Making Universal Health Care work?!

Ok, yes I am a libertarian, but I am also curios about how things work and what it would take to make things work.  As such I am willing to learn and try to see if Universal health care can truly be successful in some way shape or form. So here it goes in part 1 of how to make this universal health system work.

Step 1.  Like most changes in society, education will actually be the first thing to change to make universal health care work.  It would require that 13 year olds through 18 year olds go through a health class each and every year (just like English, social studies and math/science classes) that teaches them how to take care of themselves.  As such, the class will deal with biology of the human body with respect to diet, and exercise.  Students will learn about the skeleton, muscles and the digestive system along with our circulatory system to know how to test and cultivate their bodies into the shape and condition they want.  As the course progresses from year to year students will learn meditation and relaxation techniques to reduce stress, improve sleep and deal with societal pressures which all hinder health as we age.  They will learn stretching, and similar techniques as well to retain a nimble and flexible body including proper ways to pick up heavy objects and proper posture. Also included will be training on knowing what foods are healthy in general, when to eat certain foods and overall once they complete this course they will come out knowing everything a nutritionist does.  Likewise these students will have the knowledge and expertise to be physical fitness trainers, yoga instructors and even physical therapists (and maybe even a masseuse).  Additionally, students will learn all about medications and diseases. So they will know when to take what medication if they believe as a last resort that they will need it, and even be able to self-diagnose themselves with respect to simple conditions.  Basically they will be able to ascertain if they need to go to the doctor or not.  This all culminates into a high school graduate that knows all the basics of a doctor and even a pharmacist.

Step 2.  While schools implement step one, step two will be altering the community colleges to provide schooling for students to become a doctor, a nurse, or any other medical professional.  By focusing on this cheaper alternative to private colleges these community colleges (whether free or otherwise) we can increase the supply of doctor’s thus decreasing demand for them and therefore the costs to see them (price to see a doctor is based on supply and demand just like regular goods and services).  However, this alone will not be enough.  The curriculum will be altered as well where all classes/subjects that Medical professionals share in common will be taken together.  So human anatomy, biology and the like will be taken by people in all these disciplines, but in such a way that it reduces the time needed in school without sacrificing the quality of our health care professionals.  These soon to be medical professionals only begin to branch off into specialties later on such as neuro surgeon or pharmacist.  But costs will still need to be saved somehow for this to work, and technology will have the answer for that. 

Online learning will take the place of most of the lectures and reading that is due.  Basically if it can be learned online, then it will be done online so as to save facility costs and also increase access by students to materials the college offers (libraries can also supplement these colleges as access points for people who lack the means to acquire a computer with an internet connection so that they too can take these online classes).  So things like lectures, readings, workbooks, homework, and even quizzes and tests will all be done online so as to limit the costs while improving overall efficiency of the college to impart knowledge.  Once the core classes are done, including classroom time where required, and students shift into their specialties then they will take a series of other online courses in their area of future expertise before they enter the classroom where it will be hands on learning as the college will double as a hospital and medical research laboratory (money for costs must be maximized for this system to really work so combining them into one makes sense).  Additionally, at any time students can take tests to show proficiency in a subject which will allow them to bypass basic classes as they already have the knowledge and expertise needed, again saving the student time and the college money.

The active hospitals on campus allows for students to gain hands on learning experiences while other government funded hospitals will supplement the community colleges when room is an issue to ensure all students can continue with their education.  Private hospitals will rent these students (again to lessen the costs on taxpayers) to supplement their staff with the promise to train students in hands on roles within the hospital themselves including management which they will use to seek to improve the efficiency of their own future health care offices and hospitals they may work in. 

