will make it hard for the Epipens and Sovaldis to withstand competition, too. In a universal health care system, the government can compare pricing among products and services in a way that insurers and ordinary people cannot. They can also compare outcomes and use empirical evidence to determine the most effective treatment for any ailment.

The primary argument missing from the health care debate is that not everyone has an equal opportunity for access. To begin with, not everyone starts with the same opportunities when they enter the health care system. Nobody chooses to have an accident, an addiction, a cancer or an occupational hazard. Nobody chooses to bath in polluted water, risk a natural disaster, or eat food that is poisoned by insecticides. No one has the money to escape all risks, its simply not possible. Insurance was invented to spread the risks.

We are all doing the best we can. The person I save or help through a socialized health care system may be the one to help me someday. But it only works if we all pay in.

Yes, a universal health care system is a lot of power to give to a government, but European governments have done well with socialized medicine. So has Japan. Every major industrialized country provides health care as a right, except us, so we know it can be done. There is no reason we cannot do it, except for a lack of political will. Who lacks the political will do make this happen? The people with the most influence on government: the top 1%.

The best shot we have at universal health care is HR 676. HR 676 solves a problem created by public policy decisions made over the last 30-40 years. Who has the most influence over public policy at the national level (and probably the state level, too)? The wealthiest individuals and companies in the country. We know this because the empirical evidence proves it.

"Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens" is a study that proves without a doubt that the top 1% and the wealthiest corporations and organized business interests have the most sway with Congress. To put it bluntly, big money rules Congress. Where does big money come from? Big businesses and the people who run them. Some people call them "oligarchs".

The goal then is to lay the problem at the feet of the oligarchs and demand universal health care as proposed by HR 676 (or something like it) as a solution, and no less. Let the oligarchs explain why we should not have universal health care. Let the oligarchs justify why people should go bankrupt for health care. Let the oligarchs justify why people should die for lack of money for health care.

Respondeat superior, or, "let the master answer".

Tuesday, March 21, 2017

Fate, impunity and altruism

It is pretended by some that we can destroy without consequence, that we can give without consequence and that we can separate our own fate from that of another, whether we do good or bad. This post is written as a warning, a sort of guide, and an offering of hope that if mankind can make a final and ultimate decision to do no harm, perhaps then, there is a chance for the survival of our species.

There are some who might say that there is no such thing as pure altruism. Here is the Merriam-Webster definition:
Definition of altruism
  1. unselfish regard for or devotion to the welfare of others charitable acts motivated purely by altruism
  1. behavior by an animal that is not beneficial to or may be harmful to itself but that benefits others of its species
I happen to believe that there is no such thing as true altruism, and that it is impossible to do a good deed for another with zero reward. In this one and only respect, I actually agree with Ayn Rand who offers the following analysis:
What is the moral code of altruism? The basic principle of altruism is that man has no right to exist for his own sake, that service to others is the only justification of his existence, and that self-sacrifice is his highest moral duty, virtue and value.
Do not confuse altruism with kindness, good will or respect for the rights of others. These are not primaries, but consequences, which, in fact, altruism makes impossible. The irreducible primary of altruism, the basic absolute, is self-sacrifice—which means; self-immolation, self-abnegation, self-denial, self-destruction—which means: the self as a standard of evil, the selfless as a standard of the good.
Note for the record, I'm not a libertarian or even an Ayn Rand fan. I'm simply offering her viewpoint here for analysis. What Rand misses here is that humans are built from the ground up for cooperation for their mutual survival. Cooperation is not a choice, it is a requirement for survival. All animals are built this way, but humans have taken the concept to a level that cannot be conceived by other animals due to the size of their brains relative to any other species (with perhaps exception to certain cetaceous mammals like dolphins and whales).

In the first paragraph, Rand says we're all free agents living in a bag of skin, and that service to others is not required for survival. In another, she recognizes that doing something good or nice for another being has inescapable consequences. Rand seems to have suffered from cognitive dissonance in the sense that she cannot reconcile human beings by their very design and their environment, but urges us to believe that we are indeed free agents in a bag of skin capable of acting without consequence from other humans.

