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Ebert on Healthcare Reform

Ebert has a editorial on his blog ripping a part the libertarian and free market objections to universal healthcare. I love this part the best:

It has been argued that universal health care is an offense against individual liberty. I’ve been told by readers that they’ll deal with their own health care, thank you very much, and have no interest in government interference. At root this is a libertarian argument; conservatives are more likely to oppose it on the grounds that it undermines the free enterprise system. They warn of a Nanny State.

But what, I ask libertarians, about your families? Your children? What if the day comes that you lose your job-based health insurance and can’t afford your own? What if you’re denied coverage? That’s their business, they tell me. I should butt out.

But it won’t remain their business if a family member suffers a major illness. I know from personal experience that few people have the financial resources to deal with such an illness, and I suspect no one reading this is ready to deal with two. You and I will end up paying for them, even though they were unwilling to help pay for us.

I’ve written about this previously. It’s simply impossible for a family to financially survive a catastrophic illness or injury without the government giving a handout.

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The Detroit Lions: Cutting off its head to save its finger!

Most NFL fans know about the blackout rule. If the game does not sell out, you’re not able to watch or listen to it on local TV or radio. That never made sense to me. My analogy is a band on tour claiming that if a venue does not sell out, they’ll refuse to let their music play locally on the radio. How does that help the band?

There’s also a childlike meanness to the rule. Like the fans need punishment for not doing what they’re supposed to be doing. “If you won’t play my way, I’m picking up my toys and going home!”

The best case example in support of the NFL’s blackout rule would be a successful team with a winning record that still cannot sell out games. The players and team think, “God what else can we do? We’re winning games, why won’t people come and see us play?”

But even in that best case example, which I’d guess rarely happens, if ever, there is simply no reason to punish your fans. No one does a hobby or enjoys entertainment because they’re forced to. The minute you’re forced to do something, it becomes a chore.

It also ignores that the ticket prices in the NFL might be too high. However, instead of lowering prices, the NFL would rather punish its fans for spending its money on food, clothes, and mortgages. Is that how you build a fan base?

It also ignores the fact that by making it difficult to see games, the next generation of young people growing up will not be exposed to your team. So any short term benefits earned from the blackout BS will kill the support for your team in the long run.

Let’s face it, the vast majority of football fans do not go to see the games in the stadium. But yet they’re still fans. They still watch the game, listen to the game, and buy team merchandise.

If a team pulls its local coverage, so that the vast majority of fans cannot follow the games, how long will they remain fans? And because the children of these former fans did not grow up watching the local team, they’ll have no emotional tie to the team. So those future fans will be lost too.

I’m sure plenty of you are thinking that the blackout rule has been around for a long time and it has not killed any teams yet. But it has. Every time a team moves due to lack of local support, e.g., the Browns moving to Baltimore to become the Ravens. Or the Jacksonville Jaguars and five other teams considering moving to Los Angeles.

And the team I’m most concerned about is the Detroit Lions. They completely suck. Their suckage is legendary. Based upon the massive amount of suck, the Lions simply do not deserve any fans to go and watch them play. The whole “fair weather fan” criticism is complete bullshit. Fans should ignore teams that suck. Exactly what incentive is there for a team to do better if they’re selling out all of their games despite their losing record?

And think about this, would you consider buying your favorite fast food if it started tasting like shit? Would you buy CDs from your favorite musician if his music completely sucked? Would you continue seeing movies from your favorite actor, even though they completely sucked? And would you continue buying and drinking your favorite beer if they added horse urine as an ingredient? No of course not. When something sucks you stop supporting it.

And that’s why the Lions are in so much trouble. Right now there is no reason to go to the stadium to watch them. So the games are blacked out, so any remaining fans cannot watch. That means over time there will be fewer fans. Eventually the team will reach a tipping point where nothing will be able to save it and the team will be forced to leave the state and change its name.

Wait, maybe that’s a good thing!

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Paying for healthcare is not like buying a new pair of pants

I was watching a freemarketeer on some news show last night. He was totally against any healthcare reform. He was even against health insurance. His point was that because we the consumers do not directly pay for healthcare, there is no market incentive to drive down prices.

