The Flight Deck

Comment from doorkeeper
Time: October 23, 2007, 5:40 am

Can I ask a dumb question?? When they talk about 43 (or whatever, they should make up their minds) million people in this country who are uninsured, does that count the 12 million (that number is certainly higher) illegal immigrants?
Because that’s just stupid.
How about those who do not “do” health insurance? Certain religious groups, etc……?
Hmm–looked at the leading Democrats, and wouldn’t that be interfering with freedom of religion, to require the aforesaid to have insurance when they don’t believe in it?
Looked at the Pubs first, of course…..still disappointed in Freddo that he doesn’t seem to have much to say.
Is Romney (? got confused with so many words, I think it was him) NUTS? A $5000 family insurance tax credit? Like $5000 will buy a family insurance? wow……..
I dunno, hard question, hard problem.

Here’s a question for you. The pubs talk about “personal responsiblity” a lot, but what would you do with an adult of compromised ability to reason–someone on that vague line, like my most recent client. Able to live by himself and care for himself (except for certain housekeeping needs, and can’t drive due to his disability) but he really isn’t–good at complex decisions, like health….he’s just not able to have that level of “personal responsibility” that we do…and he’s over 30, so his Mama isn’t gonna do it anymore. What do we do there? In cities, perhaps it’s possible to have a caseworker who could be in charge….not here in the hinterlands.
What say you?
thinking hard,
doorkeeper

Comment from doorkeeper
Time: October 23, 2007, 5:41 am

Oh, and THANK YOU for the site!
d

Comment from Max Damage
Time: October 27, 2007, 12:56 am

My daughter is in the NICU, runs about $10K/day gross. I don’t care, I’ll pay whatever it takes of course, might end up asking them for a job were I to have trouble paying. I’ve excellent insurance, so Da Missus in the hospital for a month and child in NICU for a week came to under $1500 out-of-pocket.

Felt sorry for the Hutterite family with a baby in the NICU. They pay cash, generally have no insurance and self-insure. But then, they’re not out drinking on Friday night and spending the night in the ER after drag-racing a Camaro into a telephone pole, or having heart attacks after spending a day behind a desk and an evening on the couch watching the tube and eating fried hog skins snacks. Did I mention they’re among the uninsured but don’t want the insurance?

Then the sobering reflection, health care is roughly 1/7th of the economy. I don’t care if you do make for a national pool, a good plague comes along and that fund can get wiped out but good real quickly. After all, isn’t the idea that you spread the risk so only a few need the money? But the more we want, the more we ask for, so does the need for payment spread. Pretty soon it’s not a pool for emergencies, it’s a fun we tap for our basics.

But then, promising security at somebody else’s expense is par for the course. The vote of somebody who failed economics is just as valid as any other, and far easier to get.

– Max

Comment from Michelle
Time: October 27, 2007, 5:46 am

Max, you little rat!
Are you trying to say Congratulations are in order?!
Well, I will take it so. Details, man, details!
Some people got a lot of nerve!

You know with Lex (termporarily) out of commission, me thinks the blogging is going to have to pick up on this side of the house. So perhaps this is your golden opportunity to jump into the pool. What a better place to start … tell us about your new young’un. Preferably with pictures!

Sheesh… men! A casual passing reference to a babe in the NICU in a silly political healthcare thread…

Comment from Max Damage
Time: October 28, 2007, 12:57 am

Well, Michelle, it’s not like my wife and I managing to procreate is anything unusual. I hear tell folks have been doing that for, like, *generations*. In our case, our daughter was born at just under 28 weeks and is doing just fine, mother is recovering, father is bearing up as best as can be expected and trying to put on airs of confidence. We have a healthy baby girl who just happens to be too young, and if we can get her home by Christmas (her original due date) the rest is gravy.

The telling issue to me is the published costs as stated by a regional hospital. Let’s use the large university hospital in Sioux Falls, SD as an example, mainly because I know the URL.

http://www.sanfordhealth.org/SanfordCharges/PrematureInfantWithoutMajorProblems/Index.cfm

Out of 223 preemies, the gross costs are all listed. The average out-of-pocket cost is $275 for 9 days with coverage, and the maximum was $5340 for 38 days with coverage (we’ll be setting a new record next week, it appears).. There are *no* figures for costs without coverage, and only two stats for those with coverage. Why?

I have a theory.

1) Hormel has a large pork and beef processing plant in Sioux Falls. There is a significant hispanic population here working at this plant. There are no stats on how many are illegals, but it’s a fair bet there are some. Enough to open up several churches, even two specifically for the Guatamalan and Honduran factions. These people are not well-paid, nor are they unionized, and insurance costs they pay a portion of have risen over 20% in the last 5 years. They simply cannot afford it in many cases.

