The Health Care "Mandate," Poetry and a Short Story

Today I am going to burden you with some thoughts I have on health care reform. If you agree or disagree with me, your comments are welcome, and if you wish, they will be published on the blog. Once you've had enough of health care, enjoy a poem by Sid Bolotin and a new short story from the pen of Harvey Sage, touching on abortion, gun control and Presidential politics, not necessarily in that order. New contributors are always welcome on this blog. Have a nice day!

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Paying for Health Insurance

Here’s a little mental exercise to think about. Imagine that a particular hospital’s bills for the services it provides over a week’s period adds up to $5,000,000. Of this, including the adjustments (deductions) which Medicare, Medicaid and insurance companies get, $4,500,000 is paid. That leaves $500,000 which must be recovered from patients. Let’s assume that some patients are able to reach into their pockets and collectively pay $100,000 of this amount. That leaves $400,000 of unpaid bills for the week. And over the year, that comes to about $20,000,000. That’s a lot of money. Let’s now look at where the hospital can look to recover this missing money.

The easiest approach is to take that $400,000 and spread it out over the amounts which patients whose bills get paid in one means or another end up paying. So they increase the amount that everyone gets billed by about 8% and that takes care of the freeloaders who never pay, resulting in increased insurance, Medicare, Medicaid and out-of-pocket costs for the others. I think that’s the way it works today. All bills are higher than they should be to cover the cost of caring for those who do not pay.

Now if there were some mechanism to get rid of these freeloaders, hospital bills (and doctor bills for that matter since doctors do the same kind of thing to cover their non-paying patients), the problem would be solved. For years, advocates of health care reform have advocated a program whereby the government would step in to insure the freeloaders. I believe actuaries have found that the cost of doing so, which would have to come from taxes paid by everybody, would be less than that 8% mark up mentioned above which is paid not by everybody, but only by consumers of health care whose bills are already being paid.. But this approach, even in the 2010 Affordable Health Care Act, has never been able to muster enough support to come into being.

Instead, the approach that Republican opponents of broader health care reform have been advocating for decades, a private approach involving private health insurance companies, was included in the Affordable Health Care Act. This approach, I repeat, the Republican plan, mandates that those without health insurance purchase it privately if they can afford it or with government aid if they cannot. In this manner, without taxing everyone, that sneaky 8% increase in everyone’s health care bills would be unnecessary. This is the “mandate” mentioned so often in the news and the subject of various court decisions as to its constitutionality. Remember, it is a Republican idea which the Democrats have adopted, a truly non-partisan approach.

Unfortunately, the Republicans have renamed what was originally their own proposal “Obama Care,” and are now trying to repeal it. Most Republicans still do not realize that doing so will leave the country with the choice of (1) remaining with the present way of handling the problem which means that hospital and doctor bills for "paying" patients will continue to be increased to cover the cost of service for those who do not pay anything for their care or (2) turn to the oft-rejected “government option” whereby the government will insure those who presently cannot pay their health care bills, rather than have this burden continue to be carried solely by paying consumers of health care.

JL

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Don't Think Of ...

by Sid Bolotin

At twilight ‘tween sleep and wake

Once again my mind unleashes

Like a rambunctious puppy

Free of its restraint

It gambols through my “don’t think” list

Like a dog romping through the rubbish

Ah hah!” An “if only” bone

Lovely to gnaw on . . . suck its marrow

Oh! Look! Look! Here’s a tasty “what if”

With much succulence to chew into

“Oh, great joy!” it seems to shout

Spotting a tangled mat of “changes to come”

“Stop! Stop!” I bellow, think happy! Think now!”

As mind blithely ignores my plea

Am I not mind’s master?

Am I not in control of its wanderings?

If not me?

Then who?

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THE VINDICATOR

Harvey Sage

T’was the season for assassinations, and Vee was in good form. No one noticed her as she approached the target area. Slender, slouched over, with a low fitting baseball hat over long brown hair, and wearing a long sleeve shirt worn outside the pants, Vee came on like a soldier on patrol, one measured step after another. Though she didn’t look remarkably dangerous that would soon change in a flash of terror.

Vee walked within the midst of a stream of people who had come to meet and greet Senator Sam Jessup, a dynamic Mitt Romney look alike whose rising poll numbers had him pegged as a presidential contender. Signs, pennants and buttons were displayed by the faithful, proclaiming the Jessup mantra. “Jesus loves Jessup,” “Abortion is murder,” “Jessup Protects our Right to Bear Arms,” and the like. Focusing on the “Right to Bear Arms” poster, Vee’s lips curled upwards. “You’re in for a shock Sam my man.”

She approached the target who was sitting amiably behind a long folding table, an aide on either side. Were they armed? Vee didn’t know nor did she care. She walked with confidence.

