Health mess continued

The health care debate has nothing to do with health care, but everything to do with money. Mostly, it deals with insurance coverage. It does nothing about the quality of health care and very little about the accessibility of health care. It doesn't address the problems with our pharmaceutical industry or with the FDA or with the shortage of medical professionals, or with any of a myriad of other health issues, except abortion and euthanasia, which aren't about health care, but religious and moral issues instead (we are not going there on this post).

I have seen many instances where the medical treatment offered was not the best available for the situation, but was instead based on how much money the practitioners would make. The bigger the size of the organization, the worse this seems to be, in general. I have however seen a fair number of cases where they practitioner is a small operation and they still push everything based on what is best for their finances rather then what is best for the patient.

I have had people tell me that the answer to this situation is insurance, but I believe it is just the opposite. I think that the insurance industry is the primary cause of this greed. Sure, there would be the small time medical scam operators that push their patients into something that either they don't need, or that is the most costly of the viable alternatives, but for the most part, before our insurance industry did their takeover of the health care system, practitioners did seem more concerned with the actual health and well-being of their patients.

Part of the problem is that the insurance industry has been making health care choices for all of us. The doctors don't really get the choice of the best treatments, just the choice of the best treatments the insurance covers. The patents don't get informed of their options, cause usually there is only one covered option. It no longer is about the best care for the situation, but about what the coverage is for the situation.

There are lots of examples where offshore clinics have far better care at a much lower cost, using much more advanced techniques. We don't have those options here, because even if the techniques are approved by our almost non-function governmental agencies, the insurance plans don't allow those treatments. They say they are trying to save us money. I have a hard time believing it. I have seen a system wide case where the US health care industry continues to do thallium treadmill tests to gauge arterial blockage, when other tests exist that are more than twice as effective, cost less than a fifth and often less than a tenth of the cost of the thallium test, and are usually up to five times faster. I say system wide because I have seen it happen to multiple people, in multiple states, in multiple hospital systems.

I have also seen and heard of many instances where the doctors (the good ones) pull people aside to a corner and whisper that what they recommend is some kind of do it yourself homeopathic or over the counter treatment, but that they have to issue this prescription or that. I even had one doctor explain that they have a quota that they have to meet in prescription writing in order to keep their license. I don't know the validity of this claim, nor the mechanism it would work by, but just the very mentality of the industry pressuring doctors to always prescribe the latest drugs in the maximum of situations leaves me thinking that the whole thing is just another corrupt system of greed.

We need some kind of impartial informing diagnosis web based system, perhaps not to be required use for doctors, but freely available so individuals can at least see what their options are and to get a non-biased second opinion. Sure, such a system would not be able to write prescriptions, nor would it recommend courses of treatment, but it could show possible diagnoses with all the known courses of treatment and what forms those treatments take. It could even show experimental treatments and list locations where different treatments are available. It could also show how reliable various treatments are shown to be. To put this together would require the input of many people, but if it were built correctly, it would be a learning system. Therefore, it's diagnoses would increase in accuracy over time. I can even picture it being a valuable resource to doctors, regardless of their expertise, experience, and training.

Seatbelts and Freedom

I wear my seat belt when I am in a car. I think you should wear your seat belt when in a car. But I don't think I have the right to tell you to do so. In our country, and across the world, we have a lot of concerned individuals. They, like I, think it is just tragic when someone dies or is badly injured when it could have been easily prevented. However, are we going too far in making every safety precaution a legal obligation? Benjamin Franklin is known to have written "They who can give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety."

This is exactly what is going on. We decide that we need temporary safety when we get in a car, so we mandate that individuals no longer have the choice to use a seatbelt, but that they have to or else... (they get fined, etc.). They now have temporary safety. What they have given up is freedom. According to Dr. Franklin, they therefore deserve neither. Is freedom really that important. History has shown that without it you get tyranny and oppression in unequaled severity. Is that what we are heading for. As a student of history, I have to conclude that yes, we will get to that point. Sure, it probably won't happen overnight. But it will happen.

