I should be reposting some snf.me material over here shortly and hopefully I'll get time to work on the issue at hand.

The crux of this whole debate goes missing, though.  I have yet to hear people explain the reason why we are in the situation we have today.  That situation is constantly rising healthcare costs and a system whose transparency is that of a wet bedsheet.  No one knows what is going on.  The patient doesn't know what type of costs he will incur when visiting the doctor.  The doctor doesn't know what a procedure will charge when he orders it done.  The administration of the health care organization only worries about how and whether they will be paid.  In the mean-time, no one gets the entire story - least of whom, the patient. 

Let's talk for a short moment about health insurance.  Why is it so expensive?  Why can't we start to deal with those costs?  Yes... why?

"American health insurance is more expensive because private insurers compete within state markets, not regional or national markets.  The easiest way to encourage competition [and immediately lower costs] is to let the general public choose from competing private plans in a national market, just as federal employees do.  To make this so-called national "Health Insurance Exchange" work, Congress is exploring new rules to increase the reliability and transparency of private insurance plans.
However, many of these new rules are likely to make health inflation worse, not better.  Health-policy analysts call these regulations mandates.  Mandates are the earmarks of the health-policy world.  In the past, state lawmakers added insurance mandates to various laws, forcing plans to cover specific services and providers.
Thanks to mandates, insurers in one state (New Mexico) must cover oriental medicine in every insurance policy.  Two states (Washington and Minnesota) require coverage for "port wine stain elimination."  Three states have mandates for athletic trainers.  Twelve states force insurers to cover acupuncture.  Fifteen states force insurers to cover in vitro fertilization.  In these and hundreds of similar cases, insurance mandates distort prices upward to reward different political agendas - and consumers pay.
Consider Wisconsin and New York.  New Yorkers pay $12,000 for a basic insurance plan that would cost $3,000 in Wisconsin.  The difference?  Wisconsin has 34 mandates.  New York has 51.  By one estimate, mandates and other health regulations drive up the cost of premiums by 20 to 50 percent." (emphasis mine, p. 16 "Why Obama's Government Takeover of Health Care Will Be a Disaster" by David Gratzer)

As I write this, Wisconsin is considering (or may have already voted on) another mandate: coverage of mental health care.  So, if I don't care about the cost of mental health care and want a plan that doesn't offer it (so I can save money)?  Too bad.  I have no choice.  I am forced to pay a premium that I don't value and am not interested in using.  Thank you Wisconsin legislators.

The frustrating element of these debates is a lack of introspection.  There is a perverse lack of understanding as to why costs are what they are.  Instead, we are focused on outcome.  Changing the outcome of a misunderstood problem is like taking a bat to the golf course.  Sure, you'll be able to hit the ball.  I doubt, however, you will do so effectively.

"Member of Congress in both parties defend the use of earmarks and say that they are often for worthy projects.

Among the earmarks in the Defense bill: $18.9 million for the Edward M. Kennedy Institute for the Senate sponsored by Sen. John Kerry (D., Mass.); a $23 million item for the Hawaii Healthcare Network, sponsored by Senate appropriations chairman Daniel Inouye (D., Hawaii); and a $20 million appropriation for the National World War II museum in New Orleans, by Democratic Sen. Mary Landrieu and Republican Sen. David Vitter of Louisiana.

Ms. Landrieu said she was "proud" to secure the museum funding, which will pay for a new wing for aircraft, tanks and landing vehicles used during the war.

One of the larger spending items is a $300 million appropriation touted by Reps. Jim Moran (D., Va.) and Chris Van Hollen (D., Md.) to improve their region's overstressed transportation system. The road widenings are justified by expanding operations at area military facilities, including new hospital facilities."

Even if I were ok with the type of spending that takes place, I question the reasoning behind putting any of this in a defense spending bill. By its very name, one would expect that a defense spending bill is on defense, right? Apparently one can fund healthcare facilities, museums, airports and roads and jobless benefits and rent seeking companies and... Through defense spending.

Mr. Obama promised transparency and promised an end to this type of childishness. I understand that changes in long standing practices are not made overnight. On the other hand, many families in our country have found themselves without any income to speak of. Weren't they, by nature of their situation, required to make drastic changes in their practices and behavior? Apparently their representatives think it unnecessary to follow through on pledges, let alone act in a responsible manner.

