Unintended Consequences

While I was taking public policy courses at Augsburg, I quickly learned the impact of unintended consequences. It is the hardest thing to acknowledge when one is drafting policy suggestions and the hardest to convince others of us as well. Every policy, whether one thinks it good or bad has unintended consequences. The tricky part is weighing these and making a decision as to whether or not they are worth it for a desired outcome.

Health Care has recently become something near and dear to my life, on a personal and professional level. Currently, our President has declared a state of urgency in reforming health care. He wants something done and done soon. I have heard opinions for and against nationalizing our health care system. My question is: What are the unintended consequences of nationalized health care? Because, I think that most people are not considering these as they form their opinions. If we know what the consequences are, and decide to act anyway, than we have acted and formed an opion in an educational matter. However, too often we base opinions and policy on a need, rush to form policy, and then have to form new policies to solve the problems created by a rash initial policy.

What are the unintended consequences of national health care?

Back to Health Care

I come back to this because I am personally struggling with this issue, it has resurfaced in the media again, and it may be time. Here is where I am at right now:

I work for a small non-profit where I am able to get coverage for myself at an 80/20 share with the agency. The coverage is not the greatest, but it's there if needed. In order to cover my family with this plan, I would need to pay 100% of the premium, something I just cannot afford. We applied for MN care, for my daughter and wife, back in January. Due to mailing "errors" we needed to resubmit our application for coverage. It is now mid May, and we were told that they might get to processing the application early June. In the meantime, my daughter developed a cold with strep and ear infections over the winter months. Her doctor now feels that her tonsils need to come out. An outpatient procedure he says will be hard to get done for less than $5-10,000. Now, I need the MN Care to come through, fearing a pre-existing condition for my daughter now exists.

Something different needs to happen with healthcare. Everyone of us should be able to see a doctor. I am saddened by our and others situations. I have no problem with co-pays and paying for routine doctor visits, although those are the topic for a whole nother blog entry. But, it is difficult to pay the costs of routine procedures like a tonsilectomy which could cost as much as $10,000 or a pregnancy at $32,000.

If we are not careful and talk about ideas about health care, we will see our choices taken away by nationalization of health care. So, what are the alternatives to nationalized health care, that will have a real impact on people. I don't believe that nationalized health care is the only solution, but it is an option, and unless we start to think and talk alternatives, it will probably get done.

Can we be transparent?

I heard this story on the news last night and read just this one article this morning. The story has to do with some program cuts that President Obama is proposing. Evidently he wants to cut some 150 programs that would save the gov't around 17 billion dollars. Cleaning up wasteful gov't spending is great and he is following through with what he said during his campaign and in his inaugural speech.

BUT...

First, it has been noted by a couple of sources, including this attached article, that President Bush attempted also to end many of these same programs with no success. The Christian Science article also cites a Republican member of congress who calls the President out. He is not as excited because the "savings" will not be gov't cuts, but a redistribution into other higher priority programs.

I became frustrated during the campaign, by both sides, of skewing facts and history to support themselves. If the numbers support you, then cite them. If you disagree with the numbers or have an objection to them, then say so.

People's intentions/agendas are becoming more and more a driving force of relationships, business, and gov't. I think it is fine to have intentions and agendas in conducting yourself, but the "political" game that gets played in the process is getting old. As my daughter would say in a very serious manner, "Tell me the truth."

Giving

I just finished reading Bill Clinton's book titled, "Giving." I would really recommend this book as it outlines some great work that is being done in our country and around the world. He has compiled a list of great resources that enable ordinary citizens to give. Here are some of his thoughts:

"In every corner of America and all over the world, intelligence and energy are evenly distributed, but opportunity, investment, and effective organizations aren't. As a result, billions of people are denied the chance to live their lives to the fullest, and millions die needlessly every year."

"As long as more than 100 million children in poor countries are not enrolled in school, there will be poitical and social instability, with global implications."

"We can make market forces work better for the poor if we can develop a more creative capitalism- if we can stretch the reach of market forces so that more people can make a profit, or at least make a living, serving people who are suffering from the worst inequities. If we can find approaches that meet the needs of the poor in ways that generate profits for business and votes for politicians, we will have found a sustainable way to reduce inequity in the world."-- Bill Gates

What I appreciated the most about this book is the resources, ideas, and encouragement for "Joe the Plumber" to be giving. In the back of his book, Clinton gives websits, non-profit names and addresses. He talks about the philanthropist, the community organizer, and the 12 year old girl who worked towards a mission and goal. He gave equal time to multiple perspectives and, I felt, was truly motivated by the thought of creating a world free of inequalities and fear, although the occassional political pat on the back does exist.