As to the medical laboratory, these community colleges will also conduct research at the behest of drug companies possibly including testing.   These community college medical testing facilities can even double as FDA testing sites so that the students research once completed can immediately go to market to be used to help treat patients (so a portion of the FDA's budget will end up here which again reducing the overall costs).  The drug companies will essentially pay the hospital to perform research and development while the students get hands on skills in medical and drug testing.  Our goal here is to reduce the costs on taxpayers again by drug companies paying our future doctors, and pharmacists to do the work for them to develop drugs and treatments which in turn hopefully will reduce the costs of drugs/treatments as a whole.   Additionally, advertising space will be allowed on campus so that private companies would end up supplementing the government's costs and even further by having corporate sponsored classrooms, research rooms and hospital rooms.

Conclusion to part 1:  Step one focuses on decreasing healthcare costs by addressing the problems with people going to the doctor's office more often thinking that seeing a doctor is free and thus can be abused.  It also plays into the ability to provide preventive medicine by teaching people early on how to prevent diseases and even treat themselves.  Step two provides for cheaper health care by teaching future health professionals in such a way that they spend less time in school and more time actually learning to treat patients.  Additionally, other health professionals can cross train so as to provide multiple health services via this system with for example pharmacists being able to diagnose diseases as well and potentially writing prescriptions or recommending over the counter medications for antibiotics and pain relievers.  This will be the primary steps that will need to be taken to make the universal health care system work.

Trouble with Universal Healthcare

I believe I have talked about this in the past, but it is an important topic to know especially as so many people seem to want universal health care here in the States (Sanders and Clinton supporters among other Democrats).  So what is the weakness of this system?  Let’s discuss.

1) The primary weakness to this system is that in order for it to work, the government needs to decide what cures/treatments will be provided.  In this instance, the government takes on the same role as an insurance company where they decide what is the cheapest, yet most effective, treatments for an illness or a condition.  For example, if a person has cancer, the government may only cover under this system; operations to remove the cancer or placing a radioactive isotope near the tumor to slowly kill the cancer if it is too dangerous to operate on a patient.  Other treatments like Chemotherapy, and others may receive partial payment or none at all due to them not being as cost effective for the government.  They do this because the government has to meet a budget requirement that is created each year by politicians.  Likewise, private insurance companies do the same thing, but they only have to cover a smaller group of individuals which also allows for more things to be covered or partially covered.  Basically, a smaller budgetary requirement as compared to government who has to now treat millions of people.  

2) Another weakness of this system is that when deciding what treatments, the government also looks at the potential success and failure rate of those treatments for each person depending on age, and other factors.  As such, if the government thinks you will simply die regardless of treatment after a few days or even months, then they may refuse to pay for your treatment.  This has been the case with Baby Mathew, (this happened a few years ago and was covered by Fox News) a child born in Canada with an impossible to treat disease. The parents already had lost one child to the condition Mathew had, but wanted to still fight to save their child.  The Canadian government however refused treatment as they saw the case was hopeless and that the child would die regardless. As such, the parents took their child to the United States, paid for the child's treatment granting the child another three months of life before the disease killed Mathew.  Basically, the treatment allowed the parents more time to say goodbye to their child, something the Universal health system in Canada does not care about.

Conclusion:  Both the first and second weakness is what amounts to rationing in a universal health care system.  It is also the reason why in Europe that private health insurance companies still exist, but they only help pay for what the government does not cover and only at a premium as only the rich can afford health insurance as it covers only the most expensive treatments.  As such, the government has to take drastic measures to keep costs down as people, thinking that healthcare is free (they pay upwards of 50% to 75% of their income for this system in European countries) are more likely to go visit a doctor which in turn increases costs further as they visit for the smallest of cuts and curable conditions.  Basically they waste the doctor's time and thus the government's money which pays for the visit.  So is there a way to make the Universal health system work while keeping costs down?  In the next few issues I will look at exactly that. 

Carson's CDC Special teams

 Ben Carson former Presidential Candidate and retired Neurosurgeon suggested that the CDC should create special teams to deal with potential infectious diseases.  A concept that I am very interested in.  But what would it entail?  

