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Posts Tagged ‘capitalism’

Insurance is a guard against risk.  Term life insurance is provision for your family in case you die young – an unlikely occurrence.  Car insurance is coverage in case you get in an accident – which most people won’t.  What we call health insurance is not insurance.  It is a “benefit,” like a retirement plan.  Our system originated when companies were competing for labor without breaking the salary cap laws. 

We could have health insurance, an investment to pay large, unexpected expenses if they come up.  There are a few plans that cover only catastrophic needs.  These are not the kind provided by employers in our market today.  Of course, if employers want to pay for preventive healthcare and common doctor’s visits, that is their competitive option.  It shouldn’t be mandatory, any more than a salary cap should be mandatory. 

Employers could also provide grocery coverage: the planned, necessary expense; for each employee and his family.  The price of food would go up, and options would go down, and companies would do better to just pay well for their labor, letting the consumers determine the demand and value of food.  Consumers are less extravagant, more cost-conscious, and diligent to hold providers accountable for their products and services. 

What makes us think that paying rows of middle men for our health care payment system will result in saving money or improving care?  Are these middle men doing something I couldn’t do myself?  No – they’re distancing me from information about my options in health care and the shocking costs of some procedures. 

My solution is this:

1.  Do not require an employer to do anything for his employee that does not concern his job: cover injuries caused by the job and keep work environments safe. 

2.  Also eliminate what is essentially a tax break on the benefits provided by employers.  If wages are going to be taxed, so should the health care benefits and retirement plans. 

3.  Do not require insurance companies to have a minimum amount of coverage, nor any specifics.  Instead, enforce contract law: openness of the agreement being made and stiff penalties for either party dropping their end of the bargain.

4.  Do not require individuals to have health insurance of any kind.  If the problem is in collecting payment for emergency services rendered to the poor, this needs to be addressed in a wider question of bankruptcy laws and debt repayment.  Leaving individuals to the option of health insurance reduces the weight on the health care industry by discouraging unnecessary doctor’s visits and encouraging preventative lifestyles. 

5.  Allow increased competition by revoking the state line restrictions on insurance policy sales. 

6.  Reduce the cost to healthcare professionals by reforming the system that allows doctors to be sued without probable cause.  Our economy and government is almost completely biased against businesses in favor of consumers.  The customer is not always right; sometimes the “customer” is committing fraud. 

To God be all glory,

Lisa of Longbourn

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I am no fan of government involvement in commerce, even when the industry is health care.  As with most government programs, the three arguments are simple: First, it is quite illogical to think that we can funnel money through a string of middlemen, each of which receives their cut, and come out ahead.  Second, the more the government controls the money, the more they control everything else.  We see this in the recent bailouts of banks, where CEO’s were deprived of their prearranged bonuses by force, and also in the car manufacturing fiasco where the government first handed the money and second forced a government-arranged bankruptcy.  The fear is that when the government is funding health care, the government will tell doctors and patients their options.  Finally, every other experiment the government has made in taking over an industry, however charitable, has been a money-draining disaster with worse results.  For example, consider social security or the public education system. 

Obviously there are other concerns with a socialized, or even a partially socialized health care system.  If things go as they have in Europe and Canada, lines will be long, doctors scarce, and treatments almost rationed (or chosen for their cost efficiency rather than effectiveness).  Private health insurance companies (which insure no such thing) may be put out of business.  Perhaps they ought to be put out of business, but the government is hardly an improvement.  We might worry about fraud, or about people taking advantage of services that cost them nothing. 

 The Problem with Health Insurance

There are two reasons why the people want the government involved in health care:  Many individuals are not insured and cannot afford the high costs of treatment or even of preventative checks.  As an act of charitable compassion, some people argue, the government should take responsibility for these “underprivileged.”  Others, many of whom work in the industry, agree that the present health insurance system is not as good as it ought to be, and think that the government should fix it.  Not surprisingly, these two groups of constituents are looking for very different things from their government.  But they each voted for the same man as president because he at least sounded concerned about the issue. 

