Terry Du Bose recently posted the following letter from a third person, who used to SELL health insurance, on the USA.CAN listserv (USACAN@groups.barackobama.com).  It describes a practice called "adverse selection" which provides a rather good explanation of my last 13 years of experience with health insurance (even in an small-employer-sponsored group), and which also demonstrates rather nicely why government intervention in this far-from-free market is required just to restrain the evil side of greed:

Terry,

If we are going to help President Obama get the support he needs for health care we must make our intentions known and voices heard. I do know a little about health care from the insurance side. I owned an insurance agency in Austin , Texas for many years and finally walked away from a very good six figure income because I could not stomach it any more. After I got into the business and saw how corrupt it was, I thought I could make a difference. No way were, they to entrenched in the hip pockets of our congressmen.

There are a number of items I could address about the health insurance industry, but in an effort to keep this interesting let me hit on just a few high points. Most people believe that if they purchase a health insurance policy they are covered for life. That is partially true. There is a term in the health insurance industry call "Adverse Selection". In a nut shell here is what it means. You purchase a health insurance policy. Internally the insurance company assigns you to a group. An example of the group could be all policies sold in that year, or all policies in Texas , or all policies in you zip code prefix.  As people in the group get older and have more health problems the expense goes up and possibly profits go down. The insurance company offers a new policy with different coverage and lower premiums to the group. The only way you can qualify for the new coverage with lower premiums is with underwriting approval. The company moves the healthy clients over to the new group and leaves the sick with cancer, stroke, diabetes, heart problems, etc. in the old group. The insurance company will now increase the premiums on the sick group as much and as often as the law and insurance contract will allow. The goal is to make it so expensive that the insured's can not afford the coverage and will have to terminate their coverage usually through non payment of premium. Now we have a group of financially devastated sick people who will probably loose their homes and become a burden on the tax payers. Yes, it is legal and for profits.

Did you know the Health Insurance industry spent one hundred million dollars on Lobbyist when Bill Clinton was elected to office to fight his health care policies? The health care industry had three lobbyists for every congressman in D.C.  The health care industry gave George W. Bush about nine hundred thousand dollars to make sure universal health care would not have a chance.

Did you know that Ford, Chrysler, and GM have over one million retirees that they are paying for their health insurance? The Japanese owned plants in the USA only has around 300 retirees that they cover their health insurance. There is no wonder why the American auto industry can not compete with the foreign auto makers.

The insurance industry determines the quality of health care that we receive, not the doctor. This needs to change. I am now a Real Estate Agent and a while back I was holding an open house. I caught what appeared to be a real estate prospect in the bathroom stealing medication from the medicine cabinet. No they were not looking for amphetamines or barbiturates; they were looking for antibiotics for a sick child. They could not afford see a doctor.

We need health care reform now. We can not depend on our congressmen for they sold their souls long ago. It is up to us and our new President of the United States of America , OBAMA.

Mr. DuBose's informant only fails to mention two things: 1) Congress hasn't changed that much; a majority of both houses are still the same people the insurance industry owned only two years ago. 2) President Obama himself was a Senator a year ago. Therefore, he chances of real CHANGE seem minimal, but I support the proposed changes.

Posted by ian_j_site2 at 7:26 PM EST

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Ten years ago, I posted the following content on the internet under the title "The Radical Rejection of Politics as a means of accomplishing God's redemptive work:"

Modern Christians waste a great deal of time and money attempting to accomplish God's will, promote the Gospel, right wrongs and even bring in the Kingdom through political action. However, this activity is largely futile, since the problems they seek to address through politics are spiritual problems and their solutions are spiritual solutions. Moreover, since Christians often disagree sharply about political issues, the injection of political agendas into the Church tends to sharpen the pre-existing divisions in that Body and create bitterness, limiting further the effectiveness of the Church in accomplishing its true mission.

God generally does not accomplish His work by changing the behavior of the masses through the worldly political system. Instead, He establishes relationships with people one at a time and uses them to influence those around them. God works with and through individuals created in His image, not political entities.

