Political Cortex: Brain Food for the Body Politic

There are many audiovisual and written pieces on the smoking ban, health consciousness, tobacco industry profiting, and government positions in the news this year. As America snuffs out the industry costing farming losses, job losses, and all the other related domino effect of industry closure, Japan, the most health conscious in Asia, has a government owned tobacco industry that has annual revenue of $20B. Over 50% of the men smoke in Japan. Korea has no restriction - adults and children smoke - and the numbers are increasing - over 60% of the men smoke in Korea.

In America, however, there is a healthcare concern that focuses on anything that has an impact on the tobacco industry and its affiliates. The insurance companies do not want to pay for what they see as a given negative impact, but the pharmaceutical companies and healthcare equipment manufacturers have developed whole subsidiaries devoted to the effects.

The healthcare and insurance industries are at odds with reforms on this issue. The uninsured costs of smoking related illness allegedly hurts the medical providers, and those costs are passed on in the increased medical costs for others. The insured that are smokers are costly to the insurance industry, and smokers are finding it harder to obtain coverage or stay employed because of smoking. Of course, if other areas were addressed, lifestyle choices on several fronts would be the villains. Profit margin is the issue - not the health concern, and it is driven by a variety of factors, including the lack of oversight and refusal to partner in participation for progressive changes. Simply stated, it's about money, and it forces a closer look at many interrelated issues such as the burden of the under and uninsured on the system as a whole, poverty, and general political policy trends.

The World Health Organization rates Japan's healthcare system as No. 1 in the world. The system was developed using the 'Bismarck Model' of Germany, and improved upon, as Germany is ranked 14th among 191 countries. Per the article linked in this paragraph, there are three models for systems:

The world's healthcare systems can be roughly divided into three categories. One category is based on the social insurance system that originated in Germany, sometimes referred to as the "Bismarck model." This model relies on a system of mutual support among the citizens of a country as a whole, where employer and employee contributions and state subsidies are placed in a communal pool of funds for healthcare. In Germany, pensions, healthcare, nursing care, unemployment benefits and workers' compensation insurance are all covered under this social insurance model. The second category is a tax-funded model, seen, for example, in the United Kingdom. Canada and Australia use a similar system, in which healthcare costs are partially covered by tax funds. The third category of insurance relies primarily on private funding and private health insurance providers. In the United States, which employs this model, eligibility for public healthcare is limited to the elderly and to those who meet government criteria for low-income status, while all others are required to purchase insurance individually from private companies.

... Under the private insurance system in the US, a significant proportion of people have no coverage; this has given rise to a sizable gap between rich and poor in terms of access to health insurance.

According to this study, the four features that have been implemented that make the Japanese system successful are:

1. Universal coverage based on compulsory insurance.

2. Guaranteed and flexible access to healthcare - access to any healthcare institution in the nation. (The US has charity facilities, with limited access, in some regions. The UK provides a specific region only.)

3. Range of services includes private practice facilities and choice.

4. Fee-for-service payment method, which gives patients the freedom to receive any health service deemed necessary by a physician. (Services have restrictions and limits - they are also based on employment categories and income levels and have varying programs and plans.)

The fact remains that Japan is the healthiest nation and has the best healthcare system in the world according to the World Health Organization. They are the leader in life expectancy levels, and have the fastest growing aging society, putting them in a changing healthcare role, which they are targeting for 2010. Singapore has a health savings program, which the Bush Administration is favoring, but when their accounts are depleted, they must turn to family accounts to get services with increased risks for others. American family savings are decreasing, for many reasons. Some could say that forced before-tax employment based insurance deductions for employees at 16% of gross pay is intended as a pressure tactic for a forced medical savings plan. The banking industry would like this reform, and those that would benefit from use of those funds - not insurance companies.

As we have seen in the US, corporations are getting involved in programs for their staffs and management resources, providing preventative programs and evaluation studies for personal design of healthy lifestyle projects. These programs include mental health focus, as in Japan. Stress is a leading cause of productivity loss and lost time from illnesses, and has become a facet of intense focus in the workplace. Governments are involved in these initiatives, as well. There isn't enough focus on these type programs in America. There are a few models in place, but it isn't a broad investment focus. It should be.

