October 28, 2009

The Evils of a Single-Payer System?

Is government-backed health insurance necessarily a bad thing? I mean, in and of itself... I'm not talking about government-subsidized or fully government-funded - I'm talking about an insurance bloc as administered by the government. Is this a bad thing?

Because up until this point, the grand plan has been to create this weak mandate that everyone buy insurance along with some sort of plan that the government will subsidize certain people up to a certain extent of poverty. I really don't understand what the difference is between doing that and taking Medicare, Medicaid, Government Employee Health Insurance and VA Medical and welding it into a single negotiating bloc and then offering insurance at-cost to whomever else wants it.

Because, honestly, if it sucks, people will buy insurance elsewhere.

Yes, I know, this puts the already-monopolistic health insurers at a disadvantage because they will have to savage their margins. Let's assume for a minute that I don't care about that (because, really, does anyone feel bad for insurers?) and ask if there's an actual downside here in terms of the tax-payers.

Let's reiterate: I don't want to spend a dime more on subsidies than is already being spent, but we can keep spending all of the money we're currently spending. All we're doing here is offering to let people buy into the negotiating bloc of the already-massive US Government Health Insurance without adding to the amount that the Government is spending.

Is there a hidden evil here that I'm just not seeing?

Posted by Vengeful Cynic at 11:27 PM | TrackBack

October 21, 2009

On Immunization

Since I set off a firestorm on my facebook page this afternoon regarding the notion of immunization, I figured I'd come over here and at least string together a couple of links with my thoughts on the subject.

Here are the two Wired articles that got the whole thing started:

An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All
How to Win an Argument About Vaccines

Some more digging around found me a slightly more even-handed article in Newsweek featuring an interview with Paul Offit (mentioned in one of the Wired articles):

Stomping Through A Medical Minefield

In going through this, there was a tangent in the conversation that went towards flu vaccines with an interesting analysis of how the numbers that justify them seem slightly inflated. This article is good stuff but is really tangentially-related at best to the discussion of infant immunizations:

Does The Vaccine Matter?

Let me just say, to those who are on the other side of this issue, I would really like to see some cogent and well-documented, well-researched argumentation. The problem is that I can't find it. I'm not sure if it's not there because the research is expensive and hasn't been done yet or simply because my Google-fu can't slice through 70,000 autism/anti-vaccination conspiracy whacko websites (and, make no bones about it, Jenny McCarthy is a freaking whacko), but if anyone can find me any well-researched argumentation, I'm all-ears.

In the mean-time, I'll toss you this fascinating Wikipedia article in closing. Of particular interest are the half-dozen cases in the last 150 or so years since widespread vaccination where isolated communities stopped vaccinating and the results. And before you start mouthing about Wikipedia, note that all of this article's really interesting and salient points are well-documented with outside reference materials. In fact, I encourage you to look over this article's reference section... it's a real treasure-trove of myth-debunking links.

Vaccine Controversy*

*note: I hard-linked to the Wikipedia entry as posted at time of my posting this so that you don't get there to see "penis" scrawled all over the page and question my sanity. This is STILL Wikipedia after all.

Posted by Vengeful Cynic at 11:37 PM | TrackBack

October 17, 2009

Set Up For Failure

"We've been set up for failure."

I hear that expression from time to time, mostly from engineers... especially from burned-out engineers to whom things are looking exceptionally dim. The first time I heard it, it took me aback a little bit, though I'm sure by now I've said it myself or something pretty similar at least once to describe a project that I was on when I was feeling especially in need of a vacation.

I was talking with a manager about this sort of thing the other day when one of those overly-simplistic statements joined up with this one in my head. We were talking and he said, "You know, you engineers tend to lose sight of the fact that nobody on this project really wants it to fail." And I guess it took me aback because, with the exception of some really rare Machiavellian schemers, I can't think of a single reason why someone working on a project and investing time, effort and reputation in it would ever want the project to fail.

Of course, that doesn't mean that people will agree on how to make it succeed or even that someone won't make a decision even with the knowledge that certain experts predict that such a decision will lead to failure. But the point is, generally, everyone wants a successful outcome. Also, the road to hell is paved in good intentions.

Of course, nowhere is this more evident than in lowest-cost bidding. Imagine, if you will, that you're trying to solicit bids for the cheapest airplane. Company 1 quotes you a price of $50,000. Company 2 says "oh yeah, well if we make the airplane so that it's exempt from FAA regulations, we could do it for $25,000." Company 1 returns and says, "oh, if those are the rules, we could also go back to fly-by-wire and use some older avionics and get you down to $20,000." And before you know it, your airplane is a bunch of canvas and some bamboo with a cement-mixer motor tied on there with prop attached to the front.

Obviously, there are things that a customer won't accept, but you've just put together a bid to do the bare minimum that someone figured could be done. And the someone who bid it probably just told procurement that they could find parts that don't yet exist for cheaper than the ones that currently do, told the designers to cut their costs in half and told the engineers that historical indices are crap. The guy who bid this didn't want to bid a crappy product, but he wanted to win the contract and in so doing, set himself and his people up for failure.

I'm not quite sure what you do about a scenario like this. Obviously, if you're the buyer, you have to be very careful about not creating scenarios where you end up with MacGuyver's Getaway Plane instead of a 747. As to what to do if you've been set up for failure, I've asked older and wiser heads and availed no answers. Any thoughts?

Posted by Vengeful Cynic at 12:46 AM | TrackBack

October 12, 2009

The Scholarship Committee

As another example of why I shouldn't be given free time nor allowed the notion that I have money or the ability to spend it, I present you with the Shadow Council Foundation and the attendant Shadow Council Scholarship for Academic Malfeasance and Troublemaking Excellence. The as-yet-unfunded Committee would be started with the noble goal of providing scholarships to invididuals as chosen by the august members of the Scholarship Committee.

Obviously, members of the Committee would refuse to give scholarships to anyone who would willingly answer the question "What is your favorite color and how does it make you feel?" And beyond the sheer entertainment value of seeking out the next generation of subversives and intellectual malcontents, we get to give money to further the educations of the most remarkable of students.

Of course, there IS the small issue of money. But that, my friends, is where patience and compound interest comes in.

I've availed myself of some small calculations and if we assume (for ease of simplicity) that there are 10 of us, each submits $100 a year and we invest in growth-stock mutual funds with an annual 12% rate of return, 10 years will get our little fund up to $15,000. Obviously we'd need more money than that, but I'd like to think that at some point along the way, members could give more money and perhaps we could recruit some more affluent donors. Also, if we could get this organization some proper tax-exempt status, we could avail ourselves of the possibility of making a nice proper tax shelter for Wilson and Martinez when they both strike it rich as authors.

Honestly, I think the question you have to ask yourselves is "Why wouldn't we want our own scholarship contest?"

Posted by Vengeful Cynic at 09:14 PM | TrackBack