20090331

Government & Healthcare

The government is once again making a push to assume a greater role in health care. This move is nominally to provide health care to the millions uninsured. This guise is at best well intentioned ignorance, and at worse a ruse for greater control. Yes there are millions uninsured. Firstly, the vast majority of these people are young health people who do not need insurance. The young and elderly are already covered under Medicaid and Medicare. Secondly, for those uninsured who needs health care, they have access to care as no hospital can turn away a sick patient. True an argument can be made that preventive care to avoid becoming sick is better than being treated once sick, but the data on preventive care remains rather soft. And for preventive care that does make a difference, like screening mammograms, there are plenty of programs that will provide free screenings. But this is where the truth can be found, in that if you are uninsured and needs treatment, you will be laden with a huge bill. The problem of health care in the US is not coverage of the uninsured, the problem of health care in the US is a problem of cost.

Put it another way. Why are there uninsured at all? Because either they choose not to buy health care insurance, or because they cannot afford health care insurance. If they choose not to buy, it is probably because they don't see the need for it. If it is because they cannot afford health care insurance, then this again is certainly the problem of health care cost rather than a problem of uninsured.

Does the high cost of US health care means better health care? Yes and no. We spend an exhorbitant amount of money keeping premature infants and the terminally ill patients alive as long as we can. Frequently we fail, and especially with the terminally ill, we only prolonged their lives by days or weeks rather than years. Is this a smart spending of our health care resources? This aspect deserves a serious conversation in our society and culture. But this is not being discussed because the politicians would much rather talk about providing universal coverage rather than smart spending.

Certainly this is out of concern of a slippery slope that if we restrict money to be spent for premies and the terminals, we might restrict money spent on other areas of health care as well. And this gets us back to the essential problem of health care, cost. And anyone will tell you that the solution to cost increases is to control cost. Initially cost reduction can be gained through better efficiency and better care process to reduce complications (another direct contributor to cost). However, these cost control gains will never be as much as projected. Many different forms of health care delivery has been tried in the US in the past 20 years, all promising to reduce health care cost. All has provided a few years of cost control only to be followed by rising cost along the previous trajectory. Part of the problem here with government heath care and cost is that the government is never cost effective or sufficiently cost conscientious. Then it will come down to either accepting the increasing cost of health care or reducing service available.

Will the government accept the increase cost of health care? Will the people accept increasing taxation? For a while yes, but only for a while. When the cost of taxation for government health care is too high, what typically would happen next is that services will slowly but surely be restricted. And what we would all end up with would be universal coverage with less health services.

One other consideration. We all get what we paid for. When we pay for our health care directly, service is owed to us. When the government pays for health care, service is owed to the government.

20090323

Green Manufacturing: Subaru

There was an interesting article in the WSJ today on how the US Subaru manufacturing plant has become rather environmentally efficient.
Subaru of Indiana Automotive Inc., a factory of more than 3,000 workers who make roughly 800 automobiles a day, has pursued green initiatives since its launch 20 years ago in Lafayette, Ind., by Japan's Fuji Heavy Industries Ltd. With employees at every level of the plant looking for ways to save energy, reduce waste and generally make processes more efficient, one measure of its success is a 14% reduction in electricity consumption on a per-car basis since 2000. An even bigger achievement: It has not shipped any waste to a landfill since May 2004.

The authors, skeptical themselves at first, have confirmed the company's claims with their own detailed research. How did Subaru do it? By redesigning numerous plant processes, thus producing less waste and requiring less material as inputs. Since 2000, the company says, it has reduced the amount of waste it generates per vehicle by about 47%. Of the solid waste that the factory still generates, 99.9% is recycled or used by other companies as manufacturing inputs or as raw materials that they process to resell. The remaining 0.1% is hazardous waste that must by law be incinerated by a licensed facility.


Though I drive a Subaru and in general would buy another one (uncertain whether this is due to the quirkiness factor or the great service i get currently at the dealer) what particularly caught my eye was this particular algorithm below:
1. To burn material for energy is better than sending it to a landfill.

2. To recycle it is better than burning it.

3. To reuse material is better than recycling it.

4. To reduce the amount needed is better than reusing it.

5. To eliminate the need for material is better than reducing it.


That it is not just an act but a whole process, and each steps leads to a better thought, idea, and potential solution.

20090316

Media Political Distraction

There has been alot of noise in the media of late pertaining to Republicans or Conservative personas. By this I mean the White House vs Rush deal, the Steele vs Rush deal, the Steele & abortion/nazi deal, the Megan McCain vs Ann Coulter vs Laura Inghram deal. None of these things matter now or in the long run.

I think Republicans and Conservatives need to stop reacting to the Democrat/Progressive agitators. We should all remember that the Liberals control the mainstream media. All this is meant to distract the voters from the Obama agenda and incompetencies.