The part of the Japanese program that has become a major facet of the success for individuals is personal responsibility for health. The Japanese plan is trending toward reward within the system for those who are consistently and vigorously attending to these needs. However, lifestyles of the Japanese and American populations vary greatly. America is a spoiled society, for example the food service industry is not trending toward a healthy fare. 'Fast Food' is increasingly identified as a factor in declining health status, but the industry thrives without much restriction or consumer pressures that would reverse the trend.

Another factor in Japan is control. Government control, and acceptance of it. Japanese are much more likely to accept and abide by regulation and requirement, while in America, the trend is to find the loophole for profit, abatement, or abuse. The people are apathetic and mistrusting in America. The people of Japan are disciplined and well-defined. I am not aware of corruption in Japanese government, although I am certain that the temptation of man is everywhere, they say what they do and they do what they say. It's a 'get used to it' approach, even though a democracy. America resents that kind of authority. America continues to wallow in chaos and disappointment as a result. There are fair, albeit difficult, compromises that could be made. America is like a confused and rebellious child at this point with respect to nearly every aspect of our society, culture, and governing, and because of it, we are paying a heavy price into those who would take advantage of the moment.

A look at Healthcare and Poverty

The Clinton Healthcare Taskforce project was giving an indecent burial that will not be soon forgotten or forgiven. The impacts from the management of the process has caused a fair amount of distance from the subject, but I find that the ratio of statistics were basically the same in 1993 as they are in 2005. The above report indicates that the number of uninsured in America was 37 million, in 1993. Poverty had been reduced during the Clinton Administration. With a growing population, people in poverty was reduced in 1998 to 34.5M. Progress was being made. However, with a new administration and new policies, or lack thereof, poverty surged after 2001, with children still the majority. (See 2005 Poverty Guidelines) The totals were lowered by 8M from 1993-2000 (2000 being the lowest point since 1989), but 5M+ have been added back since 2001.

Uninsured Children by Race and Ethnic Origin, 2003

Uninsured Children by Race and Ethnic Origin, 2003

2002-2003 State-by-State uninsured statistics displayed at the above link indicated that a total of 44M were uninsured or roughly 65% of the population living below the FPL (Federal Poverty Level). As we all know, the FPL is calculated by an ever-changing set of standards that does not offer a clear perspective of the actual impacts. The fact sheets from The Uninsured Week.org, accumulated from various sources, gives a decisive overview and detailed informational for anyone interested in reviewing the unprecedented damage caused by a broken healthcare system.

Percentage of Uninsured Adult Workers who are Hispanic, by State, 3-Year Average, 2001-2003

Percentage of Uninsured Adult Workers who are Low Wage, by State, 3-Year Average, 2001-2003

Seeing the numbers on children and families from the 2003 survey will enhance conclusions regarding the need for reform in American healthcare. (**Note: This particular site will have a new study presented for 2006 in the near future, should you be interested in signing up for e-mail alerts to stay abreast of this issue.)

In 1992, the number one concern for the American people was healthcare reform. The Clinton Administration attempted an undertaking that would have been a step in major reform of the system, but the unilateral mentality of the Task Force scuttled the project to the detriment of millions of Americans, mostly poor, elderly and children - the majority being Caucasian - while the propaganda supports minority and immigrant factions as the burdensome elements in continuing cost factors, statistics support another position. Immigrants are barred from Medicaid or Chips for five years, except in emergency needs or refugee situations. Illegal immigrants, and even some legal immigrants circumvent the system that does not have an identification verification process and are treated at the expense of the taxpayer. It has been argued that re-establishing benefits for immigrants, legal and illegal, would quadruple the costs. If they are already obtaining the services, how can this be?

In 2006, the system is being heavily impacted. The continuing rise in poverty, education failures, increasing elderly populations, system fragmentation, ineffective management, manipulative providers, corporate refusal to partner in progress, and the insurance and medical organization continued rebuttals due to the process during the Clinton administration that caused a policy position within the industry to protect their own systems, is costing more GDP today (approximately 16%) than in the early '90's.

From a 2005 Census Bureau Report

:

• Of households in the lowest income quintile in 1996,38 percent were in a higher quintile in 1999;of those originally in the highest income quintile,34 percent were in a lower quintile 3 years later.