2) Poor people tend to not have a lot of money for insurance, of any kind. They also tend to eat poorer fare, skimping on the more expensive vegetables and less red meat than their more wealthy neighbors, and in some demographics there’s a large portion of the food budget that goes towards processed foods.. There is a direct link between diet and low-birthweight babies.

So, I conclude the NICU sees a significant number of uninsured babies, thus one would think there might be a figure available for costs without insurance, and one for out-of-pocket costs for those without insurance. There is not.

It is evident that one can be broke, uninsured, and still get health care. That should never enter the debate. Nobody gets turned away, no matter their financials. But just who is paying for this care? One is forced to assume those who have insurance or money.

One is tempted to observe this and think of all the money one might have saved by purchasing that nifty bass boat instead of health insurance. Let somebody else foot the bill, preferably somebody with so much more wealth than I that I don’t even need to feel guilty for taking their property in the process. Somebody like Sanford, who spent his life starting small businesses, growing them, and now has enough he can donate a $400 million endowment to this same hospital. But didn’t he earn it the same as the doctor and nurse who look over my sprog? Is taking his wealth morally acceptable because he has more?

That’s not the way I do things, of course. I’m incurring a debt, the doctors and nurses and janitors all have worked to keep my child alive and healthy and they deserve to be paid for their labors. Maybe we can quibble on rates, but there is no argument that they’ve earned their pay.

Except for that SOB who told us we couldn’t have kids and charged me $75 for the office visit. Yeah, that bill I’m having a tough time paying.

Pictures? http://sorenson-dan.svtv.com/baby-face.jpg

She’s named Elizabeth, after her grandmothers. Both of them. We’re not terribly creative ’round these parts.

– Max

Comment from doorkeeper
Time: October 28, 2007, 5:45 am

Max, how wonderful, and you and they have my prayers. My best friend delivered a baby 12 years ago, just about that gestational age, and he’s fine…and they managed to pay off the bill (they had minimal insurance.)
How wonderful she looks, and Elizabeth is a great name. Congratulations all ’round. Wish I could lift a cold one with you.
d

Comment from Michelle
Time: October 28, 2007, 9:38 am

“Well, Michelle, it’s not like my wife and I managing to procreate is anything unusual. I hear tell folks have been doing that for, like, *generations*. “

Yeah, yeah, Max, whatever…
Congratulations to you and the Missus anyway. And the little one will be in our prayers! I thought you had said December was the due date so when I saw this, it was kind of like … uh oh, that’s not so good.

As to the rest of it, you had me worried there for a brief moment, you were almost sounding socialist when you were discussing all those poor immigrant workers without insurance. Yuck, believe it or not, not really in the mood to enter that debate right at the moment. Except to say that whatever system used, British, French, Canadian, American… we are all going to pay for healthcare one way or the other. Whether its insurance premiums or higher taxes or a combination … we’re paying. Yeah, yeah, I know, except for those that aren’t.

But I would tend to think that one way or the other the vast majority are paying, at least in the form of some government tax (payroll, sales tax or something) cuz as you (or someone here) has pointed out before, the government has no money but OURS and how else are they picking up the slack for those without insurance?

BTW I don’t think anyone ever did respond to a question or point I raised way back when, but it does seem to me that in your system, which is pretty well insurance ran, it looks like every little thing costs a hell of a lot more. So what’s that all about? Things that make you go hmmm…

Damm, and I wasn’t going to get hooked on this again. The best laid plans of mice and men… But what I was really hoping to see in this thread was people analyzing and comparing the different plans put out their by the candidates. Oh well, you can lead a horse to water …

Comment from MissBirdlegs in AL
Time: October 28, 2007, 9:50 am

Delighted with your good report, Max. Elizabeth is a doll and I’ll keep all of you in my prayers for that Christmas arrival!

Sorry, Michelle, just not up to debating and analyzing… Kinda tired of it.

Comment from Max Damage
Time: October 28, 2007, 10:20 pm

Michelle wrote, “As to the rest of it, you had me worried there for a brief moment, you were almost sounding socialist when you were discussing all those poor immigrant workers without insurance.”

Believe me, Michelle, I am not a socialist. “From each according to his abilities, to each according to his needs” is the greatest joke I’ve heard since the one about Moe Debbinly. I figure a man or woman is only worth about a buck an hour from the neck down, that being the part that handles the unskilled labor (which, by the way, is not a joke the people in the NICU tend to laugh at). The worth of an individual is in the brain. That defines us, separates us from the euglena and the bacterium and the loyal dog who still can’t help but mistake a skunk for a kitty who wants to play.

Stupid dog.