She thought “You right wing dickhead. Your followers prevented my sister who had been raped by a gang of thugs from aborting a baby.” They had screamed “abortion is murder” outside the courthouse so vehemently that the local politicians had passed an ordinance that outlawed aborting even a child seeded by rape. Vee’s sister was traumatized and, unable to bear the emotional pain, she jumped from the hospital roof, clutching her new born to her breast. The baby died. Vee’s sister was seriously wounded with broken legs, ribs and internal injuries. Jessup’s supporters screamed “murderer,” the politicians yielded to pressure, and the recuperating sister would have to go to trial. Jessup’s poll numbers rose when he was touted to be a man who loved life and little babies, especially if they were someone else’s responsibility.

A row of folding bridge chairs were positioned in front of the long table. Those were occupied by people waiting to talk to the senator, shake his hand, share a few words, and get his autograph. For ten dollars one could even have a photo taken with the possible future president. Vee thought “Stupid sheep. Followers of a high profile demigod. Self-serving, overfed animals. Your time is nigh. Prepare to meet The Vindicator.” Vee moved closer.

She saw the TV pros with their equipment and noted how beneficial it would be to have her actions broadcast through the world. TV, internet news, facebook, twitter-

What a wonderful way to publicize. “No one is immune from The Vindicator and my message of righteousness.”

Her right hand slid under the left half of her shirt, caressing the butt of a 30 shot Glock as if it were a baby’s bottom. She took a deep breath. “Almost there. I just got to pass this guy.”

The man standing in Vee’s way was old, thin, and leaning on the back of a folded chair. It seemed he was about to sit down, blocking Vee’s way. When he felt Vee brush his arm he turned his head and then moved letting her glide by. He flipped the chair, gripping it by its legs. Vee ignored him as she arrived on station in front of Jessup.

Absolute silence hovered over the greet and meet as Vee’s hand came out with the gun. Jessup, a medium dark skinned man turned pale as he looked down the barrel of the blue steel death machine, available in metallic black, gunmetal gray, or silver with comfort grips made to fit your hand.

BREAKING NEWS- BREAKING NEWS- BREAKING NEWS

“This just in from our WHYT roving reporter. Senator Sam Jessup was attacked a few minutes ago at the mid-city rally.” The video feed showed The Vindicator approach the table and then the extended arm with the Glock. Simultaneously the feed showed an old man pick up and swing a chair like John Henry. The edge of the chair hit the gunperson behind the right ear who went down like a sack of cement, the gun falling away, unfired. The two burly aides leaped into the fray, felling the old man. Jessup heroically fell onto the ground under the table behind his stunned supporters, his shivering body curled in a fetal position.

Later on WHYT had an interview with the honorable Senator Jessup at the hospital with the elderly man, Fred Dunlop, who had a broken arm from the fracas. Jessup, whose skin tone had darkened to its normal hue, stood by Dunlop’s side, a big smile on his face. “Your brave action saved my life and the life of others. How did you know what to do?”

The old hero nodded, fighting the effects of the anesthesia given to reduce the pain in this arm. “When I saw the gun lady approaching I knew she meant evil. Let’s say

The Spirit of the Lord spoke to me and I acted accordingly.”

Jessup ignored this comment and still smiling, seized the moment. “You are a perfect example of my supporters- brave, God fearing, willing to act, and committed to the principles which my campaign stands for.”

Dunlop shook his head. “I am sorry to tell you this senator, but I am definitely not one of your supporters. Truth be told, I came to this meeting to publicly denounce your politics. I consider them vile and hypocritical. Your stand on reducing gun control is proved ludicrous by this attempt on your life. Only by the grace of God were you and others spared. We’ve got to regulate access to firearms.”

Jessup jumped back, trying to distance himself from his nemesis. His skin blanched as he spoke. “But I thought you were one of ours- Christian and conservative. Why did you save me by interfering?”

“Because it was the right thing to do. If God wants you not to be president he’ll let you lose through the normal political process, not through violence.”

A week later the poll ratings showed Jessup’s standings had plummeted. He was no longer considered a contender. The hospital interview had done him in. The Vindicator had accomplished her purpose. As she lay in the hospital bed recovering from the blow to her head she managed a weak smile, acknowledging that the ultimate Vindicator is God.

The "Outsource" Tax Rate

Readers of this blog know how little faith I have in economists. I have often considered them in a class with astrologers and alchemists. No one has ever tried to prove me wrong. With that in mind, here is an idea to solve the nation’s unemployment situation.

Once there are plenty of well paying jobs here with decent benefit packages, spending will resume and that spending will bring about more jobs, and the whole process will snowball, lifting us out of this “recession.” we are in. Simply stated, jobs are the answer. Everything else will then follow.