In this case the CDC would do more than just monitor diseases, and instead take an active role in the fight (assuming they don't already do).  I am guessing, as details were not given on the subject by Carson, that the CDC would have teams that study where each disease comes from, how it contaminates people and at the first sign of its encroachment on the United States will have the team go out and lock down all people exposed.  Then they would have the power probably to lock down travel and use the National Guard to help in case the outbreak gets out of hand.   Other members of the team would go to the diseases country of origin (and others potentially infected and attempt to eradicate the source of infection before it gets to pandemic levels by eliminating carrier animals like mosquitos, or to inoculate people around the infected and provide proper isolation and decontamination procedures (even posing as magicians for those indigenous people who reject science and view diseases as demons or cursus).  Basically they could wipe out a contagious/infectious disease potentially at the very first sign of it infecting someone.

Conclusion:  This idea is worth investigating further as this is something that other countries could copy and support.  Also, it provides a means to study diseases up close in their environment of origin and to hopefully make these deadly diseases as non-life threatening as the common cold.  As to how much a role other agencies like the National Guard and the army will take (they have a system in place to prevent a pandemic) remains to be seen if this idea goes forward. 

Dealing with Islamic Sharia Terrorists

So ISIS/ISIL has claimed responsibility for a number of terror attacks including the Brussels attack.  Now there are calls for racial, religious and ethnic profiling.  Some say this is a bad thing. While others say we got no choice.  But I have a slightly different view.

Now I agree that profiling must be done.  I want ethnic, racial, religious and even ideological profiling, but these should be the final filter after profiling people by other means.  In other words, profile people based on spending habits, is what they buy something that is or can be used to make a weapon?  If they go out of country, is that country a supporter of terrorism?  See who buys that one way trip, and how much luggage they are carrying.  See how they dress, is it something that can conceal a weapon or a bomb?  Is that person or persons acting more nervous than normal?  After answering these questions and more, then you look into Race, religion, ethnicity and ideological views to be the final lenses if all else fails, or they should be included with the others if the criminal activity is carried out in an area where the population is the majority of a particular race, religion, ethnicity and ideology.  But this will not give anyone the right to harass anyone.  Instead it will be a means to provide for further scrutiny of a selected group if said group has people who wish to harm others hiding amongst their number.  Basically, you want to filter out as much of the people who are least likely to be your suspect or even potential terrorist, and focus on the most likely candidates.  At this point an active monitoring system of patrols and espionage should take place where phones are tapped to see if people in the area are calling people in terrorist hot spots, or are receiving calls from people who are suspected terrorists.  If so, then you set up surveillance, and other means of tracking to see if it goes anywhere, if not then you just proved a person's innocence, if it does go somewhere, you just got a lead on a potential terrorist network which can be tracked and then removed before they act.  At no time does racial, ethnic, religious or ideological profiling act alone and at no time does it justify harassment. 

Conclusion:  Now this is if and only if all other profiling methods are done at the same time, and if it is used to prove the innocence of someone.  At no time is the suspect(s) approached or accosted by police unless it is absolutely necessary (if the police have reason for suspicion, but not probable cause, and they need to spook the suspect).  Basically, no one touches or even interacts with the suspect(s) save in extreme circumstances and if they are going to arrest them.  Now this brings up questions about a surveillance State, but that is what laws are for which dictates when, where, how and why the "who" is being surveilled.  So profiling is not bad unless it is used to do bad things like Internment camps as done under President Woodrow Wilson and President FDR or concentration camps or genocide like in Nazi Germany and Rwanda.  Also, it is not bad as long as people of a community know that the police are on their side and not out to harass or to "get them".  I think you get my position as I stand in the middle road between both sides of the argument.

General Elections: Reform

So we talked about reforming primaries and caucuses yesterday, but what about the general election.  If you read yesterday's issue "Primary and Caucus: Reform" you would probably think that that is a great idea for general election reform too (assuming you read it and that you liked it).  But alas, that is not optimal for a general election.  Yes, voting via the internet would work, but unlike the aforementioned proposal where the site allowed you to change your vote all the way up and to the day before a cutoff date for a particular candidate, the reform I propose here would not have such a luxury.  So what would this reform entail?

