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Fixing health care for small business, self-employed and individuals — without tax money!

Thursday, July 30th, 2009

First of all, my solution for “reform” or actually trust-busting of healthcare for small businesses, self-employed and individuals does not involve tax money, subsidies, or much of anything else from government except mandating some rule changes. Most of these will be at the state level, though it would be necessary to make a small change in HIPAA at the Fed level.

The biggest single problem for all of us “little guys” (small businesses, self-employed and individuals) is the high cost to get into or maintain health insurance coverage, if we can get it at all. This is primarily because the insurance companies and groups, whether private for-profit or run by local or regional non-profit hospital groups, insist on dealing with small entities on a group-by-group basis. This means that a business with 10 employees that includes two or three with chronic conditions or a complicated pregnancy is going to pay a fortune in premiums.

In many cases, the employer simply cannot afford to include enough of the premium in their benefits to have anything left over to actually pay the employees. Since some employees may be able to get coverage through their spouse, the employer may be able to simply not offer healthcare and still attract enough workers. Nonetheless, many small businesses would like to be able to offer coverage to attract a larger pool of workers and perhaps to have group coverage for themselves as well.

This gets really tough if you are self-employed. Unless you are married with a spouse that has good coverage at their job, about the only option is an individual policy. Individual policies are not only very expensive, they also do not have to accept your pre-existing condition the way a group does under HIPAA.

It would seem that the obvious thing to do would be to organize some sort of group that various small businesses and self-employed people could join or affiliate  with so that the insurance companies had to deal with them as a group of say 500 people, rather than many small groups and individuals.  There would be one administrator for the insurance company to deal with and the risk would be spread out over a larger group, so that 2 or 3 people with chronic conditions no longer represented 25% of the group. This affiliation would also be a group under HIPAA, so those in it would have complete portability of their coverage from employer to employer, or  from employer to consultant/contractor.

Anyway, this grouping of lots of small businesses, self-employeds and free-lancers to get affordable health coverage sounds like a great idea, right? Not if you are an insurance company. This sounds like something that has to be prevented,  and that is exactly what has happened. Although it is possible to put together a group and negotiate with perhaps one carrier to give your group coverage based on some sort of membership or professional commonality, it is next to impossible to just get together a mixed bag of several dozen small businesses and free-lancers and define it as a group, then get coverage quotes and let your members make an annual choice on which of several competing levels of coverage they want. Why? Because it is highly profitable for insurers to demand that each employer be defined as a group and make the free-lancer/self-employed apply as individuals. This is especially profitable for them when dealing with self-employed people who usually have to buy individual policies because the insurer can exclude pre-existing conditions. If this were a group plan, the HIPAA rules would not allow them to exclude pre-existing conditions.

As more and more of us become free-lancers, consultants, self-employed, this is becoming a bigger and bigger issue and becoming more and more profitable for the insurers.

What needs to happen here is legislation to force the insurers to deal with independent groups on the same basis as large employers including full portability of coverage. If you have a group of 500 people, it really doesn’t matter whether you all work for the same firm or not as far as your likelihood of illness/disease is concerned, so why are the insurers able to insist that it does?

This is NOT a case of government meddling in private business. Ask anyone that knows me, I’m a raving Libertarian. What this is is getting both state and federal governments to STOP allowing the insurers to cherry-pick the group size and composition they choose to deal with and actually restore free enterprise.

Free enterprise is a wonderful thing when it actually is free. When it uses government to grant monopolies or let it play by “special rules” that no other business gets to play by, it is no longer free enterprise. This is the root problem of our health no-care system now. The insurers, drug-peddlers and various other health-industry lobbyists have so gummed up the works with “special rules” that is has no resemblance whatsoever to free enterprise.

The Democrat solution is take money from some to pay for the rest and the Republican solution is to keep telling us that the Democrats are trying to socialize healthcare, and preaching  status quo ante. Meanwhile both sides continue to rake in campaign cash from the healthcare industry and enjoy a gold-plated benefit plan that we are all paying for.

If small entities and the self-employed could get affordable coverage through groups or co-ops, the numbers of uninsured and underinsured would drop appreciably, without any tax money! Let’s try this before we throw out more $Billions.

Guns in Parks or “When seconds count, the nearest park ranger is only miles away”

Wednesday, May 20th, 2009

Once again the gun-haters have something to scream about and once again they fail to distinguish between those who abide by the laws of the land and those who do not.  It is abundantly clear that some folks just do not understand that making or changing rules only affects the actions of those who abide by those rules.  It is already legal to have loaded firearms on property managed by the Forest Service or Bureau of Land Management.

Senator Coburn’s amendment only makes it consistent across the board to also include National Parks  and Wildlife Refuges. Since some of these can be contained within others, it has been pretty complicated and those that were  trying to comply with the laws often had a job trying to find out exactly who managed the land they were hiking or camping on.

