Affordable care costs and benefits

healthcare-spending
The U S Chamber of Commerce and the Republicans continue their opposition to #Obamacare as an employment killer; fully knowing that the vast majority of the small businesses having less than 50 employees, do not come under the employer mandate of the Affordable Care Act. The Census bureau has identified over 26 million of these small businesses, who can become the engines of American job growth for the foreseeable future. In fact their employees will now be covered under the new act; and if they are below certain poverty thresholds, will get extra income to cover the gap, of getting health insurance from the government.
The health exchanges with their limited provider networks are here to stay. People who lived through the days of the HMOs, may support this new internet model, hoping to finally bring an end to runaway costs. Their main hope is to promote modernization through standardization, digitization of data, resulting in better analytics and health care and better outcomes and quality. Small businesses should thrive as the cost of health care will no longer be a factor, for reaping the rewards of their entrepreneurships and growth. The efforts should now focus on making more accountable and robust systems, as shown in the recent VA appointment delays shortcomings. The work is only starting but it is a good start and could lay a foundation; for how we take care of our people, in America’s next century. A number of technical factors like the roll out of Electronic Medical Records and the International Classifcation of Disease management standard codeset 10 will enable a far more accurate representation of medical encounters and case histories.
When hospitals, providers, pharmaceutical, device manufacturers, radiologists, payers and numerous other constituents; can come together in an open platform, it cuts down waste. By making the rates public and involving the individual to chose his\her health care, makes each one of us more accountable in reducing costs, and getting maximum benefitts. Finally the consumer of #healthcare has to be educated and must improve lifestyles, diet and involvement in preventive care; for the model to succeed even beyond what the administration has hoped for. Do I see a flattening of the curve already, or is it just my imagination?

Fifth of humanity

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Arundhati Roy has correctly stated that the open sore that festers all the country’s political bodies in #South Asia based on the division on religious lines by the British, now lies exposed to all when she says specifically in this last Indian elections “The two main parties agreed on most policies, and each had the skeleton of a mass pogrom against a minority community in its cupboard. So now, it’s all out in the open. The system lies exposed.”

The attack on the Indian consulate in Afghanistan where luckily no official died is a symptom of this disease. The killing of 60 people in Northern Waziristan a strong hold of the Pakistan Taliban, the killings in eastern India all show countries, in a war with themselves. To the credit of the countries the security forces have behaved admirably and performed their tasks well keeping the separatists and terrorists at bay. The fear mongers and nay-sayers will predict the worst for the future atrocities that humans are prepared to undertake in the defense of their religion or their community. For tribal societies homogeneity is not a preferred lifestyle as life is lived within the remote forests and valleys in their own distinct flavor. With democratic governments all across the SARC region the imagination boggles at the possibilities of a progressive state.

Will the economic ties be strengthened and the rule of law enforced so that trade and commerce can happen in open borders with trust and conviction?

Will cultural exchanges be encouraged so that we can all understand, how much we have in common and to gain collectively, if we all pool our resources and develop together?

Will we open up seamless trade between our traditional Indian Ocean neighbors from South Asia to the far east and Africa in the greatest development of trade ever imagined?

Will pipelines of energy flow into the starved heartland from Iran and Central Asia; so great enterprises can flourish, and tech cities be built to house the next generation?

Will the harnessing of 80% of the region’s water that flows into the ocean today, be saved for prosperity, before the Himalayan snow caps melt into history?

Will healthcare, education, human development and equality be the new standard against which a nation is measured; rather than the old ones of hate, ignorance, bigotry, caste and creed?

Will the infrastructure finally be built to crisscross the land; in 12 lane highways, superfast trains and modern airports, with the bridges, tunnels, ports and warehouses that are required for a modern life?

Will we be able to leapfrog to the internet of things; as while it too a long time to collect 550 million votes, we could count them electronically in just one day. By modernizing electronic communications – imagine what we could do for agriculture, housing, transportation, crafts and local products with open markets?

Will we generate employment for the millions; that will only spur us into an upward spiral of development and prosperity at a scale, that the world has never known before?

Questions that only time and a steely resolve to improve a fifth of humanity’s condition can answer, we can all join in the effort with a single step forward.

Growing inequality

Wealth distro“This massive concentration of economic resources in the hands of fewer people presents a real threat to inclusive political and economic systems, and compounds other inequalities – such as those between women and men. Left unchecked, political institutions are undermined and governments overwhelmingly serve the interests of economic elites – to the detriment of ordinary people.” Oxfam reports that the 85 richest people own as much as the poorest half of humanity put together.
The growing #inequality between the haves and the have nots continues to grow despite all the trickle down economics that was supposed to help the poor. There is no rising tide in the forecast that will lift all the boats and reduce poverty and provide the education and skills required to improve productivity. Those who have control of the property and assets will continue to reap rewards and those without will continue to struggle to make ends meet. Nation states will continue to protect their wealthy citizens as they control the nation’s wealth. All others are second class citizens and can be controlled with the laws of the state, if they step out of line to grab a fair share of their existence. Who ever heard of laws to help the homeless, insane, destitute or of our own folks in deep despair? The laws are written to protect the precedence of established #wealth and hierarchy, by the paid servants whether by political or economic patronage. Suspect all not for profits and charitable institutions, until you can see them working with the disadvantaged and for them alone.
Modern states have all the tools at their disposal to build a more equitable economy through the use of taxation and the dreaded words to conservatives “income distribution”. A more equal world will open up opportunities for half of humanity living in dire states and allow them to achieve what the 85 can never do on their own. I am no Robin Hood who would rob from the rich to give to the poor. I would instead advocate a path of growth and development where the state provides justice and the rule of law and national security and leaves the rest to the people. The use of taxation is to take from those who have been blessed with too much and use it for education, health care, shelter of the masses by providing the infrastructure for the people to build their own lives. People are resourceful and can solve their own problems and to create what they need, to leads a happier life. We do not need the Rich or the State to provide handout but rather help the individual to develop into a productive member of society.
The state should ensure that the roadblocks from outdated laws and political patronage, should be overhauled to provide more inclusive growth. This overwhelming inequality is a moral insult to all people who value human dignity and respect human freedom. Why force people to live out a life of subsistence and depravation when we have the means to raise them out of poverty and destitution. The cost of raising their standards is insignificant in the larger political economy; as if we stop our wars for even a year, we will be able to pay for it many times over. It is the price we pay every day that is too much; to have this #inequality fester, all over the human body. Given the opportunity people will become productive and lift themselves out of poverty and ignorance. Even history guides us as Greek-Roman historian Plutarch: `An imbalance between rich and poor is the oldest and most fatal ailment of all republics.` . Is the empowerment of 85 more important than that of 3,500,000,000?