For one, Election Day would be moved to Saturday to ensure that people who have to vote by the traditional ballot system would have greater access to the polls.  With respect to voting via the internet, if the States allow it (States make the rules on how votes are to be cast or counted, while the Federal government looks to prevent corruption) it too will be limited to a single day.  In both instances the day can be first Saturday of November which will also double as a holiday that mandates all businesses and government offices save those implementing the election will be off from work.  So while this reform will not completely eliminate the need for absentee ballots or even early voting it will help with the eventual removal of these potential sources of corruption (sometimes these ballots are mysteriously found when an election is too close to call).  If using an online voting system, your driver's license number, or your social security number which aids in showing where you live and thus your eligibility to vote will be required to log in along with a series of challenge questions to insure that you are in fact who you say you are.  The Federal, State and local governments will all conduct their elections on this same day to ensure maximum turnout.  Also, special elections (where people retire before their terms are up, or otherwise removed from office) would be eliminated wherever possible so as to not disrupt this system.  An example would be having a one of two U.S. Senators leave office, thus rather than one being appointed by the governor of their State as a temporary replacement the other sitting Senator would get two votes instead of one.  Another possible example to be rid of special elections is if a local legislator is arrested and forcibly removed, if there is no votes scheduled between the legislators removal and the election, then no special election will be allowed to take place.  These are obviously two hypotheticals, but the idea is to keep the choices of who gets elected in the hands of the people and prevents as much influence by the parties and the governments in that special election as possible.

Another potential reform is a runoff election.  Say there is more than two candidates who are eligible to run after July 31st.  As such a series of runoff elections would take place on the first Saturday of September and October where candidates with less than 10% of the vote will be dropped after the first round of voting, then only the top two candidates with the two highest percentages of votes will be allowed to stay in the race after the second round of voting if there is still more than two candidates left by this point in time.  These runoffs will be based on total number of votes received, while the final vote will use the traditional Electoral College system.  Thus we almost completely eliminate the chances of a third group running in the General election and thus siphoning off votes from a potentially better candidate.  

You may be wondering why I do not remove the Electoral College.  Simple, the Electoral College acts as a filter in my opinion to prevent tyranny of the majority.  While it is fine to have a majority vote in a runoff election, we as people are prone to rash actions and judgments.  As such, the Electoral College helps to filter that out as each State has its own population sizes and cultures.  So you could say that it prevents a tyranny of the majority by the voters of New York, California and other coastal States which host a majority of the population of the United States as compared to the smaller States which even together may not even have a population size coming anywhere close to that of New York's and California's combined.  Basically, if we did our election system by majority rule the Candidates would visit exclusively New York, Texas, California, and Florida (and maybe a few others) thus winning because of the vast population sizes of these States.  In short, you would disenfranchise every voter in Alaska, North Dakota and more.  Therefore it acts as a balancer even if the winner does not achieve a victory in the popular vote.

Conclusion:  These are some basic reforms, but of course some will need a Constitutional change, and others like internet voting and making Election Day a national holiday take simple but only semi hard to achieve votes in Congress, and the State and local governments.  So about half the reforms here are feasible as is.  Any case, hope you like the reforms and personally I am in favor of internet cast ballots that you can cast anywhere in the world that there is an internet connection.  Some States have already begun to move in that direction and I look forward to seeing how far they will take it.

Primaries and Caucus: Reform

If you watched the news or participated in a political primary or caucus, you would know that it is filled with long lines and depending on your State can be annoying or difficult to vote in.  So what are some reforms that can take place to make this process less painful?  