 Status Quo

I realize the relatively-free-market health insurance system is not meeting needs, though I believe a free market solution would be better.  Let me describe the problem.  An insurance company takes money monthly to insure you and your family.  They put that money into a pot, part of which goes to pay their employees.  The rest is a bet they make that you will not need the full amount of your premium.  Sometimes they lose the bet, but as long as they don’t lose too often, they can apply the extra money they charged you to the bills for other people.  To keep their costs down, insurance companies tend to be selective and difficult about accepting claims.  They use different ploys, like keeping the most expensive treatments out of formularies; claiming that the treatments are experimental or cosmetic; restricting the doctors you see to those in a pre-approved network; or by prohibitive referral processes.  Insurance companies sign contracts with in-network doctors agreeing to pay a certain amount for specific services – usually an amount less than that which the doctor would usually bill.  This though it actually costs a doctor more to bill an insurance company, due to the amount and hassle of paperwork required.  On top of this, the insurance company usually requires you to pay a copay or percentage of your bill.  Or another old-fashioned, lower-priced option is to have a deductible.  In this system, the patient pays for routine care and emergency expenses up to a certain amount (which they may or may not exceed in a year, and would probably do better not to exceed), at which point the insurance kicks in with a discount or normal coverage.  More on this later. 

To compensate for the arbitrary reductions that insurance companies make to the amount of a doctor’s fee, doctors are almost forced to raise their prices to fool insurance companies into paying them what they need to make a living.  Competitively low prices have been eliminated by an across-the-board amount insurance will pay.  What is to be gained by a doctor charging the insurance less than they have agreed to pay? 

The Corporation Aspect

Insurance companies, except for Medicaid and Medicare, have been private enterprises, required to compete for customers.  To gain a competitive edge, there are several options.  The most obvious is advertising.  Name recognition is important.  Companies can advertise having a large pool of doctors in their networks, easy paperwork, comprehensive coverage, low premiums, small deductibles or copays, perks like inexpensive prescription drugs, or customized get-only-what-you-need plans.  The problem is, insurance companies as a rule have become accustomed to advertising to corporations or businesses, not to individuals. 

Enter Government Interference

I have not studied how the benefits became a normal offering from a corporation to its slaves, but I suspect taxes (translate: government interference and manipulation) have something to do with it.  This is what I know.  Businesses are taxed on the amount of money they pay their employees.  Employees are taxed on their income.  Some things on which people spend their money are tax-exempt (food and medical expenses in most cases).  Perhaps businesses sought to increase the incentive to work for them by offering the untaxed add-on’s? 

(excerpt from an article at http://www.ebri.org/publications/facts/index.cfm?fa=0302fact: “In 1910, Montgomery Ward entered into one of the earliest group insurance contracts. Prior to World War II, few Americans had health insurance, and most policies covered only hospital room, board, and ancillary services. During World War II, the number of persons with employment-based health insurance coverage started to increase for several reasons. When wages were frozen by the National War Labor Board and a shortage of workers occurred, employers sought ways to get around the wage controls in order to attract scarce workers, and offering health insurance was one option. Health insurance was an attractive means to recruit and retain workers during a labor shortage for two reasons: Unions supported employment-based health insurance, and workers’ health benefits were not subject to income tax or Social Security payroll taxes, as were cash wages.

“Under the current tax code, health insurance premiums paid by employers are deductible for employers as a business expense, and are excluded, without limit, from workers’ taxable income.”)

Why is this adverse?  As long as the employees of the company are not complaining – or in worse cases, not threatening strike or resignation – the corporations are under no pressure to do what is best for the patients.  They will buy insurance plans that cost them the least money.  Even if two plans cost the same low price, how is a corporation to know which health insurance provider will offer better service? 

Starbucks and Competition

Let’s compare this to something simple and familiar: Starbucks.  On every corner, there is a Starbucks.  One might be on your way out of your neighborhood when you’re headed to work.  Your grocery store might have one in the corner.  Or there may be that chic spot where you always have coffee with your girlfriends.  Which Starbucks do you patronize?  There might be a friendly Starbucks, a convenient Starbucks, the one with the drive-thru or the excellent customer service.  You might prefer a clean Starbucks or a less busy coffee location.  A few Starbucks offer different selections for their bakery, or later hours.  If you ever have a bad experience at one franchise, you can switch loyalties and frequent the Starbucks across the street. 

Now what if the company you work for, as part of your compensation package, had agreed to fund your Starbucks addiction?  Yet for their convenience they bought a package with a single Starbucks site for all of their employees.  To use your benefits, which your company already paid for, you must go to the Starbucks they chose.  The person who selected the corporate Starbucks didn’t even like coffee, has no idea where you live or whether you like bakery items or drive-thrus.  But now you’re stuck.  To take advantage, you have to drive clear out of your way, get out of your car and walk in, only to find they don’t have the muffins you like and the barrista is grumpy every day.  If you get ambitious, you may complain to your human resources department in hopes that they would change coffee shops for you.  But then someone else is unhappy, because they don’t like the busy, cramped feeling of a drive-thru when they’re reading their novel in the corner, hugging a cardboard-ringed cup of coffee. 