Coexist and prosper

System Components

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The pursuit of happiness is an explicit goal laid out by the founding fathers of this nation; and the Homestead Act was the greatest law ever passed, as it allowed for the settlement of the wild lands of the west expanding the original colonies. The native Indian tribes were driven out and the European settlers brought with them personal property ownership, to what had been a largely communal land. This basic premise where ownership of land and all the resources below it belongs to a person; and not the state was the bedrock of American thinking, which lasts to this day. It laid the foundation for the greatest wealth creation that our times have seen, and changed the course of entrepreneurship and invention over the past few centuries.
Freed from the clutches of the state each individual was truly free to pursue his or her own development and lifestyle. All lands have their own resources but to explore and use those needs courage, determination, vision, steadfast determination and a risk taking ability. Majority of such endeavors may end in failures, but even if a miniscule portion of new projects are successful, they can change the course of our human condition for centuries to come. The latest example is the development of horizontal fracturing (fracking) of shale rock to release the natural gas and oil buried deep in our earth. As people own the land and its resources a new gold rush has started and an example is the remote state of North Dakota where unemployment is 2.6% and the economy is booming.
There is no other country which could have developed this, as it is a unique American characteristic that when faced with resource challenges, its innovators and tinkerers come up with ways to achieve new breakthroughs in how we think and do things. When the oil majors gave up on the US oil fields as too mature and moved their investments to offshore and to other countries; it was the wildcatters in Texas, who continued to pursue new ways to exploit existing resources. Last year alone 150,000 wells were dug to harness this technology in the US, dwarfing all other countries around the world. Majority of these were done by small unknown companies and individuals and have revolutionized American energy growth, while the rest of the world suffers shortages and high prices of gas. Even China which sits on one of the largest shale formations; with its huge state owned oil companies, is far behind and will take decades to catch up as it copies the technology.
The new industrialization of America based on cheap gas and oil will allow the country to continue to create #wealth and become energy independent and eventually the largest exporter of petro chemicals in the coming decades, while the rest of the world will continue to play catch up. It takes trillions of dollars to increase the GDP of America even marginally and thus innovation and continuous technological breakthroughs are required on a daily basis. The internet of things is coming and it will need more energy than ever before. The problem is that all these fossil fuels like coal, gas, oil are destroying our eco system and global warming is leading to an unsustainable planet, as we are destroying habitats and environments indiscriminately.
We are exterminating whole species and microorganisms on a scale similar to the extinction of the dinosaurs. The sad reality is that extinction of a species is final and billions of years of evolution die with it. We are destroying the oceans and the land and all living creatures are threatened by the indiscriminate growth of our species. We have no idea how nature works despite our huge scientific knowledge and research in various fields. The more we learn the more we understand that there is still much we do not understand, about the interdependence of life and creatures around us. The creationists would have us believe that we are created in God’s image; but do they even understand God’s compassion and his laws that are progressive, which allow the blossoming of nature in all its variety and complexity to develop. If we are created in his image then we should be better harbingers of our environment and must ensure that we become the custodians of His world, and everything that exists in it.
There are of course some scientists who have understood our interdependence on everything around us and are pushing for change. Renewal energy whether from solar, wind, biogas, tidal, fusion, fission, algae must be developed to wean us away from the carbon dependency of our addiction to cheap coal and oil. With seven billion humans and growing our energy and resource needs are assuming Malthusian proportions. Global warming has to be reversed or we will face mass extinction of more species of flora, fauna, microorganisms, animal and bird species with devastating effects on our own survival.
There is of course progress being made on renewal sources of energy across Europe, China and America and they are the main consumers of energy today. For example GE just confirmed orders for 3,900 MW for its wind turbines in the US alone, as they have become more efficient. Similarly the dormant nuclear energy industry is showing signs of renewal and new plants are being built again, though the problem of storing nuclear waste still remains. Solar is another area where giant strides can be made to harness the power of the sun to provide for our needs. More funding is required to make alternate energy sources available and also we need innovation to make existing transportation, habitats and lifestyles more energy efficient to reduce our carbon footprint.
My #hope is that instead of destroying each other, we need to find a way to coexist and prosper. The whole universe is available for us to grow, but if we kill our own blue planet then we will have nowhere left to call home. Human ingenuity and innovation knows no boundaries and we have a lot of work ahead of us still to do. In the pursuit of happiness we need to raise our compassion and love for all creatures, as that is the only sustainable path for our future and the generations to come.