True to form, I think the health care problem in the US can be solved with market forces. Unfortunately, I am unable to determine exactly what the problem is, let alone find any evidence of a free market at work. I get bills with the names of people my wife and I have never seen, I get bills for hundreds of dollars for bed-side visits that were under 2 minutes in duration and consisted of the doctor speaking to some medical students about my wife’s condition. I have bills that show the insurance company will pay for a nurse to draw blood and later on I find they won’t cover the lab work on that sample, which kind of makes you wonder what kind of idiot thinks seeing the patient is worth covering but performing tests so you know what you’re dealing with isn’t, the aforementioned idiot being in the employ of the insurance agency. The same insurance company that has tasked an on-staff RN to monitoring my daughter’s progress and is a phone call away if I have any questions. I have hospital staff I can ask questions of, thanks, I’d rather an insurance company that understands what lab work is for rather than one who assigns a case-worker to me.

Health care is not a free market. Between insurance companies (health care is the method, not the means — they’d do just as well as a brokerage), doctors ordering tests for nothing more than lawyer repellent, state mandates that ensure a Mormon must pay for stop-smoking coverage on his insurance no matter if he needs it or not, and the very hospitals that treat premature babies unable to come up with a price for those without insurance, the health care cost debate is looking a lot like a game of creative accounting. Nobody knows who is paying what, nobody knows how many dollars are involved,for that matter nobody really knows how many are uninsured let alone how many choose to be without any or how many have no basic insurance and an umbrella policy that doesn’t kick in for the basics.

My take? A free market that can give me a supermarket full of produce from around the world at the lowest possible price can probably give me the health care I want at a price I can agree with. Unfortunately, health care is not a free market and never will be. The purpose of insurance is to spread risk. Having to pay for your decisions isn’t palatable if those decisions are risky, and if we added up the risk of childbirth compared to membership in a golf or softball team with obligatory pitcher of beer and a pizza afterwords I do believe the very continuance of the species would not be covered at an affordable rate.

The other reason health care isn’t a free market is so long as I’ll pay anything, including status as an indentured servant, to see that my daughter lives I’m not entering this trade voluntarially. On tenent of trade is that both sides enter it voluntarially, weighing the benefits and the costs. When it comes to my daughter, my wife, my family, I really don’t care about the costs. I’ll agree to anything, even if I can’t pay the cost, just so I can have them with me a bit longer and the debt can wait.

So, what value do you place on a human life? If it’s your life, is it worth more? If not, is it worth less? How about if it’s a human life but it smokes or otherwise is self-eliminating?

This screws up a free market solution. Trade in health care is not free.

But then, if that is a given, the only question left is how much are you willing to pay, or make others pay, at the point of a gun to ensure their fair share of the costs are collected?

I have a solution to this problem. The first stage involves shooting lawyers. If we selll tickets, the second stage should practically fund itself.

– Max

Comment from Michelle
Time: October 29, 2007, 4:03 am

Max, no time. Have to get my mom to the airport.
But you knew I couldn’t let that last comment go. Too bad too because here you were sounding like such an intelligent man right until the very end. Just another example of one of the many problems of healthcare I suppose, focusing on a symptom to the exclusion of all. Like, ummm, I don’t know… maybe the cause?!

Oh yeah, one more thing, I always thought that “From each according to his abilities, to each according to his needs” was a tenent of communism, not socialism. Don’t fret thoiugh, its a common mistake.

But all is well, you’re a fellow Flight Deck denizen and as such I have come to learn to tolerate, nay, even to respect you. [/snark]
Just teasin’

Comment from Max Damage
Time: October 29, 2007, 11:11 pm

Michelle, as you very well know the “shoot all the lawyers” comment is direct from The Bard himself. I believe it proceeds, “Nay, that I mean to do. Is not this a lamentable thing, that of the skin of an innocent lamb should be made parchment? that parchment, being scribbled o’er, should undo a man? Some say the bee stings: but I say, ’tis the bee’s wax; for I did but seal once to a thing, and I was never mine own man since.- How now! who’s there?”

I was fairly certain it would cause a response, though not one seemingly as serious as you’ve made. I was more hoping you’d ask about my idea involving the selling of tickets to finance my Next Great Idea.

If you wish, feel free to quote from “Jurassic Park.” I believe the line is, “God help us, we’re in the hands of engineers.”

The communism vs. socialism mistake is mine alone — I don’t draw many differences between them when attemped on a national scale and consider both to be unworkable ideas. Nice ideas, of course, but pipe dreams that fall apart in the presence of humanity and all its vices and foils.

– Max

Comment from Max Damage
Time: October 29, 2007, 11:41 pm

Doorkeeper, much as I’d like to claim that Elizabeth’s good health and continued progress are the result of my contribution to her genetics and she will, of course, be walking by 3 months and find a cure for cancer before her 5th birthday as befits any offspring of mine, I’m afraid I cannot take credit. It is due mainly to her, and also the excellent hospital staff watching over her.