In A.D. 314, Constantine, Emperor of Rome, declared himself to be a Christian and legalized Christianity throughout his empire. Unfortunately, from that day to this, most Christians have been easily distracted by the notion that God's kingdom may be established by law. This has provided at once a substitute for individual spirituality when those in power were friendly to Christian worship and morality and an excuse for lack of progress when the king was opposed to the organized Church. In the modern democracies, this notion has also provided a great distraction for otherwise committed Christians, to the detriment of the real work of the Gospel.

The scriptures are clear, however, that God ordains individual rulers for a very limited purpose. As discussed at greater length in the pages linked below, God does not ordain government organizations although these must necessarily come into existence to permit individuals to rule. No, God, who always works in and through individuals, appoints individuals to rule and holds them responsible for their work. Moreover, he gives these appointed individuals only four functions: 1) to maintain order, 2) to punish evildoers, 3) to do justice between those who bring disputes to them and 4) to praise those who do right. That is all.

When the political system expands its powers over its people by attempting to fulfil other functions, any effectiveness it enjoys will be but partial, incomplete and temporary. There is futility built into its efforts. Politics outside these purposes is futile because it has gone outside its ordained realm to approach spiritual problems with physical force. Its solutions are temporary because political "victories" always generate opposition which ultimately limits their effectiveness. Moreover, it presents only a false hope because the political system must keep problems alive in order to have an excuse to maintain and expand its powers. Unfortunately, in modern democracies leaders can only be re-elected by promising to solve social and economic problems which go far beyond the proper scope of government.

 What I wrote ten years ago may, at first, seem inconsistent with my recent activism and my announced support for President Obama. And I will admit that I have gone somewhat overboard for the last two months or so.  But the approaches really aren't inconsistent.   My approach has simply developed over the last ten years.

First, I should explain my position regarding the President.  Barack Obama is the duly elected President of my country.  I voted for him, believing in my spirit he was the one to whom God was directing me, but that is irrelevant at this point.  Even if I had campaigned and voted against him, he is our elected leader now.  As such, it would be only right for me to support him personally, to pray for him, and to support as much of his program as my conscience would permit.  Regardless of whether I agree with his program, the success of his program is the success of our country right now.  And there can be no question that the country needs a clear direction right now.

Therefore, I will support--actively--every part of President Obama's program that I do not have good reason to find morally objectionable.  At present, I see only two issues on which I find some aspect of the President's program actually or potentially morally objectionable--his support for abortion, the promotion of the gay lifestyle associated with one major bloc in his Democratic party (I have no problem with recognition that gays have equal rights).  Otherwise, I will support the President's whole program.

Now, about my recent activism: I still do not believe that I (or the President, for that matter) will be able to change the behavior of the masses, accomplish great good, or bring in the Kingdom of God through political action. Government and lawscan't cause repentance, and it is only individual repentance, occurring on a mass scale, that will really change things. 

However, one of the legitimate purposes for which God established government is to restrain the growth of evil. I have come to recognize that sometimes restraining evil requires affirmative action.  In situations in which people are regularly being oppressed  by other people, sometimes the task of restraining evil requires affirmative action to eliminate the opportunity  for  oppression.  Where people are systematically taking unfair advantage of others in their power, restraining evil may require affirmative action to change the system to limit the unfair advantage.  This is particularly true in situations in which the oppressor or the taker of unfair advantage is a corporation, an artificial person created by the law, rather than a real human being.  The task of restraining evil may not necessarily always be limited to punisihing the evildoer after the damage is done.

Thus, in a matter like the banking and credit crisis, in which the offenders are almost entirely financial corporations rather than real people, affirmative action is undoubtedly required to correct the system (which was, after all, created by law in the first place!) to limit oppression and unfairness.    Similarly, in the matter of health care delivery, affirmative action is undoubtedly required to correct some of the rapacious behavior of many of the corporate players involved in this already heavily regulated market. 

I have no illusion that great long-term changes will result from anything we can do politically.  Indeed, to expect any large positive change from politics would be to ignore my own "Warning Against Idolatry."  But systemic reforms now may restrain further evil by limiting the opportunities for oppression in our present negative national circumstances.  This is a legitimate thing for government to be doing, and I will fully support our President doing it.   