If the spending is so necessary and so justified, bring it before Congress and the people in an open and transparent manner. Vote on it as it stands alone and let it live or die on its own merit.

(via Defense Bill Earmarks Total $4 Billion )

"One of the irritating things about Klein and her ilk is their hypocritical behaviour. They gain personal wealth because their best-selling books are published and distributed by large multinational businesses (HarperCollins, Costco) and are funded by risk-taking investors.

Similarly, their newspaper columns are funded by advertising revenue from companies. They make their way around the world by buying and using the modern technologies (computers, the internet, Boeing 777s and Airbus A380s) supplied to consumers through globalisation and markets.

They live in political regimes which protect freedom of speech and association. Yet the end result of their ideas, were they to become reality, would be to deny these markets, technologies and ideas to the people of the world." (link to article)

It never ceases to amaze me how prophetic the statists are and their Orwellian double-speak - oh wo are the people who operate under the iron fist of liberal markets and minimal government. Klein and her ilk talk of the doom and gloom of commercialism and free markets and yet so much of what they do and the luxuries they enjoy depend directly upon the largess of a free culture. Klein's absurd notion that Friedman's philosophy can only be enacted through coercion is typical for her peers. There are days when I can't believe we are still fighting against such patent lies.

Under the circumstances, actions that impose sizable hidden taxes on American citizens should be put on hold, or at least exposed to much more careful evaluation to be sure their merits outweigh their costs and burdens on our struggling economy.

It doesn't surprise me that Dudley and Rosen were former members of White House budgetary staff. My comment is simple: Americans are already under far too much regulatory and tax burden. We should be subject to no more. Ever.

We revolted against King George III over a 3% tax in the 1700s (yes, it was far more complicated, but many argue that that was the straw that broke the camel's back). Serfs to the monarchy and feudal ruling class were subject to what we view to be abhorrent taxes up to 25% of their income. Those paying income taxes in the US (remember, there is a whole class of citizenry who doesn't pay income taxes - and I am not speaking of the IRS defined poor) can pay upwards of 52% of their income in taxes (that does not include sales, property and any local taxes).

Those who pay, pay too much and we need to stop making excuses as to why more is not necessarily bad. It is bad and it ought to stop.

Mr. Obama, you promised a lot of things. Many of these things I wanted nothing to do with. These two things, though, are ideals that I not only support you on, but strongly believe are the cornerstone to a good democracy and a strong republican government (small 'r' not big). (Surprisingly, there were many other things that I support you on, but these two took front and center of attention because they seemed to be a common cause between friend and foe in the political arena.)

Neither of these things have happened. We have seen some of the largest pork-barrel laden bills passed in your first 100 days. These were called stimulus packages meant to help the economy. I don't see how earmarks and a public fountain for a park in some city in Missouri is supposed to help the economy. The mess we are in is because of reckless spending on the back of reckless borrowing. Borrowing more to spend more recklessly doesn't seem to me to be the solution.
And the transparency - in the form of waiting periods so that public input could be given before bills were passed by you and Congress - doesn't seem to be gaining any traction. I thought an informed public was the most equitable way to govern.

Maybe I misunderstood what change meant. I thought it meant different than things are or were. It doesn't seem to me that much has changed. Maybe someone can tell me where I went wrong.

The thoughts I have now - especially nearing what we are hoping as much as any one (or many) can hope - are those along the lines of whereto from here? I don't want to continue down the same path. Despite what has happened, there would be something else prompting this thought - some other happening, some other occasion - but I rarely have the strength or courage to say it out loud. Steph having cancer was a shock and regardless of the outcome (and for those reading this and who are not in the know, the outlook is fantastic) it changes things forever. I know that life will go back to some norm when this is all over, but I have a feeling that some hint of the aftertaste of the experience will follow us for the rest of our lives.