Here is a link to the books website. You can read stories of giving as well as have a full list of the resources outlined in the book.

Purpose of Gov't, Purpose of Citizenship

Gov't should help people succeed in the time that they are living. Today is different than 1776, 1890, 1920, and 1980. I talk to some seniors who bought their home 50 years ago for $15,000-$20,000. Today their home is worth $200,000 to $400,000. That is a huge increase in the cost of homes. I'm not sure what the cost was in 1980 for the birth of a child, but when my daughter was born in 2004, it was $32,000. My mom remembered a doctor's visit being $15 for a kid. She said that by the time we were older, 15-18 years old, a doctor's visit was around $50. The cost of cars, gas, and public transit keep going up. I just went to workshop this weekend that talked about the cost of Long Term Care, $49,000/year in a Care Center and around $31,000/year for an Assisted Living. In order to manage the cost of living today, a person needs car insurance, homeowners insurance, health insurance, and long-term care insurance. In order to provide a service, providers need liability insurance.

Government needs to help make these things possible for people. In some cases gov't may need to subsidize part or all of these.

What I don't want to lose sight of is the call for citizenship. The responsibility of people to help and care for eachother as well. If more neighbors helped out with their elderly neighbors, long term caring cost could come down for some folks. If, friends and family encouraged healthy living/lifestyles for their children health care cost could come down. If we taught and held family and friends accountable to driving habits, could we see the cost of car insurance come down. What is the repsonsibility of a citizen/neighbor. Could we re-discover neighborhoods and community involvement. If we want to remain control over our lives and communities, then I believe we should demonstrate and do.

Purpose of Government

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America"

This is the preamble to the constitution. If we take this introductory statement as what the authors were intending in the Bill of Rights, which follows, then we can beging to talk about what the role of government is. First, I think we should understand the context in which they are righting this document. For example, I could easily misrepresent the statement, "in order to form a more perfect Union." They were trying to establish a government that would bring the colonies together.

The purpose of the government is to:
maintain the union and justice,
insure domestic tranquility,
provide for the common defense,
promote the general welfare,
and secure blessing of liberty to ourselves and our posterity.

We have seen the federal government step in at points throughout history to maintain these points. President Lincoln stepped in to insure the union remain. President Roosevelt intervened to promote the general welfare of people. I think in both cases the President and congress enacted policies that were in line with the intentions of our founders. Have things become skewed and mismanaged? Yes. However, I think that the founders were cognisent to the fact that they needed to be concerned with the general welfare of its people. When people don't do well, neither does the union. When do people rebel, and revolt against governments? When people feel like their governments have forgotten and/or ignored their needs, they rebel and revolt against that governing body. I think the founders knew this, and they saw government's responsibility as to always look out for the needs of their citizens.

Taxes round 2?

So, evidently reflection is not as much of a conversation starter as taxes... who knew.

I heard on MPR this last week talk about Minnesota's tax system. I would have to admit that I don't know much about the tax system, nor do I have or want to take the time to learn the all their is to know. I do enjoy engaging in dialog and learning though. What I heard this last week is that Minnesota's tax system has become regressive, that is that those with lower incomes are paying lower taxes than those with a higher income. If I understand it all correctly, it seems like this is strongly related to business taxes. Anyway here is a link that tries to explain this.

http://www.taxes.state.mn.us/mntaxreform/presentations/21TRC-Rethinking-Smith-091908.pdf

So as I tried to learn a little bit more I ran across Governor Pawlenty's commission on tax reform for the 21st century, which by the way, we entered 10 years ago! The following is taken from that report-- thought maybe the "fair taxers" would enjoy:

"To thrive in today’s highly competitive global economy, Minnesota needs to encourage saving and investing. Economists and tax policy experts universally agree that taxation of personal consumption – not income or investment – is conducive to increased saving and investing."

The commission's recommendation was not to consider a "fair tax" but instead they suggested broadening the scope of sales tax to currently untaxed goods and services. In addition to this, they suggested lessening the tax burdens on businesses. Evidently, Minnesota's tax system is archaic and makes it very hard for them to recruit and/or encourage business development or expansion. The thought is that businesses pass on their tax burden to consumers and workers. By decreasing the tax burden, they could lower costs of products and increase wages/benefits. Not bad as long as that is the result.

Here is a link to the commission's report if you have the time and/or interest to read 50+ pages of GOOD STUFF.
http://www.taxes.state.mn.us/mntaxreform/reports/TRC_report_2009.pdf

--Red Neck View-- Minnesota is a state on the northern side of the United States, where REAL MEN spend their winters:) See you this summer?