Posted by ian_j_site2 at 3:21 PM EST

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 I first posted the following entry on a former blog in November 2006, but it still appears to be a valid explanation of a major portion of the course of my life:

I now have a better understanding of one aspect of my past and present. The Apostle Paul wrote concerning teachers:

And he gave some to be apostles; and some, prophets; and some, evangelists; and some, pastors and teachers; for the perfecting of the saints, unto the work of ministering, unto the building up of the body of Christ

Ephesians 4:11-12

Thus, teachers in the Church are not self-appointed, and not appointed by other men based upon church program needs, education, training, interest or observed aptitudes. They are chosen and appointed by God, and given to the Church as a gift, for the purpose of building up the Body of Christ. God chooses teachers, and, given his foreknowledge and His presence throughout time, must have known from the very beginning every teacher he would give to the Church.

Somewhat by contrast, the Apostle James wrote:

Be not many of you teachers, my brethren, knowing that we shall receive heavier judgment. For in many things we all stumble...

James 3:1-2a

Thus, anyone who is given to the Church as a teacher—and anyone who presumes to act as a teacher without being called to that role—will be judged more severely than others. We see plenty of evidence of this in the treatment the world, and most of the organized church, gives to church leaders who fall into public sin.

However, I also see this pattern in my own life, from childhood. Long before I even knew Christ, and a very long time before I was aware of my calling as a teacher, I was subject to stricter standards than those around me. Performance that won my siblings praise won me criticism because I "could have done better." Sometimes it seemed that even an "A" in school wasn't good enough for me. I was punished for behavior that was tolerated in my siblings and my friends. Penalties were harsher for me as a child, and the reminders of my shame also seemed to continue longer. I was simply never good enough, whereas others around me were.

This pattern has continued since I came to Christ at age 16 and into my adult life. I have rather consistently been denied earthly rewards for my accomplishments, even when anyone else would have earned a reward. I was class valedictorian in High School, for instance, but was not permitted to speak at Commencement. I have five college degrees, including a law degree, but have a job as a paralegal—a position in which I am prohibited by law from taking any credit for my accomplishments (my work becomes my employers' work).

Outside of work, my worldly accomplishments have been largely limited to forums—like the Internet—in which no other person has to approve of me before I start work. If someone else has to give approval before I may start, I cannot work, because approval is rather consistently denied. Of course, this limitation to forums where other people don't have to approve of me also means that I'm limited to forums in which I will be ignored.

The punishment for my offenses also remains different than that imposed on others. I am still paying the penalty for relatively minor crimes I committed more than 20 years ago. These things still stand in the way of any worldly advancement—where I can show court cases to rove that others would have lived these offenses down by now. But I am not them, and they are not me. This is a major distinction!

This article is really not a complaint. It is an explanation. I now understand one aspect of my life that has annoyed me for years. God is not being unfair. He is treating me as a teacher—the calling he gave me before I was born. For the good of the Body, teachers are treated more severely.

Posted by ian_j_site2 at 9:57 PM EST

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OK, I confess, I voted for Barack Obama.   I am not disillusioned with him after his first month.   I am not disillusioned because I never had any illusions that he, or anyone else, could accomplish much.  Indeed, the voters could have elected me, and I would not have been able to do anything much different from what President Obama has done.

Yes, as I said in this blog more than once, even before the election, I had hoped that our new President would address the problems of most ordinary people with consumer credit (not just mortgages) these days in a way that would allow them to be paid off on more reasonable and less destructive terms.  But this has not happened.

I had also hoped that a new President might be persuaded to a method of health care reform more closely approximating national health care than anything we heard about during the campaign.  But this has also not happened.

However, I realize that these things, and other things that might have been good, have not happened not because President Obama is dishonest but because no one in his position would have been able to deliver these things.  Several factors contribute to this.

First, and most obvious, the economy is apparently going headlong into a depression.  This limits what funds are available to do.

Second, President Bush's rush bailout package just before the election  spent most of President Obama's flexibility before he was even elected, and spent it--predictably--on rescuing the economy by making the rich richer. 

