Transparent pricing is literally the least we can do to improve US health care

There are very few actions or aims of the current administration of the United States Executive Branch with which I agree, but one such rare alignment won a legal victory this week when Judge Carl J. Nichols ruled against the insurance-dominated medical establishment in favor of American patients.

The U.S. District Court ruling agrees with the White House that it is reasonable to force medical service providers to publish a full accounting of negotiated prices for their services. Disclosing the price a patient would pay if s/he elects to pay cash will also be required.

Insurers say their negotiated prices are their own secret treasures to share with providers, and that we—the consumers, the patients, the worried loved ones—don’t deserve to know what they are. I say that insurers offer so little value relative to the enormous fees paid to them that their wishes are irrelevant and a distraction from the goal of almost all Americans to have better health care with fewer going bankrupt to pay for it.

I believe that the administration of the U.S. medical care system could be improved in almost every way. That said, cost transparency requires no bipartisan agreements on contentious issues such as rationing of care or how much in dollars a government owes each citizen in the provision of health care.

Price transparency will cost almost nothing save a few hours of administrative work by hospital staff. Typing up and publishing these lists will take a minuscule fraction of the labor hours currently spent on insurance billing. In exchange, and, for the first time in decades, cost-conscious consumers of health care—the ill, the injured, the infirm—will have at least a passing chance to vote with the pocketbook by taking business to more efficient providers. Continue reading

Evangelical Christians trample my religious freedom by applying their convictions to all in the abortion debate

The abortion debate in America is a contentious one that I have no interest in rehashing here. While I have many thoughts and opinions on the issue, most of them fall outside of the kind of rational discussion I prefer to instigate on my little site dedicated to the wonderful as opposed to the profane.

Something I cannot ignore of late are the actions of multiple states—tellingly, states which tend to be poorer than the U.S. average with a markedly less educated populace—as they defy the moderate will of the majority of American citizens and the affirmed constitutional right of individual Americans to follow their own faiths and consciences with regard to abortion procedures.

Activists at the extreme of both sides pervert this complex and morally fraught issue by ignoring subtleties and braying out absolutes and ultimatums. I reject those dangerous simplifications from both the right and left. Most Americans believe that some abortions should be safe and legal. Less than half of Americans support either a total ban or the complete freedom to terminate any pregnancy.

In particular, as a Jewish woman, I find it offensive that conservative Christians are promoting their religious beliefs in the political arena with a total disregard for the separation of church and state.

This separation, of course, is another freedom guaranteed to each of us by the Constitution.

The actors on these Supreme Court defying laws like to portray themselves as sole legitimate arbiters of God’s will. Upon signing the most restrictive anti-abortion bill in America, Governor Kay Ivey of Alabama issued a statement that she did so because “every life is a sacred gift from God.” Of course, with no exceptions in the Alabama bill for survivors of horrific crimes against girls no matter how young or women whether competent to consent or not who become pregnant, it’s obvious that Governor Ivey feels some lives are more sacred than others, and that it is her place to judge such matters.

Jewish law argues that a mother’s life must be saved at the expense of a fetus if the parent is in danger and the process of childbirth has not yet begun. “[T]he life of those already living comes before the life of those yet to be born.”Jewish law also recognizes the mental health of the mother as a vital factor in making the decision to terminate a pregnancy. Other faiths advise their adherents differently.

It is evangelizing pure and simple for this kind of dictatorial Christian to attempt to subvert my religion with her own when it comes to my family’s medical decision making.

There are suppositions about the moment that “life” begins, but no definitive answers from science yet to trump matters of faith and belief. We may someday know when the spark of animation—or the soul—enters the bundle of cells that grow into living flesh. We do not know now beyond a general range of viability dates for human babies.

From my perspective, it would be wise for people who value unborn lives above those of living women to invest heavily in the technological leap of gestating fetuses outside the womb. If it were possible to “harvest” unwanted pregnancies and nurture them elsewhere, some of the moral quandaries would change if not diminish. Certainly at that point those with the most extreme viewpoints on the subject of abortion could offer to save every unwanted child and assume the costs—financial, social, and emotional—thereof.

https://theawarenesscenter.blogspot.com/2011/02/incest-pregnancy-abortion-and-halacha.html

Systems should serve people, not the other way around

AC/DC put it succinctly in the title of their song, “Who Made Who?” Later in the song, the lyric “who turned the screw” fits the thesis I’d like to explore pretty well, too.

