Preliminary Notes on a Healthcare Plan

Most problems with most plans, especially government plans, is that they don't set standards and omit definitions.  That's because our elected officials are career politicians and want to be reelected.  We will all be immensely better off when term limits are imposed and they can actually focus on work for us.

These are the primary pieces of my healthcare policy:

• We have to move back to not-for-profit health insurance with tight regulation of what's covered and how insurance companies are compensated.
• The primary care physician will be central to the healthcare system with extra compensation, responsibilities and defined staff positions.
• There will be a roster of universal coverage for everyone in the country that needs it paid through federal agencies that will cover 80% to 100% of various treatments.
• supplemental insurance which will be defined and named supplemental by the federal plan and not altered or marketed by insurance companies will cover up to 80% of a variety of medical treatments that are less used by the general populace.
• Orphan/rare illness may be covered 100% and monitored by scientific and medical agencies in an effort to learn more about causes and treatments.

Assumptions that are made in this policy are:

• The the Constitution intended for "the general welfare" to include healthcare for all the citizenry.
• ALL resources of the federal government BELONG to the American people and the government, as agent and servant of The People, merely serves to facilitate the use of those resources, including the budget to provide The American People with the best lives they can achieve.

Problems in implementation:

• The size of the system which is why redesigning the system  by elevating the primary care physician as the healthcare team leader with additional responsibilities than simply healthcare.

Many healthcare professionals are guilty of over-scheduling and provide less and less actual healthcare.  Many healthcare groups market their services as providing teams of professionals when they are actually top-heavy with administrative staff who structure patient visits like an assembly line.

It would be the major function of the primary care physician to replace the insurance company's monitoring of a patient's care.  They would provide:

• Annual wellness exams and any necessary accompanying lab tests.
• routine appointments for season allergies, cold, etc. and referrals to specialists that would not be second-guessed by  insurance companies. 
• Monitoring of on-going treatment of serious illnesses and conditions being treated by specialists, like cancer, glaucoma, cataracts, ulcers, etc.
• Consultations with any number of healthcare professionals who are treating a patient.
• Facilitation of exchange of healthcare documents  and lab reports among the various treating healthcare team.
• Statistical reporting of various medical information in order to maintain a high level of pertinent medical research in various areas.
• Patient assistance with unsatisfactory care from any healthcare professionals including referrals to appropriate legal services.

In order to carry out these additional, often non-medical responsibilities, primary care physicians would need a variety of technically trained staff.

Compensation for each of these additional responsibilities and for additional staff would be the responsibility of the federal government.  Where such things may have once been considered waste, they will become the funding to a well-oiled system carried out by well-compensated professionals who are able to focus on the specifics of their positions in order to provide the best healthcare for each individual patient.

•  Outdated beliefs:

'It would be too expensive'  I heard those words repeated too often growing up.

Numbers with $$ signs in front of them can be intimidating but they're just numbers.  What the the purpose of money?  It's a vehicle of exchange in trade.  Rather than trade 5 sheep and 20 chickens for a milk cow, money was invented so people didn't have to transport goods for exchange around with them.  It was also invented by men who had nothing to trade but wanted a cut of the action - the financial "industry"; keep your eye on them; they are not to be trusted.

My feeling about money, while often still influenced by the never enough, cup half empty point of view, has evolved to feeling that what money gets you is the most important thing.  I certainly think that in this outrageously wealthy country, everybody can and should get, not just good, but excellent healthcare.

• The Ultra Wealthy - whether they be millionaires or billionaires, we, the ordinary working people keep protecting their privilege. 

Here's what I think about wealth.  I had ancestors who held hundreds of acres in a particular area.  None of us in the related families have any wealth now.  Why?

Wealth is acquired in several ways:  inherited and not lost but grown; by finding something that everybody wants and is willing to pay well for and not losing that gain; by cheating, deception, theft, conning and even killing.  Those are the most common ways individuals become wealthy.  I, personally, assume the last is the most common.  And, I'm not talking about the well-off, people who have always made more money they I have because what they do is valued more than what I do.  The ebb and flow of that is fairly steady.  I'm talking about the extremely wealthy whose wealthy is difficult for most of us to fully appreciate or understand.

I, personally, feel that it's time that we see that, on  this tiny planet, our species cannot survive much longer if we continue to allow this imbalance to continue.  Many of the original colonists were people who were starving, had no possibility of rising above their circumstances and came here to this, so they believed, empty place in hopes of making a decent life for themselves and their families.  The founding fathers whose lives were much more than that but who were not the ultra wealthy like today argued a set of principles which would allow the possibility of almost anyone to achieve a good life.