Third, the ruling thinking on both sides of the aisle in Washington emphasizes consumer spending as ultimately the way to create jobs and revive the economy.  The only point of contention between the parties is how best to go about encouraging spending.  Both sides are afraid of an increase in the personal savings rate that seems to be developing. This increase is good news for the economy in the long run, but  bad for sales NOW--and no one in Washington can afford to look past the next election.  Alas, anything that helps the common people stop going further in debt--like real assistance with that debt or national health care--increases the savings rate (since paying off debt is a form of savings).  So such measures can't be countenanced, at least not now.

Fourth, and even more fundamentally, the corporate entities that are really in control of both the economy and the government are depending upon and fully committed to contnued increases in personal debt, as this increases their power.

But most importantly, our President is not free to make the changes that would really positively change things for the people because the Church of Jesus Christ in this country is still involved in the idolatry of expecting human institutions to provide for their needs. As long as this idolatry continues, things will continue to deteriorate, as I predicted more than 8 years ago.  When the Church cleans up its act, and starts trusting God to provide and doing what He says to do with what is provided, our leaders will miraculously become free to do right, and things will improve for believers and unbelievers alike.   

Posted by ian_j_site2 at 11:17 PM EST

Updated: Tuesday, 17 February 2009 11:19 PM EST

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Here is a copy of a letter I sent to my two Republican U.S. Senators recently, explaining as fully as I could the reasons national health care is necessary:

<<

 For years, I was a mostly pretty conservative Republican.  I was a
Republican precinct committeeman for 10 years. I'm still committed to the
pro-life position and conservative on many social issues.

But I've come to the conclusion that national health care is the only
workable solution that doesn't leave a lot of working people completely
out of the health care system and many of the others (and their employers) paying extortionate rates for shrinking coverage.

I have a pretty good job.  I'm paid $50,000 per year.  But my employer is
a small law firm--three employees with five lay staff (I'm a paralegal). 
Some of the employees or their family members have common chronic diseases (I'm one of those).  As of the rate increase last October, my employers pay more than $500 for my individual coverage.  I pay $907 per month to  cover my family.  And our Blue Cross plan doesn't pay a cent until we meet $2,500 per person/ $5,000 for all of us annual deductible. 

The cost of providing insurance for employees is a major strain on my
employers, who discuss it frequently.   Then again, my premiums plus my
deductible consume 54% (you read that right!) of my annual after-tax
income.  And you wonder why people aren't spending money and creating
jobs?   We need to get the burden of healthcare off of the backs of
business--without putting it squarely on the backs of ordinary people who
are unable to bear it.  (That was the problem with the McCain health
plan--it would have moved the cost off of business and mostly onto older
and sicker workers.)

All of the information I've seen on the subject indicates that something
in excess of 35% or 40% of health insurance premiums paid go to overhead costs--people whose jobs are to collect premiums, file claims, process claims or deny claims.  Great savings could be achieved here.

Finally, I note that health care on an insurance model is fundamentally
incompatible with the preventive health emphasis we will need to improve
the nation's health AND to achieve cost containment.  Insurance, by its
nature, only pays for "loss" events AFTER a loss has occurred, and expects
insureds to pay for any needed loss prevention activities themselves. 
This approach may work fine for commercial insurance, but works very badly  for health coverage.  Why?  First, because the majority of the people in the system can't afford to pay for much in the way of loss prevention
after paying their premiums and deductibles.  Second, becuase the most
effective loss prevention strategies are population-wide strategies. 

So, for all of the above reasons, I support S.4 (which I understand is
just a "sense of Congress" resolution) and H.R. 676.

>>

Posted by ian_j_site2 at 8:28 PM EST

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In an earlier blog post, I announced my support for HR 15.  I still think it's a good bill.  The problem is, it probably doesn't have a chance of passage.

Since the date of that earlier post, a group of congressmen have re-introduced HR 676, the "United States National Health Care Act or the Expanded and Improved Medicare for All Act."  This is the same HR 676 that was before the last Congress, and it has now been re-introduced in this Congress under the same bill number.  Although in some ways it is quite different from HR 15, it also establishes a single-payer system, and it also permits and encourages methods of payment to providers other than the traditional "payment for service" method.  Thus, like HR 15, it is compatible with the expansion of the prevention emphasis that will be so vitally important to improving public health and reducing the cost of health care in the long-term.

