Tag Archives: Medicare for All

Barack Obama, a Systems Thinker in the White House

President Barack Obama.

President Barack Obama.

In his State of the Union Address <video, transcript Englsh, en español>, President Obama said “The best anti-poverty program is a world classeducation

.” He described a positive, or reinforcing, feedback loop. Education enables people to accomplish more, earn more, and better educate their children, who also accomplish more and earn more. It is one of the most important differences between the populations of New Jersey and West Virginia. This is described in detail in Thinking in Systems, by Donella Meadows<link>, (C) 2008, published by Chelsea Green<link>, ISBN 978-1-60358-055-7.

The President also asked for a better health care plan. I can answer that in five words: “Single Payer; Medicare For All” <link>  just approved by the California Senate. Medicare works for my octogenarian father. Health Insurance Care doesn’t work for a 20-something friend of mine. He just graduated from college. He has no job and therefore no medical insurance. If he was a full-time student he’d be covered on his parents’ insurance. A simple reform would cover recent graduates until they find a job that pays a living wage and provides health insurance benefits. Another would be by expanding Medicare to cover all citizens. This is much easier said than done. Our medical care system cannot adequately care for approximately 50 million people – one out of six. This can’t be changed overnight – we need to train more doctors and nurses, and build more hospitals, but it must be changed.

Image showing mountain strip mined for coal.

Mountain strip mined for coal. Chris Dorst, Charleston, WV Gazette.

Energy is another set of systems problems. No one who has seen a once pristine valley after strip mining or “mountain-top removal”  uses the term “Clean Coal.” Countries like Denmark, Ireland, Israel, Japan, and Sweden built their economies with education not extraction of natural resources. As the President alluded to, conservation and clean, renewable energy technologies – solar, wind, geothermal, hydro – can be implemented faster, at a lower cost, and with fewer negative economic externalities than traditional fuel intensive resource based technologies like fossil fuel and nuclear power. This suggests another of the differences between New Jersey and West Virginia – the “Blessings of Education” versus the “Resource Curse” <link> from which economies built on extraction of natural resources suffer.

Arklow at Sunset

Arklow Bank Wind Park, off Arklow Bay, Ireland. Image courtesy Oneworld.net, UK.

The President needs economic advisors who start think in terms of ecological economics <link1 / link2>, of metrics like the Genuine Progress Indicator, GPI <link>, rather than Gross Domestic Product, GDP <link>. Simply put, ecological economics is neoclassical economics with a better understanding of the long term and of costs. Spending one dollar – or one trillion dollars – to clean up a mess is not as good as allocating those resources to build factories, houses, libraries, museums – the infrastructure, culture, and community of a nation.

Health Care – Medicare for All

I have a good full-time job. I buy the health insurance my Human Resources Dept tells me to buy. (This is not, by the way, a “free market” as described by Adam Smith, David Ricardo, John Maynard Keynes, Milton Friedman, and other neo-classical economists.) I pay enough that I could be driving a Hummer  about 2,400 miles per month (at current gas prices).

But my coverage is rationed by insurance company beancounters. When I need a doctor, I see one of their docs.  A complete physical is free once a year. It takes about two hours and 30 seconds – two hours waiting and 30 seconds in which the doctor says “You’re breathing. That’s good. You’re blood pressure is high, if it gets higher we’ll put you on meds.”

That’s ok, or what passes for ok. As long as I don’t get sick I’m ok. That’s why my blood pressure is high. I’m worried about getting sick. Or losing my job. Or losing my job and getting sick. In that case I’ll lose my house.

One thing I don’t worry about is that my father. He’s well over 80, and he has good health, and good health care. He’s on Medicare. It’s great. Efficient.  Government run. Not sexy like the Apollo Mission to the moon, but very important. And for the health care that my kids teachers get. They go to public school. The teachers are in the unions. And the health care is good. The kids too get good health care. My kids, my kids friends, even if their parents work but don’t get health care, then, thanks to Presidents Clinton and Obama, and despite the efforts and vetos of President Bush, they get health care.

But one of the things that really gets me, the thing that makes my blood boil – which is why I’ll need blood pressure meds – is that close to 50 Million Americans – one out of six – have no health insurance. And it’s people between the age of 18 and 65. People who work, or would work, if they could find jobs.  This is wrong on many levels. It’s not just that I have friends in that position, and that I was in that situation – working hard, falling backwards, no health insurance – barely able to afford food. According to Paul Krugman, in the New York Times, “many of the protesters who don’t want “Government Run Health Care” are on Medicare.” While that’s almost funny, it’s also very sad.