Note: using the term “fruit of my loins” to denote the child, while catchy, does not go over well with others. Nurses, mothers, some doctors… Heck, it doesn’t go over well with pretty much everybody, come to think of it. Don’t use it. Trust me.

I’ve been “kangarooing” her regularly. That’s where I get all bare-chested and hold her to my (did I mention bare?) chest with a blanket draped across. The idea is taken from marsupials, infants craving the skin-to-skin contact and the body heat of the parent serving to keep the infant warm the same way a marsupial keeps its young warm in the pouch. In countries without access to reliable electricity this would make a passable substitute for incubators.

I find it astounding that I can think of these things while holding my little girl, my hands being capable of covering her completely. Why must we spend thousands on incubators when a parent in attendance and a blanket are all we need? Why must thousands die for want of the latest technology when there are such inexpensive options open to us?

The third world and the animal kingdom have a lot to teach us, if only we could forget for a few minutes that we’re the highest primates.

– Max

Comment from Michelle
Time: October 30, 2007, 5:03 am

Heh. I guess maybe I should actually watch Jurassic Park sometime. But I will definitely remember the line. Thanks!

You must forgive me, Max. I was going through a terrible time, a loss in the family almost. But then the heavens opened (or was it the seas) and Himself surfaced for a brief moment. And all is now well with the world … well, at least until Thursday anyway.

Seriously though, about that whole lumping communism with socialism thing, personally I think its part of what’s (gasp) wrong over here … yes, harsh words, I know … Y’all do seem to see the two as one, a far different world view than mine. But then again, I guess you already know that by now.

Quaere: How and to what degree will the arrival of the “fruit of his loins” change Max’s world view?
To paraphrase the immortal words of Babs, “Enquiring minds want to know…”

PS The kangarooing sounds great … but for goodness sake, do cover that nakid chest when you set her down! Almost enough to make he want another…

Comment from KrisinNewEngland
Time: October 30, 2007, 12:01 pm

Max – late to the party here but Congratulations on Elizabeth. She’s but a peanut, yet clearly with the strength of 10 men. So glad the prognosis is good, even if the getting there will be so stressful.

No comments on healthcare here – just a hearty congratulations to the new parents. Been down the road of “can’t have kids”. So happy for you (genuinely, from the bottom of my heart) that it turned out this way for you.

Comment from Max Damage
Time: October 31, 2007, 10:31 pm

I recognize that, as a new parent, I am subject to some sort of hormone, or steroid, or maybe it’s toxic residue from the paperwork I had to fill out, but I’ve found myself actually somewhat changed. More protective. More interested. My other behavior changed too, becoming less risky. I bought a cell phone. I bought a photo album. I’ve found myself pondering educational toys, and have you *seen* what an erector set costs these days?

Fatherhood hasn’t really changed me, I don’t think — I’ve been sort of planning on this for about 10 years, so I already have my role defined and fit into it fairly well. What has changed, significantly, is my allotment of time and money. Where once money went into the 401K for us now it’s into growth stocks and mutual funds for her. Where once I would take an afternoon off and go pheasant hunting, now I push such things aside in favor of readying the home for her arrival. Note that this is done with some insistence from My Good Wife, so it’s not completely me.

Michelle? I realize communism and socialism are separate ideas, but they have a common root and a common mistake, they are different mainly in matter of degree. Kind of how there are few truly capitalistic systems around, most are fascist to a degree because government does exert influence over the means of production. This is akin to our being a constitutional republic but referred to so often as a democracy. As ideas go they are very similar, the difference being a matter of degree.

– Max

Comment from Michelle
Time: November 1, 2007, 4:53 am

Oh Max, what we going to do with you?
Give the fatherhood thing a bit more time, my good man. Come back in five years and we will talk. Then again in another ten. Just the voice of experience.

So, let me ask you this, sir. When first I suggested we take the never-ending health care convesation over to TFD, you made a comment … something to the effect that even if we couldn’t stand to make polite conversation with the other in the same room, at least as denizens of Lex’s, we would leave the battlefield well-met. Something like that. So here’s the question … I know I haven’t changed your opinion any much on healthcare, but any change to the rest of it?

Comment from Max Damage
Time: November 1, 2007, 11:23 pm

The rest of what? Sorry Michelle, but while I do remember my footloose and fancy-free days before My Responsibility was born, I’m afraid I’m not understanding your reference.

People can disagree. If they meet in the spirit of healthy debate and leave that field with personal repspect for the other, well, then they leave that field well-met.

I never expected to change my mind. I expected merely good argument.

– Max