Failure of “free market” health care

By Erik Dolson

In the last two weeks of March, nearly 10 million people lost their jobs. Of those, more than 3 million also lost their health insurance.

With the coronavirus looming over every household, think how this might feel — your father is sick? Your child? Everything you worked for is on the line when you sign those hospital forms. Feeling sick yourself? Maybe just see if it clears up, right?

That loss of health insurance affects not just you and your family, but everyone you come in contact with.

The brilliance of capitalism is the efficiency with which it allocates resources. In theory, capitalism balances costs versus quality by giving buyers a choice in a transparent market place. This is the essential mechanism.

But health care has disconnects that violate the basic rules of capitalism: consumers (patients) don’t pay the bills and don’t really make the choices. Insurance companies and government pay the bills, and consumers rarely “shop around” for the best or least expensive care.

This malfunction of the market place is seen by comparing costs of health care in the U.S. versus other countries: U.S. health care is twice as expensive, for mostly mediocre results, than any other developed country in the world. Ultimately, the burden of this falls on citizens through high insurance rates and taxes. We just don’t get to choose.

It’s legitimate to ask, where does the money go?

Drugs cost ten to twenty times more in the U.S. than elsewhere in the world because drug companies have purchased the U.S. Congress.

Private equity firms have swooped in and purchased doctor’s offices and hospitals across the country. Like insurance companies, their goal is to maximize profit, which they do by increasing fees and cutting costs. If you notice absurdly high charges and confusing write offs on a hospital bill, or long wait times and hurried doctor’s visits, this is part of the reason why.

But wait. If the payers and the providers are both interested in reducing cost, why don’t we have the least expensive health care in the developed world? Because insurers and corporations take a large share, and fighting over that share costs about 30% of every dollar spent on “health care.”

Why don’t we have the best health care in the world? Because when we talk about payer and provider, what’s missing from the “free market” equation? The receiver of the service, the patient, you. The one who is most concerned about the outcome. For a market place to work, the receiver of the product or service has to make a choice between price versus quality, and that doesn’t happen in health care.

And, as we see with the coronavirus crisis, health is not an individual concern. You choosing which car to buy doesn’t really affect me. You coughing in line behind me at the grocery store does.

Narcissist strategy

By Erik Dolson

Donald Trump  does not care how many die of the virus. He does not care about the economy, either, except how it affects his own wealth. He only wants to be reelected, and rich, and prove he is the greatest man in the world.

On Monday, realizing the economy is getting ugly, he panics. He wants to reopen the country for business, now!  He says he has total control over the nation.

Somebody points out this isn’t true, and actually makes him responsible if things don’t work out. Deaths don’t matter, reelection does.

So on Thursday, he bellows that he’s giving governors the right to open — or not —their individual states. That he had no such power doesn’t matter — he gave himself cover if opening businesses too early results in more deaths. Not his fault! Deaths don’t matter, reelection does.

On Friday, he tweets support for those protesting restrictions, undercutting the governors he “allowed” to act just the day before. So if the economy falls off a cliff, he tried to prevent it! Not his fault! Deaths don’t matter, reelection does.

It’s a perfect strategy for the narcissist. If deaths go up, it’s not his fault! If the economy tanks, he tried to prevent it! And, who else is better qualified to lead the country out of a pandemic depression? Why, it’s Donnie Wonderful to the rescue! Four more years!

Roll Your Own Mask #3

By Erik Dolson

Okay, this is my favorite so far.

An article in Business Insider described how three women who know fabric were appalled that people, including health care workers, were wrapping T-shirts around their heads as a mask against the coronavirus.

Lindsay Medoff and Heather Pavlu of  Suay Sew Shop in Los Angeles, and friend Chloe Schempf, bought a $1,400 particulate-counter device and actually tested out various potential mask materials. They discovered that blue shop towels actually have good level of resistance to particles like the coronavirus.