• About one-half (49.5 percent)of people who were in poverty in 1996 were not in poverty in 1999.

According to the NCHC [fact sheet], healthcare inflation is advancing at four times the national rate.

NOTE:

The Coalition is rigorously non-partisan. Its honorary co-chairmen

are former Presidents George H.W. Bush, Jimmy Carter, and Gerald R. Ford. Its co-chairmen are former Iowa Governor Robert D. Ray, a Republican, and former Florida Congressman Paul G. Rogers, a Democrat. Our members believe that an effective response to the crisis in American health care is urgently needed and that it will require leadership from both political parties and a willingness to compromise across ideological, economic, and social divides.

The NCHC published a 2004 reform study that stated:

The Coalition projects that the average annual premium for employer-sponsored family health coverage will surge to $14,545 in 2006 -- more than $5,000 higher than last year's average premium of $9,068 and more than double the average premium of $7,053 in 2001.

We are there - and then some.

In the fight on poverty, universal healthcare coverage should be a focal point. Increased educational benefits, increased productivity, reduced costs (e.g., Japan spends 3% of its GDP on healthcare as compared to 16% for the US per the Organization for Economic Cooperation and Development - Germany, France and Canada are less than the US as well).

Under the G.W. Bush Administration, healthcare insurance costs increased 63% for single participants and 58% for family coverage. That not only pushes the poor and struggling immigrants back from the possibility of obtaining personal coverage (wages have not increased to any performable level). These pricing grabs by the medical, insurance, and pharmaceutical industries bar corporations, and particularly small businesses, from being able to effectively participate in a positive solution, and it diminishes the savings abilities of middle-class families, in particular, further burdening.

Using this healthcare discussion as an example, and reviewing the recent exposures of oversight failures that have plagued the US government, citizens of this nation should demand accountability for failures that have reduced the systems in many areas to which we have elected representation. It might have a major impact on campaign finance reform, too. This is equivalent to taxation without representation. It is theft of services by other means. How can the government prosecute immigrants or anyone for resorting to any means to get needed services when they are guilty of manipulating the very same systems for gain?

Cigarettes, illegal immigration, lifestyle choices are not the leading detrimental forces of healthcare system failures. Lack of enforcement, accountability and leadership focuses with Congress and industry encouraging or enabling fractures for gain, are a large part of why we have these broken systems and wasted funds. Reforms of systems are also needed, but cultural-societal evolution should not be confused as a cause without considering the aforementioned in the grand scheme of things.

Poverty - Healthcare - Education - Economy - Jobs - Environment. It's all taking a backseat to this giant explosion of confusion and chaos created by the Bush Administration, and they are all areas that need focused attention, reasonable debate, and rational remedies for the ailments. Oil and war are all we have funded for the last six years. It looks like it's all we will be funding, at the expense of our own systems, for years to come. Fears are whispered across the financial markets that the dollar is history - the world will leave America behind in the scheme of global interface as the Euro becomes the monetary system of choice.

Two things to watch this week - the 3rd Annual Short Sea Shipping Conference in Orlando and TOC2006 Asia, the Terminal Operations Conference and Exhibition for Asia, is the definitive meeting place for the world's shipping, port and terminals industries, both beginning on March 14th. One of the featured speakers:

Reaching scale and aligning interests: how will mergers and acquisitions among terminal operators and carriers change the face of the industry?
Mohammed Sharaf, Chief Executive Officer, DP World

If the text of this presentation becomes available, it will be posted here.

We are fast becoming a bankrupt society in so many ways. Given these few domestic concerns reviewed herein, we must realize that the international issues weigh heavily on our ability to survive - as a nation, much less considering a social class. The Dubai ports deal was merely a step in the direction of universal control - a tool in a plan. The reaction and the actions are exactly as anticipated. MEFTA was a goal in the DP plan, to strengthen not only the Middle East, but to strengthen and protect the US monetary system. To color the failure of the deal as a prejudiced reaction is a smoke screen and another tool.

Ask yourself, because they have - How do you control the United States of America? (And ultimately, the western hemisphere.) Isolate her. Mass national protectionism, weaken internal systems, ownership of services-systems-property, establish an alternative monetary system, and control international trade.

I don't know about you, but I need a cigarette.