In other words, when you go for a checkup, because you’re not paying for it directly, you don’t look at the bill and say, “This is too high. I’m going to find a cheaper doctor.”

To drive his point home the freemarketeer rhetorically asked something along the lines of,

Why is it that healthcare is the only service we do not directly pay for ourselves? We pay for our own groceries. Our own cars. Our own clothes. But for some reason we expect someone else to pay for our healthcare.

His arguments are about as pro free market as you can get. It sounds so simple. Let’s solve the entire healthcare crisis by treating it like going to the mall. Everyone will be happy, we’ll get the exact care we need, and prices will be lower than ever.

It might sound simple, but that’s only because it’s complete hogwash.

We don’t completely pay for anything directly:

Healthcare is not the only service or product we do not directly pay for. When was the last time you directly paid for a road? A military airplane? The police who drives by your house? His police car? A fireman’s salary? That airport across town? Your public education?

You don’t even pay directly and completely for your groceries due to farm subsidies.

Did you go to a state university? You may have paid a tuition, but it was highly subsidized.

Which also means all of that college basketball and football you watch is also not directly paid for by you.

Heck, that local NFL football stadium was also likely paid for by public subsidies. So when you watch those millionaires play football, you’re not directly paying for that either.

Even oil companies, despite earning billions in profits, still get government subsidies to drill for oil and such.

Heck, I have to wonder if there is any product or service in the US that is not subsidized in at least some small way.

So healthcare is not the only service we expect other people to pay for. We expect the government and the private sector to subsidize and spread costs over large groups. Expecting the same for healthcare is no different.

Healthcare is catastrophic and unpredictable:

And even if we did pay for groceries and cars directly, which we don’t, the freemarketeer is still wrong that we should pay for healthcare directly. That’s because healthcare is catastrophic and unpredictable.

When we do our weekly shopping, we’re not suddenly faced with $65k bill for peas that simply has to be paid. When we buy a $30K car, we do so after fully researching our finances and either saving for it or obtaining a loan. The dealer doesn’t show up one day demanding payment for a car we neither want nor need.

Catastrophic and unpredictable events have always been paid publicly by the government, e.g., military, police, firefighters. Or privately by insurance, e.g., automobile, fire, healthcare or by organizations such as the Red Cross.

Of course some will argue that we should simply save a portion of our income, 40% believe it or not, just in case a medical emergency occurs.

However, relying on savings to pay for healthcare would simply not work. How would savings help a 21 year old guy who was diagnosed with cancer? Is he just supposed to die because he didn’t live long enough to save money? Of course not.

Here’s the main difference between healthcare and clothes, cars, and to an extent, even groceries. We choose to buy clothes. Accordingly, we can decline to buy when we are unable to afford them. However, there is no choice when it comes to healthcare. We cannot say to our son,

Timmy, money’s a little tight this week. We’re going to have to skip a few chemo treatments until I build up some more savings. No problem, right?

Even with groceries we can buy a cheaper brand or grow our own. Heck, we can save money by eating less. (Lord knows we should!) However, you cannot scrimp on chemo treatments for your son. There’s simply no generic alternative.

This “savings plan” gets worse. The average family income is about $50K. Let’s assume the impossible. You manage to set aside 40% of your income for unforeseen healthcare issues. (Of course you’ll also have to save 30% in case your house burns down, there’s a flood, hurricane, or whatnot. Plus 10% in case your car breaks down unexpectedly. I’m sure in the end you might have a few pennies to spend on food and a mortgage.)

Anyway, let’s assume you’ll need at least a quarter million dollars per each person in your family in case of catastrophic healthcare emergencies. The average family has five members. So you’ll need to save up $1.25 million to cover everyone in your family. By saving $20K per year, that means the average family will have to save for 62.5 years. So if you start your family when you’re 25 years old, you won’t be able to get catastrophically sick or injured until you’re 87.5 years old. Yeah, that’s a plan!