So, I have abandoned furnace filters in my quest for the best mask we can easily make at home. Too expensive, too complicated. But I’ve kept some of the things I’ve learned, such as, pleats allow masks to conform to our face. And, tying a bow in string behind your head in Costco is far too complicated for a man, although I have no doubt a woman could do it in 7 seconds.

But this new mask is very easy and inexpensive to make, and therefore disposable, a requirement of mine. Here’s what you need: Shop towels, string, rubber bands (4), and scissors.

 

I lay one shop towel on the counter and put another one on top of it at right angles, so the perforations that allow us to easily tear the towels apart are not lined up on the two sheets. Then I folded in the pleats. For me, it was easiest to flop the towels over for each pleat, which are about one ince wide.

When I was done pleating, I wrapped rubber bands tightly around each end, with another rubber band fed under. I pulled one end of the second rubber band through itself.

I then cut a piece of string about the width of the mask, and tied it to the ends of the rubber band loops.

I pushed on the center of the mask which gives it shape, and then put over my head, with the string above my ears.  I pull the bottom of the mask under my chin, and the top across the bridge of my nose.

On my mask, I also folded a piece of coated wire into a pleat and bent it down to bring the mask tight to my nose, but I don’t like putting a piece of wire close to my eyes and think there is probably a better solution.

Another improvement might be to use the wide elastic that “professional” masks use instead of string and rubber bands, but one goal of the project was to use items easily found, and this mask fits well.

Remember, this mask is a kludge, and you should use a proper N95 mask if you have one available. But if you can’t find one of those, or have decided to donate that mask to a nurse, a cop, a doctor, or the person who sells you groceries, then perhaps the Blue Moon mask could help you from getting sick with COVID-19, or prevent you from spreading COVID-19 to someone else.

Roll Your Own Mask, #2

By Erik Dolson

My local hardware store carries pleated furnace filters. The highest grade of these claims to have a pore size of .1 to .3 microns and be able to filter viruses. So I bought one and tore it apart, getting rid of the metal screen on both sides.

Then I cut a piece a little larger than the width of two of my hands with about seven (7) full pleats.

I wrapped a rubber band tightly around one end, and then another rubber band tightly around the other end.

Then I cut two pieces of string about double the width of one of my hands.

I fed one end of one string under a loop of one of the rubber bands, and then tied the two ends of the string together with a square knot. I did the same to the other end of the mask.

Done.

I opened the pleats, which turned the mask into a small “bowl” shape or half dome and put the mask on. I had to adjust one of the strings around my ear for a better fit, and I was finished.

I like this mask. It takes very little time to make, is disposable, should provide adquate coverage and protection. I read that some are recommending Tyvek, the white plastic they use now to sheathe houses before installing the final siding, as a filter. The furnace filter does feel like Tyvek, but I have no idea about relative effectiveness.

In fact, since I have no way of testing, I have no idea how effective my new mask is going to be. There are no guarantees.

But it fits, is easy to wear, cheap and disposable, and I’m going to leave the N-95 masks for health care workers, cops, grocery story clerks, post office employees and delivery people — those who make “shelter in place” possible for the rest of us.

Roll Your Own Mask #1


 

By Erik Dolson

There’s growing support for all of us to wear masks to prevent the spread of Covid-19, but N95 masks are hard to find and the ones available should probably be reserved for nurses, cops, doctors, grocery clerks and post office employees — you know, people who keep the wheels turning.

So I was looking online for DIY Covid-19 masks, and there were many good ideas. Some were more complicated than others, and some you wouldn’t want to throw away. I thought the best mask would be easy, cheap, and disposable, so I made one. I call it the “Opus.”

Here’s what I did.

one full size paper towel
two #4 cone coffee filters
two longish rubber bands
Tape
string
scissors
hole punch (optional)

Fold the two bound edges of one coffee filter about an eighth of an inch (one mm) from the pressed seam.

Put this filter inside the unmodified filter so that it fits exactly.

