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!

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.

The Strength of America

By Erik Dolson

Three weeks ago today I headed back up to Canada. I needed to prepare the boat for her trip up the Strait of Juan de Fuca to Anacortes in Washington state, where work was scheduled to be done about a week later. It was pleasant in Victoria, even without my car. The city is beautiful, I worked on the boat, enjoyed the nearby restaurants, went to the gym, rode my wheel.

I read news about the Corona virus, about a death in a Seattle nursing home, but it all seemed far away.

A nice weather window opened up a day earlier than I planned, and the trip up the strait was uneventful. After three nights in a marina, Foxy was hauled out of the water and put on stands to paint the bottom and install a new depth, speed and temperature sensor compatible with modern electronics.

I stayed on board the boat, despite the occasional 33 degree F weather and winds that howled through the rigging.The Corona virus, hitting San Francisco and then Oregon, still seemed far away: I could shop at Safeway without enduring lines too long, buy a coffee at Starbucks and sit and read the news.

Work on the boat lasted a little longer because of weather and by the time Foxy was back in the water, travel restrictions between the U.S. and Canada were being discussed. There were rumors that ferry schedules were changing. If I took Foxy back to Victoria, if Canada would even let me in, travel back and forth was going to be difficult. So I took the boat to Friday Harbor instead, and drove back to Oregon about three weeks after I left.

The world had changed.

With California under an order to “shelter in place,” I went to Costco Saturday morning for food that would last me a few weeks if need be. I was in a lane one away from where I needed to be to make a turn so I accelerated quickly, but the car next to me raced to block me out instead of letting me in. Hmmm.

At 9:30 in the morning at Costco, people were pushing carts piled with toilet paper and paper towels out the door. Inside, there was no hamburger or toilet paper left. I bought a jar of peanut butter, some eggs, bricks of cheese, a few steaks I could cut in half, OTC medications I’ve come to depend on.

People weren’t functioning very well. Some would stop in the middle of an aisle and stare off, no doubt checking things off a mental list. I can’t carry all that in my head so my list was on paper. Others blocked an aisle while disagreeing with a warehouse worker who said that Costco was not in control of toilet paper shipments.

There was anxiety in the air, and I could feel it try to get to me. I wondered if social anxiety was more infectious than the virus. I made the decision to bury my frustration and pushed my cart around them, saying “excuse me.” Maybe too loudly. I had to accept that the changing world affected some more than others.

I went to Trader Joe’s for the oats I like to eat at breakfast, but there was a long line out the door, longer than I wanted to wait for a can of rolled oats. Instead, I walked over to Dick’s Sporting Goods to buy some simple dumbbells, since my gym is now closed. But Dick’s was closed too, except for curbside delivery.

So I went over to the nearby Sportsman’s Warehouse, thinking they might have some dumbbells. There was a line there too, but it seemed to move quickly, so I waited. As I got to the front, a sign said that ammunition purchases were limited to two boxes per customer, and they were out of 9 mm handgun ammo.

I thought about that for a minute.

You can’t shoot a Corona virus with 9 mm ammo. It just isn’t sporting, and there’s the possibility of collateral damage. So obviously, the run on ammo was in anticipation of social chaos. Did ammo hoarders think all those people who didn’t stock up would descend in clouds to steal their toilet paper? Didn’t ammo buyers have any left over from when they panicked and cleaned out the shelves when Obama was elected?

The fact that some of them seemed almost giddy at the prospect of social collapse made me a bit uncomfortable. It made me wonder if I had enough ammo at home. In that moment I knew social anxiety was contagious.

Maybe I’m still taking the world the way it used to be for granted, but look, I get it. A “shelter in place” is something we haven’t seen in our lifetime, and we’ve been left pretty much on our own to deal with it. The world has changed.

But still, the enemy is a virus, not each other, right? Everybody grabbing and hoarding and shooting are symptoms of social disorder that will make it worse, not better, right?

So I’ve had to slow down my defensive reactions a little bit. I’ve had to pause a second longer before I say something, or change lanes, or make judgements. Even that might not be enough. In fact, I may have to go out of my way to help someone else, a stranger perhaps, if they seem to be having a hard time.

Maybe that might be the strength of America, that we can put down our differences and give each other a hand when times are tough? I think I’ll give it a try.