Healthcare options

Like it or not, health care is going to be a big issue in the coming election.  Bernie Sanders is an unapologetic supporter of universal government-provided healthcare and has pulled the entire Democratic party over to his corner on the issue.  Health care was a top concern of Americans going into the 2018 mid-term elections.   It won't be far off the top of the list in 2020.   If there is corona virus epidemic in America this year, it could be the issue in the election.

As we grapple with how to deal with health care in America, it might be useful to look at a couple of other options which preserve much of what we value in our current healthcare system - freedom of choice for both patients and physicians.  Here are a couple of articles that look at healthcare systems in  Australia and Switzerland.

A Public Baseline: The Australian Health Care Model by Rosalind Dixon and Richard Holden describes the Australian health care system in fairly glowing terms.  It is not a single payer system like that in Canada, the United Kingdom or some European countries; it is a combination of both public and private medicine.  Their "Medicare" system provides a base level of services:  emergency, critical care, non-elective surgery, primary care coverage and coverage for essential pharmaceuticals.  It isn't fancy but it's enough for the basics.  The government pays for this.

They do have private insurance.  If you want anything at all extra, you pay out of pocket or take out insurance coverage.  In fact, the government strongly encourages you to get insurance coverage.  If you fail to sign up early or only do so when you get sick, expect no help; they freely allow insurers to charge significantly higher premiums.  In addition, if you're well off with a high income, you're penalized (with higher income taxes) if you don't have some sort of insurance.  The net effect of this is to take a lot of pressure off what otherwise would be an overloaded system.

The authors maintain this works very well, striking the right balance between allowing patients freedom to chose and physicians freedom to practice.  It appears to deliver solid outcomes:

 Total health care expenditures (public and private) in Australia are around 10 percent of GDP, compared to 18 percent in the United States. And the Australian system works well—contributing to a life expectancy of 82.8 years, the fourth highest in the world.

It's an interesting idea and they freely admit there might be problems implementing such a system in America.  With relatively open borders for example, such a system might exacerbate our illegal immigrant problem.  Perhaps with modifications it might work.

 

Kevin Williamson at National Review provides another view, based on the Swiss health insurance scheme.   This apparently was the model Massachusetts used in designing their system, a precursor to the Affordable Care Act.  The way it works is that there is no government provided health care service - none, zip, nada.  Instead, all citizens are required to buy health insurance and the government strongly penalizes you if you don't.  They provide generous supplements to poor folks but it is still everybody's responsibility to go out and get coverage and prove they have it.  If you don't, the government signs you up for very basic coverage and comes after you with the bill, including missed payments.  He proposes a modified form of this program, which strangely for a libertarian Republican, has a lot of similarities to the Affordable Care Act.

It's safe to say the ground has shifted in America with respect to health care.   Our old employer-provided system is a legacy of  World War II when wages were capped and companies were permitted to compete for employees by offering "free" healthcare.  They were also allowed to expense the costs in what can be considered an indirect government subsidy to large corporations.  It hardly helped the self-employed and those working for small businesses.   Nowadays, employer-provided health care is a dream for a very large group of us.   Finally, neither of these articles deal with problems within the health insurance industry, abundantly clear to those of us dealing with huge co-pays, rising premiums and gaps in coverage. 

Nonetheless, this election cycle there is going to be a debate about the fundamental structure of our health care system.  Other countries have experimented with various schemes and we can profit from their experience.  We should do so and use it as a guide to build a system where all Americans have access to affordable quality healthcare.

-- Mike Power   

Taking the politics out of political districts

As Steve Selelius points out, when somebody proposes a change that neither Democrats nor Republicans like, you might want to take a closer look.  That "somebody" might be on to something.

In this case, the League of Women Voters of Nevada have proposed a ballot initiative to take the redrawing of electoral district boundaries away from the Nevada legislature and put it in the hands of an independent commission charged with redrawing electoral boundaries according to independent criteria.  Neither side likes it but the Democrats, after decades out of power, are particularly choked with losing their chance to tilt the playing field back their way.

At the Federal level, Nevada isn't the worst offender when it comes to gerrymandering.  By virtue of its small population (few districts), the location of major cities and the shape of the state it doesn't come off as bad as Maryland or North Carolina..   Christopher Ingraham has catalogued some of the worst offenders, several of which are shown below.

    

Interestingly, he points out that the aim of gerrymandering isn't to build bullet-proof constituencies for the incumbents. 

Contrary to one popular misconception about the practice, the point of gerrymandering isn't to draw yourself a collection of overwhelmingly safe seats. Rather, it's to give your opponents a small number of safe seats, while drawing yourself a larger number of seats that are not quite as safe, but that you can expect to win comfortably.

The Alliance Party of Nevada wholeheartedly supports the ballot initiative to place redistricting in the hands of an independent commission.   Gerrymandering is undemocratic and self-serving, cheapening the vote of citizens in affected districts.  If you'd like to do something about this, why not help the League of Women Voters of Nevada get this question on next fall's ballot

by signing up as a supporter. 

-- Mike Power

Light a candle - don't curse the darkness

If you've followed this blog from time to time, perhaps you too have felt a sense of hopeless frustration with the current state of American political affairs.  Our politics and social discourse have become completely polarized with each side talking past the other.  Behind the scenes however the pattern is the same - our political parties are puppets for their very well heeled financial backers.  While we might argue about social matters, government programs and the like, the essential interests of the ruling financial class are protected by both major parties.  Meanwhile on TV and social media, we're subjected to rancorous political battles that might make Jerry Springer blush.

