The Banker Barons?

Ohio Congressional Rep. Marcy Kaptur and MIT economist Simon Johnson don’t hold back on the past, present and future of big banking and its negative impact on the economy on Bill Moyer’s Journal this past Friday.

If you haven’t seen it or want to see it or the transcript again, here you go:

Are Doctors paid like Mechanics?

When you take your car into an auto dealership for warranty work or for work covered by auto insurance, the situation is quite similar to how your doctor is paid by medical insurance companies.  Basically, there are set fees or “flat rates” for most auto repair jobs and it seems medical insurance companies also pay a set fee or flat rate for human repair jobs.

So what’s wrong with this?  Don’t get me wrong, like most people I’d like to know ahead of time how much I am going to be charged for repair work.  But the thing is, the flat rate doesn’t adequately compensate either the mechanic or doctor to think about the situation, properly diagnose it and answer any questions you may have.

Fortunately for us, most mechanics and doctors don’t want us to get hurt and won’t cut corners when it comes to safety.  But wouldn’t it be better if we could have better communication with our mechanics and especially our doctors?

Oh, if a mechanic has a car “come back” with a problem from a flat rate repair job, the mechanic has to work on it again at no charge.  If a doctor has a patient “come back” with complications I’m not sure if the doctor gets paid again or also does it for free.  I’m not sure how often mechanics get sued but being sued for malpractice is a never ending concern for many doctors.  For some medical specialties, malpractice insurance is the #1 operating expense.  I wonder who pays for that in the end?

Bad Credit = No ID Theft Worries

Most of us have heard about the millions of credit and debit account details stolen recently.   I don’t have any brilliant suggestions as to how you could fully protect yourself from this.  But I do have a some what unproductive observation.   Namely, that bad/poor/lousy credit could serve as a buffer against both identity theft and bogus credit card charges.  Well, nothing else to see or say here.  Good luck in this economy.

Action=>Unequal, Opposite Overreaction…

Yeah, this is about health care but not the way you think…I hope.  It seems like a bunch of people are signing up for nursing and physician assistant programs, medical transcriptionist training and other medical jobs.   And right now this sounds like a good thing what with the relatively high pay and job security.  In part this is due to the relative under supply of staff.

Well what is going to happen if there is an oversupply of staff in these areas  in a few years?  How ironic and sad would it be for these newly-minted workers to get another free market kick in the teeth?  And facing facts, present and future, somebody somewhere, private or public, will have to pay the health care bill.  No free lunch, no free checkup.

And obviously the current healthcare debate and the various bailout plans could be well described by the title of this blog posting.

21st Century 5 and Dimed…

More than several decades ago, “5 & Dime” was slang for a store that sold low cost merchandise, primarily household items. The “5″ represented a nickel. Well with inflation, we’re up to the 99cent or dollar store. Ah progress!

There’s also a related saying – “nickel and dimed” – which means a series of small charges or expenses. And this brings us to the title of the 2001 book, “Nickel and Dimed – On (Not) Getting By in America” by Barbara Ehrenreich. If this title sounds familiar, it’s probably because it did quite well when it first came out and made it to the New York Times bestseller list. (I wonder if it was inspired by Haverford College President John Coleman‘s 1974 sabbatical into the hands on America and chronicled in his “Blue Collar Journal”)

Ehrenreich spends a few months working as a waitress, maid, housecleaner, nursing home aide, and bigbox retail. She carefully logs both income and expenses as she seeks affordable housing, a healthy diet that conflicts with spartan storage and cooking facilities, staying healthy and uninjured, and dealing with the pitfalls of workplace politics. These jobs all pay around $7 an hour. Ehrenreich is unable to survive at that pay rate. She points out that she would have been able to manage in the short to medium if she shared the cost of housing with a roommate. However, she also speculates how one would be able to save money to cope with an illness or injury and the accompanying loss of income and medical expenses. Having to repair or replace a car, being the victim of a theft, or just a period of unemployment would pose similar economic peril. It seems to me that even more people today are facing the economic trap Ehrenreich explored 8 years ago.

There are several other books by Ehrenreich that sound applicable to the current situation:
“Fear of Falling: The Inner Life of the Middle Class”
“The Worst Years of Our Lives: Irreverent Notes from a Decade of Greed”
“This Land is Their Land: Reports From a Divided Nation”
“Bait and Switch: The (Futile) Pursuit of the American Dream”

I wonder how depressed I will be after I read them? Ladies and Gentlemen, it looks like serfdom has returned to these United States.

Low-Wage Workers in This Economy – New York Times

W.H.O. Are You?

Quite a few people seem rather upset about changing the US health care system and are being very impolite to our elected officials.  Now this is not necessarily a bad thing (the impoliteness) but only when it is the officials that misguided and ill-informed.  The main issue I’d like to address here is the notion that medical care in nationalized systems is plagued with delays and poorly-trained, overworked doctors and nurses.  Well that’s not the impression I’ve gotten from friends and relatives in Canada and the EU.  I’ve been told the exact opposite – that health care is quite good and reasonably quick.  And the evidence is growing that the US is not the leading medical technology innovator.  So where does this leave us?  We spend more money on health care than any other country yet other countries have better health care, lower infant mortality, longer life spans, less obesity and chronic illness? Something is definitely wrong with this picture.

