An Incremental Approach (or how i found my pants)

If there is one thing that I know, it's that nobody is happy with the progress of the health care reform bill. Liberals are pissed because the public option looks to be gone. Conservatives are pissed because there is an expansion of Medicare and Medicaid being tossed around. Nelson is pissed because of abortion. Lieberman is pissed because...well, nobody really knows why.

However, I am not pissed. Rather, I am a bit pleased - assuming, that is, the bill gets past the filibuster that has been promised by the GOP.

See, while some would tout the public option as the method to obtain some sort of universal health coverage, I would go so far as to say that they are wrong. Expansion of Medicare really is the way to go.

And it has to be done in baby steps, because just expanding the program isn't enough. There are plenty of other issues with the health care system that also need addressing.

For one, education. I know, Education doesn't seem like it would be of major import to improving health care in America, but it is.

For one, we need to have better physical and health education in schools. We need our children to eat better, understand why they should eat better, and to exercise. Long term benefits are reduced obesity rates, which come complete with reduced diabetes, heart disease, and compression arthritis, among a host of other obesity related ills. All of these cost a fair amount and then some to treat, and they are all chronic diseases.

Some people are furious that a college is denying obese students their degree, I applaud them. We should do the same in all levels of education, but that requires proper funding, and for the schools in poor communities to be given the tools necessary to not just educate in the classroom, but to apply that education in the home.

Another major issue is the cost of higher education. I won't try to say how much it costs to obtain an MD in this country, but I know it is plenty. To obtain these degrees requires taking on of debt. That is followed by all of the other costs associated with practicing medicine, plus the long hours, the difficult patients, the new technology, the new testing, etc, etc, etc.

All of these combined are what lead to the exponential rise in health care delivery costs. Doctors have to charge more and more just to survive. Insurance companies, in their bid to be more and more profitable, continue to pay around 75% of what they're billed, Medicare in the mid-50's, and Medicaid in the mid-40's. This further complicates the ability for a physician to focus on what they are best at - healing people, and giving them the tools to ward off disease.

Any long-term health care reform will require a complete re-thinking of how we educate our doctors, and how we educate the populace as a whole. That's a conversation in and of itself.

Regardless, starting by expanding Medicare so that people 55-65 can "buy in", and expanding Medicaid eligibility from 133% of poverty to 150% of poverty, while opening up the Federal Employee Plan to be purchased by individuals, is a great start. Health insurance premiums are basically a tax, anyway, just to a for-profit corporation that will gladly deny claims for their benefit.

Completely overhauling health care is going to be a long, arduous process. Doing too much at once will scare voters. Scared voters will vote for the Party not in control, and I'm sure the GOP would jump at the chance to use the nuclear option to completely overturn anything good that comes from this bill.

So, the incremental approach is good. Calm down, my liberal and progressive friends. Social Security wasn't available as widely as it is on the first bill.

Back to those Pesky School Issues...

Here's what I have heard -

There is a chance that a marijuana decriminalization bill may reach the floor of the State House this year. What this does is turns possession or use of a small amount of marijuana into a civil infraction, complete with a fine, instead of a criminal infraction. There are cost savings involved (courts, prosecutors, police, jails), and this would create a new revenue source (fines). What I would like to see is that revenue source be allocated.

First, I would like to see our education leaders in Olympia work with the folks trying to get this bill on the floor. One of the things that will be done to sell this to more moderate and conservative lawmakers will have to be some sort of prevention or intervention program(s) paid for out of the new revenue source (although, in these difficult economic times, that may not be necessary, but stay with me here).

I think that the first thing to get funding, directed funding, is arts in schools. Band, drama, choir, etc. These are things that not only enrich the brain, but also give kids something to do that don't have the aptitude or desire to do sports, and gives them a creative outlet. Creative outlets are good things.

While I get that it's not that simple, and that Districts would probably not be fond of being given money with strings, too damn bad. We are seeing cut after cut to arts programs across the State. We have a new SPI that supports limiting the impact and necessity of standardized tests, we should be able to allow a broad based education system again.

Of course, I'm sure fines wouldn't be enough to fully, or even partially, fund arts in schools. One big component missing from our state's medical marijuana law is the lack of dispensaries. I would step out and say we should allow for a limited number of dispensaries, do a bit of taxing, and split it between health and education.

But that's just me.