Monday, January 29, 2007
Less hesitant statements
I just recently saw Dr. Dowd’s video from his website (www.dowdforpittsburgh.org), the short version of his campaign announcement. The extent of my involvement in his campaign has pretty much been documented here, I have yet to go to his campaign headquarters, or do any volunteering (if I am so inlcined). But I want to say that he is saying, if not all the, then many right things, in my opinion. I am cynical about politicians and politics, how can you not be if you spend any time following politics? But I try to look with a clear enough eye to see that mostly this time is no worse, if no better, than any time in a variety of pasts, stretching from my lifetime on back. Which is to say my cynicism is itself tempered with a realization that all politicians are people, and therefore none should be seen as a saint. But some are better than others. If Dr. Dowd’s record is a short one and not from council, at least he is saying right things. If he is only able to follow through on one or two of what he is talking about, such as putting in place public measurements of city government progress or fighting for public transit, then Pittsburgh will be a better place. Or at least no worse than it is now. If that sounds like damning with faint praise, from experience I will say that faint progress is pretty well miraculous for most politicians. The ones around here seem trapped in the old time union rust belt mentality, so any new point of view is worth taking a look at. In my opinion.
Saturday, January 27, 2007
Health care
I posted this puppy largely verbatim over on Fester’s Place, in response to his post on the difference between US and over developed nations health care costs.
There was an article in the NYTimes a few days ago; the guy who created the “South Beach Diet” turns out to have been a cardiologist for years before he created the SBD. He opened a practice after his books first came out, and in it his doctors and nurses actually spend a lot of time with patients, work with them on diet and exercise, in other words, those low cost things that help us stay healthy, statistically speaking. And in his practice, according to what he tells the Times, there is very little uncontrolled heart disease (he is claiming rate something like point three percent of his patients had a heart attack last year). And he finds that his practice loses money in a big way.
Private medicine turns out to have little incentive to push preventative care. Your doctor makes a lot more money if he talks to you only for a moment and otherwise interacts with you through expensive tests, procedures and drugs. The people who do have the incentive to push preventative care, unfortunately, have no traditional role in health care: the government and your employer.
Health insurance companies, to some extent, certainly do have an incentive for you to pay premiums and not submit claims. And the best preventative care program I ever saw was at Blue Cross (now Highmark) offered to employees when I worked there. But I suspect that Blue Cross and Aetna and UPMC and so on would be worried they would eventually have to reduce premiums if fewer claims were submitted.
I personally would like to see a candidate for City Council (hint, hint) incorporate these ideas into his platform; that city employees and retirees would be put on an aggressive wellness program, to reduce costs across the board. Not only would the city benefit, but it could serve as a showcase plan for what is possible.
There was an article in the NYTimes a few days ago; the guy who created the “South Beach Diet” turns out to have been a cardiologist for years before he created the SBD. He opened a practice after his books first came out, and in it his doctors and nurses actually spend a lot of time with patients, work with them on diet and exercise, in other words, those low cost things that help us stay healthy, statistically speaking. And in his practice, according to what he tells the Times, there is very little uncontrolled heart disease (he is claiming rate something like point three percent of his patients had a heart attack last year). And he finds that his practice loses money in a big way.
Private medicine turns out to have little incentive to push preventative care. Your doctor makes a lot more money if he talks to you only for a moment and otherwise interacts with you through expensive tests, procedures and drugs. The people who do have the incentive to push preventative care, unfortunately, have no traditional role in health care: the government and your employer.
Health insurance companies, to some extent, certainly do have an incentive for you to pay premiums and not submit claims. And the best preventative care program I ever saw was at Blue Cross (now Highmark) offered to employees when I worked there. But I suspect that Blue Cross and Aetna and UPMC and so on would be worried they would eventually have to reduce premiums if fewer claims were submitted.
I personally would like to see a candidate for City Council (hint, hint) incorporate these ideas into his platform; that city employees and retirees would be put on an aggressive wellness program, to reduce costs across the board. Not only would the city benefit, but it could serve as a showcase plan for what is possible.