Keep in mind also, that this new provision only allows concealed carry if it is already allowed in the state where the park is located and then only if you have a carry permit. For those that enjoy hiking and such in the back country, it will be nice be able to legally protect yourself from predators, whether they have four legs or two. As far as the “worst-case scenario” that is painted by the Brady Campaign (and usually embraced by the Tulsa World) it is highly unlikely that your family is going to be staring down an AK-47 while on a picnic since most states do not allow open carry, and even then pointing or waving a firearm in a manner that appears menacing to others, known as brandishing,  is still a criminal act in most states and locales.

Just because you will be allowed to have a loaded firearm in your vehicle or on your person does not automatically transform the area in a free-fire zone. Much to the chagrin of the local daily fish-wrapper, allowing citizens to carry concealed firearms has not suddenly transformed our streets into a non-stop wild west shootout, so there is no reason to think that it will be any different in federal parks and wildlife refuges.  If anything, it means that these often isolated and remote areas will no longer be “no one will shoot back” areas, and thus be safer for the law-abiding to visit.

When seconds count, the nearest park ranger is only miles away . . .  if you can even get a signal on your cellphone.

And, for the record, I do agree that attaching this provision to the credit card legislation is goofy and says a lot about what is wrong with our Congress and the games that are played in order to get things done.

Don’t confuse entertainment with discourse

Sunday, May 17th, 2009

What do Rush Limbaugh, Rachel Maddow, Sean Hannity, Rosie O’Donnell and Keith Olbermann all have in common? They are entertainers.

Before you bow down and follow them or anyone else that makes their living by entertaining an audience, keep in mind that it’s all about entertainment and ratings and how much can we sell airtime for. None of these screaming or whining pundits of the airwaves has or is likely to ever run for office or actually “do” anything. At least with cage-fighting there is no pretense that it is anything else but watching gladiators.

The sooner we quit letting entertainment people drive the political agenda, the better off the republic will be. It’s bad enough that we have 24-hour entertainment masquerading as news in order to sell more pharmaceuticals, identity-theft insurance and gold investment schemes. We don’t have to let this bear-baiting in suits run the political process.

Rush and Rosie are both big fat idiots, and we are too if we let people like them drive the bus!

Subsidizing irresponsibility with stimulus and bailout

Friday, February 20th, 2009

David Brooks’ column in today’s NY Times (Money for Idiots) points out that these government bailouts and stimuli will necessarily end up supporting some of the most reckless while ignoring those who were responsible and prudent, but that it is probably inevitable.

This effort faces the same challenge as most government assistance. We want to provide enough help to keep the community from crumbling, but not enough to subsidize and therefore encourage irresponsibility. From there on it gets into definitions of responsibility and crumbling. The assistance has to have a price that is only a little better than collapse to keep it from becoming a subsidy for recklessness.

I do not want my neighborhood to become a sea of empty foreclosed houses, but there are limits on how much I can afford to keep it from happening before it becomes attractive to stop paying my mortgage too.

This is probably not a good time to wonder how we are going to mange all this national debt as the baby boomers come in to social security and medicare with IRAs and 401(k)s that were supposed to keep them comfortable, now worth a fraction of their value.
Seniors will be competing with youth for entry-level jobs in call centers and retail and giving an ever-larger portion of their pay to the government.

If you take the King’s shilling . . .

Wednesday, February 4th, 2009

Finally someone is going to lay done some reality rules for the firms that take OUR tax money bailout. The administration’s proposed cap on executive compensation is a good start, but also needs to address things like the infamous Merrill-Lynch executive suite remodeling and other extreme perks of the Marie Antoinette class of executive royalty that has driven many of our largest firms into ruin.

Despite what Rush Limbaugh and other entertainers will say, this is NOT undermining free enterprise. This IS the price of coming to the taxpayers with your hand out. Free enterprise means free to succeed and free to fail no matter how large or small.

The enormous salaries, bonuses and stock options are supposedly ensuring that firms can compete for the very best executive talent.  When we look at what these highly-compensated super executives have done to many Wall Street and automotive companies, it is hard to imagine how someone could have done worse. For some time now a variety of business/financial writers have been decrying the bloated compensation for top executives, regardless of their performance, but for the most part the stockholders of these firms were powerless to change it.

At least now the taxpayers won’t have to keep rewarding failed performance in this area and there is a chance that the stockholders may once again have some say.

“If you take the King’s shilling you must do the King’s bidding.”

Only the little people pay taxes – or apparently worry about the IRS

Tuesday, February 3rd, 2009

That seems to be the message we are hearing from Washington these last few weeks. If the “best and brightest” of the new administration’s nominees cannot be bothered to accurately pay their taxes we can only wonder about those passed over for consideration for a senior post in the Executive Branch.