As I have said before, paying for health care under the traditional insurance model--which only pays for insured "loss" events AFTER the "loss" has occurred--is fundamently incompatible with a focus on prevention.  A system focused on prevention will provide services BEFORE any loss occurs.  HR 676 is compatible with this focus, and would allow medical providers to choose to be paid on models that favor prevention, though it also would leaves providers the option to be paid on the traditional pyment for service after loss model if they so chose.  

Thus, on these grounds alone, HR 676 would be far preferable to the approach the President seems to prefer--mandated private health insurance coverage, with the federal employeees' Blue Cross plan being opened to everyone who doesn't have other insurance.  Any approach which continues our dependence on the payment for "loss," only AFTER the loss, approach to health care financing stands in the way of prevention and will lead to escalating future costs.  

HR 676 also has the virtue that it will get us completely away from all of the other trappings of "insurance"--premiums, deductibles and coinsurance--that disproportionately burden low- and middle-income insureds.  

However, the real advantage of HR 676 over HR 15 is that HR 676 has a decent chance of passage.  This is a big advantage!

I now support HR 676.

See the HR 676.org website

Posted by ian_j_site2 at 10:29 AM EST

Updated: Sunday, 8 February 2009 4:19 PM EST

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OK, now that the new Congress is in session, I can identify some bills that I can support. 

On the subject of consumer credit reform, I support S 3, HR 627/ S 235, and S 255.

On the subject of health care,  I support S 4 and HR 15.  If HR 15 cannot be enacted, I would accept HR 193 or some similar bill as much better than nothing.  But HR 15 is preferable.

None of the bils pesently before Congress on the subject of consumer credit or economic relief provide any direct relief to distressed consumer debtors, and none of them reverse the "reforms" of the bankruptcy bill three years ago that made consumer debts much more difficult to obtain any relief from in bankruptcy (although there is one bill that would allow some additional bankruptcy relief for  distressed mortgage debts).  However, there is a "sense of Congress" resolution before the Senate, S.3, the "Homeowner Protection and Wall Street Accountability Act," that appears to be calling upon Congress to enact legislation for the relief of consumer debtors, among other things. And there are three bills that would make at least a good start on the kinds of reforms in the consumer credit markets that I was proposing in my post last September:  HR 627/ S 235 identical companion bills entitled the "Credit Cardholders' Bill of Rights Act of 2009," and S 255, the "Empowering States' Right to Protect Consumers Act of 2009." 

On the subject of health care systems, there are three bills presently before Congress that would appear to be, or to call for, a large step in the right direction, though none of them is perfect.

S 4 is entitled the "Comprehensive Health Reform Act of 2009," but it is really only a "sense of Congress" resolution.  However, if Congress actually enacted bills incorporating all of the reforms called for in the resolution, it would take a great step forward.

HR 15, the "National Health Insurance Act," and HR 193, the "AmeriCare Health Care Act of 2009," present alternative models for arriving at something approximating universal coverage.  Either one would be a great step forward. In my opinion, HR 15 is a better bill.  If I'm reading it correctly, it wouldn't cover quite as many people as HR 193, which is a disadvantage.  But it has the strength that it appears to get farther away from the old "insurance" model  of health care delivery, with its insistence on strict fee for service payment, and its insistence that individuals bear deductibles and coinsurance payments. In this way, HR 15 appears not only to be friendlier to low- and middle-income people, but also to be more consistent with the much-needed shift to a preventive medicine emphasis. The insurance model requires that medical services be paid for only AFTER the insured "loss" has occurred.  HR 15 would permit alternative payment systems--advance contractual retainers and hiring of physicians on salaries to provide care--that are more consistent with prevention of disease.