There are market controls on healthcare costs:

What I find most hilarious is the freemarketeer’s argument that insurance companies and the government have no control over costs when it comes to healthcare. What he’s conveniently ignoring is that insurers and the government do keep strict control over healthcare costs. Procedures have to cost no more than a specified amount before either the insurer or the government will pay. The healthcare industry does not set healthcare prices, the insurance industry and the government does.

Think about it this way. If a physician could charge anything he wanted for a procedure, why doesn’t he? If there was absolutely no control over what he could charge, then why aren’t mere office visits charged to the insurer or Medicaid for a trillion dollars? Under the freemarketeer’s theory, that could happen and mysteriously nothing could be done about it. He strongly argued that unless we pay directly for healthcare, there are no market controls on price. Yet, there clearly are such controls. Mmmm… I wonder where they come from?

Update – 9/2/09: I just came across an article on Slate about how medical prices are set. It’s actually quite disturbing.

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Do companies do anything anymore?

I read the Consumerist nearly everyday. It’s a website devoted to consumer issues. If you’ve been wronged by a company, you can write in and complain. After your problem gets national exposure the company usually backs down and fixes your problem.

There are a lot of complaints about companies such as AT&T and Comcast. In reading through those types of complaints, I’ve figured out the gist of the problem. Despite what people think, Comcast is not a cable TV provider and AT&T is not a DSL provider. They are both marketing companies.

By that I mean their main focus is on marketing services and getting people to sign long term contracts. The day to day hum drum stuff like taking service calls, installation, and sending techs to repair your line, are outsourced.

Think about it, Comcast doesn’t employ a single person to help out in tech support. Why? Because Comcast is not in the tech support business. AT&T does not employ anyone to come out and install your DSL line. Why? Because AT&T is not in the DSL installation business.

So the problem these companies have, and the reason they are almost universally reviled, is that they’re run by their marketing departments. (Companies used to have marketing departments to help sell their products. Now companies contract with outsourcing companies to give their marketing departments something to sell.)

The problem with all this is that the marketing department does not care if someone has a problem with their DSL. All they care about is whether the person signed a two year contract for DSL service. Once the contract is signed, the marketing department’s obligation is done. If a customer has a problem, the “solution” is to let him cancel and make him pay the early termination fee.

So it’s not as if the companies are turning a blind eye to customer problems. That’s what most people think. “When is Comcast going to start caring about its customers?” The problem is that these companies no longer have any eye on the customer after the contract is signed. Any eyes on providing the services sold, helping customers, and on repairing the services sold have been outsourced. Out of sight out of mind.

To better explain this, imagine your local Comcast building as a microcosm of the much larger Comcast. Imagine a meeting with the boss, the marketing/sales guy, the installation chick, the tech guy, and the help girl.

The marketing/sales guy would have ideas about how to get customers to sign up. The installation chick would be there and chime in about how many techs she’d need to install an x amount of new customers. The tech guy would talk about what sort of technology, hardware, software, and upgrades would be required. The help girl would talk about how many of those new customers would need help and what sort of support would be required to help them.

Now imagine that same meeting with only the boss and the marketing/sales guy. Does that make the problem clear enough?

Update – 7-25-09:

Read this woman’s story of Verizon’s attempt at installing FIOS! Well, Verizon never installed it of course, utterly incompetent contractors did. A hurricane would have been less of a disaster. And it perfectly explains what I’m talking about.

What’s most interesting is that Verizon does not even provide FIOS services, their own product! That has been outsourced to a company called Frontier Communications.

I can’t help but wonder what Frontier Communications actually does. Is it yet another marketing/sales company outsourcing to other companies to have real work performed? Is there a never ending chain of marketing/sales companies all outsourcing with each other to avoid ever having to do real work? Maybe all of Corporate America ™ is nothing more than an Amway-like multi-level-marketing scam.

Update – 9-3-09:

I came across this post on Tech Dirt about how Netflix has refunded money to its customers without even a single customer asking for a refund.

This proves my point exactly. Netflix is not a mere marketing company. Netflix owns its entire operation (other than the United States Postal Service, of course). So it still cares about the service it provides and the customers it serves.

Update – 9-8-09:

Apparently Sprint cannot even market its own phone!