Monday, January 22, 2007
Mayor Luke and, seperately, health care
Just some things, freehand, off the top of my head. First, I just read a comparison between Clinton and Mayor Luke (from the “People’s Republic of Pittsburgh”?). Good comparison; what was her name, Linda Tripp? There’s always a Linda Tripp. There probably don’t get what they want out of snitching, but the point is they do. Mayor Luke has had two controversies in a few weeks, between the McNeilly/Reagan thing and now the stadium incident. In both situations the most important thing is that Mayor Luke has shown poor judgment and political skills. It is stating the obvious that he is young, but there it is. I caught him on Delano’s Business report Sunday morning, and he is just not that impressive a speaker, at least off the cuff. The fact that he is in fact college educated just shows how little a BA is worth today.
Apparently Bush’s Saturday radio broadcast called for health care/insurance reform. It is being seen as a precursor of the State of the Union. It sounds like Bush wants to go further down the road of people using HSA’s as their health care./insurance mechanism. What’s new is that, incredibly, Bush complained about people who opt into better health insurance plans. He called them “gold plated” and wants to tax high end plans. Well, all this is what Krugman said in his column today, I am making the assumption that it is true. More later…
Apparently Bush’s Saturday radio broadcast called for health care/insurance reform. It is being seen as a precursor of the State of the Union. It sounds like Bush wants to go further down the road of people using HSA’s as their health care./insurance mechanism. What’s new is that, incredibly, Bush complained about people who opt into better health insurance plans. He called them “gold plated” and wants to tax high end plans. Well, all this is what Krugman said in his column today, I am making the assumption that it is true. More later…
Tuesday, January 16, 2007
Pat Dowd part deux
Must ... resist ... urge ... to ... start ... post ... with ... "So". (should resist urge to be Shatnerian)
errrr, I have to say the Dowd campaign got back to me in an actually fairly timely fashion. And Yahoo promptly dumped their emails into my spam folder (they call it bulk mail, as if I should avoid internet launched packages ...). Yahoo also dumped the work schedule for the part time tax job into the bulk folder. Of course, I missed all those messages for several days. Well, I just need to be vigilant with the spam folder. Dowd’s campaign manager had read my blog post (Google?), and suggested I call if I had other ideas (call? not email? but email never has problems). Nah, those ideas I put in my last post were pretty much it. If I can’t think on a big scale, I tend to get bored and unfocused. But she said they want to be an idea’s campaign, and I think that’s a great thing. Definitely a way to distinguish themselves from Mr. Bodack and the traditional democratic infrastructure. Might dovetail with the upcoming Peduto campaign, but doesn’t have to.
errrr, I have to say the Dowd campaign got back to me in an actually fairly timely fashion. And Yahoo promptly dumped their emails into my spam folder (they call it bulk mail, as if I should avoid internet launched packages ...). Yahoo also dumped the work schedule for the part time tax job into the bulk folder. Of course, I missed all those messages for several days. Well, I just need to be vigilant with the spam folder. Dowd’s campaign manager had read my blog post (Google?), and suggested I call if I had other ideas (call? not email? but email never has problems). Nah, those ideas I put in my last post were pretty much it. If I can’t think on a big scale, I tend to get bored and unfocused. But she said they want to be an idea’s campaign, and I think that’s a great thing. Definitely a way to distinguish themselves from Mr. Bodack and the traditional democratic infrastructure. Might dovetail with the upcoming Peduto campaign, but doesn’t have to.
Wednesday, January 10, 2007
Pat Dowd for something ...
So, something of a gearshift from my usual nationally oriented posts. Last week I got a flyer saying Pat Dowd is running for City Council in my district. Being who I am, I noticed right away there was no website address. There was an email for Mr. Dowd (not his campaign, supposedly, him), something like Patrick @ dowdforpittsburg.org. No “h” on Pittsburgh. So I tried www.dowdforpittsburgh.org and there it was. There were other problems, though, in email addresses on the website itself that bounced.