The creation of brand new jobs is a wonderful solution but it a slow and tedious process. It would be far easier to bring back the millions of jobs which have been outsourced to other parts of the world where labor and other costs are less than in the United States. Putting tariffs on imports would seem to be the logical solution, but that would throw a monkey wrench into our global economy and only result in retaliation from our overseas markets which supposedly spend the money here we send to them for their low-labor cost manufactured goods. Economists claim that was tried in the 30s and it did not work (Smoot-Hawley Tariff).

I propose we look at American corporations which outsource much of their manufacturing and even service functions to low-cost-labor and basically unregulated countries. Doing this contributes mightily to their bottom line, their profit, and makes their boards and stockholders happy. But it is really unpatriotic if not un-American because it keeps Americans out of work, taking away their jobs.

There has to be a way to determine what percentage of a corportation’s bottom line, its profit, is derived from outsourced operations. For example, if a corporation’s profits for the year were $100,000.000 and it were determined that 30% of that was the result of its outsourced operations, then $30,000,000 of their bottom line would be scrutinized to determine how much that portion of their profit would have been if the processes producing that amount had been conducted in the United States rather than overseas. Let’s say that profit number would have been reduced to $15,000,000.

Once these figures have been developed, the corporation would be taxed at the normal corporate tax rate for $70,000,000 of their profits developed in the United States and also be taxed at that rate for the $15,000,000 value of the profits developed from outsourced operations had they been performed in the United States. As for the remaining $15,000,000 of their bottom line, that would be taxed at a significantly higher tax rate which we will call the “outsource tax rate” and that would be a rate sufficiently, if not prohibitively, high enough to cause the corporation to bring jobs back to the United States, recognizing that taxes on outsourced profits will make outsourcing unprofitable to them.

This is a simple idea and therefore, probably something that economists would scoff at. I think it is worth a try.

JL

Inner Satisfaction

For those of you who do not live in Cascade Lakes, and I really don’t know who looks at this blog, a brief explanation of the following story (which that community's magazine declined to publish) is warranted. One of the three fountains at the community’s main entrance has frequently been out of commission over the years, despite frequent repairs and reconstruction of its plumbing. And now it’s time to read

Inner Satisfaction

Jack Lippman

Julien Bonhomme was one of the workmen employed in the construction of Cascade Lakes back in 2000. Actually, he worked for Bongiovanni Tile & Mosaic, the subcontractor which did the ornamental tile work decorating the fountains at the community’s Military Trail entrance. Julien was very angry. His employer had paid him every Friday during the first three of the four weeks he had been setting tiles on the fountains, but when payday came during that final week when the work on the last fountain, the one to the left of the entranceway, had been completed, Bongiovanni had disappeared. Apparently, once the developer had paid him, he had taken off, leaving unpaid bills and unpaid employees behind him.

Bonhomme and some of the other workers took their complaint to Buck, the construction foreman for the whole job. Buck felt badly about it, but explained that there was nothing he could do for them. The developer had already paid Bongiovanni, and if he had taken off without paying his employees, it was their problem, not his. Buck suggested they get a lawyer but since most of them were in the country illegally, going to court was the last thing they wanted to do.

That night, in the apartment he shared with a half dozen of his relatives, Julien explained what had happened. His uncle Pierre smiled at him.

“Why are you smiling, Uncle,” Julien asked.

“Because I think I can help you. You will never get the money from Bongiovanni, or this Buck fellow for that matter. I do think, though, that I can tell you what to do so that you will feel better about the whole thing. It’s the way we dealt with things like this back in Haiti. The important thing is that you get some kind of inner satisfaction, even if it isn’t money.”

And so it was that over the next few weeks, on the kitchen table in the apartment, Julien and Pierre built a clay model of the fountain which stood at the left side of the Cascade Lakes entrance. They put as much detail into it as they could. The family members in the place thought it looked remarkably like the actual fountain which some of them had seen while driving by on Military Trail, and offered words of encouragement to the pair.

“Now that we’ve built this model, Uncle, what are we going to do with it?” Julien asked.

“It’s hard to explain,” Uncle Pierre, suddenly very solemn, intoned. “I will recite some words in an ancient language which you will not understand. I learned these incantations from my father, words which have been passed down through generations of Haitians. They are very powerful and when you see me about to lapse into unconsciousness, and that is the effect saying them will have upon me, you must take this metal spike and this hammer, and drive it into the clay model. Trust me!”

With that Uncle Pierre handed a spike and a hammer to Julien, closed his eyes and started uttering an incomprehensible babble in a singsong manner. After a few minutes, Julien did what his uncle, whose body was now twitching uncontrollably, had told him to do, and the South Fountain at Cascade Lakes has never been the same since.