| Smart Health Blog |
| Written by uche okeke | |
|
Becoming Less Dependent on Money
Before you go out a quit your job, lets look at what you can't control when it comes to money:
SELF-SUFFICIENCY DEFINED Self-sufficiency by definition is a state in which someone or something can self-sustain oneself without using outside resources. If you take that statement literally, it is impossible to obtain. Each and every living creature on this planet is dependant upon outside resources in order to survive. For instance, all animals need food to live. Most animals (excluding humans and the animals we feed) hunt and gather food as they did thousands if not millions of years ago. The majority of humans on the other hand, rely on others to produce food. We are no longer hunters and the gatherers, but rather consumers. This interdependency for the most part works. Most people buy their food instead of foraging for food themselves. Of course, buying food means that we must have money. And in order to have money, most of us need a job. Thus starts the vicious circle that has gotten most of us removed from the basics of being self-sufficient. Besides food, we need other things too - water, shelter and warmth. Again, most people today rely on outside resources to provide these things. People get their water from a faucet, live in a mortgaged home or apartment and rely on heat from an electric or gas utility company. So what does being self-sufficient mean in today's society? We can be self-sufficient by using our own physical and mental skills to produce food, shelter and warmth in order to sustain one's own existence. It means not relying on others for things that you can do yourself. It is a way of life that reduces our dependency on external resources in order to live. Self-sufficiency for most homesteaders means rekindling the skills once commonly used by past generations: growing, raising and preserving food, making and repairing tools, cutting and drying firewood, mending and/or making clothes and even building a house or a barn. This is by no means an easy feat. It requires a ton of self-discipline and a determination not found in most people. Especially in today's society where over the years we have grown accustom to depending upon others to provide for our basic needs. As technology makes life "easier", we move further and further away from the basics and lose the skills that once sustained us. What is gained by self-sufficiency? A greater sense of freedom and greater control of one's life. You will also eat healthier knowing what went into growing and raising your own food. You will reduce your dependency on money and reduce your need to work a stressful, 60 hour per week (or more!) job. Instead of paying a repairman to fix something, you take pride in fixing it yourself. How self-sufficient one becomes is entirely a personal decision. There are plenty of things to consider and weigh. It is up to each of us to determine how self-sufficient to become.
The following is information from a farmer who grows and packages carrots for IGA, METRO, LOBLAWS, etc. The small cocktail (baby) carrots you buy in small plastic bags are made using the larger crooked or deformed carrots which are put through a machine which cuts and shapes them into cocktail carrots . Most people probably know this already. What you may not know and should know is the following: once the carrots are cut and shaped into cocktail carrots they are dipped in a solution of water and chlorine in order to preserve them (this is the same chlorine used your pool) since they do not have their skin or natural protective covering, they give the m a higher dose of chlorine. You will notice that once you keep these carrots in your refrigerator for a few days, a white covering will form on the carrots, this is the chlorine which resurfaces. At what cost do we put our health at risk to have esthetically pleasing vegetables which are practically plastic? We do hope that this information can be passed on to as many people as possible in the hopes of informing them where these carrots come from and how they are processed. Chlorine is a very well known carcinogen. Please let us make this information available to as many people as possible. If you care about your family and friends, pass it on.
Despite being buried in Health 2.0 work, somehow I’ve been managing to read a few books lately. But none of them have been quite as staggering as Free Lunch, the latest from former NY Times investigative reporter David Cay Johnston. Johnston’s best known for his exhaustive investigation into how corporations and very very rich individuals subvert the tax code so that they pay less, while the rest of us pay more. But in this book (probably because he’s no longer a NY Times Reporter and is off the leash of restraint that the Grey Lady seems to put on its reporters) he gets almost biblical in calling out the cheats, crooks and murderers. And when I say murderers, Johnston is talking about John Snow, Bush’s former treasury secretary — yup the one who did such a great job regulating the sub-prime mortgage market that the potential for a credit and housing collapse in the latter part of this decade was avoided…oh, wait….
A few months ago, the MA Division of Health Care Finance and Policy (DHCFP) released a study that showed that mandated health insurance benefits cost insurance purchasers about $1.3 billion - or 12% of their premiums - each year. Thanks to DHCFP for publishing the study. This issue is always the source of heated debate, and it’s nice to have a piece included on it that tries to inform the discussion. Business people read the study and said, “Ah ha! Mandates cost a lot of money!” That would be correct. Health care advocates read the study and said, “Ah ha! Mandates don’t cost that much money!” That’s correct too - sort of. As usual, where you stand depends on where you sit, how much twelve percent is worth to you for what you’re getting, and who pays the bill. It’s also hard to tell if this kind of reporting influences the policy debate in MA or not. People here are screaming about the rising cost of health care, and the legislature responded by focusing on and enacting a cost containment bill. But at the same time, the legislature considered many new mandates during its last legislative session, including significantly expanding the mental health benefit mandate for kids and adults. Many in the legislature would argue - correctly - that the final bills that passed didn’t expand the benefit as broadly as many advocates would have liked, thereby significantly limiting the increase in costs associated with the new coverage requirements. Again, I think this is mostly a philosophical argument about how much is enough - and one that on the margin is hard to calculate.