Posted by ian_j_site2 at 12:16 PM EST

Updated: Sunday, 25 January 2009 3:34 PM EST

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After I watched the festivities today, I understood WHY the President picked Rick Warren for the invocation, and just how intelligent the choice was. The President was announcing, just as clearly as he possibly could, that he wants unity in this country so much that he is willing to work with ANYONE who will work with him, regardless of their ideological purity. This even includes (GASP!) conservative Christians.

Pastor Warren lacks liberal ideological purity on the homosexuality and abortion issues, of course. The media and the President's supporters from the gay community have been making a fuss over that ever since the choice was announced.  But the President was attacking an even deeper division. The principle that all gods are equal is a basic tenet of traditional liberalism. To traditional religious liberals, all gods are equally relevant; to traditional non-religious liberals, all gods are equally irrelevant; but all of the gods of the world religions are equal. Traditional liberals, for the last 50 years, at least, have uniformly insisted that their leaders respect this principle in all of their public pronouncements.

However, Pastor Warren did not respect this principle. He prayed in the name of Jesus (a big no-no all by itself) without mentioning any other gods.  The President worked with Pastor Warren on a televised forum during the campaign, and knew him even before that.  The President   must have anticipated that Warren's prayer, though very positive and proper in every other respect, would be politically incorrect in its failure to recognize other gods. The only conclusion that can be drawn from this is that the President intended to announce that he was not going to insist on dividing the country over this issue by excluding people whose faith allows them to acknowledge only one God.  (I note that this is true not only of Christians, but also of religious Jews and of followers of Islam).   It's about time!

I am a conservative Christian myself, at least in my theology.  Yet I am very willing to work with this President, to accomplish most of the the things that form a part of his vision for this country.  The few matters on which I disagree with him do not diminish my support for him personally, as our leader, or for most of what he is trying to accomplish. All I can say is, let's get started!

Posted by ian_j_site2 at 11:08 PM EST

Updated: Tuesday, 20 January 2009 11:11 PM EST

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He that oppresseth the poor to increase his riches, and he that giveth to the rich, shall surely come to want.

Proverbs 22:16.

This was the observation of King Solomon--himself a very wealthy man who received gifts from many people seeking his favor--over 3000 years ago.  I observe that this is exactly the pattern of the bailout.  Tax the poor, directly or through inflation, and give the bailout money to the rich.  Stated another way, increase the nation's wealth by taking from the poor to give to the rich.  And, while we are at it, we are giving no relief to the poor.  On the contrary, we are giving the rich more legal protection to enable them to more effectively enforce the debts the poor owe them.  (We've actually been systmatically increasing the remedies of the rich for at least 20 years).  Furthermore, to make the money available to pay the bailout, we are going to have to reduce the level of assistance we presently afford for the poor, and the public services everyone who is not independently wealthy must rely upon. Solomon predicted that such an approach would not work.  In fact, it will lead us to poverty.  The rich will get richer, but the poor will get poorer faster than the rich get richer. Our total wealth will decline. We "shall surely come to want."

 But I also note that the government's approach in executing the bailout is just an outgrowth of the dominant trend in our culture. You can see it all over entertainment.  You can see it in "game shows."  You can see it in the advice we give each other, and the advice our popular "experts" give us, about careers, office politics, and financial planning.  You can see it in the fortunes amassed by a few promoters in the drug industry (both legal and illegal), and in the pornography and sex industries, and the devastated lives of "little people" that are considered OK to achieve these fortunes. You can see it in the steady and growing popularity of pyramid schemes that never work for anyone but their founders, multi-level sales plans that promise that "anyone" can sell them when only a few have the real "sales" ability to succeed, and other get-rich-quick sales gimmicks.  It's all about getting rich, or, at least, looking rich, and catering to the rich to make your fortune. It's about giving to the rich to make your fortune, and taking advantage (knowingly or unknowingly) of as many "little people" as you have to along the the way.  Giving to the rich and oppressing the poor to amass wealth is a growing part of our culture.  The government has just followed the culture's lead.

The problem is, the approach doesn't work in the long term.  It leads only to poverty.  The wise have known this for 3000 years.  

Posted by ian_j_site2 at 10:56 PM EST

Updated: Monday, 19 January 2009 11:01 PM EST

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