Affordable Health Care Act, designed to fail.

I realize I have written about a national health plan that could actually work. I am, perhaps out of sequence, writing why the Affordable Health Care Act (aka. ObamaCare) was designed and passed by Congress to fail.

As a reminder, Managed Care was modeled after Kaiser Permanente in California. It was formed by the Kaiser family for their employees and was/is not for profit. Some corporate suit saw an opportunity to make large profits by using that model and creating large profits. Hence, HMO’s were formed.

The Kaiser plan used about 10% of its income for corporate needs and 90% for patient care, facilities, staff, equipment, etc. The HMO’s needed an entire department for investor relations and profit management.

In case you are wondering if size matters, in the insurance business it absolutely does. The number of people who sign up for coverage is the Risk Pool. The larger that Risk Pool, the stronger the likelihood the company could make a profit. For the most part, people don’t use their insurance in a given year. Young children and the elderly use it a lot, but the idea of the large Risk Pool is to have many more people who don’t use the services than those who do.

When the for profit companies found that they just didn’t have enough income to keep investors happy, they became creative in ways to save money. Doctors were given financial incentives to not use extra testing like MRI and specialists. The groups were given a “budget” to work with for an entire year. If they were below budget, a portion of the money remaining was divided among the doctors. If they were above the budget, they were dropped from the plan. Another way was to reduce the reimbursements to doctors. At one time, MANY years ago, Pima Care paid surgeons $45.00 for appendectomy, tonsillectomy and cholecystectomy (gall bladder removal).

The primary problem with those plans was that the risk pool was too small. It is absolutely the same today with the Affordable Health Care Act. The current population in Arizona is about 6,927,347. There were eleven providers listed in the Arizona Health Insurance Exchange. IF everyone were included, that would leave an average enrollment of 629,759 per provider. In reality, all citizens are not covered. According to Arizona statistics, 203,066 people are covered by private health plans. That would be an average of 18,460 for each of the eleven providers. The number of those covered by group plans was not available. Remember, all the providers are FOR PROFIT corporations.

The population of California is estimated to be 38,000,000. One provider, Kaiser Permanente has 10,600,00 clients (more than the total population of Arizona). Clearly, there is a greater chance for health insurance providers to have a large enough risk pool to be profitable. Even there, the Affordable Health Care Act has made it difficult to be profitable. That is NOT a bad thing. Here is why.

Previously, for profit HMO’s would spend 50% or less on patient care, using the other half for corporate operations and profit. If the risk pool decreased, the amount spent on patient care also decreased. Nothing was allowed to interfere with profits.

Along came the Affordable Health Care Act. The providers were required to spend 80% of their income on patient care with the other 20% going to all other costs, including profit. If there were large groups, involving 50 or more employees, the percentages were 85 and 15. NOW YOU KNOW why companies are leaving the plan. That is not necessarily a bad thing. The fewer the number of companies in the Health Insurance Exchange, the more people in their risk pool. Sadly, as good as this could be, there is really no way a for profit health insurance company can make enough money to keep their investors happy.

To make things worse (better for the insured) health insurance companies are required to regularly submit data on the portion of premium revenues spent on clinical services and quality improvement. It is called Medical Loss Ratio (MLR). Those companies are required to issue rebates to policy holders if their MLR does not meet minimum standards.

All the requirements listed above are designed to improve the quality of care patients receive and improve availability for all citizens of America. It works and always had for Kaiser Permanente in California. The key to success is that health care providers cannot and must not be for profit.

I repeat, the basic design was intended to fail because it used for profit corporations. A much better idea would have been to include ALL American citizens in Medicare and demand all providers live within the Medical Loss Ratio. Of course, that would require that providers be not for profit corporations. Another option, for those who are afraid of government run programs (the best insurance coverage my wife and I have ever had is Medicare), is the one I sent to Washington more than 20 years ago. I wrote about it in my blog about a national health care plan.