But what was sort of cool was that Pat Dowd went door to door in my neck of the woods (Stanton Heights) on Sunday, so I got to meet him. And he remembered me from one of the emails I had sent. And he had already fixed at least the flyer.
So we chatted for a while, he got going and then suddenly exited himself (I expect he had a lot of ground to cover and couldn’t afford to stay any one place for too long). What we chatted about was not that impressive. He is running in part on his record on the school board. I gotta to say I don’t see the connection. He talked about the level of long term debt the city has (its high, I’ll take his word for it). He didn’t mention a specific solution, but referenced the notion that outside entities are more likely to help you when you have a more professional council. He made the connection between the school board before he came in and its troubles with the foundations and now. This is the way he is running on his record. He talked about metrics, about getting more information out about the city. And we talked a bit about the 311 number. He agreed Mayor Luke had done some good things, but maybe we need to do better.
I have to concede, I may not have gotten all or any of the points Mr. Dowd was making, or where he was going or trying to tie things together to. He may have been more subtle than I was ready for.
So I’m not totally convinced, but I’ve never even met Len Bodack, he has not gone door to door in my neighborhood. I don’t know that I agree with all of Mr. Dowd’s positions, actually I don’t know hardly any of them. But I don’t know any of Mr. Bodack’s at all. Dr. Dowd has a doctorate, I believe Mr. Bodack did not finish an undergrad.
What I would like to see Dowd do is step up to some politically neutral but technically smart *policies*.
Let’s see the city alter it’s healthcare plan by requiring employees, retirees and any family covered to get a yearly physical, and also to participate in a healthy lifestyle program that examines health factors like cholesterol, weight, exercise and whether you smoke, and rewards those employees with parameters considered healthy. The reduction in absenteeism and possible increases in productivity would be well worth it.
Let’s see an expansion of the 311 lines hours, and expand it to take non-emergency police calls.
Let’s look at whether adopting the European style of road work, where the road bed is more extensively prepared than it is here, might yield a long term cost savings.
Let’s have the city set what examples it can, with maybe hybrid cars (maybe just the Ford Escape, since we need to buy American) and what ever other green technologies can be found. CMU and Phipps could provide input.
So there’s stuff Pat Dowd can do, and I will do my part to nag him, if he gets elected. But it seems pretty likely he is going to get my vote anyway. I hate politicians because they always break your heart, but in the end I can’t claim to be any better of a person (and usually a worse one). There might be high expectations for Pat Dowd, and that might mean a bigger letdown. But at the end of the day he is still preferable to Mr. Bodack.
But what was sort of cool was that Pat Dowd went door to door in my neck of the woods (Stanton Heights) on Sunday, so I got to meet him. And he remembered me from one of the emails I had sent. And he had already fixed at least the flyer.
So we chatted for a while, he got going and then suddenly exited himself (I expect he had a lot of ground to cover and couldn’t afford to stay any one place for too long). What we chatted about was not that impressive. He is running in part on his record on the school board. I gotta to say I don’t see the connection. He talked about the level of long term debt the city has (its high, I’ll take his word for it). He didn’t mention a specific solution, but referenced the notion that outside entities are more likely to help you when you have a more professional council. He made the connection between the school board before he came in and its troubles with the foundations and now. This is the way he is running on his record. He talked about metrics, about getting more information out about the city. And we talked a bit about the 311 number. He agreed Mayor Luke had done some good things, but maybe we need to do better.
I have to concede, I may not have gotten all or any of the points Mr. Dowd was making, or where he was going or trying to tie things together to. He may have been more subtle than I was ready for.
So I’m not totally convinced, but I’ve never even met Len Bodack, he has not gone door to door in my neighborhood. I don’t know that I agree with all of Mr. Dowd’s positions, actually I don’t know hardly any of them. But I don’t know any of Mr. Bodack’s at all. Dr. Dowd has a doctorate, I believe Mr. Bodack did not finish an undergrad.