From the Merriam Webster definition of System

“d : a group of devices or artificial objects or an organization forming a network especially for distributing something or serving a common purpose 

Systems surround us, especially the designed networks rapidly replacing naturally occurring phenomena that might once have been the primary driver of human choices. Weather systems can still pack a punch, but a typical modern person on a typical day can live almost completely oblivious to heat, cold, and moderate precipitation.

It is man-made systems that increasingly dictate to the people who use them. The financial system, health care systems, your cellular provider’s system, our highway system: how much of modern life could continue unimpeded without these conveniences?

A question I’ve found myself asking far too often of late is this:

When did the systems humanity designed become master of almost every human action?

Not simply “who made who?”, then, but also “who’s in charge here?”

Continue reading

Make America civil again

America is in the midst of a crisis. It’s a crisis of uncivil behavior.

Merriam-Webster dictionary definition of Whether you feel undermined by shifting demographics in the United States of America or unhappy with the man who currently occupies the Oval Office, each of us is entitled to an opinion.

The First Amendment specifically protects our right to express these opinions freely. The language is unambiguous, and our democratic republic can never be considered secure where this right is threatened.

Amendment I

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

copied from official US government site archives.gov (emphasis mine)

When any individual or group employs harassment and violence against another in an attempt to silence peaceful expression of free speech, the aggressor is the greatest threat to American values and freedom. Continue reading

College cheats: getting in is nothing; learning is everything

The most obvious truth revealed by the recent college admissions cheating scandal that has ensnared Hollywood celebrities and other rich fools nationwide is that typical Americans have completely lost sight of the purpose or value of education.

Paying bribes to be admitted to university is frankly moronic for most of us. All of the real value of the college experience comes as a direct result of studying—and learningtherein.

Graduation cap and degree captioned University of DeceitRich kids will continue to stumble into lucrative careers because they have the right connections. Average kids, and the less well prepared, will take on massive debt for less and less substantive rewards when we devalue our universities by sending kids with no direction or purpose simply to fill seats.

Naturally, those who steal and cheat to get into college go on to cheat while attending college. I wouldn’t want to work with or hire that kid!

Businesses already decry the lack of qualified applicants for job vacancies though the percentage of Americans attending college has been increasing for decades. Being admitted to college confers zero qualifications. Learning—at a university or anywhere else—actually builds skills.

So, too, does honoring oneself and one’s community by behaving with honesty and dignity.

True scholarship also enhances one’s life in less quantifiable ways. The cheaters are too cowardly to risk realizing this fact for themselves.

Pile of moneyEarning a college degree has held, thus far, as a predictor of higher pay, but for how long? When students are enrolled only because “college is the next step after high school” vs. following an interest in deeper, more focused study of something specific, the automatic pay bump for a bachelor’s degree will disappear.

We ought not mold our colleges and universities into the image of our less and less functional compulsory K-12 system. Academia is not the right fit for everyone. All students are not the same. Disparate careers benefit from differing methods of preparation for new workers. Human beings have different learning styles.

Jobs go to people who can do the tasks required. College, in and of itself, teaches no specific skill save mastering the “admissions game.” That’s defined as test taking and/or bribery and fraud, apparently.

Children should be encouraged to do their best academically, but honor their unique selves by accepting both their strengths and weaknesses. Don’t let them fall victim to the patently false modern myth that admission to “the right college” is a golden ticket to happiness, prosperity, or success.

Consider trade schools, sampling classes at a local community college, internships, or self-directed online study if there is no perfect path to a four year degree right after high school.

Life is so rarely perfect! Why would one person’s education be?

One of the most compelling stories by an alumna of the small women’s liberal arts college I personally attended came from someone who went on to attain an MBA from an elite American business school. This woman was committed to attending that particular institution for her advanced degree, but had to apply three times before she was finally accepted. They were eventually persuaded by her passion and dedication.

Her message to us: persevere when you know what you want. This particular woman of color had reached her own definition of personal success by working hard and refusing to take no for an answer. She was a CFO at a startup at that time.

Education is not a zero sum game, though seats at a particular university may be. Focus on attaining the skills required by a career suited to your personality and strengths, and do realize that “where you went to college” becomes irrelevant very quickly after graduation for the vast majority of people.

“Steal,” yes, because cheaters have taken, through fraud, a slot at an institution where another scholar might benefit and contribute honestly to the campus experience for the entire community.