This week my local NPR station had a very timely conversation with 3 current Las Vegas residents who used to live in countries with nationalized health care.  They all seem to have been quite satisfied with the quality of care from the “free” nationalized health care systems of Canada, Australia and Germany. Now just 3 opinions for 3 nations is hardly a deep sample set but it jives with many mainstream news reports.  And if you know people in nationalized health care countries and you’ve asked them how they like it, then perhaps this has the ring of truth to you as well?

” Now Timmy Franz Geithner, you go wash your mouth out with tarp this instant!”

Everyone’s heard about this.  Well put me on the side of the aisle that thinks it’s actually a bit humanizing and refreshing.  But then again I wasn’t called to the carpet F-bombing so I won’t be demanding that he walk the plank.  And face it, DC went Planet Hollywood ages ago.  I am pleasantly surprised and sort of disappointed that no transcript or better yet, an audio recording, has not yet leaked or surfaced.  (but wouldn’t leaking lead to sinking rather than surfacing?)

Geez, I thought this was supposed to be the dawning of the age of always on and “connectededness.” <sp>  Shesh, even Saddam Hussein (you know, Obama’s distant Uncle :-) ) had his execution recorded with a covert cell phone.   I’ll also sneak  in my regret here that no audio or video was available for “When Louis Gates met Officer Crowley.”

New GI Bill will Payoff

Finally a government funding initiative I can feel good about.  If history repeats itself, just as the GI Bill after WWII helped so many Vets move on to the next stage in their lives and helped America move ahead to its greatest period of prosperity, this will be a good good thing.  And the influx of money will also help many colleges and universities maintain funding for programs, staffing, faculties and facilities.

But there are at least three big differences to consider comparing post-Gulf war to post-WWII.  First the other major world economies haven’t been shattered with war damage.  Second, the average educational quality of the US high school graduate from the past decade does not compare well to that of the 1930s and 1940s.  And third, the US doesn’t have the abundance of natural resources it had 60 years ago.

Still, it’s definitely a step in the right direction and hopefully we’ll start seeing the benefits less than a decade from now.  Perhaps historians and economists will be able to refer to this as one of the contributing factors to a revitalized 21st century US economy.

This “Post 9/11″ GI Bill was approved last Summer in Congress so kudos to the outgoing Bush Administration as well.  I’ll also be a bit meow and and say how sweet it must be for Secretary of Veterans Affairs Eric Shinseki to get both the tacit nod that his stance on the second Iraq war when he served as Army Chief of Staff was the right one and now he can improve the VA and help his fellow Vets.

About SECURITY, Health Care and education…

This is kind of obvious but everyone does know that stuff like TSA airport security and health care are on the expense/non-revenue generating side of the balance sheet right?  And every dollar spent there is money that could have been spent on education – the ultimate revenue generator.

Now I know we don’t live in an ideal world and we need a certain level of spending on commercial security, the TSA in our airports, (what a truly victorious long term negative annuity Osama saddled us with!) the police, and the military.  Sorry but fire trucks and ambulances fall into the same category of resource consumer not producer.   And so we segue to health care.

It certainly is obvious that the US health care system needs to change so we can get more efficient and effective service.  The thing that bugs me is that like so many other areas of American culture, the expectation is that we can have technological magic bullets to fix things. While there are some voices trying to let us know that it is just not affordable to use medical treatment to correct obesity, poor diets, lack of exercise, smoking and other substance abuse, this requires more individual sweat, sacrifice and discipline.  In other words, it’s not likely to happen.

In my ideal world, there is enough money for the minimally acceptable levels of security, police, fire and defense – in other words they would be reasonably funded and people who work in these fields would be reasonably paid.  Now education would be very well funded, extremely even, but not excessively so,  and this definitely means teachers would be very nicely paid.

After that, we’ll to something about excessive executive and finance professional compensation.

You Can Call Me Dave…

Any of you remember that tagline from a beer commercial a fair number of years ago?  Well reaching even further back, to 1993, gets us to the movie simply titled “Dave.”  Superbly played by Kevin Kline, Dave is a man with a good heart,  runs a modest employment agency and also earns extra money as a Presidential impersonator.

The movie came out near the start of the first Clinton administration and this President is both a womanizer and to put it bluntly, an asshole.  Well Dave is tapped to double for the President and then suddenly finds himself working a much longer term gig when a severe stroke strikes the President and this is known to only a few people.

Dave quickly fills the shoes and then some.  He fools the First Lady, admirably played by Sigourney Weaver, for a bit but then his common decency tips her off and she learns that her husband in name only is basically a vegetable.   They sneak out of the White House but decide to come back, continue the ruse and make the country better.  This being counter to what the evil and power hungry Chief of Staff wants  (Fank Langella (Frost/Nixon)) means that some hilarious political infighting ensues and then we get a charming happy ending.

So where am I going with this?  Well “Dave” is an excellent movie to watch in this economy.  The movie presents the fanciful notion that government should be here to help us and that the evil ones will get their due.  I’ll suggest some depressing/distressing movies next week.