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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My earlier proposal that those stuck beneath consumer debts should be provided some assistance in paying them—in the form of government or government-guaranteed low-interest loans with reasonable payment terms—was not very popular.  So I’ll present a proposal on the opposite extreme—ABSOLUTE personal responsibility for debts—to see if it is more popular.  For purposes of this test of public opinion, I propose the following:

1)  Bankruptcy relief, as we know it, should be strictly limited to wealthy individuals and corporations seeking relief primarly from business debts and from obligations to ordinary people. 

2)  Ordinary people should be held ABSOLUTELY RESPONSIBLE for their consumer, educational and medical debts, and debts arising from the needs of ordinary living, including any interest and late fees their creditors may, in their sole discretion, decide to add to those debts.   No bankruptcy discharge of these debts should be permitted.

3)  Instead of permitting bankruptcy discharge for ordinary people’s ordinary debts, insolvency preventing payment of ordinary debts should be a federal crime, a crime against the interstate financial system itself, punishable by imprisonment in a federal debtor’s prison for a term proportionate to the size of the debt.

4)  Inmates of federal debtor’s prisons should be leased as laborers to private companies, and to public entities in need of labor, at rates competitive with the wages of "cheap foreign labor."

5)  The proceeds of a debtor prison inmate’s labor should be paid first to the expenses of maintaining the debtor’s prison program, then to public charges for public relief paid on behalf of the debtor’s children, with any remaining proceeds being used to pay the debtor’s debts to his or her creditors.  The debtor should remain imprisoned until his or her full debt is repaid with interest.

6)  Any imprisoned debtor who lives long enough to ultimately be released should be placed on a permanent federal Financial Offenders Registry, and employers should be prohibited from hiring any registered offender to perform any "responsible"  job.

This Absolute Personal Responsibility Proposal has been posted for voting on the Presidential Transition Team's Citizens' Briefing Book here. All voting closes tomorrow, Sunday, January 19, at 6 p.m. So hurry there to vote!

Posted by ian_j_site2 at 12:48 PM EST

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OK, everybody, you now have the opportunity to vote on some of the ideas I've been presenting on this blog lately.  The voting opportunity is presented on the Citizen's Briefing Book feature of the Change.gov, the Presidential Transition Team website.  The idea on which your votes are invited are found at the links given below (just click on them and they'll take you there):

"Solve the whole consumer debt crisis, not just the mortgage crisis."

"We must end the preference for "high-deductible" health plans that put heavy burdens on average people."

"The administration should fund both fission and fusion research" (nuclear energy).

"In the long-term, only some form of single-payer system will work" (health care).

 Enjoy!

Posted by ian_j_site2 at 8:43 PM EST

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A few months ago, Congress agreed with the President to give a collection of large financial institutions that were in severe debt trouble an obscenely large quantity of cash, with almost no strings attached, to get them out of their financial trouble.  Our leaders publicly expressed hope that, after they provided for the big institutions' debts and so saved them from destruction, the recipient institutions would start to make credit available again and would also cut some slack for the ordinary debtors that owed them money, thereby averting any larger crisis.

However, to date, none of the things our leaders publicly wished for have happened as a result of their generosity to wealthy corporate institutions.  The institutions given the money have used part of it to pay their debts to other large entities (but defintely not to unimportant "little" people), have used part of it to pay huge bonuses and golden parachutes to their top executives, and have sat on the rest.  The big institutions that received the infusions of public money have proceeded with their plans to lay off large numbers of their employees.   Credit has become tighter since the bailout, leading to business closures and layoffs throughout the economy.  The infusion of cash into the banks does not seem to have helped the economy at all, just those at the top of the financial entities that received the infusion. 

And, perhaps worst of all, the very same financial entities that were bailed out are now systematically putting the screws to all of the "little" (a/k/a real) people who owe them money. Banks have started to raise interest rates, late fees and other miscellaneous fees on existing balances wherever they can.  Average interest rates for existing credit card balances are already heading for 25%, and some experts believe they will reach 30% or above in the next year or so.  (This used to be called "usury" or "loan sharking," but it's now "business as usual").  They have made it clear that collection will be strictly enforced.

All I can say about this is that it could have been predicted.  The President and Congress were acting on a pipe dream.  Our large financial entities were acting the way most large debtors act when they are forgiven--by interpreting the forgiveness as favor to do whatever they want and consequently oppressing those who owe them money.  Even Jesus recognized this tendency.