Impunity is the antithesis of altruism. Impunity assumes action against others without consequence. Merriam-Webster, again:
Definition of impunity:  exemption or freedom from punishment, harm, or loss laws were flouted with impunity
Impunity assumes that harms done to another being can be committed without consequence. But as noted above, just as the consequences of good deeds are inescapable, so too are the consequences of a bad deed. For this discussion, we can find a continuum of behavior between altruism and impunity. Both terms have something in common: expressions of altruism and impunity can often be seen as attempts to do something without consequence to oneself.

Humans are motivated to do good for the feelings that come from doing good. We can feel it in our chest and gut. We sort of glow for a day after doing a really good deed. An anonymous good dead, an act of altruism, is often performed without witnessing the the receipt or discovery of such a gift. We leave a gift at someone's door, or we send something nice in the mail anonymously, or we donate to a charity without revealing our identity. No matter how hard we try to separate ourselves from the consequences of a good deed, there are still consequences.

In the same vein, when humans attempt to do harm to another, from slavery to murder, to genocide, there are consequences. Even acts of racial discrimination, collusion, frauds and other abuses, have long term consequences that at the minimum are difficult to calculate and are rarely foreseen by the abuser, yet they are there and they can persist for years if not decades later. And with every act carried out with impunity, the body is shot with adrenaline and other hormones, making ready for fight or flight. Every act of harm done to another takes away resources that could be used for the betterment of ourselves or another. That is the primary consequence abusers fail to contemplate in the heat of the moment.

Abusers who believe they can act with impunity believe that there are no consequences to their actions. But there are. Newton said that for every action, there is a reaction. This is every bit as true in society as it is in physics. It is true in the game of billiards just as it was true in the events leading up to the French Revolution.

In both cases of altruism and impunity, we see actors seeking to act while attempting to escape the consequences of their actions. It is simply not possible to act without consequence. We are inextricably tied to the consequences of our actions, no matter the reason or action.

I am using this line of thinking to understand what is unfolding before us, in an enormous power struggle between the wealthy and the poor, between different faiths and those with no faith at all. This struggle has always existed for the history of human civilization. Against this backdrop of a continuum of altruism and impunity, I see the actions of Congress, and their wealthy benefactors, as a strenuous effort to separate their fate from the people they claim to represent. To a certain degree it may seem they are or even have been successful. But as I will show below, our fates are tied and no amount of effort will untie them.

The effects of global warming, climate change, or whatever you want to call it, are real. They are worldwide and affect everyone on this planet. It is now clear that human inputs of carbon dioxide into the atmosphere play a role in the warming of Earth. Spring has been coming earlier and winter is coming later at places closer to the poles. The equatorial regions are indeed warming up and we are seeing new record temperatures across the world.

Government responses to global warming can be seen as the greatest political blunder in history. We have allowed climate change at our own hand due to the wishes of very wealthy interests to continue to profit from their efforts to extract and sell energy based on carbon. Here in the United States, we know for a fact that the average person has zero influence on public policy at the national level. This condition is a result of public policy choices made by people who already have power and seek yet more power.

The illusion is this: with power comes the ability to separate one's fate from others. Yet everyone will be affected by a warming Earth. There is no escaping that consequence.

Fanatical Christians, Jews and Muslims may believe that they can act with impunity because they believe they can ask forgiveness for their sins and be absolved, but that still doesn't separate their fate from that of others, or even of others they may have injured. Atheists seem to understand this concept better because they do not seek immortality. They have compassion because they believe that this is it, their one shot at a life and that their fate is tied to others, that they cannot separate their actions from their consequences. Buddhists at least understand that we are all connected.