That sounds bad, but if we shouldn't mandate intelligent behavior, what then can we and should we do? Also, what is appropriate in terms of laws so that our society functions. Since we are using traffic laws as an example, lets continue with them. Should we have speed limits? Why or Why not? What about required stops at stop signs and stop lights? How about lane changes? What should we do about them? Obviously, there has to be some kind of regulation to ensure that our traffic system functions, but does that logically extend to forcing people to wear their seat belts? Perhaps we call out the difference in that it doesn't affect other drivers or passengers in other cars if I don't wear my seat belt, so therefore, it shouldn't be a law.

Seat belt usage still is desirable, though, cause it certainly has a positive outcome for society. So what should be done about it? How about public education and encouragement programs? How about seat belt billboards quoting the smartness of it, or the statistics of how smart it is? I think much of our mandated laws could be converted to educational programs. No force, but it would be something that people would know. Then we could have both freedom and safety, and be deserving of both.

Back from the dead

Ok, I admit it, I have dropped off the face of the earth. Well, actually, life happened, and I keep meaning to get back here to post some more. Well, amongst all the other things going on, like a lot of trips to the hospital due to my wife's preterm labor, I finally have a new job. I am now working as a content developer for a company called Socratic Arts. I was supposed to start as a project manager for them, but that project fell through, and the next one needed someone local to the New York City Metro area, so I got the content developer role instead.

Well, in the mean time, I have added another blog that comes from the president of my new company. He is a really incredible thinker. I also added a list of recommended sites for further reading. Really, you should read those sites. Well, at least as much as you have time for, but the information is quality. I have only read the free chapter of the startup book site, and I figure, once I have done everything in that first chapter, then I can worry about the rest.

Well, that is the latest update from me. I hope to get back to making regular posts on here so you have more to think about. After all, I am sure you of all people wouldn't be suffering from information overload. That is just for the rest of the folks. :)

Fundamental Flaws in American Education

Public education is one of the things that made America great. It surely wasn't the only thing, but it was a huge factor in America becoming the "Land of Opportunity". Unfortunately, any time something becomes institutionalized, it also becomes a target of political, social, and economic forces who view it as a short cut to achieving their goals. Education is even more so a target due to the effective of having nearly all of the very malleable minds in the country captive and required to participate in the activities. Education in America has become a battle ground between opposing sides in far too many wars. Conservatives and Liberals, religious and anti-religious, business versus... well, business fights well enough by itself, call that the civil war of business philosophies, and many other sides fighting to influence the collective minds of American youth. The casualties in this war too often end up being the students who are supposed to be served by education, and instead they become cynical, bitter, and/or hateful. Doesn't matter which of the various sides they end up on, they are given disservice by this situation. At the same time, there are a few who make it through this maelstrom who are highly enabled to thrive in life.

There are a few things that could be changed about our educational institutions which would greatly expand the number of students who are able to greatly thrive as a result of their education. The first thing has to do with those sides. The ability to lobby and influence education is strongly related to it's centralized nature. The solution then would appear to be the decentralization of it. However, there still need to be standards, and those standards are where the various sides will try to attack or influence our youth. Our youth are not stupid, and we should stop treating them like they are. They are inexperienced, and we should try to help them understand the challenges they will face because of that inexperience, but we should do so in a respectful and supportive manner. If there is a side of something presented, then any other side of that issue should also be presented, regardless of how unpopular it might seem. If you don't want certain sides of things presented, then just define that there is an issue, and inform the kids they will have to ask their parents or research it on their own. Also, when an issue with it's various sides is presented, the alignments and history of those sides should be presented, but no side should be favored over another.

Sounds pretty lofty, doesn't it. I know it is possible, cause I had a professor in a philosophy class that did it with such exactness that none of us could guess or even come close to what his personal philosophy was. He ended up being pretty normal.

The next thing that needs to change about education is that we need to stop limiting the growth and progress of some students in order to keep them at the same place as their slower peers. In fact, we need to change our whole approach to education from a group based progress, to individual progress in a structured, yet self paced, environment. There are several forms of this. Some of the older forms often are used in independent study programs, but there are much better scaffolding programs that can incorporate both the independence of the individual as well as social learning and support structures. In this way, each student could progress at a rate where they felt comfortable and could best succeed at.