In Matthew 18:21-35, Matthew recounts a story Jesus told about two debtors who were both subjects of the same king.   The first debtor owed the king a huge debt, much more than he could ever repay in a thousand lifetimes.  The second debtor owed the king nothing, but owed the first debtor about three months' wages.  Both debtors defaulted on their debts.  When the king called in the first debtor to pay his huge debt, the first debtor pleaded for mercy, and the king graciously forgave his astronomical debt.  After the king forgave his huge debt, the first debtor went out, found the second debtor, took him by the throat and threatened him with debtor's prison if he did not pay immediately.  The second debtor pleaded with the first debtor for mercy--or even for just a little more time to make payment--but the first debtor would not listen.  He had the second debtor put in prison until his full debt was paid.  The point of the parable was the king's response to the situation when he heard what the first debtor had done--"You evil servant!  I forgave you that tremendous debt because you pleaded with me.  Shouldn't you have mercy on your fellow servant, just as I had mercy on you?"  He then had the first servant cast into prison until he fulfilled his obligation to forgive the servant who owed him money.  The lesson is that we are to freely forgive others for their sins against us, not holding against them the debt of their sins, because God has forgiven us an immeasurably larger debt. We are to forgive others as God has forgiven us.

However, the important point for purposes of this discussion is that Jesus' story resonated with his listeners because they recognized that the first servant, the one who was forgiven the gigantic debt, behaved in exactly the same way most wealthy people forgiven a large debt would behave.  That is, he undestood the forgiveness as the king's permission to make a profit for himself however he could, even if this meant oppressing poorer people who owed him money. This is, and always has been, the way of the greedy when they are forgiven their debts.

Of course, there are some individual debtors who will choose to have mercy on their debtors when forgiven their own financial debts, just as there are some individual sinners who will follow Jesus' instructions to forgive their grudges against others when God forgives their own sins. 

But both of these statements only apply to individuals, not corporations.  Corporations, as artificial, soulless, non-human entities, are incapable of compassion and mercy.  They exist only to make the largest profits possible for their shareholders.  Yes, corporations are run by groups of real, human officers and directors.  But those officers and directors have a fiduciary duty to the artificial, soulless corporation that employs them to only make decisions that will maximize its profits.  If any officer or director of a financial corporation that recived the government's bailout largesse had actually attempted to do what the President and Congress publicly expressed hope the big banks would do--i.e., by making more credit available (to a "bad," risky market) and by having some mercy on the corporation's indiviadual human debtors--that corporate officer or director would either have been removed from office, subjected to a shareholder derivative suit to recover the losses of profits occasioned by his decision, or both. 

Thus humans who make the decisions for the financial corporations are not free to make the kinds of decisions Congress and the President hoped for.  They are free to do only exactly what they have done--pay their own debts, give themselves a cut of the action (to the extent permitted by their own employment contracts), put the screws to their debtors because of the increased risk in the market right now, and sit on the rest of the bailout money until the market improves.  Neither mercy nor risk-taking are on their agenda.  Our leaders would have known that if they had read the book of Matthew before proceeding with the bailout!    

Posted by ian_j_site2 at 10:38 AM EST

Updated: Sunday, 11 January 2009 11:36 PM EST

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Mood:  surprised

It's amazing how much St. Augustine's view of the Rome of his day applies to America today.

For the last few weeks, I have been carrying on a debate of my proposal regarding consumer debt relief on the Presidential Transition Team's general discussion bulletin board, in string that started here.  The debate has been lively, stretches over several pages and includes comments by a number of people.  I had consistently made the point that consumer debt is an important component of our country's financial crisis, and that finding a solution to the consumer debt component of the problem is absolutely essential.  I had also argued, and several others had agreed, that through education and other means, the country absolutely must be weaned off of its dependence on consumer debt.  Other commenters, however, took the position that the only cause of the problem was individual weakness and the problem would be completely solved if we would all learn to "just say no."

  Then, in response to these comments, Bradley MacLeod made the very perceptive observation that, because of the intense marketing of debt by banks and because of other social pressures, "It is getting to the point in our society that just saying no is socially unacceptable."

I agree with this observation.  But this is not the first time in history this pattern has been seen.  St. Augustine described Rome in the early part of the Fifth Century as follows:

"Do not imagine that it was by force of arms that our ancestors made a great nation out of a small community.  If that were true, we should today have a far more glorious nation.  In allies, in our own citizens, in armaments, in horses, we have greater resources than they enjoyed.  But it was energy in our own land, a rule of justice outside our borders; in forming policy, a mind that is free because not at the mercy of criminal passions.  Instead of these, we have self-indulgence and greed, public poverty and private opulence.  We praise riches: we pursue a course of sloth.  No distinction is made between good men and bad: the intrigues of ambition win the prizes due to merit.  No wonder, when each of you thinks only of his own private interest; when at home you are slaves to your appetites, and to money and influence in your public life.  The consequence is that an attack is being launched on a republic left without defenses."

St. Augustine, Concerning the City of God Against the Pagans, Book V, Ch. 13, quoting Sallust, who was commenting on a still earlier phase in Rome's history--but could easily (except for the reference to "horses") have been commenting on the history of the United States.

Posted by ian_j_site2 at 11:56 PM EST

Updated: Sunday, 11 January 2009 12:18 AM EST

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