Posts tagged ‘Government’

Health Care Reform

Health care reform in the U.S. got a rude wake-up call recently. The Congressional Budget Office (CBO) looked at a draft of the first substantial health care reform proposal since Obama became president—the Senate’s Kennedy/Dodd proposal—and announced that it would increase the national debt by $1 trillion dollars during its first decade, while covering only nine million more Americans. About 37 million people would remain uninsured.

Health care reformAs supporters of that bill will point out, it was just a draft.  If it were a baseball game, health care reform would be in the first inning.  But the truly eye-awakening reality check that followed was the discovery by the chattering, blogging, and twittering classes of another proposal, one that been in the works for three years, one that provides universal health care in the U.S. while producing, according to the CBO, an annual budgetary surplus starting in 2014.  One that ensures that Medicaid, Medicare, and private health insurance offer benefits that are at least as good as those that U.S. senators and representatives get today.

It’s called the Healthy Americans Act (HAA), and it already has the support of more than a dozen U.S. Senators from both parties.  Senator Ron Wyden (D-OR) has been working on this bill since 2007, with Senator Bob Bennett (R-UT) as the other sponsor, and co-sponsors that include Lindsey Graham (R-SC), Joe Lieberman (I-CT), Arlen Specter (R/D-PA), Bill Nelson (D-FL), and Lamar Alexander (R-TN).

Assuming you agree that our current system is financially unsustainable and a threat to U.S. quality of life and competitiveness, and you don’t approach the subject with any sacred cows in your barn (We must have single-payer!  Only the free market can solve this problem!), reading the details of HAA might make you wonder if the bill is too good to be true.  Here are some highlights:

  • Employees happy with their current coverage don’t have to change
  • All plans offer the same (or more) benefits that Congress gets from their health insurance
  • Portability across jobs (unless an employee chooses an employer-supplied plan)
  • Private health insurance providers cannot deny coverage to those with pre-existing conditions
  • Doctors get paid for time spent on chronic disease management and prevention.
  • States provide Consumer Reports-like analysis of the options available to its residents

The biggest change for those happy with their current employer-supplied coverage is that the current system of how that coverage is paid for changes.  The money the company is spending on your health care plan is given to you.  You can then keep the status quo and buy the coverage you already get, or you shop around, using information gathered by the state to help you choose.  You are required to buy coverage somewhere, but if the coverage your employer gives you is not what you want, you can go with an alternative.

Of course there are catches.  Employers, who usually change insurance options each year, could instead choose to just give you the money and make you go on the open market for insurance.  And those employees and union members who get top-of-the-line coverage, with little or no deductible or out-of-pocket expense, will also lose something.  Once the whole system transitions to the HAA one, really expensive plans will cost more than they do today.  That might be unfair in some cases: if you were a union member and gave away some pay increase in favor of that kind of health plan, you’ll be pissed off.  But one of the keys to containing costs is through HAA’s system of making us all aware of the cost of our health care choices.

And like the switch to digital TV, the anticipated pluses identified by the CBO (and private groups like the Lewin Group who have also reviewed HAA) probably have failed to find some other issues with HAA.  The analogy to the digital TV may be particularly apt, since that conversion showed that even after all the warnings and converter box subsidies, there were still millions who didn’t take advantage of the “preventative” services available to them.

So there will probably be a devil we don’t know. But the devil we do know is the current, unsustainable system.  At least the Healthy Americans Act has had more than two years of analysis behind it, and its politically viable.  Even if HAA in its present form isn’t adopted, it sets a standard against which all other options should be judged against.


June 21, 2009 at 12:39 am Leave a comment

The code of the west

Apache County, Arizona apparently had too many city slickers moving there with unrealistic expectations about what they should expect.  The county created an interesting document called “The Code of the West” and made it available on their website:

Here are my favorite quotes:

County governments are not able to provide the same level of service that city governments provide. To that end, we are providing you with the following information to help you make an educated and informed decision to purchase rural land.

  • The existence of an unobstructed road to your property does not guarantee the road will remain open in the future or that you will have unlimited access.
  • You may need a four wheel-drive vehicle and/or chains for all four tires to travel safely during storms, which can last for several days.
  • Apache County maintains about 800 miles of off reservation roads- 60(+/-) miles are paved.  If an existing road is unpaved; it is highly unlikely that Apache County will pave it in the foreseeable future.
  • Electric service is not available to all areas of the County; [installing it may require] underground trenching costs, material costs and electrician fees. In some cases, it is necessary to cross your neighbor’s property to bring power to your property (either overhead or underground lines). It is important to verify [or] obtain the proper easements prior to construction of the power lines. Due to ongoing development and limited utility line capacity, electric power that is available today may not be available when you decide to build. If you are purchasing land with the plan to build at a future date, there is a possibility that electric lines (and other utilities) may not be large enough to accommodate you, if others connect during the time you wait to build.
  • Sewer service is not available in most rural areas, [so] you will need an approved septic system or other treatment process. The type of soil available for a leach field is very important in determining the cost and function of a new septic system. In some cases, a standard septic system will not work (based on soil conditions) and an alternative septic system is required. Alternative systems can be very expensive (they could exceed $20,000).
  • Trash removal:  In more remote areas, the most viable option may be to haul your trash to a landfill or a solid waste transfer station. It is … illegal to create your own trash dump, even on your own property.
  • Existing easements on your property may require you to allow construction of roads, power line, water lines, and sewer lines etc., across your land. These existing easements may also prevent you from building your residence, accessory buildings, or fences where you want to locate them.
  • Many property owners do not own the mineral rights on/under their property.  Owners of these rights can change the surface characteristics in order to extract mineral deposits.
  • What surrounds your property now is not a good indicator of what the surroundings will look like in the future. Spectacular views can be replaced by structures if neighboring private parcels are already approved for development. There is also no guarantee that surrounding public lands will remain undeveloped.
  • North facing slopes or canyons rarely see direct sunlight in the winter. There is a possibility that large amounts of snow will accumulate and not melt throughout the winter. In these conditions, keeping an access road open can be difficult and expensive.
  • The Rural “Aroma”- Many people who live in rural areas keep livestock on their land.   Living in rural areas means living with the smells inherent in rural life. Development of new residential areas is not grounds for shutting down existing permitted agricultural uses.
  • Arizona has an open range law. This means that if you do not want cattle, sheep or other livestock on your property, it is your responsibility to fence them out. It is not the responsibility of the rancher to keep his/her livestock off your property. Also, if your dog harasses livestock, the rancher may legally shoot the dog without prior notice to you.

Since the rural west will not change immediately to accommodate your lifestyle or expectations, you should be prepared to adapt accordingly.

November 9, 2008 at 4:13 am Leave a comment


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