Update – 9-15-09:

Comcast is advertising a high Def NFL channel in Chicago which it cannot offer due to technological reasons. Why be bothered figuring out what you can actually deliver when it’s so much easier to promise everything, right?

Verizon is unable to provide an actual working DVR to its customers who pay for such devices.

Update – 9-17-09:

Bad news. This “do nothing” disease is spreading to the hotel industry. Hyatt is now outsourcing its cleaning staff.

Update – 9-30-09:

AT&T sells a guy a 3 mbps DSL Pro service. The guy pays for it for three months. He finally calls to complain about the slow performance when he’s informed that despite selling him the Pro service and charging for the Pro service, AT&T does not offer the Pro service in his area.

Update – 10-12-09:

Yet another example. Here’s Verizon refusing to honor the price agreed upon for their services. The customer and the sales guy entered into a signed contract that the TV, phone, and internet service would be no more than $77.99 a month for the first year. Of course the bills received were double that.

Verizon blames the salesman for promising more services than he should have at that price. Exactly how does that happen? Seriously! Verizon advertised a triple play service for $77.99 per month for a year. The customers wanted it and Verizon’s salesman sold it. Suddenly Verizon doubles the price?

Update – 10-14-09:

Comcast was more than willing to take a customer’s money, but could not be bothered with honoring its rebate. Of course the task of actually doing what was promised was outsourced, with disastrous results.

Update – 10-15-09:

The sole business model of 1-800-Flowers is delivering flowers to a specific location at a specific time. Apparently, that doesn’t actually happen because 1-800-Flowers does not actually do anything like that, instead it outsources doing deliveries to businesses that are closed or that no longer even exist. Seriously.

Update – 3-02-10: Apparently, Time Warner cable cannot provide the HD service it sells.

Update – 9-03-10:
AT&T cannot provide the DSL it sold the customer.

I love this comment from that link:

I had almost the exact same experience years ago signing up for Verizon DSL. The order would simply be cancelled. Eventually, after several tries I got them to tell me that the sales dept had no idea if the equipment in the area could handle a new customer, and if there wasn’t room for another the order would get cancelled.

This is exactly what I’ve been talking about. It’s all about sales without any idea or plan on how to deliver.

Update – 9-07-10:

AT&T sales people apparently lie to customers to get more sales and higher omissions.

Update – 1-12-11:

Someone from Comcast called a guy and offered him a plan. He accepted it. He never got it. When he called about the plan, he was told they never offered the plan. He kept calling back until someone finally told him what was really going on….

I finally got someone and once again explained my predicament. Here I was finally given an answer to my question of who the hell was calling me. It was a satellite office. Comcast apparently outsources upgrade-calling to smaller companies. These companies offer deals that Comcast doesn’t and supposedly can’t replicate.

Update – 4-14-11: A guy bought a mattress and box spring set from a Sears store and paid for delivery. After two months and 13 attempts later, Sears has been unable to make the delivery.

What’s Sears’ excuse? A Sears’ spokesman stated,

I do know to resolve the issue, Sears worked with several outside vendors.

Think about that. The guy bought a mattress set from a specific store. “Couple” mean two. “Few” means about three. So “several” means at the very least, four. Why did Sears need at least four third party vendors involved? One for the warehouse and one for the delivery. That’s two. Who are the other two?

Sears might save a little bit of money not doing anything, but it’s certainly getting bad press about it. Check out the Consumerist.com for more information about how Sears treat their customers like shit.

Update – 11-30-11:

I got the machine (Asus G73 gaming laptop PC) 1.5 years ago, 6 months ago sent it in for overheating, got it back and the HDD was installed backwards. And not screwed in. 20 phone calls later, I get a “Oh, yeah, we outsource our services and they screwed up, not us” kind of answer.

Update – 1-06-12:
Apparently, even opinions are being outsourced nowadays.

Update – 4-05-12:
Kraft bought high-end coffee retailer Gevalia and outsourced its sales operating meaning that even long time customers can no longer buy coffee.

Update – 5-02-12:
Intel is kicking major booty by not outsourcing chip manufacturing. While other chip design companies, e.g., AMD, nVidia, IBM have two foundries from which to choose, Intel has been able to leapfrog past them by keeping the design and production in house.