Every drone strike is an attempt to separate the fate of one group from another. A drone strike is a unique example of an attempt to split fates since the operator of a drone is sitting safely and comfortably in a military station while the drone is exposed to harm, and armed to harm another. Yet every drone strike is destructive and not only does it lead to the destruction of the target, it leads to the destruction of the abuser, in this case, the United States for every drone strike gives impetus to at least one more terrorist.

In a similar vein, the people who created Social Security, Medicare and other social safety net programs understood that our fates are irrevocably intertwined. While conservatives bleat that "it's my money", they have little to say when "my money" is being used for destructive purposes, like a drone strike, or worse, a world war. Social safety net programs were created as an acknowledgement of not only the destructive forces of capitalism, but also the creative forces of the same. Visionaries like Henry Wallace, John F. Kennedy and Franklin Roosevelt understood these opposing forces and also understood that men who promoted and exhibited destructive behavior could not easily be convinced of the damage they were doing to all Americans.

Another and more subtle example is the business tax break. States and cities all over the country, in an effort to prop up their ailing economies, offer tax breaks to big businesses in the hopes of creating more jobs at home. Such tax breaks are usually geared towards building upscale housing for the wealthy or tax breaks for large businesses to "come hither". Consultants who earn enormous fees for doing essentially nothing, almost always suggest a handout to the private sector. Such handouts are only enjoyed by the upper classes and yet few people in the working classes are even aware of this intervention by the government in the supposedly "free" market extolled in conservative rhetoric.

It would seem ironic then, how few cities (and states) are willing to consider offering a "community broadband" service, public infrastructure that can be enjoyed at a reasonable cost by everyone. As our economy sours in anticipation of another wave of "privatization", a nice word for transferring public monopolies into private hands, little is said in the news of the benefits of community broadband, but a new stadium subsidized at public expense is always worthy of celebration. Once again, we see in a subtle way, how the upper classes try to separate their fates from "the unwashed masses".

In his book Hegemony or Survival, Noam Chomsky took notice of work done by biologist, Ernst Mayr with regards to the prospects for finding intelligent life beyond Earth. Mayr suggested that intelligence may not be favored by natural selection, noted that the average life expectancy of a species is about 100,000 years, and that humans are pretty close to the end of their 100,000 years right about now. We could be at a turning point larger than any of us know right now, and all of us may at last realize that our fates are still irrevocably tied together.

As an intelligent species, we have a choice between acts of destruction and acts of creation. We have a choice between acts of exclusion or inclusion. Whatever we choose to do, if our species which we like to call "homo sapiens" is going to survive any longer, we must recognize that whatever we do will affect ourselves as well as another. We must take heed of the inescapable reality that when we hurt another that we hurt ourselves, and our prospects as a species for survival, and that when we do good to another, we improve ourselves as well as our prospects for survival. This concept is agnostic as to matters of faith and is supported by all of the science we know now. We ignore it at our own peril, and acknowledge it as a requirement for survival.

Tuesday, March 14, 2017

Hedging on a transition

For the past few weeks, I've been working against competing demands for my blogging time. Besides the normal demands like work, family and a really cold basement where my computer happens to rest, something else has come to the fore: Steemit.

If you follow me on Google+, Facebook and Twitter, you may have noticed an occasional post regarding my efforts at Steemit. I'm just learning about it and I find it a fascinating venture. Steemit is yet another blogging platform but with one big difference. It pays to write on Steemit. From blogging to comments, to following and being followed, Steemit is an attempt to capture the value of social media interaction on a blogging platform and return at least some of it to the users.

Here is where it gets interesting. Every interaction is captured in a distributed transaction record called a blockchain. A blockchain is a database with encryption that is used to verify each transaction and store it so that every transaction can be verified against another. It is distributed across many peer computers for redundancy, security and speed. Computational effort generates value in the form of Steem, a cryptocurrency very much like Bitcoin.

I've been working out the logistics and am close to the point of letting Blogger go for awhile to give me time to try this out full time, that is, for all the time that I have available to blog, I will post there. I'll keep my day job, but when I'm blogging, I'll be doing it there, on Steemit. I want to see what a full effort there can do.