So, the big question that awaits an answer is which thoughts will have the greatest consequences? Every few days or weeks, I move in and out of a shell. There is a period of time where the only thing I can concentrate on are Steph and what it means to care for and watch someone go through the things she has endured and then the shell-shock of experiencing the world around me as I come out of the cave. The reality of today - each time I return from my retreat - is disturbing, at best. For years, the change towards the problem is someone else's has been gradual. What I mean is the subtile changes in average the average citizen's opinion that someone else will be held accountable for their failures (but of course, not for their successes - for that they alone are responsible). I'm scared by the constant move towards collectivism - as if, it is the only solution out there - and this move is brash in some instances and very meek in others. But, the march goes on.

Through life's experiences, you are confronted with those big things. Everyone is. The big things have always made me go back to wanting to take my own responsibility for my actions and the regret of having bowed to the opinions and advice of others when it was really my (or my and Steph's) opinion(s) that made the biggest difference. The subtile message was that, we, as individuals, knew best. As we move forward, picking up certain pieces, it is hard not to see where we mistakenly took the advice of others because of a certain respect we thought owed to them (for whatever reason). Luckily, these were not big mistakes and life has treated us well. But, they have been important enough decisions to have made a difference.

I want to change that. I know I can't always make my own decision. Survival (the type I would like to continue to enjoy) requires some amount of pragmatism. I stand before the precipice of which thoughts?

"The Journal Sentinel reported last year that eight of the 20 top-paid correctional officers in 2006 called in sick for a shift and then worked the immediate next shift at least once. Those employees earned eight hours of regular pay for the time they were off and eight hours of time-and-a-half pay for the shifts they worked."

What is being described here is not working overtime. This type of scheme makes my head spin. How does someone who hasn't even worked their normal shift receive overtime hours for showing up to the next shift (forget the idea of having to reach 40 hours before receiving overtime because many places - including our company - you receive overtime pay for working beyond your shift)?

In the end, I think the focus on overtime in it and of itself is completely misguided. Already trained workers being paid time and a half for overtime hours are likely to be more efficient and conscientious than someone who has been hired solely because too many overtime hours have been worked by the current staff. When we look at the details, however, of how overtime is defined, the question that needs to be asked is, "what is the state thinking?" And, if this type of financial behavior exists with something as simple as defining overtime, imagine what other types of ridiculous indiscretions take place.

via 25 State Workers Earned More than $50,000 in Overtime in '08 - JSOnline

One thing struck me more than anything: we have all but forgotten about individual property rights. By that, I mean, the general idea that when you own something, you may do with it as you please. As we all know, this is never cut and dry. While I own my car and it is more than capable of traveling at speeds of well over 100 mph, I cannot legally do so. So, on one hand, I may take a hammer to my car and destroy it if I wish, but I may not always use or treat it in the manner that I see fit. The problem that I have with the mentality on display tonight is that of the creep effect. Once it is allowable to dictate what one is able to do with his or her thing in one particular instance, It must be acceptable to decide for them what they may or may not do in another setting. This mentality has the inevitability of creep... It creeps into everything.

The flip side to this story is that of two events that have truly made me smile. The first is a simple one: people voted... and a lot of them. (I'm sure there were plenty of duplicate and dead voters, but I guess no system is perfect.) I've always been raked over the coals by my German friends at the lack of voter turnout in our presidential elections. Thank you American friends for actually going to vote! Now I have something to brag about. Sure, we could do better than 60% (I hope the real numbers - once all of the votes are counted - are higher), but that is pretty amazing, considering I've read that turnout has been as low as 30% in the past few decades. And that's just sad... So, despite having to chose between two left leaning senators, I'm happy people tried to make the choice.

The second thing that really, truly made me smile was this: A. voted. I gave an employee (who is a contemporary) shit yesterday because I heard him say that he doesn't vote. I badgered him ... I even offered money ... not to vote a particular way, but to simply vote. I really didn't think much of it. I thought he'd take his raspberries and shake them off. This morning I was left with the following note on my desk:

"Steve,

Here's your sticker buddy, and if you need any questions answered ask away!

For real - I just wanna say thanks for pushing me to vote. I never had in my life, so I just felt a 'lil weird. Now that I have, it felt pretty good. So, for it being my first time I just wanna' say thank you.

A.

And it really wasn't hard at all & only took 5 min of my time!"

If that's all it takes to get people out to vote, I should have given everyone in the shop a hard time... That would have been at least 100 more people at the polls. There's always next election.