Tuesday, March 29, 2011

Where the Competition in this Hospital Visit?

A day passed before I realized there had been no competition.

Had a wonderful little visit to the hospital Monday. Then, today, as I reflected on how expensive it had been, as I wondered for the umpteenth time in my life on how medical bills need to be brought down, it occurred to me --

There had been no competition.

It was marvelous when I checked in, that I was showed an itemized bill explaining what I would be paying for. Ahh, but here's the catch, and this dawned on me a full day later: I could not pick up the cost quote, take it next door, and say, "Here's what Jordan Valley wants to charge me. Can you do better?"

That would be competition.

This was not. I could take what they offered, or go home hungry. Take it or leave it. I had a choice of one. I was buying in a "free market" of one. Competitors for my business? Just the one. Sellers to choose from? Just one.

Just one is not a choice. It's a monopoly. Just one is not a free market. Just one is a way to drive up prices. However, in America -- the world leader in free enterprise and capitalism -- did we ever arrive at this: no competition?

You want to know why health-care costs are so outrageous? Look no further. While some clamor for national health care while crying that the free-enterprise system has failed us, while some are suggesting a one-payer system, let it not go unnoticed that we've already abandoned the free market.

Why, after getting the quote yesterday, shouldn't I have been able to drive down the street to another hospital, shown them the quote I had received, and asked them if they wanted to do me better?

You might be ready to remind me doctors often do give their patients the choice of which hospital they want procedures done at. In my case, I said Intermountain Medical Center, and still received Jordan Valley. The point is, though, when the question was asked, I was not given a price quote that I could take and shop around. That didn't come until I was already at Jordan Valley, checking in.

Now, mind you, it was a procedure that could be done by one doctor as easily as another. You might say, "But Dr. Neveratemperature is your cardiologist, so he must do the angiogram." But, fact is, Dr. Hasnofever (forgive the false names),  could do it just as well. The procedure is all the same, regardless who does it. Fact is, Dr. Neveratemperature wasn't available, so Dr. Hasnofever stepped in on less than a day's notice. (Well, he had from Friday afternoon until Monday about noon, but I doubt he was in the office during the weekend.)

Tell me why is it that at the point of sale, the point at which we learn the cost, we are already committed to which hospital we will use?  Why do they reduce our choices to a choice of one?  I mean, that is the way our system is set up. Why?

Seems that if we really wanted to reduce the cost of health care, instead of coming along with a 2,309-page bill of Obamacare confusion, we'd do better with a once-sentence declaration of independence-type bill: "We, the People, shall have the right to price quotes and shall be given the liberty to take these quotes from one hospital to another until We, the People, select the provider of our choice."

Freedom is choice, and we are being given no choice. To the walls, fellow Americans. Let's scale these prison walls and get out of here!

Saturday, March 26, 2011

Not Once Has Congress Asserted Authority

Every time  a president takes us into a military conflict without Congressional approval, we jump him for violating the Constitution.

But, why is it no one ever jumps Congress for not assuming the responsibility? Never once has Congress taken the initiative, without being asked by the president, to declare war.

That's zero, never. One might well conclude Congress is shirking its responsibilities. After all, says the Constitution: "The Congress shall have power . . . To declare war." If it is Congress's responsibility to declare war, it needn't wait on the president for an invitation. Congress, itself, has the call, so why does it never act on its own, as if it needed to first get permission?

You don't need permission, Congress. It's your duty.

Yet, of the five times war has been formally declared, they all came only after the president asked Congress to declare war. One would think it is time Congress would step up, and when it sees a military possibility arising, rush into session, not necessarily to declare war, but to consider whether to declare war.

Say, like with the situation in Libya, had Congress met, it could have voted against the military intervention. Then, when President Obama tried to lead forces into the conflict, Congress could have said, "No, the Constitution grants us authority on this matter, and we've already ruled on whether to enter this war, and the answer is 'no.' "

I, for my part, have not decided whether I favor U.S. air presence in Libya, but I do believe it should come only with Congressional approval.