Who would have thought that the “cleanest” one of the bunch would be Hillary Clinton. It looks like the White House needs to get the people that vetted HRC before her campaign to work for Obama’s team now.

And rememeber, if these folks had not been nominated to head an Executive Branch agency, they likely would never have paid the taxes that we now find were long due.

Surprise? – Banks sought foreign workers: AP Investigation

Sunday, February 1st, 2009

A recent AP Story, picked up by a number of outlets, details that lots of those giant banks that taxpayers are now bailing out have sought government permission to bring in thousands of foreign workers, even while they were laying off lots of American workers.

Why would they do this – because it is cheaper. If you can’t offshore the whole company, then bring in cheaper offshore labor and dump the US workers. These are some of the same giant banks that are pinging us with sudden jumps in credit card interest and incredible fees. Am I shocked and surprised that giant banks are behaving this way? No. Despite tons of public relations efforts from stadium naming rights to landscaping the public roads to anything else that will show banks as good citizens and neighbors, we are still talking about the business of usury. Banking is about one thing – MONEY. Whether you are talking about money changers from centuries past, or Potter’s Bank in “It’s a Wonderful Life” or Shylock from the “Merchant of Venice”, they are all fixated on money – or their pound of flesh in lieu of the money.

It is sad and disappointing that the very banks that came rattling their tin cups to the Treasury to save them from their own rampant greed were also going to great lengths to save money by bringing in foreign workers to fill jobs in U.S. offices while they were dumping U.S. workers. This is a the worst type of abuse of the whole H1-B visa program. This is way below bringing in scabs during a strike to keep the plant or mine running.

It is sad, but unfortunately not terribly surprising. It is the nature of the beast, no matter how much glitter or community relations they try to dress it up with.

Twilight of the far-right kingmakers

Tuesday, October 28th, 2008

The apparent imminent election of the liberal Democrat Barak Obama with a Democrat-controlled Congress should be the final nail in the coffin of the far-right wing’s ability to dominate the Republican party. As Michael Bates observes, we are about to elect a far-left liberal with almost no track record at a time when the liberals in Congress are bursting at the seams to “fix” all the perceived inequities in our country.

How is this possible? Has the U.S. electorate suddenly gone socialist? I think not. The answer is that the far-right and religious-extremist wing of the Republican party has simply gotten out of control as kingmakers. This was clear in the 2000 election, when McCain, a strong leader with a solid background, a mind of his own and heroic military service was passed over for an empty suit with a bankable name, and the “correct” religious reprogramming that could be easily shaped and formed to suit his backers.

Unfortunately for McCain, he waited too long in this campaign to try to get the far-right on board with him and had to do it at the time when he really needed to be talking to the undecided moderates and independents that actually decide the election. Picking Gov. Palin for the VP and hearing her on the campaign trail is a constant reminder to the moderates of how powerful the extremists are in the party. Her scolding tone and self-righteous manner are exactly what many fear about the Republican party. It is also a constant reminder of the last eight years of ideology and religion trumping knowledge and experience. It also has not helped that many of the Republicans in Congress have acted and voted a lot like the Democrats when it comes to spending and protecting sacred contributors.

Hopefully, this stunning loss of a seasoned statesman with solid conservative credentials to a smooth-talking liberal with little more than magic beans will be enough to make the Republican party wake up and realize that a major house-cleaning is in order if they want to win the White House any time soon. It took the Democrats a few cycles to also realize that they had let the extremists take over. But they finally decided that they wanted to win more than they wanted to continue to appease the ” ban all guns and save the transgender spotted owls” set in their party.

The Republican Party is a natural place for the religious right, but there is more to it than that. For many Libertarians, middle-class working families and entrepreneurs the Republican party is also a logical home because of the same basic beliefs in keeping government restricted to certain “legitimate” roles while allowing the populace a maximum of individual freedom. But in recent years, the Republican party had been so dominated by religious/morality issues that it has driven out many of us. David Brooks has a very good piece on this called “Ceding the Center.”

Here’s hoping that it doesn’t take the Republican party any longer to figure out that abortion and gays aren’t the issues that matter to a lot of Americans, especially when the economy is on the brink and we are fighting wars in two distant countries.

It’s Dole vs. Clinton again, with the same result likely

Tuesday, October 21st, 2008

As election gets nearer and nearer I can’t shake the feeling that we have been here before. It sure seems like Dole vs. Clinton all over again. A young energetic voice with little national political history, who actually is black this time, vs. the aging war veteran who’s turn finally came up. And, once again, the elder statesman McCain cannot seem to close the deal with the voters.

Even with a major national/world crisis ongoing, too many of us are afraid to let someone who has a some things in common with the administration of the last eight years come in and try to fix what his peers allowed to happen. Apparently the feeling is that we really need a fresh leader in there to shake things up. Even though McCain has some distinct differences from the W. gang, the resemblance is still close enough to frighten many into trying someone with no real leadership or executive experience.

