Flu shot season

This week had another story worth telling, about the newfound efficacy and efficiency of the US healthcare system.

I got a flu shot.

It was the first time since being cast to the winds of fate, that I have been able to get such basic healthcare.  And it is thanks to important reforms that were passed that allowed me to buy the insurance I need to cover such things.

My flu shot took exactly 22 minutes.  I left my house, went to the hospital, and had my shot, within 22 minutes.  And my out-of-pocket costs at the time of service?  $0.

That is an amazing outcome for public health in the United States, where we have previously allowed preventable diseases to roam freely amidst the gap between a patchwork of hopelessly underfunded and reachless free clinics on one side, and the ever-dwindling pool of half-decent employer-provided health insurance.

The new healthcare law is working for me, and millions of other Americans.  Supposedly it’s in for a major rewrite now that both houses are under Republican control.  Two things I’ve heard about, that are actually feasible, are changes to the employer mandate and medical device tax.

A repeal on the medical device excise tax is rather troublesome.  Part of the reason why health costs are spiralling out of control is an uncontained willingness to buy various expensive inventions.  Most of these devices are simply thrown away after use.  Isn’t that wasteful enough to be worthy of a sin tax?

What would have positive effect would be a solution to the employer healthcare mandate that makes the marginal cost of labour favour full-time employment again.

My concept is a refundable payroll tax on all employers tied to the cost of the second-cheapest silver plan for an employee’s state of residence.  That cost, say $260 a month, is divided by 130 hours — the same as an average of 30 hours per week, working out to perhaps $2 an hour. That tax, plus any curve tweak designed to re-incentivise full time employment, is charged to the employer for every hour an employee works.  The tax is then refunded if the employer provides qualifying insurance that the employee is enrolled in, otherwise, it subsidizes the employee or the employee’s exchange plan.  Excess tax collections (from the large number of employees with multiple part-time jobs) would then be used to cover individuals who need exchange subsidies or work for non-profits.

Net neutrality is the only option

Will the FCC embrace the “not on my lawn” philosophy and stand behind Internet Service Providers that choose to monetize any statistic they develop, and allow ISPs to dictate the terms on which they will allow other speech on their private networks?

Will the FCC embrace the “net neutrality” philosophy, designating Internet service as a common carrier, and require Internet Service Providers to move its customers’ data without favour or prejudice?

“Not on my lawn” surrenders control of everyone’s speech to private interests, and would deeply violate the public spirit of the United States of America. The answer that the average American citizen, small business, and non-profit would give is resoundingly in favour of net neutrality.

Arbitrary corporate policies now entrenched as ‘religious belief’

The Supreme Court’s ruling in Hobby Lobby is a major coup against the the rule of law — superficially handing down a ‘win’ for the cultural right, while opening a door to untold market manipulation in the name of whatever Ferengi gods our businessmen now choose to believe in.

I mean, before Hobby Lobby, there was no way in the world you could break the law and say that the devil made you do it, and still get away with it.  Now?  I guess anything goes.  Is it going to be medieval Europe or just the Wild West?

Kentucky fights for its hemp program, ND still waiting

It’s an historic year in American agriculture:  Industrial hemp crops are returning to the fields for the first time in decades.  Colorado’s program steamed forward without any second guesses. Kentucky had to sue and file for permits that it really shouldn’t have had to, but still managed to plant hemp this season.

North Dakota’s Agriculture Department and NDSU Plant Science haven’t been as aggressive, however, and seem to have acquiesced in the face of undue restrictions on importing hemp seed from Canada.  Maybe next year — or for sure next year?  North Dakota’s ag leaders need to stop slouching on this.

John Thune selling out the Internet

Our neighbours seem to have much stronger opinions about Net Neutrality than North Dakota’s Senators:  You have Al Franken on one side, defending the open internet in defiance of his old bosses at Comcast, and then you have John Thune in South Dakota signing on with the pay-to-play crowd, yukking up about “opportunity” while showing off to FCC Commissioners the kind of small businesses that won’t be able to afford access to the marketplace if regulations allowing ISPs to double-dip go forward.

“Net neutrality” isn’t something new — it happens to be the way the Internet has always worked.  What has changed is that certain ISPs want to change the rules of the game, count things they shouldn’t and charge people they shouldn’t as many times as they please.

Dalrymple triangulates on Carbon Dioxide

It’s not surprising that a quixotic quest against federal environmental regulations would be a top priority for the people that benefit from the oil trade in North Dakota, but that doesn’t mean that they’re right.

Governor Dalrymple is at least not claiming, like some on the right, that Carbon Dioxide isn’t a pollutant at all.  But he talks of heel-dragging on the issue.  Short-sightedness on the consequences of carbon regulations is easy when you’re used to a narrow business model, but drill, pump, refine, burn has nearly run its course.  Yet, if people stop burning Bakken crude in their gas tanks, it will still be saleable to the chemical industry, as stock material for plastics and pharmaceuticals.

A recent study suggests that moving to practice and policy on carbon-based energy that will keep CO2 levels under 450 ppm is only going to cost the global economy about 0.06% of annual GDP.  If public policy can provide the right incentives and penalties, the big CO2 generators can clean up their act, without really stopping them from being  big money generators.

Nearly 7 million covered by ACA

ACAsignups.net reports that despite demand crashes at HealthCare.call trends are on track to breach at least 6.9 million, a number that surprisingly makes congressional estimates of how many would get coverage by this point correct.

Essentially, demand trumps goofy implementation. Once word got out that the sites were finally mostly fixed, the promise of actual Health Care was more compelling than the hiccups and annoyances that came before. As one of those 7 million (or at least, someone who will be starting in May), I can say that it is a little easier to sleep at night.

And the best news of all: Even if you only start your sign-up today, you can still come back to the exchanges, finish by April 15, and enroll in coverage for May.

BCBSND blows Maryland Health Exchange

Noridian Healthcare Solutions, one of the many faces of the Blue Cross Blue Shield North Dakota complex of companies, reportedly botched the Maryland Health Exchange so severely that the state was forced to re-open the insurance market to private brokers, and the local health insurance co-op has had to scale back as no one can access its plans.

Even among the health exchanges, characterized so far mainly by bad performances, Maryland’s site sticks out as one of the poor showings.  There’s been serious talk of reverting to the federal exchange for next year, but starting Tuesday, it will be federal exchange provider QSSI running their show.