The reform I can think of primarily revolves around the amount of time it takes to pick a candidate.  Now, I am not going to say have all the States vote all in one day.  The reason being is that the process being so lengthy is beneficial so as to prevent rash decision making.  You see, if it were not for the amount of time it takes to choose a candidate in this election year, we would have a battle against Hillary and Trump as opposed to a possible battle with Sanders and Cruz for the nomination.  So we need it to take a while to finalize who will be the candidates in both political parties.  Also, part of this little issue of time is that in some States candidates are still on the ballots even after they have pulled out of the race, in part, due to the fact that they paid for their names to be there.  As such the internet can provide us with a wonderful solution.  

With the internet we can set up an online voting system for nominating people for political races.  What it would entail is a system that allows people to vote from January 1st of an election year to July 31st. In this time people can vote or even change their votes for candidates as they see fit all the way up until the July 31st deadline thus combining an element of caucuses into the system.  This insures that a person's vote is not locked into a candidate who may turn out later to be a big jerk (Trump and Hillary), or if their candidate dropped out of the race (Rubio and Carson), they can then throw support behind their second choice or even third choice.  Additionally, this ends the need for early and absentee voting with respect to primaries and caucuses especially as absentee and early voting can be used as part of manipulating the vote in favor of one candidate or another. Basically, it reduces the amount of possible corruption involved.  To top it off, it even allows new candidates to enter the race during the election season, but a cut off would have to be implemented where no new candidates may enter past say May 1st as we will need time to get to know the candidates so as to prevent nominating people on emotion rather than logic and reason.  But how would this system work and where would the delegates who have the final say on who runs in each party come in?

So we will not eliminate the State by State system at all (so you are still voting as a member of your party, but also as a citizen of the State in which you live).  In fact we will keep it where you win a number of delegates per State, but they are awarded at the July 31st voting cut off all at once.  The role of delegates would change though as they would act as a tiebreaker if no one candidate achieves a 50% plus one majority by the end of voting  In other words, there will be one or more delegate per State and U.S. territory.  Whoever wins more than half of those is declared the winner and thus has the nomination and the parties support.  However, as stated, some or all the candidates may not achieve that majority, thus delegates vote in a convention held at the very end of the nomination cycle to confirm the best out of the top two or three candidates who achieved the most wins (three if the next best two are tied or are so close in the number of wins per State that they can be considered tied, otherwise all other candidates are dropped from being considered).  Now how do we prevent people from screwing around with this system?

For one, each person will receive a national membership code from the political parties, and should even be able to change party affiliation at any time, but if they have voted as a Republican and switched to being a Democrat for example, then their vote for that Republican candidate will be nullified unless they switch back, but at that point their voting for the other candidate on the Democratic side will be nullified.  This switching back and forth will stop being allowed during the May 1st through July 31st dates so as to provide stability to the voting process as no new candidates are allowed at this point. It provides stability by preventing ideologues from manipulating the vote in favor of their candidate by switching parties to vote for the weaker candidates of the opposing party.  Anyhow, back to that membership code.  The code itself will indicate first and foremost which State you are currently living in, your age, sex, gender, and race.  The reason for this is partly to allow the parties to analyze your demographic, but also makes it harder for a person to pretend to be you as a series of challenge questions may ask these things and more to confirm if you are in fact you.  This helps to prevent voter fraud at least with respect to someone pretending to be you if they for whatever reason get your code (the code can also be your social security number or driver's license number depending on what is easier).  The political parties will have to work together to pull this off and other political parties like the Tea Party, Green party and others must be allowed to host their primaries here too, but follow along with the same rules.  The site will also have to be protected from hackers, which means a combination of government agencies and private firms hired by the parties will be needed to prevent any form of manipulation electronically as well.