The Affordable Health Care Act needs to be fixed. Even President Obama suggested that. Unfortunately, Congress refused to act in order to try to make it better. That is because when they passed the legislation, it was with the intention that it would fail. They were sure the Supreme Court would find it illegal. Amazingly, a conservative Court said it was legal. Having done so, Congress opted to do nothing, hoping for total collapse of that program. Yet, with all its faults, the Affordable Health Care Act made us the last of all industrialized nations of the world to have a national health plan.

We have the most expensive health care costs in the world. We have the most expensive drug costs in the world, yet we were ranked below Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom. (Organization for Economic Cooperation and Development, comparing health care spending, , supply, utilization, prices and health outcomes. 2013).

We need and deserve a high quality, affordable health care system like the countries listed above. It is possible. The Affordable Health Care Act was the first step in making that happen. It needs to be fixed or replaced. It should, under no circumstances, simply be eliminated.

 

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Women As Second Class Citizens of the World

WOMEN AS SECOND CLASS CITIZENS OF THE WORLD

 

This Blog will share some thoughts and ponderings.

Women give up their name when they get married. Why? Who wrote that rule/law? My best guess is that it was men.

Women have to wear a ring when they get married. For men, wearing a ring is optional. Why? Who wrote that rule/law? My best guess is that it was men.

In great and not so great musical movies and shows and in normal social life, men lead and women follow by dancing backward. Almost always, they do so in high heels while men wear their regular shoes. Why? Who wrote that rule/law? My best guess is that it was men.

Bathrooms are a current issue. Men just have to open a zipper or buttons and “whip it out.” Women have much more clothing to deal with in order to use such facilities and have to use stalls rather than stand up urinals. It takes women significantly longer to do their thing than it does men. So, with rare exceptions, why are there the same number of bathrooms for women as there are for men? In reality and fairness, there should be two or three times as many bathrooms for women as there are for men. This is why, when necessary, I have “stood guard” while my wife or daughters used the bathroom designated for men rather wait in an irrationally long line to get into bathroom designated for women. Why? Who wrote this rule/law? My best guess is that it was men.

If a man has multiple sex partners, he is called a “Stud.” If a woman has multiple sex partners, she is called a “Whore.” I never understood that system of classification. I still don’t. Why? Who wrote this rule/law? My best guess is that it was men.

Men have been circumcised for religious or health reasons. Women are still being circumcised in several countries to prevent them from enjoying the sexual experience. It’s okay for men to enjoy but not women? Why? Who wrote that rule/law? My best guess is that it was men.

The Missionary position for sex (indicative of some religious connection) refers to women on the bottom and men on the top. In the greatest majority of cases, the man is much bigger and heavier than the woman. Why? Who wrote this rule/law? My best guess is that it was men.

Many religions require that women walk behind their husband. During religious services, they are segregated so that they do not sit together even to worship the same GOD. Why? Who wrote that rule/law? My best guess is that it was men.

The Catholic Church has spent centuries treating women as second class citizens. Priest, Bishop, Cardinal, Pope all men. The only official position for women is that of Nun. Interestingly, I have never read of Nuns being guilty of sexual abuse. Why? Who wrote this rule/law? My best guess is that it was men. I can’t imagine that GOD made different rules for different religions.

Some religions require that women be completely covered, while others require that the women shave their head. No such requirement exists for the men. Why? Who wrote this rule/law? My best guess is that it was men. I can’t believe that GOD had different attire and hair style requirements for women of different religions.

In some countries, associated with religious doctrines, women are not allowed to drive vehicles. Why? Who wrote this rule/law? My best guess is that it was men. It could not be GOD. Cars didn’t exist when such regulations took place.

Several religions, past and present, recognized that their survival depended upon numbers. The more members, the better chance for survival. As a result, rules/religious laws required that women have as many babies as possible. The more the better. During the Third Reich, Hitler chose the women who he felt had the best genetic makeup to “breed” with men who he believed to have the best genetic makeup. His goal was to produce the “Master Race.” The women had no choice with whom they were matched. In neither case was the woman considered. The toll, physical and emotional, of having baby after baby after baby really was not as important as the survival of the religion or the master race. Effective birth control was out not allowed. To question was an affront to GOD or to Hitler. The importance of numbers is valid. The use of women as breeding machines, not so much. We know why. We know who. In all cases, it is men who made those rules/laws. It is unlikely that GOD made different “breeding rules” for different religions.

