All-Savers Certificates and Obamacare
During the Ford Administration, the government was desperate to halt inflation. When Carter was president, interest rates reached 18%. One of the solutions was the “All Savers” Certificate. The idea was that if more people would save, the banks would have more capital to lend and since the supply of money for lending would increase interest rates would go down. The program didn’t work. Why? Because almost no one signed up.
Thirty years later we have the Affordable Care Act, otherwise known as “Obamacare.” Sign-up for the program was to start in November, 2013, but due to well-publicized technical issues, a mere 15,000 were able to sign up. Now that the technical problems are fixed, another 50,000 have signed up. And this in a country of over 350 million people. I heard one of the senators from Kentucky who helped draft the legislation explain that the senators “assumed” that every State would have an insurance exchange, sort of an online flea market where people could buy insurance. Unfortunately, just as with All-Savers, the assumption was wrong. Half of the States didn’t buy in. Now it comes out that the only way, the only way that the program can work is if droves of healthy young people sign up. The program is counting on them to pay for care for the older uninsureds. People believe that the only issue with the program is a mysterious web problem. It’s not. The whole program is based on false assumptions, not on a glitchy web page. Young people aren’t signing up. With three weeks left in the year, less than 100,000 people have signed up nationwide. More people bought All-Savers.
The sad thing is that the U.S. already has institutions which could address these issues. Expanding Medicaid is the obvious choice. “Oh but you can’t do that,” they say. Why not leave the design of the horse to a committee and hope we don’t get a camel?
Solving the Medical Malpractice Crisis
One of the reasons why health insurance is so expensive in the United States is because of the lack of tort reform. The lawsuit lottery is alive and well and the cost of playing it raises everyone’s costs. I would like to make the modest assertion that I can fix the problem in one day. Fact is, half a day is all I would really need. And I wouldn’t need a single new institution to accomplish these feat. And trial lawyers would be accommodated, would have a role to play in the process and could have no principled basis on which to complain.
Before the 1920’s, a workman injured on the job could not recover compensation from his employer unless he proved his employer was negligent. A great advance of the U.S. legal system was to remove fault from the equation. An injured workman need only show that he was injured on the job. He would receive medical care and compensation for permanent injury. This system is successfully operating in every single U.S. state.
The solution to the medical malpractice crisis is simple. Take fault out of the equation. Better still, roll over the injured into the workman’s compensation system. In order to recover compensation for his injuries, a patient need only show that he was treated by a physician. There would no longer be any need to prove fault. Compensation would be guaranteed, but would be no more and no less than that compensation afforded to the injured at the workplace. There are already administrative tribunals in place to handle the cases—and lawyers have a role to play at these tribunals. So no med mal lawyer can claim that the adoption of this proposal would take his livelihood away. He can still represent the injured.
The advantage of the system is that wild jury awards and recoveries would disappear. Insurers costs would be fixed. The beauty of this proposal is that it is already working and working well. In every state. On every single day. Should someone who is injured on the job receive more than someone who is injured by a doctor? Why?
We have much to gain by making patients compensation a part of workers compensation.
A Tip from Jerry Pournelle and Byte Magazine-Keep a Log
I used to read Byte Magazine. I also had a subscription to Infoweek when John Dvorak was a columnist. There is one very useful, non-computer related tip I picked up from Pournelle’s column, Chaos Manor. Pournelle said that he kept a log and whenever he was given a telephone number (this was before the wide use of e-mail) or another piece of useful information he would write it in his log. The log was a notebook and not a binder so that pages couldn’t be lost. No matter how trivial, the number went in the log. This lessened, but did not eliminate, the little scraps of paper that accumulate during the day and always seem to get lost. Your discussion with customer service three months ago over a problem that was supposed to have been solved? What was the name of the rep who fixed it for you? It’s all in the log. Passwords, account numbers, all of this useful daily information would go into the log. I kept the names of case agents, witnesses, clerks of court and others. The information was kept in chronological order so it helped me remember the event and what I was doing around that time.
A paper notebook has the advantage of longevity, though it can be lost or misplaced and if the information falls into the wrong hands you could have a very serious problem indeed, especially if account numbers and passwords are recorded. Nowadays you can keep an encrypted text file on your computer. The advantage of a text file is that it is multi-platform: everything from the Palm Pilot of recent memory to the latest Samsung Galaxy, any Mac or any other kind of computer can easily display text.
I cannot count the number of times that having such a log pulled me out of a jam. Pournelles’ advice is very, very useful and it’s worth keeping in mind.
Maglev Train in Shanghai
The world’s only operational Maglev train runs between Shanghai’s Pudong International Airport and the city. Here are the tracks.
Train arriving at the station.
Waiting to leave. The trip takes 8 minutes.
256 km/hour
Maximum warp: 301 km/hr.
Shanghai 8
The gangster’s limo from the film, Shanghai Triad. I saw this movie in Miami in the 1990’s. Little did I know…
Shanghai 7
To avoid accidents with pedestrians and smooth the flow of traffic there are elevated walkways (with escalators) at several intersections in Pudong. The red building on the right is a shopping mall.
Welcome to Al-gul 