This site in addition to voting in a primary (based on the changes here), and being able to change your party affiliation (or even be able to be part of multiple political parties if the parties allow it) will enable people to see all the candidates who are running and will have links to all of their campaign websites.  This ensures voters can make an informed decision (candidates can opt to not have their websites linked to this one if they choose and any new candidate who announces must have their name and website up on the site within 24 hours of their announcing so as to ensure their voters do not miss their chance to vote for their preferred candidate).  It would also be useful to allow people to be able to donate to their candidates through this site directly, via the political parties, or to the political parties themselves.  Additionally, you can change your address here as well if you move which will allow you to keep the government and the parties up to date on where you are legally allowed to vote.  The idea here is to insure that the site is useful outside of Presidential elections and even Senatorial, and Congressional elections as well with respect to the national nomination process.  Eventually it can even be used to handle State and local election nominations as well and could even put out a newsletter via text, email or other to keep people up to date on whether there is an election they can vote in or not.

Conclusion:  This site will be partly supported by the parties, but money will come proportionally based on the number of members of each party has.  The rest of the money will come from the States and or Federal government via the federal election commission and State equivalents as they have a vested interest in free and fair elections even during the nomination processes.  This insures fairness with respect to keeping this site up to date.  Of course this site would require States to harmonize their election laws to fit the new structure and for the political parties to agree to participate as well.  Needless to say it will take some effort to implement this system.  The older voting system will not completely go away however as areas with shoddy or no internet access will still need the traditional paper ballot (or similar), which will have to be tallied before delegates are distributed. Overall, this is an outline of a potentially cheaper (as taxpayers are helping to pay for a website as opposed to voting booths), more effective voting system that helps to reduce voter fraud and gives people more access to vote for candidates of their choosing.

Donald Trump's Healthcare plan

Trump has a decent health plan.  His Of course completely repeals Obama Care so that people will no longer be forced to buy insurance unless they want to.  He will do basically what Ted Cruz advocated at this point allowing people to buy and sell health insurance across State lines, but so long as they meet State health insurance requirements such as catastrophic care or covering specified conditions by State law.  So it is not complete freedom to buy and sell, but it comes very close.  People under Trumps plan will be able to deduct their health insurance premiums from their taxes.  So if your premium is $4,000 a year or a million a year, the full thing is tax deductible.  He also advocates tax free contributions and inheritable health savings accounts (HSA's).  Trump wants these accounts to accumulate (presumably including gaining interest) and that when they are inherited that no death taxes will be applied to them.  At the same time, the HSA account can be used to pay for any member of the family without penalty.  Now with Dr. Ben Carson's endorsement of Donald Trump, these plans may change slightly to reflect some of Carson's ideas, but this remains to be seen as the overall plan is really just an outline at this point.  

Other changes that Trump wants to do are just as helpful to health care as Dr. Carson's, Senator Cruz's and Governor Kasich's ideas.  Trump wants to implement a true price transparency law that would require health professionals, Doctors, and health organizations like clinics and Doctors to publish their prices for their services.  The goal is to allow consumers to pick and choose the places with the cheapest health prices for the same quality services.  Donald Trump also will block grant funding for Medicaid.  What this means is that the Federal Government that provides financial support for Medicaid will give States a specified amount of money per year for States to spend as they wish on Medicaid patients.  Mr. Trump’s logic is that States know more about the needs of their residents and that States will do a superior job of combating waste, fraud and abuse while providing healthcare to the needy (this idea is shared between all the Republican candidates).  The final part of his plan will open the market to drug providers that "offer safer, cheaper and reliable" drugs.  Basically, this means Drug companies from overseas will be able to compete against domestic drug companies and potentially laws governing generic drugs and patent rights may be adjusted to increase competition.

Final Thought:  Trumps outline of a plan is very solid and does what most of the other candidates want to do and possibly even a little more in areas that the other candidates did not think of trying such as opening the market to overseas drug companies.  I am not a fan of Donald Trump, and I end up about every three weeks saying I would never vote for him.  But then he has stuff like this which can do wonders to help people, and it forces me to reconsider him again and again.  I am still a Cruz guy, but hey if you like Trump for his mind rather than his mouth (and potentially loose morals), then it is possible you will not go wrong voting for this guy.