In the United States, the Constitution was officially ratified on 6/21/1788. The Second Amendment, dealing with Militias and the right to bear arms, was ratified on 12/15/1791. The emancipation of slaves was part of the 13th Amendment, and was ratified on 12/18/1865. The 19th Amendment, giving women the right to vote, was ratified on 8/18/1920. Clearly, from the very beginning of our nation, women were less important than guns and slaves. In fact, women’s rights were dealt with 129 years after guns and militias and 55 years after dealing with the issue of slavery.

In the judiciary, women are still treated as second class citizens. Recent rulings dealing with the rape of women are an example. The judges, mostly men, consciously or unconsciously, know that as a young man, under the same circumstances, they may have done the same thing as the defendant did. Having sex with an unconscious woman, according to them is at least as much the fault of the female and a young man’s life should not be ruined for one such act (or at least the one he was caught doing). That fact that there will be long term negative effects on the female are not really a consideration. Females are told they should not go to such parties or drink alcohol. Males get no such advice. After all, boys will be boys.

It only took about 200 years or so to get laws dealing with “Dead Beat Fathers.” Even though they exist, for the most part, judges are extremely lenient when dealing with the Dead Beat. In the meantime, the woman has to provide money, food, health care, love, help with homework, after school activities and staying up all night with a sick child or children. All this, while in most cases, working full time to provide for her family. If she is late or can’t provide for an assigned visitation for the Dead Beat, SHE is chastised more than he is for missing payments.

If the woman gets pregnant, it is considered to be her fault. If she gets pregnant or just has sex with a married man, she is called a home wrecker. The man is free to keep having sex and getting women pregnant. The woman carries that baby for about nine months and goes through all the agonies, physical and emotional, of the process alone. The man keeps “poking fun.” Why? Who made this rule/law? My best guess is that it was men.

If a man can show that he was fearful for his safety and/or life when he kills another person, it is considered self-defense. If a woman has called the police (often fearing for her life if she would press charges) or gone to the hospital multiple times because her husband or significant other has beaten her, and she claims fear for her life when she kills that person, she is charged with murder. Why? Who wrote this rule/law? My best guess is that it was men.

Decisions about women’s health have become a hot topic. For the most part, those issues involve men and women who never walk in the shoes of the women whose lives are impacted by those rules. Planned Parenthood, which is MUCH more than an abortion site, is under constant attack. Those attacking have not had to deal with the exact same situations and circumstances as the women who need the help from that organization, but assume the role of GOD in determining what is right and wrong for all women. They claim to do this because GOD said so. Really? My best guess is that these rules/laws were made by men and women who believe they are acting on behalf of GOD. That authority was never expressly given to any individual human.

Sexual harassment, exploitation and abuse have existed for centuries. Hollywood has been famous for such activities involving little boys, young girls and women who want to get into that industry. Even recently, FOX news has been involved in such a scandal. It still goes on because women are afraid of what will happen if they tell the truth. For the most part they would not be believed, would be fired and ridiculed. Imagine trying to get another job to support your family. We have seen just the tip of the iceberg when it comes to this subject.

Did you ever notice how many television commercials involve attractive, sexy women? This is done on purpose. The sponsor and the advertising agency know that this will get people, mostly, but not exclusively, men to focus on the ad. In advertising, it is not the message that counts. It is the repetition of the name and your focus on that commercial using the name.

A few other examples of women as second class citizens have come to my attention. I am now adding to the list above. Did you know that until 1972 unmarried women could not purchase birth control pills? Did you know that, while abortions had been done illegally in the U.S. and legally in other countries, it wasn’t legal in America until 1973. What it meant was that instead of just rich people who could afford to go to Europe, all women had legal access to that option. Did you know that until 1974 women could not get a credit card in their own name? How about the fact that until 1977 women could not sue for sexual harassment. Did you know that until 1987 women could not work while pregnant? It wasn’t until 1993 that women had the right to refuse to have sex with their spouse.