Steemit is still in beta, that is, they're still testing it. Few people really know that it exists, but it's there and so far, I like what I see. I will miss the integration with Google+ to be sure, but I won't miss the tremendous efforts required just to pull a few cents out of it. Don't get me wrong. I have a passion for writing and a passion for a cause. I'd like to be able to pursue those two passions and still pay the bills.

I'm grown to love Blogger. It's simple, easy to use and integrates well with Google+. When I post my articles on Google+ the comments received show up on my blog for others to read, too. That is a feature I really like that allows me to track comments wherever I happen to post the article on Google+.

Then again, I post articles on Facebook and Twitter and really don't have any integration from there. So there isn't much lost going from Blogger to Steemit. I can still link Mailchimp to my blog on Steemit, too.

Relative to Blogger, Steemit seems to be very good at generating value for content produced. Steemit also allows for upvoting of posts like Reddit. But that costs Steem Power, a sort of influence token. It gets more complicated from there and I'm planning on spending a lot more time there just to make myself familiar with it. All I can say for sure is that I'm optimistic about Steemit and I also see that Steemit is not the only social media site using cryptocurrency to pay their users. There are already a couple more to follow Steemit.

Steemit is attempting to do something that Facebook, Google+, Twitter and a few other social media sites have so far refused to do: pay their content creators for their work, and except for Google+, they show ads at the same time. There are no ads on Steemit, at least not now. Maybe not ever. The investors who created Steemit seem to think that content creators should be paid for their work. They have a business model that I'm still learning about it, but from what I can see, ad support is not an obvious consideration.

There is something else that I like about Steemit which, I think portends of the future: people will find ways to earn a basic income from something they are already doing. It is possible that in the long term future, say, 10-15 years, much of the routine labor will be automated. Trucks will drive themselves. Trains will drive themselves. Robots will stock shelves and pick produce. It is possible for this to happen, but it's not happening yet. Steemit could be an acknowledgement that we need to prepare for that eventual future. The future envisioned by Piers Anthony in the Blue Adept may not be so far off.

Billions of people are engaged in social media. Steemit is pioneering a way to channel that energy into blockchain computing. With Bitcoin, you can buy rigs and run software to mine Bitcoin. Blocks on Bitcoin are created by sheer computational power. In a way, such systems are minting money.

Steem generates blocks on the blockchain by a more familiar user interface, a social media network, something that billions are already doing now. The more content you created the more you earn, based on the votes you receive. The transition from social media networks familiar to us now to a social media network that actually pays their users for content would not be that hard to make.

I can even see these pioneers like Steemit pulling the old dogs along. I suggest that the appeal of a blogging and/or social media platform that pays for content will eventually be impossible to ignore. If Steemit proves to be successful, others will have to follow or lose their users and their revenue sources: the users. Ultimately, the users generate the value and they are the revenue source that social media relies upon. I see no reason they should not be paid.

Going even one step further, it is no secret that central banks have been rigging national economies. What appears to be not very well known is who benefits from this manipulation. I can recall in the days when I used to watch TV, and I mean broadcast TV, how the markets would go nuts when interest rates were raised or lowered. The Federal Reserve Bank is our central bank. They control the interest rates in America. When they raise rates, millions are thrown out of work, and stock markets rally. That seems like a good clue as to who benefits from the way our central bank works.

Cryptocurrencies have no central bank. There are hundreds of them, all competing for your use. The more people use a cryptocurrency, the more valuable that currency becomes. Most can be traded for traditional currency like the dollar and the Euro. There are now exchanges (like this one) that allow for purchase and trading of cryptocurrencies, much like any other security or commodity. And they're growing.