What I would like to see Dowd do is step up to some politically neutral but technically smart *policies*.
Let’s see the city alter it’s healthcare plan by requiring employees, retirees and any family covered to get a yearly physical, and also to participate in a healthy lifestyle program that examines health factors like cholesterol, weight, exercise and whether you smoke, and rewards those employees with parameters considered healthy. The reduction in absenteeism and possible increases in productivity would be well worth it.
Let’s see an expansion of the 311 lines hours, and expand it to take non-emergency police calls.
Let’s look at whether adopting the European style of road work, where the road bed is more extensively prepared than it is here, might yield a long term cost savings.
Let’s have the city set what examples it can, with maybe hybrid cars (maybe just the Ford Escape, since we need to buy American) and what ever other green technologies can be found. CMU and Phipps could provide input.
So there’s stuff Pat Dowd can do, and I will do my part to nag him, if he gets elected. But it seems pretty likely he is going to get my vote anyway. I hate politicians because they always break your heart, but in the end I can’t claim to be any better of a person (and usually a worse one). There might be high expectations for Pat Dowd, and that might mean a bigger letdown. But at the end of the day he is still preferable to Mr. Bodack.
Monday, January 08, 2007
You know, my last post requires some revisiting. Ford may not have been a cheerleader in chief, which is why (I think, and off the top of my head) Whip Inflation Now really had little force behind it. But the 60 minutes story on Betty Ford reminded me of what an extraordinarily decent man Gerald Ford was, which is a thing in itself. If only Nixon could go to China and Bill Clinton could reform Welfare, maybe only Ford could pardon Nixon. Anyone else, and the Congress might well have stepped in to nullify the pardon, or do some other thing.
And Ford brings us back to Vietnam. Frank Rich actually nails my thoughts fairly closely (usually he is a bit too much for my tastes). The issue of this surge is Vietnam versus Czechoslovakia. When the Soviets invaded Czecko in ’68, they dropped on them like a ton of bricks. If this “surge” is not a ton of bricks, then it is more like the escalation in Vietnam, giving an enemy more targets, and turning neutrals or friends into enemies. Lindsey Graham, on Meet the Press on Sunday, kept asking whether we want to think about what happens if we lose in Iraq. He didn’t want, I think we have to now.
And Ford brings us back to Vietnam. Frank Rich actually nails my thoughts fairly closely (usually he is a bit too much for my tastes). The issue of this surge is Vietnam versus Czechoslovakia. When the Soviets invaded Czecko in ’68, they dropped on them like a ton of bricks. If this “surge” is not a ton of bricks, then it is more like the escalation in Vietnam, giving an enemy more targets, and turning neutrals or friends into enemies. Lindsey Graham, on Meet the Press on Sunday, kept asking whether we want to think about what happens if we lose in Iraq. He didn’t want, I think we have to now.
Saturday, January 06, 2007
I am going to try for two points here, before I try a long run on the Nordic Trak. First, Brent Scowcroft’s Friday contribution to the NYT essentially endorses a “surge” of troops, the new term for putting in the number of people (or closer to the number) that we should have had in the first place. And I am firmly in this camp. Now, maybe reality does not support the policy, maybe there are too few troops. And maybe this is too late (if it is also too little, then I don’t support it). But I think Iraq needs a period were violence is a lot more difficult. I don’t care if we bus Iraq trainees to Jordan or France, so they have to show up for training, for six weeks or six months or even two weeks. If, after a period of relative calm, the Iraqis can’t get it together, then we can say we (sorta) tried. But right now we are relying on the restraint of Iraqi insurgents, since we have too few troops in country, and that’s pretty silly.
