Monday, August 12, 2013

Some Thoughts on Obamacare

     Why do we need health care plans in the first place?  My answer is that it is a question of risk mitigation.  On the average, we are going to spend a certain amount of money on health care.  But some of us are going to spend much more.  If you are involved in a bad car accident or get cancer, suddenly you need to spend much more money than the average.  I don't think we want to be a society that refuses to give care to children  if they have a life threatening illness.  We don't want to say, "Sorry kid, your parents are deadbeats, so you have to die."   That's what you need health insurance for--to guard against an improbable event that would otherwise be unaffordable.

    Nor do we want to be a nation that cuts off the elderly when they retire.   

      But now let's ask, why do politicians need health care plans?  Well, the main reason is to get re-elected, and for that reason it behooves them to generate some form of gratitude among the electorate.  In this case, politicians want more than the vote of people who survive serious illnesses--they want the vote of the masses.  So for that reason the optimum plan for politicians is one that has a small benefit for the largest possible number of people.  Handing out money to make prescriptions cheaper, or flu shots or other cheap trinkets are examples of what could be helpful to a re-election campaign.

      The goals of the people and the politicians are the opposite.  One needs a major benefit for a few people, and the other needs minor benefits for as many people as possible.  That is the fundamental conflict of interest that voters need to be wary of, imho. 

      In the pre-Obamacare era, our health care plans are meant to help those who do not need them. Private industry seeks to maximize profits, not benefits.  Thus insurance companies will not allow persons with pre-existing conditions to pick up insurance.  Health care is for the healthy.  Those who are unhealthy should kindly go away.   

     Health care plans do not create additional health care, they merely decide how health care will be paid for.  The number of sick people will stay about the same no matter what is decided in Washington. Health care plans probably encourage people to buy medicines that they would otherwise do without, and that sort of thing.  They offer convenience of payment, by having employers and workers pay a monthly fee, which kind of smooths out the month-to-month expenses of medical care.  Right now, hospitals pay billions for uninsured patients and leads to higher overhead expense, which is kind of  a de facto form of coverage. 

     I like the Scandanavian model, in which basics are provided for via tax dollars, but other needs come from the consumer.  So if you have a life threatening illness, tax dollars will pay your expense.  You can also make an appointment with a doctor, but it has to be way in advance. If you want to get in to see the doctor immediately--say for the flu or something--that is going to cost you, and that's where the private insurance kicks in.   That's what we should be doing.  Have the feds provide minimalist health care, basically to keep you from dying, and have private insurance to provide better quality care and broader care.  I think they should be kept out of prescription drugs (for example) unless those drugs are really expensive.  Instead, however, we have a hodgepodge.

    The Democrats, in order to get the support of insurance companies and pharmaceutical providers, loaded up Obamacare with as many goodies as possible, thus creating a very expensive plan that incentivizes extensive use of medical benefits. To make a long story short, they seem to want to provide unlimited health care on demand for everyone--Cadillac coverage that will pay the doctors and insurance companies and the pharmaceutical companies as much money as possible.  While a laudable goal, that is not affordable and leads to shocking increases in what we are paying for medical care.   But the Republicans have not been able to articulate any alternative to Obamacare, other than to say that they don't like it.

     Now that we have a national health care plan (flawed though it is), why can't the Republicans identify, say, the three biggest things that they think is wrong with Obamacare, and introduce legislation to remedy it?  

    The Republicans mainly offer obstuctionist opposition to the entire Obamacare program, but otherwise have very little ability or desire to affect medical care in the US.  In the area of medical care, they are in danger of becoming a party of professional complainers, and as a result they have allowed President Obama to almost completely set the agenda for medical care in our nation.  The train is leaving without the fiscal conservatives.    
 I think that most Republicans are mainly content to protest Obamacare, trying to get sympathy from voters while offering virtually zero legislative amendments or fixes.  That is pathetic. 

Sunday, August 11, 2013

Update from Beautiful Lake Vostok

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Lake Vostok may or may not be capable of harboring life.  Have researchers from Bowling Green University found proof of life?

   Over the years I've written many times about Lake Vostok, an underground lake in Antarctica which has been frozen over for millions of years.  Recently, a team of Russian scientists succeeded in drilling through more than two miles of ice to find the fresh water underneath.  They retrieved some samples of lake water, and kept some and sent some to other scientists.  Everyone wants to know whether any kind of like was able to survive for millions of years in total blackness.  Some people figure that it is impossible since there is no light to support photosynthesis.  
    I am far from an expert in the field, but on the other hand the problem is kind of like pro football in the sense that the casual fan's opinion is about as good as the experts'.  They just don't know.  

    My personal sentiment is that I would love for some life to exist, preferably some prehistoric type. If it does, maybe it is also possible for life to exist in other dark cold oceans.  In particular, Europa is a moon of Jupiter the size of a small planet, and which has a water ocean covered completely by ice. Many observers have suggested that the search for life in Lake Vostok, may have implications for the likelihood of life in the ocean of Europa. 

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Jupiter's moon Europa is known to have a water ocean underneath its icy surface.  In that respect it may resemble Antarctica.

    Last year the Russians thought they had found evidence of an unknown bacterium from ice that came up with the drill bit, but this was disputed in scientific circles ( ). Otherwise the water brought up from the upper layers of Lake Vostok seems to be lifeless ( Lifeless surface layers of Lake Vostok ).  Now an American group from Bowling Green University have analyzed some ice cores (not pristine lake water, but ice taken from close to the lake surface).  They claim to have found abundant evidence of  microorganisms ( ). The media has been quick to embrace their claims.  "Teeming with life!"  gushes MSNBC ( ).  Why they have even found some bacteria that live only in the guts of maybe there are fish in Lake Vostok and they are puking this bacteria....

    But hold on just a daggone minute!!   If these bacteria only live in fish guts, and the sample is not fish guts, doesn't it seem more likely that this is contamination?  Yes the researchers tried to not handle the water samples, and they wore gloves.  But can they be sure that nobody touched the gloves?  Or the containers?  Contamination is always an issue in a project of this sort.  I think the guys involved in drilling were eating fish, and so wouldn't it make more sense to assume that the fish gut bacteria probably might have come from them?

Indeed Nature magazine has reported on the controversy ( Nature article about Lake Vostok  ).   The scientists are not so quick to embrace the wild claims of abundant life as the news media.

   More data will likely resolve the controversy.  I'm still hoping that they will find evidence of something glamorous, like the Loch Ness monster. But at the moment it is questionable whether anything at all can in fact survive.  

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I loved the Godzilla movies when I was a kid. Wouldn't it be cool to find some prehistoric life form living in Lake Vostok?