Bitcoin started out small. As developers built the software to exchange Bitcoin, businesses started to see value in using Bitcoin as a medium of exchange. It's still very tiny relative to the worldwide economy, but it's there. Checking on the prices today, Bitcoin is now on par with gold. Gold is selling for $1,204 per ounce. Bitcoin is now at $1,250 per coin. I can recall one story that I saw on Steemit that tells of a man who bought $27 of Bitcoin, forgot about it for a few years and found out that his investment had appreciated to $889k. The growth is there, but can ordinary people use it? I think so.

Bitcoin is now big enough that governments can no longer ignore it. All power derives from the people. It doesn't matter what form of government you want to call it, all power still derives from the people. When the people get tired of being manipulated by the banks, it is natural for them to seek alternatives. Cryptocurrencies are that alternative until a better one comes along.

Cryptocurrencies rely upon computational power to generate value. Through personal computing, this power is distributed to everyone who has a computer. Compared to traditional central banks, cryptocurrencies are fairly democratic and not easily prone to abuse by central banks run by governments. Perhaps through a union of social media and cryptocurrencies, the people can finally gain control of the governments that claim to represent them. If not, they may have to form new governments that provide the representation they seek for their mutual benefit.

I'd say there is a peaceful revolution in process now. Most of us just don't know it yet.

Thursday, March 09, 2017

The debate over Obamacare is not a debate over economics, its really about ideology

The GOP has finally released their bill to overhaul Obamacare. Though some key elements of Obamacare will remain, it is clear that the GOP is uncertain just how to undo Obamacare without facing serious political repercussions in the 2018 mid-terms. Given the onslaught of legislative initiatives working through Congress now, it would seem to me that Republicans in Congress now have enough rope to do themselves in for the next midterm election.

The American Health Care Act, as introduced by Republicans in Congress, is the bill that the GOP has been working on for weeks behind closed doors. The key features of the bill show that allowing parents to keep their kids on the plan until age 26, banning discrimination based on pre-existing conditions, and even the Medicaid expansion will survive for now. The bill has serious changes for much later baked into it so that the current Congress has a chance to survive the midterms. That's cute.

At the Washington Post, they've noticed that opposition to the bill is fairly universal from the industry the bill purports to regulate. Organizations representing doctors, hospitals and even insurers have expressed surprise at the contents of the bill mostly because they were not invited to offer input on the bill. Afraid of offending their donors and their voters, Republicans in Congress seem to be mum about their true objectives, even in this bill.

Economist Dean Baker suggests that the GOP Congress will top 50 million uninsured once this bill becomes law. Here is one very interesting observation Baker makes about how people use Medicaid:
For example, the plan leaves in place the expansion of Medicaid through 2020. This should be long enough so that most currently serving Republican governors will not have to deal with the effect of the elimination of this provision. After 2020 people benefiting from the expansion will be allowed to remain on Medicaid, but new people will not be added. Since people tend to shift on and off Medicaid (something rarely understood by reporters who cover the ACA), after two or three years the vast majority of the people who benefited from the expansion will no longer be getting Medicaid. By 2025, the impact of the expansion on the number of the uninsured will be trivial.
This is something I did not know: people go on and off Medicaid. Once enrollment is frozen for Medicaid, the people who were on it once, will find that they cannot return after 2020. Great for Republicans in elected office who are already set with gold-plated insurance, bad for people who need the help.

Numerous critics have requested a scoring of the bill by the Congressional Budget Office (CBO) for the reason that no one knows the true cost of the bill. This is interesting considering that many Republicans claim to be fiscally conservative. Why wouldn't they wait to find out? Perhaps their objective is not the repeal of Obamacare. Their objective is repeal of the taxes imposed by Obamacare that would result in a nice, tidy windfall for the wealthiest of Americans who run very large businesses, but can't wait to externalize the cost of health care for their employees.

I suggest here, that the debate over Obamacare, and health care in general is not about economics. It's about ideology. Conservative rhetoric maintains that people should be responsible for their own health. In a perfect world, that might be true, but this world is far from perfect, at least with humans in it. What conservative talking points miss is that business does the majority of the polluting, while funneling most of the income generated by the business to the top 1%. 