The mania for Gerald Ford retrospectives goes on, and I want to throw my two cents in. We need a man like Ford today, but not particularly as President. Far more we need him as Speaker of the House or Senate Majority leader. I am still not reconciled to the notion that the President needs to be a bully, but I am coming to realize that the President needs to try to set an agenda, and you need to speak out to do that. I don’t know how Ford worked exactly in the House, but I believe he was one of those old time operators who worked without an agenda except to serve his district and his party, over the long haul. That means making deals with the other side time and time again. If you have to reneg on the deal, you have to be able to explain it. This is the thing, though. A reporter on Washington Week told the story of how Ford, as president, made a point of inviting George McGovern to a White House Dinner. McGovern remarked that he had not been to the White House in either the Johnson or Nixon years, and Ford replied simply that he knew that. And that is a fine thing, in fact it reminds me (in contrast) of Cheney’s famous use of the F-word with Pat Leahy. Cheney apparently didn’t spend enough time in the House to know that you deal with these people again and again (and now Pat Leahy is chair of Senate Judiciary). But at the risk of sounding contradictory, I think Ford was too far in the direction of conciliator. Some blog I read (Tube City? The Conversation?) suggested Ford was a best an average President. I have agree with the sentiment if not the reasons. I think was unused to the spotlight, was maybe more of a behind the scenes guy. Well, if you are President I think you have staff for the behind the scenes stuff. I remember someone saying the Clinton often struck people as the smartest guy in the room. If he paid attention to you, you felt the weight of it and the sense of gratification (that a smart guy thinks you idea is good). I have heard similar things, strangely, about Nixon. Obviously it would be different with Reagan or JFK, but a similar sense of gratification that such a charismatic person would care about your opinion. Ford lacked the kind of ego that helps us pay attention to the President. And dare I say it, the President needs to be cheerleader in chief, needs to be able to get enough of us excited or motivated about things. Lincoln obviously had that, as well as an exquisite sense of timing (eg, a majority of us elected him to keep the Union together, later a majority of us supported freeing the slaves). The current Bush gained the ability to convince a thin majority of us that he felt strongly about our safety after 9/11, the ’02 midterms and ’04 general election show us that. But since he linked our safety to success in Iraq, and defined success in Iraq only loosely as a democracy (identical to ours?), he seems to have lost power as cheer leader in chief.
One full page of Word, single space, that’s enough. Off to Nordic Trak.
The mania for Gerald Ford retrospectives goes on, and I want to throw my two cents in. We need a man like Ford today, but not particularly as President. Far more we need him as Speaker of the House or Senate Majority leader. I am still not reconciled to the notion that the President needs to be a bully, but I am coming to realize that the President needs to try to set an agenda, and you need to speak out to do that. I don’t know how Ford worked exactly in the House, but I believe he was one of those old time operators who worked without an agenda except to serve his district and his party, over the long haul. That means making deals with the other side time and time again. If you have to reneg on the deal, you have to be able to explain it. This is the thing, though. A reporter on Washington Week told the story of how Ford, as president, made a point of inviting George McGovern to a White House Dinner. McGovern remarked that he had not been to the White House in either the Johnson or Nixon years, and Ford replied simply that he knew that. And that is a fine thing, in fact it reminds me (in contrast) of Cheney’s famous use of the F-word with Pat Leahy. Cheney apparently didn’t spend enough time in the House to know that you deal with these people again and again (and now Pat Leahy is chair of Senate Judiciary). But at the risk of sounding contradictory, I think Ford was too far in the direction of conciliator. Some blog I read (Tube City? The Conversation?) suggested Ford was a best an average President. I have agree with the sentiment if not the reasons. I think was unused to the spotlight, was maybe more of a behind the scenes guy. Well, if you are President I think you have staff for the behind the scenes stuff. I remember someone saying the Clinton often struck people as the smartest guy in the room. If he paid attention to you, you felt the weight of it and the sense of gratification (that a smart guy thinks you idea is good). I have heard similar things, strangely, about Nixon. Obviously it would be different with Reagan or JFK, but a similar sense of gratification that such a charismatic person would care about your opinion. Ford lacked the kind of ego that helps us pay attention to the President. And dare I say it, the President needs to be cheerleader in chief, needs to be able to get enough of us excited or motivated about things. Lincoln obviously had that, as well as an exquisite sense of timing (eg, a majority of us elected him to keep the Union together, later a majority of us supported freeing the slaves). The current Bush gained the ability to convince a thin majority of us that he felt strongly about our safety after 9/11, the ’02 midterms and ’04 general election show us that. But since he linked our safety to success in Iraq, and defined success in Iraq only loosely as a democracy (identical to ours?), he seems to have lost power as cheer leader in chief.