The United States Congress, in spite of having some women members, refuses to pass legislation that would require equal pay for women doing the same jobs as men. For this we know why. Big and small business (via Chambers of Commerce) don’t want the extra expenses associated with equality. They keep YOUR congressional representatives in office year after year after year after year, etc.

It is funny/ironic that there is an organization called PETA, which protects the welfare of animals. Why is there not such an organization that protects the welfare of women? The answer is that basically, in this country and throughout the world, women are still, consciously or subconsciously, considered to be second class citizens.

 

 

 

 

 

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Women As Second Class Citizens of the World

WOMEN AS SECOND CLASS CITIZENS OF THE WORLD

 

This Blog will share some thoughts and ponderings.

Women give up their name when they get married. Why? Who wrote that rule/law? My best guess is that it was men.

Women have to wear a ring when they get married. For men, wearing a ring is optional. Why? Who wrote that rule/law? My best guess is that it was men.

In great and not so great musical movies and shows and in normal social life, men lead and women follow by dancing backward. Almost always, they do so in high heels while men wear their regular shoes. Why? Who wrote that rule/law? My best guess is that it was men.

Bathrooms are a current issue. Men just have to open a zipper or buttons and “whip it out.” Women have much more clothing to deal with in order to use such facilities and have to use stalls rather than stand up urinals. It takes women significantly longer to do their thing than it does men. So, with rare exceptions, why are there the same number of bathrooms for women as there are for men? In reality and fairness, there should be two or three times as many bathrooms for women as there are for men. This is why, when necessary, I have “stood guard” while my wife or daughters used the bathroom designated for men rather wait in an irrationally long line to get into bathroom designated for women. Why? Who wrote this rule/law? My best guess is that it was men.

If a man has multiple sex partners, he is called a “Stud.” If a woman has multiple sex partners, she is called a “Whore.” I never understood that system of classification. I still don’t. Why? Who wrote this rule/law? My best guess is that it was men.

Men have been circumcised for religious or health reasons. Women are still being circumcised in several countries to prevent them from enjoying the sexual experience. It’s okay for men to enjoy but not women? Why? Who wrote that rule/law? My best guess is that it was men.

The Missionary position for sex (indicative of some religious connection) refers to women on the bottom and men on the top. In the greatest majority of cases, the man is much bigger and heavier than the woman. Why? Who wrote this rule/law? My best guess is that it was men.

Many religions require that women walk behind their husband. During religious services, they are segregated so that they do not sit together even to worship the same GOD. Why? Who wrote that rule/law? My best guess is that it was men.

The Catholic Church has spent centuries treating women as second class citizens. Priest, Bishop, Cardinal, Pope all men. The only official position for women is that of Nun. Interestingly, I have never read of Nuns being guilty of sexual abuse. Why? Who wrote this rule/law? My best guess is that it was men. I can’t imagine that GOD made different rules for different religions.

Some religions require that women be completely covered, while others require that the women shave their head. No such requirement exists for the men. Why? Who wrote this rule/law? My best guess is that it was men. I can’t believe that GOD had different attire and hair style requirements for women of different religions.

In some countries, associated with religious doctrines, women are not allowed to drive vehicles. Why? Who wrote this rule/law? My best guess is that it was men. It could not be GOD. Cars didn’t exist when such regulations took place.

Several religions, past and present, recognized that their survival depended upon numbers. The more members, the better chance for survival. As a result, rules/religious laws required that women have as many babies as possible. The more the better. During the Third Reich, Hitler chose the women who he felt had the best genetic makeup to “breed” with men who he believed to have the best genetic makeup. His goal was to produce the “Master Race.” The women had no choice with whom they were matched. In neither case was the woman considered. The toll, physical and emotional, of having baby after baby after baby really was not as important as the survival of the religion or the master race. Effective birth control was out not allowed. To question was an affront to GOD or to Hitler. The importance of numbers is valid. The use of women as breeding machines, not so much. We know why. We know who. In all cases, it is men who made those rules/laws. It is unlikely that GOD made different “breeding rules” for different religions.