MY strongest feeling on this race is serious disappointment that these two are the best this huge nation can come up with. This is a nation that has many fine examples of leadership in many realms from many different viewpoints. It is very sad that the requirements for massive amounts of money and the media-frenzy of micro-analysis of what key someone belches in keep out so many highly qualified leaders.

One good thing that will probably come from this is that the Republican party will have to reasses itself. There are just not enough hardcore Christian conservatives and millionaire business people to give them enough votes to win any more. They are going to have to do the same sort of internal analysis that led the Democrats to through open the tent flaps and silence their own extremists in order to bring in the working people who just want to make a decent living for themselves and their family. The Democrats have finally learned to keep their rabid anti-gun crowd and transgender spotted owl supporters in a back room somewhere until after the election.

Likewise, a lot of us that have voted Republican in the past, the ones David Brooks calls “Patio Man” have had to take a long hard look at our own situation and try to decide if this Republican candidate really offers us anything. The last one told us he did, and then turned everything inside out chasing a white whale into Iraq before deciding to have his minions rewrite or reinterpret much of the Bill of Rights. Meanwhile others on his pick-up team watched idly as Katrina roared through and the greed hounds destroyed our financial system.

Can you really blame a lot of us for wondering how a President Obama could be worse? Sure, taxes will likely go up and there will be some wealth transfer for social programs that have questionable results, but we may actually get some progress in the healthcare morass. If you think the healthcare system is only broken for those at the bottom end that do not have any medical insurance, ask anyone who is self-employed or owns a small business. There is a lot wrong with our healthcare system or more precisely how it it paid for. If there is a chance that the next administration will push the insurance giants aside and actually shame Congress into making some real changes, then I’m for it.

Quite simply, the Republican party no longer represents those of us who are just trying to go to work, do our job and take care of our family . . . unless we are millionaires or evangelical Christians or both. I’m a Marine vet, and an NRA Life Member, but I may have to hold my nose and vote for Obama. Although respect McCain and his service a great deal, I’m just afraid that more of the same protection of the millionaires is going to force me to sell my guns for food, house payments and medical care before Obama, Schumer, et. al. get around to confiscating them.

We really need better choices next time.

It’s the end of the financial world, but the credit card offers keep coming

Monday, September 29th, 2008

I know that retail credit cards are a long way from the millions and billions in mortgage-backed securities that are bringing down one institution after another, but it’s why Main Street is not behind what looks like bailing out Wall Street. I would have been surprised if the $700 billion deal had successfully passed the House, despite the all-weekend sessions to get the leadership behind it and supposedly their members as well.

The entire House is up for election in a little over 30 days and neither the Administration nor the Congress has made their case to the voters of exactly how this gigantic deal is going to work a miracle in the finance world. We all see the news and understand that some of the biggest players like AIG, WaMu, Fannie/Freddie, Lehman Bros., have gone under due to this mortgage-backed securities fiasco. And we understand that similar things are happening in other nations for the same reason. However, no one has provided the information that would close the deal. News reports say the calls, faxes, emails, etc. are running 100:1 against the package. Any why not. We have not seen anyone held to account for this monstrosity. Sure, lots of workers in the failed investment banks have lost their jobs, but so far, no one, from mortgage brokers to securities packagers to bankers to executives to government agency watchdogs has been charged, indicted or even lost their job.

So far Sen. McCain is the only voice calling for SEC Chairman Cox to be cashiered. Instead its hard not to wonder if Cox isn’t going to get a Bush “heckuva job Brownie,” and go right on until the next President takes over.

Yes, I realize that the finance mess is indeed going to affect all of us. I’ve certainly seen my IRA nosedive over the last several months, then go free-fall today. And since most US workers no longer have pension plans, these IRAs and 401Ks are all we will have to live on besides a meager social security payment, if that’s still around. For those that do work for a firm with a pension plan, the short term could be even worse. As the investments in those pension plans lose value , the employer will have to pony up more cash to maintain the required reserve – if they have the cash. For some of the big guys, they may end up facing bankruptcy because they cannot borrow enough cash to pump into their pension funds.

Yes, I understand that there is a serious financial crisis. Yes, I understand that it may well take strong action by Washington to avert much more serious consequences. BUT, despite a good deal of research online and reading a variety of news sources, I do NOT understand how this plan and only this plan is clearly the solution. If the voters understand, then they can support their representatives’ voting for whatever measure seem justified. Until the members of Congress, especially the House, feel they can count on support for this unprecedented action back home, how can anyone expect them to just go along with it.

Yes, there were actually four credit card and/or convenience checks offers in today’s mail, including one from WaMu. Most of us would be more than willing to help a recovering alcoholic get back on their feet, but we have to feel like that they are in recovery and the money we contribute won’t just go for more liquor.