What I would propose about this problem will appear in a future post. 

 

 

 

 

 

We have a Constitution

and a process for amending it.

There has been talk, from time to time, of rewriting our Constitution.  Certainly any reasonable person would think that now, when we are so divided and combative is not the time to do that.

Certainly, there are changes that need to be made but the existing amendment process that would normally work is also compromised by those same divisions and fights.

The Constitution is very clear about some things and intentionally vague and open to interpretation in others.  I think that's by design.  However, that's not really the problem.  The problem is that the division of the 2 major parties, to the exclusion of any other, has resulted in nearly complete abandonment of what is actually in the Constitution.

The current administration, lead by a pathological con man who is completely disinterested in anything other than whatever happens to be in his own mind at any particular point in time, has little interest in our Constitution, particularly if it is at odds with the current interests of the Lunatic in Chief. (He has been diagnosed by many professionals).

Even those who probably know better are ignoring what the Constitution says because it serves their immediate purposes to do so.

Still our Constitution exists and will, eventually, be the measure of the lawlessness that currently reigns in the White House and other government institutions.  It is the basis of the Law of the land despite the Supreme Court's own abandonment of its principles whose purpose is to rule on the Constitutionality of all subsequent laws and regulations.  They too will be measured by those principles.

What I've learned recently - updated

 I've been playing with this blog for a couple of years.  

I began this in April so this is an update even though I didn't publish it earlier.

What I've learned over the past couple of years is that I, and therefore most of you, have not been sufficiently educated about the founding of our country, the history of the colonies that became the early states and the men who wrote the defining documents of our government.

As I begin to write something, it is my intention to be accurate about the topic while expressing my opinion about the topic.  In order to be accurate, it's necessary to know what you're talking about, in contrast to the person who currently occupies OUR White House, who has little interest in accuracy or truth, only in his own wishes, whims and aims.

I realized that I know little about the men who wrote the documents that define our government and the early presidents.  I decided to do some research about them.  That will take time.  There will be a page that shows that research.

In the meantime, I will say that I have some experience that may explain my interest in this and what I bring to this discussion.

I have lived and worked in 4 states in public employment, specifically as a librarian, but as an executive librarian.  I was considered a municipal department head and named as such in a couple of positions.  

I worked with a variety of municipal departments, individuals and various community organizations.  In the case of community organizations, I have had the experience a few times of assisting them as the organization was being formed; that included writing their By-Laws (like a Constitution).  I also did the same with a couple of larger library organizations of which my library was a member.  

I have also, over the years, worked with many library boards and municipal councils and know how they work.  I've also seen that regardless of the purpose and function of any organization, the individual members and their personalities, strengths and weaknesses, affect the operations.

"Story:"

I worked as a branch librarian in a town (which will remain unnamed) in the San Francisco Bay Area, for a while. I was warned to be careful around a particular Town Council member, an older man who'd been on the council for a long time.  

Apparently, one of the things he liked to do was to spend time at the Corporation Yard, the town's place where they house and maintain the town's vehicles. This particular operation varies from town to town depending on the budget and the facilities they have.  In any case, this old fart liked to drive the vehicles around the parking lot of the Corporation Yard and he was allowed to do that.  It's just not acceptable behavior but some people get away with things.  

Why is it a problem?  THINK!!  They aren't his vehicles; they're bought with tax-payers' money.  Some of them, like fire engines, are enormously expensive and are expected to last as long as possible.  Is he going to pay for the gas, any repairs that might be needed?  Unlikely.  In addition, by being on a town's vehicle, any injury he might incur - who's going to pay for that?

Some of us understand all of that without explanation; we were raised with boundaries.  Some of you might not understand if you were not so raised.

People who think they have the right to take advantage of their position, whatever that might be, are problems and potentially dangerous, in various ways, for others around them.  They can be stopped but the repercussions can be as much of a problem as the bad behavior.

So, local councils and boards are much like Congress and the Senate.  They are elected officials, entrusted to represent the best interests of their constituents and OUR country.  But, they are just people.  When we elect them, we don't know them, we hope they'll make things better or leave things in good shape.  There are little guidelines in OUR Constitution about how they should do their jobs.

When the Constitution was written and the country was being formed, things were much different than they are now.  The federal government operated much like local councils.  Now, many of them are making decisions far beyond their abilities.  It's really frightening.

In any case, as early as Civics class in high school, I have questions and opinions about how the process of government worked, thus this blog.