Just Asking

Wednesday, April 04, 2012


While waiting to see a doctor, I jotted down a list of odd words containing the "th" letter combination. Besides that, what do the following words have in common?

Theme, Rhythm, asthma, athlete, algorithm, breathe, theory

Thursday, February 02, 2012

Free Market Medicine

In the U.S.A, we have developed a very unwieldy system for funding medical care. It has a big engine, no brakes, and a very loose connection between the driver and the gas pedal. The little clinics do okay, but the hospitals with operating rooms have a difficult time getting ends to meet. They feel compelled to provide medical care to anyone who walks in the door who needs it, no matter how they might pay for it. It is the judgment of the doctor and patient on the treatment, within the confines of guidelines set by the hospital and the insurance companies. In the wink of an eye, the fully insured patient can agree to a $50,000 procedure with only $1,000 out of pocket. It is like driving a car with no brakes!

But hospitals are staffed by hundreds of highly trained and educated individuals who are devoted to providing the best medical care possible. And hospitals purchase extremely rare and expensive equipment to provide the best care they can afford. But who pays for it? The insurance companies pay for it. I believe they are billed at 2-3 times the cost of the procedure, and then they negotiate the price down to something acceptable (or previously agreed upon in a contract). And who supports the insurance companies? Hard-working Americans who have jobs. So we have a trickle down from the wealthy Americans (meaning, those with jobs with medical insurance) filtered through the insurance companies to the perennially broke hospitals.

A government-run medical care system would in fact be very similar, in that we would have a trickle down from the wealthy Americans (meaning, those with jobs paying taxes) filtered through the government to the perennially broke hospitals. And of course the government would have to put restrictions on how the money is spent, and would have to set priorities on who gets the medical care. Injuries before cancer? Youth before age? How will they decide? And it will get ugly, with long waits for simple procedures. Ask any Brit.

So the basic choice is, do we want the government bureaucrat deciding who gets what treatment, or do we want the free market deciding? I think medical savings accounts combined with a free market system will result in the best care at the lowest prices. So I recommend a third system, where the patient buys the medical care that they can afford. Some will get a Mercedes for medical care, some will get a Studebaker, and some get will no medical care. The latter choice is not unthinkable to me, since my grandmother never knowingly accepted any medical care in her life. An employed person accumulates his money in a medical savings account (filled by employer and employee contributions) in their youth, spends it as they see fit to age and die comfortably, and gives the rest to their heirs. This approach encourages the patient and the doctor to be very careful with the patient’s money, which are the brakes that the medical insurance system needs. This approach also allows the patient to shop around for the best deal before getting sick or for elective procedures, instead of paying top dollar with the insurance company paying the bill. This approach will no doubt force states to provide medical care for the truly needy (I'm thinking of children with Down’s syndrome or birth defects), but once again there will be a whole swath of people who don’t work, don’t accumulate medical savings, and still want medical care. We need to constantly remind these people that hospitals are staffed by hundreds of highly trained and educated individuals who use extremely expensive equipment to provide their medical care. Ultimately, these people will be at the mercy of the state bureaucracy, as it must be up to the states to choose who gets the medical care (not the federal government, because that is unconstitutional). But hopefully this approach will motivate them to get a job, accumulate medical savings, and pay for their own medical care. I think it connects the driver with the gas pedal, and puts some brakes on the big spending.

Monday, December 05, 2011

Time to Let the “Payroll Tax Holiday” Expire

President Bush raised the issue of saving Social Security over ten years ago. Even our youth know they cannot rely on Social Security.

In light of this, I thought it was wrong to cut our Social Security payments (also known as the payroll tax or FICA) for 2011. Why cut $100 billion in payments to a program that is teetering on the edge of bankruptcy? So they tried it for a year to stimulate economic growth. It did not work. It is clearly time to let the payroll tax holiday expire.

So why are many Republicans and most Democrats in Congress now discussing an extension to the payroll tax holiday for another year? Have they conceded that Social Security is doomed?

Friday, June 17, 2011


At the Garfield High School graduation ceremony, the program listed 438 graduates, considerably more than the 300 or so that were listed on the senior awards ceremony program. I am not sure why, because many names on the senior awards ceremony had nothing listed under them (such as an award or a college).

Also, at the graduation ceremony, each of the valedictorians was given about a minute to speak. Many quoted poets, etc. Our graduate took the opportunity to express her appreciation for the support she had received from her parents and a certain family whom she had only met four years ago. It was very sweet.

Friday, June 10, 2011

Elite High School

I attended the senior awards night at Garfield High School last night. This is an elite high school. The senior class of around 300 students included 152 students who are Washington State Honors Award Recipients, indicating they are in the top 10% of Washington State high school graduates. According to the program, the senior class also included 17 National Merit Finalists. Of the 208(!) graduates accepted at and headed for 4-year colleges or universities this fall, three are going to Harvard, one to Yale, one to Columbia, one to Cornell, one to MIT, and 57 to the nearby University of Washington.

Tuesday, May 03, 2011

The Direction of Time

The timeline points to the future, right? Clock numbers get bigger, day numbers get bigger, and year numbers get bigger in the future.

And how about daylight savings time with its "Spring forward, Fall back"? They want you to move the clock forward (to a bigger number) in the spring and to move the clock backward (to a smaller number) in the fall.

So why do we move meetings forward (meaning to meet sooner, at a time with a smaller number) and deadlines back (meaning to deliver later, at a time with a bigger number)? Or am I confused about meeting times? Maybe that explains why I am almost always late to meetings.


Wednesday, April 20, 2011

Liberals Make Messes

I have a hypothesis that conservatives are forever cleaning up messes made by liberals.

I have observed that there is always a big mess (bottles, can, tissues, paper scraps, etc.) after liberals hold a political rally, but there is never a mess after conservatives hold a rally.

And certainly this hypothesis is true on the national and state-wide political stages, where the liberals in charge are making huge messes that only conservative governments can begin to clean up (and it will take decades).

Does this hypothesis also apply to families, small businesses, and other organizations?