On a related note, Delta Airlines has bought its own oil refinery to keep fuel costs down. That’s a reverse outsource!!! The ridiculous myth that “it’s cheaper if someone else does it” seems to be weakening. Clearly paying someone else a profit to do something costs exactly that profit. While it can make sense to outsource when you don’t have the expertize or resources to to it yourself, eliminating the expertise and resources you do have to give some other entity the profit generally makes no sense. Other than the temporary “benefits” due to the initial “savings” gained.

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How low can the Right go?

I’ve been writing a lot about the sorry decline of the GOP. In fact, a couple of days ago I argued that the party was actually dead.

I don’t really want to obsess about the GOP and religious right nuts, but with crap like this being published, I have no other choice.

I’m talking about former SNLer Victoria Jackson. She wrote an opinion piece about Obama’s health care plan.

First, despite what Jackson says, Democrats are not the only group pushing for universal health care. Republican Richard M. Nixon proposed a similar plan way back in 1974.

And it should be noted that big business favors building factories in Canada because it saves massive costs on employee healthcare.

And I’ll also point out that every Canadian I’ve met (and I’ve met quite a few because I live near the US/Canadian border) hates Canada’s healthcare system. So I have little doubt that there are legitimate problems with universal healthcare.

However, Jackson does not raise any legitimate problems with Obama’s plan. She attacks Obama’s plan not based on reason, but upon ignorance and hatred. She starts off saying,

You see, evil doesn’t just show up. It disguises itself as something nice; so you’ll let it in. It tricks you.

Murdering babies is called Pro-Choice. Unfair Censorship is called The Fairness Doctrine. Outlandish Taxes and the Death of Freedom is called Cap & Trade.

It’s not enough for her to attack Obama’s plan. Nope, she has to attack a whole litany of left wing issues.

Next she makes the extremely ridiculous claim, completely out of her ass, that liberals do not “actually care about sick, poor people.”

With those two premises set, that everything liberals support is wrong and that liberals do not care about the sick or the poor. She asks, then why do liberals want universal healthcare? The answer. “Euthanasia!”

Yep, that’s it. Liberals (including Nixon and corporations such as Toyota) want universal healthcare so “Obama… can legally kill Grandmas.” I’m not making this up!

Without missing a beat Jackson lays down her trump card: Godwin’s law. Yep, she compares Obama’s healthcare plan to Hitler’s murder of 6 million people.

Then she recites a conversation she had with a small business owner where it is claimed as fact that “our country just turned Socialist.” Really. Jackson really thinks that we’re suddenly a Socialist country. What legislation was passed which caused this? Was it Obama’s pure force of will?

Does Jackson even remember that our economy crashed prior to Obama being president?! Yes, the economy crashed after eight years of Republican control! What proceeded those eight years? Eight years under Clinton of the highest economic growth this country has ever experienced.

So we have eight great years under a Democrat. After eight years under a Republican our economy is wasted. Bet yet all of this is somehow Obama’s fault. I really want someone to explain that too me, because I’m perplexed beyond fricken belief.

I’m sure she’s referring (at least in part) to Obama’s “taking over” of the financial and automotive sectors. So let me get this straight. The financial and automotive industries ran themselves into the ground. They were able to do this because the prior Republican administration provided absolutely no oversight. So these sectors come to the government and ask for our money to save them. Because we’re talking about our money, Obama puts conditions on the money. GM agrees to the conditions, Ford says no, and yet somehow, this is socialistic. Did she forget that Bush signed over about 700 billion dollars of our money (about $2,631 from every man, woman, and child) to the financial sector before he left office with absolutely no strings attached? He simply took our money and gave it to the very same people who lost it, and that was a good thing Miss Jackson?

And of course there’s the problem with the poor automobile dealers who were shut down. I’ve already wrote about their plight and why I have no sympathy for them. If you choose to live by government fiat, you should be willing to die by government fiat.

Anyway, Jackson concludes her diatribe by claiming that “ignorance is bliss.” She should know.

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