In the United States, the Constitution was officially ratified on 6/21/1788. The Second Amendment, dealing with Militias and the right to bear arms, was ratified on 12/15/1791. The emancipation of slaves was part of the 13th Amendment, and was ratified on 12/18/1865. The 19th Amendment, giving women the right to vote, was ratified on 8/18/1920. Clearly, from the very beginning of our nation, women were less important than guns and slaves. In fact, women’s rights were dealt with 129 years after guns and militias and 55 years after dealing with the issue of slavery.

In the judiciary, women are still treated as second class citizens. Recent rulings dealing with the rape of women are an example. The judges, mostly men, consciously or unconsciously, know that as a young man, under the same circumstances, they may have done the same thing as the defendant did. Having sex with an unconscious woman, according to them is at least as much the fault of the female and a young man’s life should not be ruined for one such act (or at least the one he was caught doing). That fact that there will be long term negative effects on the female are not really a consideration. Females are told they should not go to such parties or drink alcohol. Males get no such advice. After all, boys will be boys.

It only took about 200 years or so to get laws dealing with “Dead Beat Fathers.” Even though they exist, for the most part, judges are extremely lenient when dealing with the Dead Beat. In the meantime, the woman has to provide money, food, health care, love, help with homework, after school activities and staying up all night with a sick child or children. All this, while in most cases, working full time to provide for her family. If she is late or can’t provide for an assigned visitation for the Dead Beat, SHE is chastised more than he is for missing payments.

If the woman gets pregnant, it is considered to be her fault. If she gets pregnant or just has sex with a married man, she is called a home wrecker. The man is free to keep having sex and getting women pregnant. The woman carries that baby for about nine months and goes through all the agonies, physical and emotional, of the process alone. The man keeps “poking fun.” Why? Who made this rule/law? My best guess is that it was men.

If a man can show that he was fearful for his safety and/or life when he kills another person, it is considered self-defense. If a woman has called the police (often fearing for her life if she would press charges) or gone to the hospital multiple times because her husband or significant other has beaten her, and she claims fear for her life when she kills that person, she is charged with murder. Why? Who wrote this rule/law? My best guess is that it was men.

Decisions about women’s health have become a hot topic. For the most part, those issues involve men and women who never walk in the shoes of the women whose lives are impacted by those rules. Planned Parenthood, which is MUCH more than an abortion site, is under constant attack. Those attacking have not had to deal with the exact same situations and circumstances as the women who need the help from that organization, but assume the role of GOD in determining what is right and wrong for all women. They claim to do this because GOD said so. Really? My best guess is that these rules/laws were made by men and women who believe they are acting on behalf of GOD. That authority was never expressly given to any individual human.

Sexual harassment, exploitation and abuse have existed for centuries. Hollywood has been famous for such activities involving little boys, young girls and women who want to get into that industry. Even recently, FOX news has been involved in such a scandal. It still goes on because women are afraid of what will happen if they tell the truth. For the most part they would not be believed, would be fired and ridiculed. Imagine trying to get another job to support your family. We have seen just the tip of the iceberg when it comes to this subject.

Did you ever notice how many television commercials involve attractive, sexy women? This is done on purpose. The sponsor and the advertising agency know that this will get people, mostly, but not exclusively, men to focus on the ad. In advertising, it is not the message that counts. It is the repetition of the name and your focus on that commercial using the name.

The United States Congress, in spite of having some women members, refuses to pass legislation that would require equal pay for women doing the same jobs as men. For this we know why. Big and small business (via Chambers of Commerce) don’t want the extra expenses associated with equality. They keep YOUR congressional representatives in office year after year after year after year, etc.

It is funny/ironic that there is an organization called PETA, which protects the welfare of animals. Why is there not such an organization that protects the welfare of women? The answer is that basically, in this country and throughout the world, women are still, consciously or subconsciously, considered to be second class citizens.

 

 

 

 

 

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