Business creates pollution. Ordinary people minding their own affairs do not even come close to the effluvia created by business. Business sells things that pollute and people buy them. From plastic doo-dads of all manner, shapes and sizes, to electronics that need to be properly recycled, to vehicles that spew CO2 and particulate matter into the air for us to breathe, to oil spills, and coal ash spills.

All of that pollution has an effect on the health of the people who use products and services created by the very businesses that seek to escape the costs that businesses can impose on everyone else. This is the argument missing from the debate. There are a few more arguments missing, too. Like how doctors have engineered a shortage of doctors to prop up their incomes relative to everyone else. Or how drug patents now cost Americans roughly $360 billion a year. Or how lawyers game the courts with torts to increase the cost of protection for doctors.

The entire game is about shifting costs from one party to another. This is how they keep us divided. This is what the GOP plan to replace Obamacare is about. It's time to bring everyone together, into a system that keeps everyone in, everyone covered, and lets nobody out. After all, we're stronger together, right?

Enter now, the bill now in Congress that is nowhere to be seen in the news, H.R.676 - Expanded and Improved Medicare For All Act. This is a universal health care act. This requires everyone to pay in and everyone to be covered. Based on my reading so far, there is very little way that I can see, for any single group to externalize or shift the costs of health care onto another. Here is the bill summary:
This bill establishes the Medicare for All Program to provide all individuals residing in the United States and U.S. territories with free health care that includes all medically necessary care, such as primary care and prevention, dietary and nutritional therapies, prescription drugs, emergency care, long-term care, mental health services, dental services, and vision care.
Only public or nonprofit institutions may participate. Nonprofit health maintenance organizations (HMOs) that deliver care in their own facilities may participate.
Patients may choose from participating physicians and institutions.
Health insurers may not sell health insurance that duplicates the benefits provided under this bill. Insurers may sell benefits that are not medically necessary, such as cosmetic surgery benefits.
The bill sets forth methods to pay institutional providers and health professionals for services. Financial incentives between HMOs and physicians based on utilization are prohibited.
The program is funded: (1) from existing sources of government revenues for health care, (2) by increasing personal income taxes on the top 5% of income earners, (3) by instituting a progressive excise tax on payroll and self-employment income, (4) by instituting a tax on unearned income, and (5) by instituting a tax on stock and bond transactions. Amounts that would have been appropriated for federal public health care programs, including Medicare, Medicaid, and the Children's Health Insurance Program (CHIP), are transferred and appropriated to carry out this bill.
The program must give employment transition benefits and first priority in retraining and job placement to individuals whose jobs are eliminated due to reduced clerical and administrative work under this bill.
The Department of Health and Human Services must create a confidential electronic patient record system.
The bill establishes a National Board of Universal Quality and Access to provide advice on quality, access, and affordability.
The Indian Health Service must be integrated into the program after five years. Congress must evaluate the continued independence of Department of Veterans Affairs health programs. (emphasis mine, text of bill here
Note that private insurance is effectively cut out of the basic health insurance business. An enormous, confusing bureaucracy of multiple private insurance companies will be replaced by one federal agency, with one neck to grab in November. No one gets out from paying the taxes to support the program, which means that there can be no cost shifting for profits. Increase the burden on party at the risk of increasing the burden for all, and anyone who tries to do that will be found and made known.

Taxes are imposed at numerous sources, including securities transactions like the sale of stocks and bonds. That means those with lofty incomes who engage in high frequency trading might have to do something more productive with their time and computers. Everyone pays in for their mutual benefit.

I note with interest that Bernie Sanders is not a cosponsor of the bill. I wonder if he has an opinion of it. In 2011, Sanders introduced a similar bill, but the Physicians for a Single Payer Plan liked HR 676 better.

This is our moment. HR 676 is a far better plan and does not set one generation or even one faction against another as the Republican plan does. If everyone pays in, the costs are nominal for all. Under the current system and worse, with the GOP plan as proposed, burdens are shifted and concentrated on the people who are least able to afford it.