What’s more, as this trend catches on, more and more businesses start choosing a Starbucks for their employee benefits.  Starbucks realizes that they can earn as much by pleasing one corporation as they could by catering to a thousand individual customers.  Once the contract is landed, there’s almost no possibility the business would pull out.  Service wanes, options are reduced, prices inflated, and soon no one who is not part of a corporate plan can afford to buy Starbucks.  Opting for your old favorite Starbucks near your house with the drive-thru and muffins costs you an arm and a leg – and they don’t even have muffins anymore, because that isn’t part of the plan the corporation who chose them wanted.  Your neighbor has to give up his Starbucks addiction because he is self-employed and can’t afford it. 

And the economics get worse, because your wife and kids used to love Starbucks.  The corporate plan includes them (and the trend has made it impossible to afford mocha frappachinos anywhere else), only at that one Starbucks.  To reduce corporate costs, though, they start to restrict the family plan.  Wives and kids under 18 can be included for now for a monthly fee.  After 18, if they enroll in college, the company will still fund their Starbucks life – who knows why the company cares.  Then all of a sudden, at 25, no matter what your family values or circumstances, your kids are no longer covered.  “So get over it,” my reader says, “It’s only coffee.” 

Dire Consequences

But I’m not talking about coffee.  I’m talking about health care, without which you will live with chronic pain or illness.  When you break a bone and can’t afford the X-rays and doctor’s visits, you forever cripple yourself, limiting your employment possibilities.  Or you may die, after exposing your community to sickness.  And remember, the reason an average uninsured person cannot afford basic health care is because the prices are inflated due to insurance policies and corporate-appealing non-competition. 

 Every Man for Himself

In the Starbucks illustration, I even skipped a step, eliminated the middle man.  That middle man not only harms you, the patient, but also the doctor.  And the less lucrative it becomes to be a doctor, the less people want to be doctors.  When there are not enough doctors for immediate care, you wait.  The service gets worse, more and more limited because all these unnecessary people are skimming off their share, and there isn’t enough money to pay for what is needed at the inflated prices.  But everyone is out for themselves, including the patient.  They’re going to get the most they can out of their coverage, too, taking advantage of any free or fully covered procedure, necessary or not.  These procedures have their place, and their price, but are not for everyone.  Someone is paying for them, even if it is not the patient, and no one is benefiting. 

How the Government Makes Things Worse

An astute observer may already have realized that if the government takes over the Starbucks plan system, the problem is only going to get worse.  There will be even less competition; more cost-cutting standardization of inventory; and less incentive for providers leading to less providers and longer waiting and higher costs.  This is not even to mention the regulation that will accompany the government plan, or the government-funded coverage for those who could not afford health insurance under the old system. 

 Creation Rather than Creativity

Nevertheless, the Obama administration presses on towards a government option for health insurance.  A nation already so much in debt that it cannot hope to get out of it, threatened with economic collapse, high unemployment, and runaway inflation is going to invent more money (and possibly also increase your taxes) with which to provide health care to its poor.  The US may be able to create dollars ex nihilo, but it cannot create doctors, and we are going to run low. 

Government Advantage

What’s more, this government plan will have the unmatchable advantage of an endless supply of money for which they will have to give little account, as opposed to the private competitors who have to make do with what they can collect by way of premiums.  Analysts fear that private insurance companies will be shouldered out of business by the government “option.”  Corporations will not choose to carry the expense of health insurance when their employees could get coverage from the government. 

Rationing

Others who risk prophesying anticipate a responsible government (don’t know where they got that idea), which will limit the amount of imaginary money they’re spending, and be forced to ration care.  Even aside from the money, as I said, fewer providers in business may demand rationing, too.  The most fearful consequences of this potentiality are the way decisions will be made.  Would a rationing system choose a younger person for care over an elderly person?  If your condition is the most expensive to treat, would you be left untreated?  Or perhaps your chances of survival are small, so there will be no attempt made to save your life.  An extreme government might choose by party loyalty or by race.  When choices like that have to be made, motives become suspect. 

Forecasting Good Things

Now for the bright side.  Barring a law prohibiting paying for your own care or health insurance, the private half of the system might be improved by this sudden competition.  If under a national health care system you cannot get treatment or if you doubt the quality of the treatment, you may take your savings and pay dearly for health care yourself.  It will be interesting to see if all doctors will be required to accept the government health plan, or if they will have the option of demanding private pay. 

