Friday, October 10, 2014

Which way on Initiated Measure 17?

I've been pondering Initiated Measure 17, (see Ballotpedia.org summary) which we have to vote on in a few weeks.

The law asks the question whether we want to continue to allow insurance companies to charge more for "out-of-network" care than "in-network" care. I finally found an article that helped me think about it. This article talks about how it is done in New York. In that state, like here, they leave it up to the insurance companies.

Surprisingly, they insurance companies have shown that they prefer closed networks. Why?

The Medical Society’s Mo Auster said that the idea that insurance companies and individual doctors engage in a genuine negotiation — whether concerning fees or medical decisions — is a fiction. Since the insurer’s terms are “pretty much ‘take it or leave it,’” he said, a doctor’s only influence over the process was his or her ability to run a practice without signing up with a network. “The extent to which that ability is minimized,” Auster said, “further enhances the negotiating leverage of the health insurance company to basically take the clinical control away form the doctor.” (Out-of-network coverage in New York? We left it up to the insurers, Remapping The Debate (10/30/2013)  (emphasis mine)


This argument is pretty strong:

If you want medical decisions to be just a little more tilted toward insurance company's bottom line instead of the best care for you and your kid, vote no on IM17.

I know there's balance, if the business end of healthcare doesn't work, everyone's care suffers. But I've been reading both sides on this one, and have been a participant in our health-care "system"... and my research and my experience lead me to believe that patients and doctors both are getting the fuzzy end of the lollipop on this one.

And insurers and big hospitals seem to be doing overt well on Main Street and Wall Street.

This isn't as radical an idea as it sounds. If IM17 passes, insurers won't be required to include everyone in their network, the insurers just can't deny providers the opportunity to join the network as long as they agree to meet the insurer's requirements. Today, it's invitation only, like joining a fraternity - I think it make sense to open up the process just a little bit.

I'm voting yes on IM17.




Friday, October 4, 2013

Government Shutdown Day Three

Today begins the third (full) day of lockout for me; with a nasty blizzard to match my mood.


I am one of the more than 8,500 proud Federal public servants who live and work in our fine state.


My office in Rapid City, which hosts some 35 Federal scientists and support staff that study and protect natural resources across the State is shuttered. I am not allowed to visit my desk, or even power up my GFE ("government-furnished equipment"), that is, my work laptop, until a continuing resolution is passed and signed.


It was encouraging to see even the South Dakota liberal media see this "defiance" from Republicans in Congress for what it is: a tantrum held in opposition to the legislative process.


To make things worse, given the current appetite for austerity (despite that the deficit is dramatically dropping every year), it seems unlikely we will be paid for our forced unemployment.


Hey, I'm a smart guy, why can't I just get a real job?

  • I do have a real job. The Speaker of the U.S. House is keeping me from it by not allowing an up or down vote on a clean continuing resolution. Is this that complicated?
  • It's not our fault our income has been taken away.
  • We are left with very limited ways to replace that income during a shutdown.
    • We are prevented by ethics rules from taking outside employment related to our Federal jobs. There are exceptions, but they have to be approved by our supervisors and the agency Ethics Office, which, you guessed it, are locked of their offices as well.
    • Even if it were allowed, who is going to hire me for said skilled job when I could be called back at any time, when the moment finally comes when the Speaker of the US House of Representatives decides to, uh, allow an up or down vote on a clean continuing resolution?
  • The cumulative economic hit from about one percent of South Dakota's population having their income (and spending) is big. It's even worse in other states.
  • Lastly, I have been fortunate to be able to do some side work (unrelated to my Fed job of course), but of course at a small fraction of my regular pay. It's not enough to meet my expenses.
Whether our pay is docked or not, this shutdown is very bad for America, South Dakota, and Robbinsdale. You can bet this level of uncertainty is docking my household spending and that of the many other Feds in our fair city -- the ripple effects in our local South Dakota economies are going to hit Main Street hard here.


Oh, but it will be the President's fault because uh, freedom.


What happened to Republicans that promised simple up or down votes? They seem to have checked their brains, and their sense of fairness, at the door.


Yesterday, in the aftermath of the Mall security scare, the WaPo editorial board really laid it out well:

“We all owe the Capitol Police a debt of gratitude for their work every day; no finer examples of professionalism & bravery,” tweeted House Speaker John A. Boehner (R-Ohio). That’s true. But Mr. Boehner owes them, and the rest of the federal workforce, more than a 140-character message of thanks. He owes them a paycheck; he owes them a budget; he owes them an apology.

Thursday, May 2, 2013

Help recall Bill Clayton - Saturday @ BHBagels

Do you remember Bill Clayton? He's the Rapid City Councilman who is an embarrassment to himself,  his city Ward, our fair City, and frankly the whole State.

Many citizens of Rapid City agree, and, my friends, here's a chance to do something about it:


Sign Petition to Recall Clayton at Black Hills Bagels on Saturday 
Gary Brown will be at Black Hills Bagel at 913 Mount Rushmore Rd this Saturday, May 4 from 9 to 12 to collect signatures on the petition to recall Alderman Bill Clayton. Anyone that can vote in Rapid City elections can sign the recall petition. 
You can also call the Petition Hotline to find other locations to sign the petition! CALL: (605) 388-2749.  
The petition says: 
The people of Rapid City expect their leaders to display good judgment in their interactions with the public, their constituents, and their colleagues. We believe William Clayton has repeatedly violated this expectation and fails to take responsibility for his actions. He has displayed a pattern of conduct unbecoming of an elected official, including comments made to a reporter on August 29, 2012.

Rapid City has 60 days to get 6,000 signers. If we don't succeed, we'll have to read more outrageous stories until 2014. Clayton is bad for our city -- he should go. Please consider signing the petition.