Run pieces of tape over the two pressed seams of the outside filter from one side to the other. This is to reinforce these pressed seams, which are not very strong. I went lengthwise, and then added two more pieces of tape, overlapping the first, on each side to further strengthen the outer cone.

Punch two holes all the way through the nested filters about an inch and a half from the wide end and through the tape (you did put enough tape there, didn’t you?) I also reenforced with those little circles you can buy at stationary stores. The tape might be adequate.

Put a rubber band through each hole. (See all the tape?)

Cut four pieces of string, about the length from elbow to extended finger tips. Tie a string to each end of the two rubberbands.

“Flag fold” a paper towel so that forms a triangle, a cone when opened (great in a coffee emergency if you’re out of filters).

Fold the pointy end of the paper towel triangle up so it will fit snugly inside your coffee filters. Tape point to itself. Push towel into the mask, and trim the excess off the wide end, maybe leaving just a little extra. You choose..

Put the mask on, and tie the “top” strings that are attached close to your nose down and behind your neck. Tie the “bottom” strings up, above your ears to the top back you your head. Make both fairly tight.

Adjust for good, snug fit. You can use paper towel trimmings to prevent air leakage on either side of your nose.

I had no way to test, have no idea what particle size will make it through all three layers, and offer no guarantees. I do know when the mask fits well, air goes through the three layers and not around, because the mask will flex on inhale and exhale. When N95 masks become available, those are what you should use.

In the mean time, my “Opus Mask” may keep you from getting the virus, or sharing your virus with others.

~ Erik

 

 

Why bailout stalled

By Erik Dolson

Republicans are using the national pandemic to enrich themselves and their friends. Democrats want to help Americans. It’s about that simple.

Trump wants to put Steve Mnuchin in charge of distributing bailout money. Mnuchin, formerly of Goldman Sachs, the company at the center of “Main Street bails out Wall Street” during the Great Recession. (see photo of Mnuchin and wife above — Chicago Tribune)

Mnuchin thinks economic health starts with big business in New York. The rest of us are expendable. Under his plan, how much money will go to Trump family hotels?

Need another example of Republican priorities? After receiving inside information that the economy was in trouble, Senator Richard M. Burr, Republican of North Carolina, and Senator Kelly Loeffler, Republican of Georgia, (whose husband is chair of the New York Stock Exchange) appear to have sold massive amounts of stock while reassuring America that everything was okay. 

Everything is not okay, especially because of the Republican party of oligarchs and plutocrats. This pandemic is worse because of their actions and inaction.

Democrats want to give relief to ordinary people who are out of work, those worrying how to pay rent or make house or car or insurance payments. Democrats want to make sure these people have sick leave so they don’t spread the virus. Democrats want to help Americans see a doctor!

Trump did not cause the Corona virus, but his policies and those of the Republican party have made the consequences much worse for the working men and women of America.

Those Trump insulted for the last three years — scientists, the Federal Reserve, and yes, bureaucrats, are trying to help average Americans survive.

They know their duty is to all of America, not just padding the lives of the top 1 percent.

Boeing rot again on display

By Erik Dolson

Boeing Chief Executive Officer Dave Calhoun has now stepped in another large pile of his own deposit. Think of it as interest on the Boeing’s inheritance from General Electric (G.E.). Just more of the same from the plane maker.

Calhoun was trained by G.E. Chairman Jack Welch, who died last week. Welch was known as “Neutron Jack,” nicknamed after neutron bombs that killed people but left buildings intact. The Welch style of management was ruthless, including termination of 10% of all employees every year.

This had consequences for morale. Several recent Boeing CEOs were from G.E. or heavily influenced by that company. Morale at Boeing suffered, as well.

Boeing’s Calhoun was quoted in an interview that appeared in the New York Times last week as laying the blame for Boeing failures on previous CEO Dennis Muilenberg. “If anybody ran over the rainbow for the pot of gold on stock, it would have been him,” Calhoun said. The problems at Boeing, he said, “speaks to the weakness of our (former) leadership.”

