If Health Care Was More Like Flat-Screen TV's

We'd apparently all be getting treated in France:

Now don't get me wrong, I am just as much for the profit motive as the next guy, but the question I keep coming back to is simply why is the United States health care system so expensive?

I mean $116,796k for a bypass operation here vs. $11,916 in France? Really? Are we 10x's better at it than the Frogs?

If so, great!

Well I certainly don't know the answer, but if you're interested in finding out more, here's the CEO of Kaiser Permanente attempt at answering this very question in a recent interview with the Washington Post.

Part I

(Highlights include, "Why do we need private insurance companies?" "Do we have a competitive market in the US?" "Why is the US system the most expensive?")

Part II

(Highlights include, "Do you believe that the problem is 'fee-for-service'?" "How will electronic medical records affect the delivery system?")


Favorite exchange:

A number of the organizations that are considered the best and most cost-efficient in the United States – Kaiser, Mayo, the Veteran’s Health Administration – are integrated at a level that’s really quite rare. Normally, you’d expect that to give them a competitive advantage, and they’d eventually take over the market. But that doesn’t seem to happen. Why?

Well, the VA has its own population. When you look at the Mayos of the world, they’re doing well. They have a good business model that’s working for them. But everyone else has a good business model that’s working for them, too. There are $2.5 trillion in this market. There’s no reason, if you have a comfortable cash flow, why would you do hard things and heavy lifting to get to a different model? That’s one reason I’ve been such a strong proponent of exchanges. I believe we need a truly competitive market for insurance.

Great stuff!

The Texas State Government is Inefficient

Before heading out the door to start our Thanksgiving holiday, my plan was to spend a few seconds filing my annual vehicle registration renewal for the state of Texas. As I was about to pay the fee however, I stumbled across something that was too good NOT to pass along.

Keep in mind this is the cost to register ONLINE:

(A 38% tax rate on vehicle registration? Reflectorization? A mail-in fee for online
registration? Rick Perry has some splaining to do.)

You should immediately notice that all of these fees add up to a ridiculously high tax rate of 38%. Now take a second to reread line #3 and #6.

Go ahead I'll wait...

That's right the Texas Government found the time to pass a budget resolution that tacked on $0.30 per vehicle for "Reflectorization." Not only does this seem like a complete waste of tax payer money, but as I finished typing the word reflectorization, my spell-check informed me that it is in fact NOT A REAL WORD!

If you're telling me that it costs $0.30 to add the reflective skin onto a window decal, shouldn't that be included in the cost of the decal? What am I missing here? Also, $1.00 "MAIL IN FEE" for an on-line payment? How is this legal?

And I feel as though I should inform you that the cost to file this IN-PERSON is $52.80, while the cost to MAIL-IN the form is $53.80. In other words, according the state of Texas, it is cheaper in the aggregate to staff a window full of people forced to interact with irritable (at the moment anyways) vehicle owners such as myself than it is for the US Postal Service or the Internet to consolidate each of these transactions.

It's as if the technological achievements of the past 20 years have only served to INcrease INefficiencies in delivering information to end users. Unbelievable!

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Thanks for listening, now back to your regularly scheduled Thanksgiving holiday.

Where Should I Eat Fast Food?

The holidays are quickly approaching, with Thanksgiving now only a few days away, which depending on who you are can mean a lot of time on the road.

Andrea and I for example will spend the first half of the week here in DFW and then head up to Tulsa, OK to see our new nephew for the first time as well as the rest of my family.

That's the good news.

The bad news is that we both love to eat. A lot.

Thankfully Andrea hates fast food due to the high calorie count and overall negative nutritional effects. I however love fast food due to its high levels of deliciousness. So naturally an argument or two is inevitable.

If you have similar conflicts arise during your holiday roadtrips, I thought I'd do my friendly blogger duty and pass along this helpful decision tree for you to take on your next roadtrip.

Enjoy!

Congress: S-A-T-U-R-D-A-Y NIGHT!

Today marks a "major" milestone in the Senate. Now I'm not sure why Congress is all about Saturdays lately, but to help explain the "" around major, here's Ezra Klein:

Little will illustrate the absurdity of the filibuster as neatly as tomorrow's vote. This is not the vote to pass the bill. It's the vote to begin considering the bill. Changing the bill. Amending the bill. Recall that the purpose of the filibuster is to protect debate and ensure that members can make their opinions heard and ensure they have an opportunity to add their ideas to the legislation. Tomorrow, however, 40 Republicans are expected to use the filibuster to close off debate and ensure that no more opinions are heard nor changes considered. The right to unlimited debate has become a tool for cutting it off.

Just in case you don't find that as noteworthy as I do, you might enjoy the fact that the Senate bill is described as a proposal “To amend the Internal Revenue Code of 1986 to modify the first-time homebuyers credit in the case of members of the Armed Forces and certain other Federal employees, and for other purposes.”

Wording that seemed odd until the interwebs informed me that it is is a Constitutional requirement that these types of bills originate in the House of Representatives.

You're welcome.

(Title Inspriation: The Bay City Rollers)

The Worst Commerical of 2009

Undoubtedly goes to the GAP's GO HO HO:



I'm still trying to figure out whether it's the Joaquin Phoenix-esque rhyme scheme, the inclusion of "solstice" with the 3 other December holidays, or the guy doing the jump-shimi thing at the 0:17 mark that really gets under my skin, but feel free to leave your thoughts in the comments in the meantime.

How We Hurt By Helping

Have you ever heard of the Poverty Trap? Me neither.

Thankfully Greg Mankiw is here to help:

He goes on to conclude, "The Bottom Line: If you are poor, the government is inadvertently ensuring that you have little incentive to try to improve your condition." Of course one could also conclude that "The Bottom Line: If you are poor, the government will ensure that your family will not starve" but that retort only leads us into a means vs. ends conversation that I find extremely boring.

Not to mention the fact that I tend to agree with both assertions.

So instead I'll turn to a new book from the Brookings Institute entitled Creating an Opportunity Society, co-written by a former Bush adviser, that reveals one very sobering fact:

42% of American men with fathers in the bottom income quintile remain there as compared to: Denmark, 25%; Sweden, 26%; Finland, 28%; Norway, 28%; and the United Kingdom, 30%. They present a wealth of new and old research evidence to support the conclusion that if you're born poor in America, you're likely to remain poor.

The book ignores the traditional left-right divide to arrive at a set of policy recommendations that are novel only in the comprehensive and non-partisan way in which they are presented (via Pete Davis):

• We start out life with advantages and disadvantages which are hard to alter.
• We underinvest in the disadvantaged.
• Personal responsibility it very important.
• Promoting education, work, and family is very important. Convince disadvantaged kids at an early age that they need to go to college, develop a strong work ethic, and get married. Policy incentives aren't enough. Publicity campaigns are needed to change attitudes.
• Government should do more, but it can't do it all.
• Slow the growth of benefits for the elderly to fund a $20 billion per year program of specific policy changes, including some spending cuts.

But don't take my word for it, click here for the full summary. My intention here is simply to raise awareness to the fact that there are no easy answers, and that oftentimes it is the unintended consequences that can have the greatest impact. However with half of American kids set to live in households that receive food stamps by the age of 20 , this is a problem we cannot afford to ignore.

Let's hope the administration is paying attention.

Travel and Leisure Inspires New Dallas Slogan

"Dallas, where white people go to buy designer shoes."

(via: Travel and Leisure Magazine)