Thirdly, and there will be many who will think I have political motives here (I really don't. Read carefully and you will see what I am getting at.), we need to change how education is funded. I recognize that if we removed government involvement that we would just be favoring the upper classes over the lower classes. This is not intended, nor desirable. The government has a very important role in the funding of education, as well as in the standards that are set for it and in making sure that it is not abused. However, creating a big bureaucracy and turning over a major portion of each state's budget over to that bureaucracy is worse than most other ways you could go about it. I recognize that any effort to standardize or support or govern education will require government funding, but those funds should be completely separate from the funding of the actual education. The parents should determine which qualified school or teacher should receive the funds paying for their child's education. I am not saying just open up the funding spigots and dump it on private schools. On the contrary, if a private school wants to be eligible to receive public education funds, they should have to meet the standards attached to receiving those funds. In this way, there becomes more of an economy around education, which will help maintain the quality of education.

One last thing, and perhaps this would never fly, but a parent should be required in every class that is conducted. Just to sit in and listen, and they could help if they and the teacher agreed on it. Just one parent. Assuming that each class has 20 students, and half the students have both parents at home, each parent would only have to go to every 30th class. The point here is that the parent is the consumer. They are the customer. They need to know what is going on, and far too many parents are complacent to just ship the kids off and not look into the quality of the education again until report card time, and sometimes, not even then. Would this create an additional burden on parents? Sure it would. And for those who have a lot of kids, even more so. If you have that many kids, you need to be involved. I suppose you could designate someone else such as a grandparent, or some other responsible adult relative, and meeting the requirements should be somewhat flexible, but a parent needs to be there. The result this would have would be better performance by the teachers, the students, and most especially, the parents.

Scary, isn't it. But, it would work. I am sure of it.

How much wealth is too much?

I was reading a wikipedia entry yesterday about globalization. One of the statements was that "The three richest people possess more financial assets than the poorest 10% of the world's population, combined." Now, it said there was a citation needed, and the link they listed there got a 404 error (meaning not found). However, it got me to thinking. How much wealth is too much wealth. Is there a problem when someone is vastly successful and thereby amasses amazing wealth. I don't have a problem with people being successful, as long as they were honest, and didn't abuse people to get there. However, I do have to agree that having too much wealth in the hands of too few is a problem, but it wouldn't be fair or right, or productive, to restrict people from earning as much as they can. So what is the answer.

What about those who inherit significant wealth. Well, I think about my own children, but I wouldn't want to dump ridiculous wealth on any of them, but I would want them to have enough to be well established. I thought about Warren Buffet, who has often indicated that he won't give significant inheritance to his children. He is strongly in favor of the inheritance tax. I began to think about this. If there were some kind of limit on inheritance that would meet with Buffet's famous statement that "I want to give my kids just enough so that they would feel that they could do anything, but not so much that they would feel like doing nothing", but that provided that kind of limit for everyone, then that might provide a better distribution of wealth.

I often think of wealth in terms of the poverty level. And by poverty level, I mean the poverty level in the United States. If there was unlimited inheritance up to say, 500 times the poverty level, that should be enough to provide a great start for anyone. Those who then have way more than that, would have to look for additional heirs to distribute their wealth to. Beyond just an inheritance tax or limit, I would also apply it to gifts given before death. The total anyone could receive should be the same whether the received it before their benefactor's death or after. If donating to a trust, then the total number of full beneficiaries of that trust should be multiplied by the limit. Buffet's donation of over 30 billion to the Gates Foundation would be just fine in this instance, since the trust specifies everyone as beneficiaries. All assets should fall in this category, whether cash, stock, real estate, or anything else. Any assets not specified to an heir would then be liquidated and turned over to the government. By distributing wealth better, there would be less pooling and reduction in economic activity, and also result in greater opportunities as there would less plutocracy and fewer inherited power positions in big companies (think Walmart or Ford).

I would say that this would be one of the first requirements for the Good Government Initiative. It wouldn't work if there was a permanent royal or elite class. Distribute that wealth and get it back in circulation. That is what will benefit the nations and individuals.