What Calhoun failed to say, possibly because he is incapable of it, was that as an important outside board member, his leadership was part of that weakness as yet another alumnus of General Electric, touted during the 80s and 90s as the zenith of corporate capitalism. In fact, the Welch legacy may be turning out to be a failure when not implemented by Welch.

Growth at all costs, huge payouts based on stock price, and ruthless cutting of costs (talent and expertise) in the effort to increase profits (and bonuses for management) may have resulted in destruction at Boeing and other companies where Welch protoges landed after drinking the G.E. Kool-aid.

That beverage also involves public relations at the expense of honesty. Last month, Calhoun said that emails and texts between Boeing test pilots lamenting the build quality and training of pilots on the 737 Max represented a problem with emails and texts, not the airplanes themselves or culture at the company.

It should be noted that Calhoun stands to receive a rather large fortune if he can quickly get the 737 Max approved by the FAA  and flying again.

Denying that the communications between pilots accurately represented a crumbling corporate culture, where engineering decisions were overruled by managers under the gun to cut costs, frightened they might lose thier jobs if they failed to do so, Calhoun said the emails and texts would stop.

How reassuring.

Now, Calhoun has turned on the top managers of Boeing that he supported while he was a crucial board member and they were putting profit ahead of safety.

And he has implied it was the fault of pilots who were overpowered by software that flew two of his jetliners into the ground, software that did not exist on aircraft they were trained on. These pilots apparntly did not read the fine print in manuals that accompanied the new planes. Shame on them.

The loss of 348 lives had nothing to do with greed and failure to provide adequate instrumentation and training.

His hand in the till while he is cracking the whip, Calhoun has defended his salary and is in full CYA mode, rather than being accountable. This is the G.E. way when followed by men other than the admittedly brilliant Jack Welch, who was dealing with a fat corporation in another era.

The leadership at Boeing is still in denial, which means the company has not yet hit bottom. This is not over. Even NASA recently suggested that agency no longer trusts the company.

Small wonder. Boeing will not recover until the company redevelops the honesty required to admit and then publicly correct rot caused by 40 years of misdirected leadership. Boeing builds airplanes. Airplanes need to be safe, not just profitable.

There was another capitalist icon of the 1980’s era who seems to have been forgotten in recent decades: W. Edwards Deming, who was essential to the rise of Toyota and other Japanese automakers. Like Welch, Deming was a believer in statistics and process control, and the elimination of defects in manufacturing.

But Deming also advocated team building (rather than cutthroat competition among fellow employees), distribution of responsibility and accountability (as opposed to top management collecting absurdly valuable stock options via intimidation), and listening to those actually doing the work (as opposed to firing or smothering dissenting voices).

Calhoun has to go. He is not the man for this job. No graduate from G.E.’s school of abusive management is. Perhaps Boeing could lure Dan Davis, former director of Motorsports for Ford Motor Company, out of retirement for a couple of years. Davis has a resumé and a style that Boeing needs about now.

Back to where we started

By Erik Dolson

It took a few hours but Foxy is mostly ready to make the trip up the Strait of Juan de Fuca tomorrow. Leaving Victoria is melancholy, like having dinner alone in a favorite restaurant, but we’ll be back in a couple of weeks, a month, or later in the year. It’s hard to say, there are too many factors not under my control. I’m trying to focus on what I can control and adjust to outcomes that will be what they will.

I’d like to get out of here about 7 a.m., which means 8 a.m. and I have no clue why but that’s been the case for years when starting out. It’s weird, but I’m rarely late for an arrival. But if I’m going to beat what looks like pretty strong currents against us when we arrive at Guemas Channel, an early departure is a must.

Or I’ll lay over in Friday Harbor. It’s good to have a backup plan.

The tool bag is up in the cockpit, sails are uncovered, jib sheets run. No, I don’t plan on sailing and weather for tomorrow looks calm. But the sails are my back-up propulsion in case of engine failure.