One full page of Word, single space, that’s enough. Off to Nordic Trak.
Tuesday, January 02, 2007
So I am still not posting as much as I should. Stirring up trouble on other people’s blogs is frankly so much more fun …
I seem to annoy people when I say I haven’t researched an issue. Maybe I should just pretend to be an expert, but I am trying not too. I still believe that my opinions are somewhat informed, but I should say too my own standards for research are somewhat high. I don’t really want to accept something just because a liberal or conservative website says it’s true. I am willing to discuss anything, however, from a single source website. Just as an aside, I am still impressed with wikipedia as a source of information. It is fun to read the debates about content presented.
So I have just a little thought to follow. I will start by saying that I believe the President really values loyalty, to the point where it blinds him. How else to understand the lack of reconstruction progress in Iraq? I mean, seriously, how could a President let that go for so long? I don’t buy this Bush is an idiot stuff, no one goes through Yale and Harvard Business School as a total idiot. I’m sure his father’s name got him in and may have bought him some slack, just enough for him to question his own abilities, but still Dubbya actually has to have a bit going on upstairs. But I think a lot of the contractors in Iraq are friends or donors, or friends of donors. So we have this vast plundering of government money.
But we have seen the President turn on those who he feels are disloyal (mostly those who question him in public). I am thinking particularly of O’Neill and Powell. But, here’s what I am wondering about now. If the President dumps people who are disloyal, how will he react to the public now disapproving of his conduct of the war and of other public policies? I guess maybe he will be even more helpful to his wealthy supporters, at the expense of the general public. Minimum wage? Maybe not. Tax reform headed the other direction (a different definition of reform)? Better find a two thirds majority.
Just a predication, that the last two years of the Bush White House will resemble a wagon train with the wagons circled.
I seem to annoy people when I say I haven’t researched an issue. Maybe I should just pretend to be an expert, but I am trying not too. I still believe that my opinions are somewhat informed, but I should say too my own standards for research are somewhat high. I don’t really want to accept something just because a liberal or conservative website says it’s true. I am willing to discuss anything, however, from a single source website. Just as an aside, I am still impressed with wikipedia as a source of information. It is fun to read the debates about content presented.
So I have just a little thought to follow. I will start by saying that I believe the President really values loyalty, to the point where it blinds him. How else to understand the lack of reconstruction progress in Iraq? I mean, seriously, how could a President let that go for so long? I don’t buy this Bush is an idiot stuff, no one goes through Yale and Harvard Business School as a total idiot. I’m sure his father’s name got him in and may have bought him some slack, just enough for him to question his own abilities, but still Dubbya actually has to have a bit going on upstairs. But I think a lot of the contractors in Iraq are friends or donors, or friends of donors. So we have this vast plundering of government money.
But we have seen the President turn on those who he feels are disloyal (mostly those who question him in public). I am thinking particularly of O’Neill and Powell. But, here’s what I am wondering about now. If the President dumps people who are disloyal, how will he react to the public now disapproving of his conduct of the war and of other public policies? I guess maybe he will be even more helpful to his wealthy supporters, at the expense of the general public. Minimum wage? Maybe not. Tax reform headed the other direction (a different definition of reform)? Better find a two thirds majority.
Just a predication, that the last two years of the Bush White House will resemble a wagon train with the wagons circled.
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