And, I think it would be neat if for the first time in history, Congress were to take the initiative and rule on the issue without being called upon to do so by the president.

Congress, step up and assert your authority.

Wednesday, March 23, 2011

Do Unto Politicians As You Would . . .

This HB477 thing is a tremendous opportunity to take the old axiom, "Do unto politicians as you would have them do unto you," and apply it. It is an opportunity to do good unto the politician. (No, do not add, ". . . and them that spitefully use you" to that sentence, for I truly believe the politician does not try to do us harm.)

Hey, take it the way the axiom was originally written, "Do unto others as you would have them do unto you," does it make room for exceptions? Does it leave the politician out? It doesn't. So, if were you in this boat, how would you want to be treated? Would you like your text messages to be open game for the public? Would you like to have to dig up all your old messages months later and send them to someone who wanted to sift through them all in search of something to use against you?

Actually, I might agree to having all my appeals for government change to be splashed out before the public. And, though I don't like the idea of someone going on what has been called a "fishing expedition" against me, I think I can say, "Have at."

I would not at all, though, like to have to keep all I have texted, and all I have emailed, and have to dig it all up. Too much work. With all the record keeping the government requires of us, this is the time to turn the other cheek and say we won't require it of them.

But -- now listen to this -- if we were using some form of social media, and not erasing our messages, they would remain there and I wouldn't have to dig through them and make them available. They would be sitting there free and available. I won't say, free and easy for the picking, because the person who wanted them would have to be the person making the effort to dig them out. But I will say this, when that person misquoted me, it could be made easy for the public to look up the full and correct quote.

So, having ran the HB477 question through the "do unto others" test, I still say, "Keep those records open."

Tuesday, March 22, 2011

Choose, Then, Between Good and Good

Some would portray the struggle against closing some records in Utah as a battle between good and evil.

On one side: Those wanting openness, transparency and accountability to the public.

On the other side: Those wanting to operate out of back rooms, hide their doings from the public, and make secret deals and alliances.

But, those favoring HB477 -- the legislation closing some records -- cannot be judged so harshly. I do not know whether the bad motivations I just mentioned are behind some of them, but I certainly believe good motivations are behind many of them. They seek for privacy, and privacy can be a worthy goal. They seek to avoid an overly strenuous burden of tracing out old records.

Some must surely want their texting back and forth protected as they know being in the information-gathering stage often means expressing test opinions, if they can be called that -- opinions tossed out to see what stands against them. It involves asking questions that might seem silly. Someone once said no questions are stupid, but when someone is looking for something to hang you on -- and all politicians have someone who fits that description -- most questions can be made to look stupid.

There is at least one more good reason behind HB477. Those favoring it seek to protect the confidences of constituents who approach them for input.

Those, all, are good motivators.

So, closing off some records through HB477, or leaving them open? Sometimes it is not a choice not between good and bad, but between good and good.

Saturday, March 19, 2011

Come Along, Citizens, To Cast That First Stone

Come along, citizens. If you will call on your legislators to be open in their discussion of public matters, you come along, too.

Now, we cannot have legislators texting back and forth without us having access to it. Just can't. 'Tis an outrage. Who knows what manner of undo influence someone might wield on them if we do not learn of it.

I say, make it public. Make it all public.

Privacy? These are public officials, you know, and when a person enters the public arena, they give up much of their privacy. You've heard that said, and probably said it yourself.

Would ask you to notice, though, that this is not like watching a basketball game or a movie. You are not just a spectator this time around. Often, you do more than just comment on these public matters. You join in the process. You, too, seek to have a say in what is done. Yes, you are more than a spectator. You are a participant.

Well, then, maybe your doings should be a matter of public record, as well. Something along the lines of, Let him that is without sin cast the first stone. If we would have them be open, we must be open, too.