Free Markets Fight Back

When corporations start dropping benefits from their compensation packages, employees worried about the level of health care they might receive under a government-run plan will have the competitive option of buying health care for themselves and their families outside of the corporate insurance model.  I believe the best option for reforming the health care industry is to make just this shift, to competing for the business of the individual rather than the company.  Already I see insurance companies marketing to that class of consumers.  Such policies would be most efficient as catastrophic coverage, for medical expenses exceeding tens of thousands of dollars.  Patients would pay out of pocket for routine medical visits and simple treatments like antibiotics, but in case of surgery, hospital stays, or a disease like cancer, those high costs would be covered.

The Answer for the Poor

In either case the solution requires that you have enough money of your own to pay for health care.  Most people do not.  So in the end we may survive this government takeover only by prevention and caring for each other in community.  Eat healthy.  Wash your hands.  Get enough sleep.  Join a community of people who are going to watch your back – maybe even an insurance community where you all save your money together, agreeing to help each other if any of you incurs a major medical expense. 

To God be all glory,

Lisa of Longbourn

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Obviously there is an economic crisis.  The world is unable to borrow money.  As a result countries have stopped trading money.  People have stopped spending money.  Within weeks businesses will stop paying money to employees.  Unless something changes. 

 

The government of the United States has already acted.  They passed a $700 billion bill that, along with unnecessary tax cuts to special interests, relieves stupid and irresponsible bankers and investment agencies of their risk.  Initially confidence was back up, and the stock market regained some of its points.  I don’t know what else to call it, because there isn’t inherent value in the stock market, or money. 

 

Now the economy has regained its sense.  The people of the United States, those whose money fuels the investments and liquidity, told the government not to pass this imaginary money bill (a huge loan taken out by the US Congress in the name of the US people).  Now they are still not confident, still right that the bailout bill was the wrong thing to do.  The Congress went ahead and stole our free market.  So the stock market crashed more than it ever has before. 

 

The world is in turmoil, because most of the world owns stock in our financial stupidity.  Of course looking out your window no one seems to be in turmoil. 

 

I have been in tears.  Yesterday morning, watching news of voter fraud and financial collapse, an eerie thought crossed my mind.  Much like the compulsion to watch the news all day on September 11, 2001 and remember every event and emotion, I thought I should remember these days and their news, as though recording the last days of an era, an ideology, or a country. 

 

I’m generously predicting complete socialism in America in 3 months.  My dad says it could be sooner.  So, as a matter of fact, does President Bush.  The government has acted and will continue to act, he says with regards to the economy and the failing markets.  Our country may soon be socialist. 

 

That is, if country still means anything. 

Today the G7 world leaders are meeting to compose a unified plan for a unified global solution to the economic crisis affecting people internationally.  “In an interconnected world, no nation will gain by driving down the fortunes of another. We are in this together. We will come through it together,” Bush said. “There have been moments of crisis in the past when powerful nations turned their energies against each other or sought to wall themselves off from the world. This time is different.”

My friends don’t know who to vote for in the presidential election.  They’re discouraged with the options offered by major political parties.  We all know that neither candidate will accomplish much of anything toward fixing the massive problems in our government and economy (financial markets and health care), nor will they actually do much of anything for the social interests of people (education, immigration, abortion, and marriage).  The best answer I have is that it won’t matter what we vote.  Our government is rapidly running away from republican principles, the Constitution, and even its national existence. 

Have a good day. 

(My personal philosophy is that whatever is out of my control is in God’s.  He has the future thoroughly planned, and has revealed the end of the world in His word in several places.  What’s more, my personal welfare and provision is securely in his good hands, not ultimately in the government’s.  Whatever happens, however discouraged I may be by world events, I can trust His sovereignty, goodness, and grace.) 

To God be all glory,

Lisa of Longbourn

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My brother and I were talking the other night and I had an insight (being only informally trained in economics – I could have been taught it if I’d just taken a class).  But I don’t know if there’s a name for it.  So I’m asking. 
 
I heard an ad for investing in gold.  The price per ounce has gone up a lot in the past couple years, and is understandably predicted to continue to rise.  Right now I think the commercial said the going price is $700 an ounce.  But while I might have $700 free cash to invest waiting for the gold to increase in value, I’m not allowed to buy gold one ounce at a time.  So there is a minumum amount of money I have to have before I can participate in investment.  Buying a home is very similar.  Debt makes money more available in larger amounts (paid back in smaller increments), thus raising the minimum line. 
 
Bartering went out of fashion because having one cow didn’t work as a trade for one spear, since the cow was really worth say, 300 spears.  So we have capital, money, to be the fluid in between and prevent us needing a minimum number of available cows to trade in order to participate.  Capitalism, therefore, should have fixed the minimum line problem. 
 