Health Affairs ran a couple of partisan analyses last week. Joseph Antos, of AEI, Gail Wilensky, former Bush 41 HCFA administrator, and Hans Kuttner labeled the Obama plan as excessive tax and spend socialized gulag regulation. In the other analysis, four liberal academic wonks -- Thomas Buchmueller, Sherry A. Glied, Anne Royalty, and Katherine Swartz -- derided the McCain plan as the counter-productive ravings of a right wing nutjob. OK so they didn’t exactly say that, but you get the message. No surprises here. The McCain plan is so far out of the mainstream that, when Bush proposed something very similar in 2006, he could not even get it introduced into a Republican-controlled Congress. Obama's plan is a wishwashy centrist Democrat plan that doesn’t even pretend to get to real universal coverage and ignores the fact that the vast majority of Democrats prefer a straight single-payer plan (and so does he when scratched hard!). So who does Health Affairs chooses to create a middling compromise between these two? It chooses Mark Pauly, the only leading academic health economist among the Ivy League elite who’s a paid up member of the right-wing free-marketeer club. Here’s what I wrote about Pauly in a much longer article about Malcolm Gladwell a while back:
Since then there’s been a Health Affairs article where Pauly—sitting in his risk-free tenured position at U Penn with great group health insurance—provided data that showed that the individual private insurance market was egregious and discriminatory in the way it did its risk pooling. But he essentially declared that private insurers were OK because if they were any good at their jobs they could have been even more egregious and discriminatory in their risk pooling! Of course in reality he missed the behavior of health plans in that individual market place where they showed themselves to be very good at being discriminatory by retroactively kicking out individuals who were poor risks. Luckily for the rest of us Lisa Girion was paying attention. So now Pauly is the moderate in the middle? That defies belief, but it’s worth taking a cursory look at what he’s says. He of course dismisses single payer, and sets up a fake dismissal of a counter-weight which forces everyone moves to HDHPs and HSAs—even McCain isn’t crazy enough to suggest that (especially not after last week!). The bit that I find most interesting is when he attacks Obama for advocating pay or play—and for his desire to keep employer-base health insurance around. Now (along with Maggie Mahar channeling Uwe Rhienhardt) I’m no fan of employer-based health insurance, but Pauly’s reasoning reminds me of another smackdown I issued a while back. He says:
This is bunk. In Paulyworld any time a union wants to increase health benefits, the employer happily does it and correspondingly reduces wages. In Paulyworld the proportion of corporate income extracted for profit and returned to shareholders (and executives) is constant. In reality Wall Street will tell you that the proportion of revenues going to corporate profits increased dramatically in the early to mid 2000s while the share allocated to employees’ wages fell. Of course that’s the continuation of a pattern where real wages for the vast majority of Americans have fallen over the past 30 years while corporate profits (and the “wages” for those that own corporations) have dramatically increased. The proportion of profits to revenue matters because it dramatically impacts stock prices, and stock prices determine how senior corporate executives and shareholders get paid. So for Pauly to tell you this doesn’t matter is just not true. Which is why in the real world disputes over wages and health care benefits are such a big issue. Pauly and the other theoretical economists (including the one I ripped a few years back) will tell you that this allocation will sort itself out in the long run. I’ll just remind him of what a rather greater economist said about how we’d do in the long run. Give him his due, Pauly does say one sensible thing about the politics of McCain’s proposal to remove tax deductibility on health benefits. The Democrats are rightfully calling that a tax increase on some people (not that I’m opposed to that!)
Funnily enough that was how Maggie Thatcher got rid of mortgage tax deductibility in the UK. But when comparing the segmentation strategy that McCain envisages, or the closer-to-universal pooling concept of Obama, it’s not hard to guess where Pauly ends up.
<Sigh…>
This needs serious parsing. Pauly’s basically OK trusting segmentation “corridors” in a separate-but-equal mode where the really sick are going to be sent off to risk pools. We know two things about those risk pools.
Now Pauly finally he says something I can agree with. We should indeed be cautious about the ability of providers to gouge the system—after all they’ve had 43+ years practice at it. Unfortunately Pauly neglects to notice that those nations which have succeeded in avoiding the “generosity” of the public’s largesse to the heath care system to the extent we’ve seen in the US, have done it precisely because they use one integrated risk pool, or a very close approximation of the same thing (e.g. in Holland). That pooling prevents those more advantaged from cutting those “separate but equal” groups adrift in their leaking lifeboats—as happens in programs for the poor here (to wit Medicaid). That’s why Ted Kennedy is so determined to keep everyone in Medicare, and that’s why the rest of the world believes in some variant of single pooling. But to be fair, anyone reading the name of the author here would know what we were going to get and would know that it would not be a sensible proposal, but instead a “compromise” twisted by Pauly’s peculiar view of the health insurance system. At best we would we might have expected a “lets’ report both sides” story similar to what most media outlets do — even though one side is clearly operating on the fringes of both political and economic reality (and that’s not to say Obama is that much better). The real question is why Health Affairs chose Pauly, rather than a sensible middle of the road academic, to write what could have been an important piece? |