My buddy Roy gave me a good lesson the day he signed me off as competent to be out there. He sent me forward to untie the sail cover when Foxy was heaving through pretty high chop. I learned it’s hard to hold on and at the same time use both hands to untie even simple knots. Some tasks are better wrapped up when it’s calm and Foxy’s tied to the dock.

Especially when single handing.

Even so, I’ve probably forgotten some things and made decisions that could come back to bite me. The dinghy motor is still on Foxy’s transom. Mounting it on the dinghy is a tough job by myself — I’ve done it, which is why I know. So, while I made sure the dinghy is inflated in case I need a life boat, I’ll depend on oars if I do. Which reminds me, I need to charge up the hand-held radio because using oars in the Strait of Juan de Fuca seems just ridiculous.

But jack lines are tight from bow to cockpit, my harness and life vest are on the cushions above along with my heavy weather coat. I’ll practice with the somewhat-new radar and the Automatic Identification System tonight, though I doubt the radar will be required. Still, better to have a handle on it.

It’s been five months since Foxy’s been off the dock. This is our first trip of 2020. It’s not far — we (that would be Foxy and me) are just headed back to friends at Marine Servicenter in Anacortes where she was recommissioned four years ago. Or was it five? She needs another couple coats of anti-foul paint on her hull, we’ll grease and check the Maxprop, enlarge a through-hull for a new water speed sensor. Maybe reroute some plumbing. Maintenance that can only be done on the hard.

Then we’ll splash and either head back to Victoria or maybe just to the buoy at Friday Harbor. Wherever we are on the water, that will be home for at least as long as we’re there.

Trump x 2 = 0

By Erik Dolson

Andy Cross/MediaNews Group/The Denver Post via Getty Images

Proving he is a loathesome creature (nut doesn’t fall far from the tree), a tweet by Donald Trump Jr. about Senator Mitt Romney’s vote to impeach Donald J. Trump Sr. shows junior’s complete lack of ethical or logical constraint.

Romney had carefully explained his religion-based decision in the Senate. No one can doubt that Romney is a man of faith. But DJTjr. chose instead to substitute his own explanation, that Romney was “bitter” that he would never be president. This is no less than saying a man is a liar about his relationship with God.

Of course, DJTjr. has no logical basis for believing he knows Sen. Romney’s intentions better than Sen. Romney, except a twisted Trumpian view of the world. But logic has never been a Trump family trait.

This classic Trump malignancy, like father like son, puts on display a vile moral emptiness that damages not the intended victim but the fabric of our society.

Of course, Romney did lose the election in 2012, but probably by a smaller margin than Trump if he’d had to run against Obama. Crowds at inauguration don’t lie.

Good God, Democrats

by Erik Dolson

Seriously? This is the best Democrats can do? Goddamnit.

Where in hell is the wicked smart, 50 to 60 something, experienced enough, visionary, charasmatic man or woman (I really don’t care) to lead my America into the next half century of challenges that face us all?

Hey DNC! Don’t you watch TV or the movies?! There’s your prototype. Find a Martin Sheen or Louis-Dreyfus! Look at the GOP! Their two most popular presidents were a “B” grade movie actor and a reality TV star! Can’t you figure it out?! Liberal bona fides don’t matter. The filters are too fine.

You have the most unpoular president in recent history, one who didn’t win the popular vote and hasn’t gathered many more supporters after three years in office. You have tremendous issues to run on, and, in Clinton and Obama, two of the best politicians to advise you. Why can’t you figure this out!?

You bumbling party incompetents are going to put up a candidate to lose against a man most people recognize as deranged, who is harming America, using the constitution to clean himself and to whom you will give another four years because you can’t find, across all this great land, a woman or a man who inspires, a leader around whom Americans can come together?

Then your system is broken. It is designed to fail in some fundemental way. Please, please, fix this before it is too late.