So let your Congressperson know that you know about HR 676. Let those who oppose HR 676 explain why the people should not be united in the pursuit of quality health care that is already enjoyed by every other industrialized country, as a right. We have an alternative to the GOP plan. Let's talk about that.

Thursday, March 02, 2017

It's time to start thinking of racism as an addiction: a preventable, progressive and fatal disease of the mind

Here's an interesting story about a couple in Georgia who were sentenced to a combined 35 years in prison for participating in a parade of trucks flying the Confederate flag in front of an African American family's home while hosting a birthday party. At least, that's what we get from the headline. During the parade, Jose "Joe" Torres stopped his truck, brought out a shotgun and pointed it at the party-goers threatening to kill them. Kayla Norton, the other defendant in the couple, also made threats while at his side. Nobody was physically hurt, but the family in the home brought charges with evidence captured on video and numerous witnesses. Consequently, the couple were arrested, prosecuted and convicted.

While several other participants were charged in the incident for lesser crimes, it is worth noting that some participants, including the couple, were charged with violations of Georgia's Street Gang Terrorism and Prevention Act. Finally, we're starting to see racists being charged and identified as terrorists for their acts of aggression. That is a very significant turn of events in terms of prosecution and reporting.

I watched the video at the head of the article to see how Norton, the female defendant, cried in court and turned to the victims to display an incredible degree of denial (from the CNN article referenced above):
Norton apologized for her role in the incident saying, "I want you all to know that is not me. That is not me, that is not him. I would never walk up to you and say those words to you. I'm so sorry that happened to you. I am so sorry."
This is the kind of denial someone might have expressed after discovering what they had done while blacked out from a drinking binge. It was all fun and games until they found themselves in cuffs in front of a judge (from the same article):
"Many people tried to make the case about simply flying the Confederate Battle Flag," Douglas County District Attorney Brian Fortner said in a statement. "This case was about a group of people riding around our community, drinking alcohol, harassing and intimidating our citizens because of the color of their skin."
Step back for a moment and consider the kind of ride these people were taking. I'm not just talking about the alcohol or anything else they might have been taking. I'm talking endorphins. Endorphins are the brain's response to threats and other intense stimuli. The most well known experience of endorphins is the "Runner's High".

Another well known endorphin is adrenaline. Have you ever been in a heated argument and felt the rise of anger? Have you ever felt fear from a threat, like a car that you didn't see behind you, but just whizzed past you? Those examples provide a very mild shot of adrenaline.

Those people in the parade were packing serious heat (at least one shotgun) and had organized a parade in front of their victim's house. The entire affair appears to be premeditated. In other words, they spent time collaborating and planning their "event", complete with giggles and anticipation. During the event, the alcohol further released their inhibitions enough for them to shout threats and throw objects at their victims, too. The acts of shouting racial slurs, throwing objects, and pointing a gun capable of deadly force, all give rise to huge shots of adrenaline.

I think we can fairly say that they really didn't think this thing through. Especially the part about getting arrested and going to prison.

The planning, the acting out and the displays of domineering behavior all arise out of obsession. Obsession is also a form of addiction and is every bit as addictive as drinking, gambling and power. From beginning to end, these people were orchestrating actions to bring about the maximum high that they could achieve. I'm not saying that was their conscious objective, I'm just saying that how it works.

These people displayed all the hallmarks of an addict, or someone in the throes of an addiction. Here's a handy definition from Psychology Today:
Addiction is a condition that results when a person ingests a substance (e.g., alcohol, cocaine, nicotine) or engages in an activity (e.g., gambling, sex, shopping) that can be pleasurable but the continuation of which becomes compulsive and interferes with ordinary responsibilities and concerns, such as work, relationships, or health. People who have developed an addiction may not be aware that their behavior is out of control and causing problems for themselves and others.
In this case, the couple experienced intense pleasure, the high from the endorphins they experienced while threatening the lives of another. Their actions disrupted the lives of others, when they terrorized an African American family with their parade. Their actions disrupted their own lives when they were sentenced to hard time in prison. This is the power of addiction.