And, if you haven't noticed, that is exactly what will happen. If the legislator's text messages and email and correspondence are to be open, so will the text messages and email and correspondence from all the constituents -- that would be you.

Now, you might sense sarcasm in the way I have said this, but do not suppose that means I do not like it that our doings should be a matter of public record. I do.

Saturday, March 12, 2011

If I Had The Ear of the Immigrant

One week has past since the rally at the City-County Building, where I almost took my support of immigration up a notch.

I stood there, amid the frenzy of the crowd, listening to Archie Archuleta speak of the right of the undocumented to receive social benefits, more, to receive every right every other person has.

And, the tone of the day, among some of those there, was that the undocumenteds owe no apology for being here illegally. The notion seemed to be not so much that they should be given every right that every others have, but that they already own those rights and it is simply time for the rest of the public to admit it.

I thought, perhaps it is time I agree they deserve amnesty. Now, amnesty means different things to different people. In its purest sense, it means granting those who came here illegally pardons, telling them we forgive them flat out, with no need of them doing anything to qualify.

Well, if you look back on my blogs, you will find me arguing for pardons, for straight-out amnesty. I've noted we grant pardons to people committing much more serious crimes, so why should we not pardon the person who is simply here without getting permission? Murderers win pardons. Why be appalled that someone without paperwork should be pardoned?

The only thing that has kept me from being completely for amnesty is that, yes, it does send a message back to those not yet here: Come now, get your permission later.

That phrase, "Do it now, and ask for permission later" is followed by many of us, when it becomes convenient. But we do not like it that someone coming from outside our country should use it.

Standing with the chanting crowd at the City-County Building, I also wondered if, indeed, we should accord the undocumented with every right, including full right to our social programs.

This would be a step up in my advocacy of the immigrant. Mostly, I have suggested we should make it so they can come legally, make it so right from the start, they are legally here, and therefore, right from the start, they deserve our social programs.

As I walked away from the rally -- I could not stay for the march to the Capitol -- I found myself ill at ease with the feeling some of the undocumenteds see no wrong in what they have done, coming here without first getting permission.

The old "rule of law" thing, you see -- I do believe in it.

As I think on how I felt as I walked away from the rally, I want to cry out to them, to the undocumented immigrants, "Please, please, do be remorseful. Do believe you have done wrong. Acknowledge it. Yes, plead for the right to stay. Hold rallies for the right to stay. Appeal to authorities for the right to stay.

"But, do not suppose you are above the system. Please be humble. Please be the just-want-to-enjoy-a-better-life type of people I envision you to be."

As I walked down the sidewalk, away from the protestors, I thought how often what goes unsaid is so often the same thing that is misunderstood. Perhaps that is what is happening with the immigrant. I thought of my own argument, that since the Declaration of Independence calls for all people to enjoy the inalienable rights of life, liberty and the pursuit of happiness, then we should extend them those rights.

What I might not have mentioned when I made that argument, and what others might not have pointed out when they made the same argument, is that, no, even though the Declaration of Independence calls for all humanity to enjoy those rights, the Declaration, they do not presently fully have them. The Declaration itself, cannot fully give you those rights, for it is not law.

Has what has gone unsaid, come back to haunt us? The immigrant perhaps doesn't even know the Declaration is not a law. He only hears us say that he deserves life, liberty and the pursuit of happiness. Period. That is it, and he lays claim to it.

But, the Constitution grants the federal government authority over naturalization. If we make laws that are unjust, they are still our laws. Yes, the Declaration declares no person should be barred from life, liberty and the pursuit of happiness. It even says they are inalienable rights, which, to some, means that is the end of it -- no government can take them away. To others, it means they are inalienable and therefore no government should take them away

Either way, the fact remains, the Declaration is not law. If keeping the law is of value, they must seek for more permission than what they already have.

When laws are not just, we should change them. Would that the undocumented would not seek violation of our laws, but the changing of them. And, do I believe most of them earnestly seek permission, rather than asserting they already own the right to stay.