I think I'm a pretty much average guy, just trying to make a living and look after my family.  Either major party might classify me as a moderate member of the other party.  During the 2016 election, I couldn't stomach nor vote for either of the presidential candidates with a clean conscience.  In the aftermath I decided I had to look around for a new political home.  

I stumbled onto the American Whig Party, now deceased.  I liked the fact that it was founded by veterans; I'd served in the infantry.   I liked the fact that it had a definite, moderate and pragmatic platform but that it was a big tent.  I decided to send them a few bucks.  Big mistake.

Shortly thereafter, the head of the American Whig Party contacted me and issued the call to service.  At the time there was no one in Nevada willing to set up much less run a state affiliate party.  I'm not a rabid political animal and get no joy from party mechanics.  Nonetheless I said I would do it on the understanding that I would just be a caretaker until a more capable and motivated person stepped forward.  I was happy to serve as a corporal but didn't want to be the general.  I've got enough experience with business and community groups to set something up and get it running.  After that I wanted to turn it over to more capable hands.  That was August 2018.  I want to thank Nathan Cunningham and John Barker for being willing to put their names forward and give me a hand during this phase.  Brent Drayton also lent a hand later, for which I'm grateful.   They've had to move on but their support is appreciated.

When the American Whig Party was folded into The Alliance Party I was initially enthusiastic.  That waned a bit when the launch had a couple of false starts.  As 2019 unfolded, the lack of financial backing at the national level also took its toll. 

On a more basic level, the direction of The Alliance Party initially left me a little cold.  I felt the national platform was so broad as to be insipid and less than inspiring.  I love Mom and Apple Pie but I was looking for something a little more solid here in the way of policy & platforms.   I attended the virtual town halls and listened to the "rally the troops" message but I didn't get too fired up.  Despite all this, I decided that I had to keep at this because I felt there was something worthwhile going on here - even if I didn't get it yet.  By this time, the Alliance Party of Nevada was definitely a one man band and I began to joke with the national leadership that I was their lighthouse keeper in Nevada.

 

Now however, I've started to see things in a different light.  The Alliance Party platform is pretty simple with only two really firm guard rails:  term limits and full financial disclosure.  Their guiding vision is the one who, like Washington and Cincinnatus, step forward to serve their fellow citizens.   The very loose position platform makes this a big political tent where people with different views can meet and hammer out a way forward that works best for most of us.  The lack of a hard and fast political platform is a blessing not a curse.  You won't find a smorgasbord of political platform planks nicely tuned to meet your political preferences here.  It will have to be hammered out  among people who don't exactly agree but are dedicated to working together for the common good.   The fact that the Alliance Party is an "anti-party party" really does provide an alternative to America.   The challenge is to build this into a movement where dedication to our country and the welfare of all is the guiding principal and where the platform meets these needs at a local level.   

There really is no other way.   Things change and time doesn't flow backward.  We will not be soon returning to an Era of Good Feelings nor the relatively bucolic politics of the 1950's any time soon.  Social media and changing times are working to make us more fragmented, polarized and insistent on getting our own way.  Our party politics reflect this.  The only way out is to confront set-in-stone positions with compromise guided by principle; and to confront a thirst for power and influence with humble service and a devotion to our country.  The Alliance Party doesn't look like another party because it isn't.  Now I get it. 

So now I'm more determined than ever to follow this through.   You'll see political commentary from a hopefully moderate and practical perspective on our blog and Twitter feed.  You'll get the regular newsletters reminding you what the Alliance Party of Nevada is up to.  We'll support worthwhile non-partisan campaigns to make our democracy better and we'll throw our support behind moderate citizen candidates intent on serving rather than being served.  We don't have to win to do good; it would be enough if some of our more useful and practical positions were adopted by the major parties and enacted.   We'll also give them credit where credit is due when they act to improve things for all Nevadans.   Even if the Alliance Party of Nevada remains a party of one for a while longer.

-- Mike Power           

Vulture Capitalism

After decades of ordering stuff from Cabela's by mail, my wife & I paid a visit to one of their stores near Reno.  We don't follow business news too much and didn't realize that Bass Pro had bought the company.  We asked some of the employees about the change in ownership and we got averted glances and non-committal responses about the whole deal.  This week, I found out why.

If you have any doubts that some of the heavy hitters in our financial class don't have America's best interests at heart, watch Tucker Carlson's piece on the takeover of Cabela's and the destruction of Sydney Nebraska.

Our economy must serve Americans - providing jobs, salaries, profits, taxes and supporting healthy stable communities.  Some in our financial class have lost their moral moorings, putting profits ahead of people, communities and their country.  Small town America is paying a very high price for this.   This is an abuse of the economic freedom our plutocrats are so lucky to enjoy.  To make matters worse, they appear to have bought our politicians and created a system that provides cover for their predatory business practices.  

President Trump's 2016 election was in part a repudiation of this system which appears to have trampled on people on the bottom - blue collar, rural people in flyover country in particular.   We need to build an American economy that works for everyone,  putting our neighbors, communities and country ahead of an unbridled thirst for profit. 

While this isn't a plank in The Alliance Party platform, it should be.

-- Mike Power