To put this all in terms that most people would not ordinarily use: racism is a sign of mental illness. Now that I think about it, I've never seen or heard anyone say in the news or in civil discourse that racism is a mental illness. Symptoms in this case include obsession (the websites, the Facebook posts, fantasizing, etc); acting out as in their parade, the display of weapons, shouted threats and the slurs; and the crash, like when Torres and Norton were stone cold sober as they both cried and while she apologized in court. Wash, rinse, repeat. We don't even know how many times they've done this before as this was probably the only time someone pressed charges and made them stick.

To call them addicts suffering from an unrelenting addiction is by no means a defense of their behavior. On the contrary, they are adults and they make their own decisions, but at the least, they are very confused adults. At the time of their crime, they were high on, and addicted to power.

They are not evil. I've said before that I don't believe in evil. Evil is a supernatural explanation of challenging behavior in children and adults. There is no evil and good. To put it simply, there are two kinds of people in the world: confused (what we call evil) and less confused (what we like to call good).

The couple and their cohorts are now in jail awaiting a trip to prison. They didn't plan on going to prison and sincerely believed that what they were doing was right and just, even if the people outside of their little world disagreed. That kind of bravado doesn't come from deciding one night after a game of beer pong, that they're going to act racist for a day. No, this is a result of a long line of decisions, spanning years, maybe decades, of imitating or following behavior from some authority figure in their lives. You know, like their parents.

I think they learned that behavior from their parents, and from abuse at the hands of their parents. Hitler's Germany was authoritarian and Christian, and it should be noted that Hitler suffered tremendous abuses at the hands of his father as a childAmerican racism has its roots in Christianity to be sure, but I think we'd find that racism arises from abuse in authoritarian families where "might makes right". Yet, millions of other Americans can read the Bible without making conclusions of racial inferiority based upon skin color, just as Martin Luther King did.

If the parade organizers truly believed that African Americans were inferior, and had taken the time to read their "Good Book", they might find that their purpose (according to their book) is to help those "inferiors", to lift them up, not abuse them. Here's where I get confused. Were they trying to help them? If so, how did they ever come to believe that abusing someone else is even remotely helpful?

In authoritarian families, the rule is that the child lacks motivation to do well, pay no mind to the skills the child might need to achieve the morality that is preached by the parents. Punish the child and he will do better. That's the rule.

Yet, by their actions, it would seem that Torres and Norton weren't even thinking that they would make better people out of those party-goers with their abuse. It was an entirely cathartic affair. Racism is not about superiority and most certainly has nothing to do with helping others out. I am here to say that racism is about people acting out the story of the abuse sustained at the hands of their parents. This acting out is the ritual of their addiction as all addictions have rituals in their expression.

It is right to restrain with imprisonment, such individuals as those who are willing to brandish weapons, parade in the streets and terrorize people on the basis of color, we must consider the source. People are not born racist. They are born into this world without a care about skin color, religion, sexual orientation or nationality. Racism is a learned behavior. It is taught as a set of skills designed to marginalize, minimize and enslave, others who are deemed, "inferior" only due to the color of their skin. They're not the most productive skills, but they are skills, nonetheless.

Racism is a preventable, progressively fatal mental disease, but it can be arrested. I believe that to be true because it is up to parents to set the example of how to live with others, regardless of skin color. Parents set the example by collaborating with their children to solve the problems that children might encounter, problems that if left unsolved, give rise to challenging behavior. Solve those problems with kids and challenging behavior goes away - and kids learn new skills at the same time. A model for solving those problems can be found at www.livesinthebalance.org.

Racism is a set of skills borne of religious dogma, a perversion of morality. Morality is a skill, not dogma. Teach the skills required to achieve the morality of peace, love and compassion, and racism fades away, into grey.