But then we add inflation (caused by debt on a national level), which depriciates the money someone below the minimum line has, so that they are, rather than gaining worth by saving money, actually losing ground.  They must continue going to work (as an employee, most often) just to get enough money to survive – if that.  And there’s no way out.  This is the modern equivalent to serfs, or the slave class. 
Marx saw this, I assume (never read Marx myself), but his solution doesn’t solve anything.  It emphasizes inflation and simultaneously erases any home of overcoming it through investment.  Marxism is like bailing water from a still-sinking boat. 
 
So what’s it called, the minimum line to participate in investment that would protect your income? 
And what should we do?  
 
To God be all glory,
Lisa of Longbourn

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Why am I writing this series?  On Saturday I went to a jewelry party (like Pampered Chef, Tupperware, PartyLite candles, etc.)  There are rules for how to wear your jewelry!  People are afraid to try something new or not their typical style.  Layers are very “in” right now.  But you can go with a classic look that never goes out of fashion.  My friend who was hosting the party disagreed with some of the fundamentals of wardrobe, and the jewelry saleslady assented, “If it looks good to you, wear it; it’s all about confidence.”  I know my friend is independent-minded.   

Style is a big industry.  People advertise their designer creativity with crazy lines of clothing in fashion shows, and somehow make plenty of money.  This happens even though I don’t see anyone but models wearing those things, and if they’re not wearing them, are they really buying them?   Why do people follow trends, anyway?  The popular girl wore that, so I will too?  We really think the movie star’s life is so wonderful that we want to do everything like them, including clothes and hair? 

Because something is popular, we consider it beautiful?  Or just because it is new and different, edgy, we invest money in it?  I can understand doing that with a car (whose innovations usually look good and have functional improvements in performance).   Apparently advertising agencies run the world.  They created the concept of teenager, which now governs economics, education, family, marriage, morality, justice…  The industry tells us how to spend our money by manipulating emotional, need-to-fit-in people into feeling like they need their products.   

Do we have a choice?  Does God have choices?  What is the meaning of not choosing something?  Is value subjective or objective?  Is value placed on a thing by a chooser, or is it inherent?   The capitalist system of economics is based on the notion that consumers will act on their sense of value.  For example, I value a necklace at the jewelry party, but I value other uses of my money more. 

A wrench is thrown in the theory of capitalism when I say that even though I value something more than my fluid cash, I won’t buy the item because of moral/spiritual convictions.  I may believe that God doesn’t want me to spend money I don’t have, for example.  I believe that $15,000 would be a great deal for a house.  But I don’t have 15 grand, so I’m not acting on my sense of value.  Even if I need a house, or think it is a great investment, I won’t buy.   

God is also teaching me about embracing sacrifice, intentionally going without what I want.  This is part of the concept behind fasting.  Fasting is a huge exercise of will over want.   If I was being sincere, I would tell you how I really feel about fasting.  My convictions tell me that the way I feel is sometimes wrong.  So I will exercise my will in acting upon what I ought to be in order that I may become that ideal in sincerity.   

Finally, I’ve been reflecting on strong-willed people, especially children who try their parents.  Some strong-willed rebels are breaking my heart.  Other strong-willed children are too young to have made life-altering mistakes.  I listen to their parents talk about them, and I wonder if I could help them to understand the puzzles who are their children.  Would it benefit them to know?   Dr. Dobson wrote a book.  I haven’t read it.  He doesn’t seem to be strong-willed to me.  I think President Bush is.  President Reagan was. 

Heroes are strong-willed, fictional or historical.  Villains tend to be that, as well.  In Beauty and the Beast, both main characters are strong-willed.  Think of their argument after she runs away.  But, as the song says, somebody bends unexpectedly.  Notice it doesn’t say somebody was bent.  They bend.  The tense is intransitive.   

I can relate.  This could be titled, “Confessions of a Strong-willed Christian.”  In writing this series, I discovered a lot about myself, and happily connected dots.  I have a friend who thinks that it is inconsistent with the rest of my personality that I like to watch football.  My position is that it must be linked to my fundamental identity.  This has been an exercise in associating who I am with that identity.  But no, I still can’t explain why I like football. 

Still to come:

What is a Strong-Willed Person? 

How Can you Tell if Someone is Strong-Willed? 

What should Parents of Strong-Willed Children Do?  

Is there Hope?  The Good Side of Strong Will.  To God be all glory,

Lisa of Longbourn

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