David Brooks - "Kill the Rhinos!"

In several columns recently David Brooks has been pounding on the failure of the proposed health care reform legislation to restrain costs. I agree with him. Politicians generally prefer pandering to people by telling them that they can have insurance coverage and it won't cost them much, if anything. They don't like talking about cost control.

Brooks is absolutely correct that the rhino in this system is cost inflation and it must be tamed. Any legislation that fails to do this is folly.

In Vermont, which is no exception to cost growth, one has only to look at job growth. It is higher in the health care industry, (followed by education) while nearly all other job categories are shrinking. This fact alone points to one reason health care costs are out of control. Costs must be restrained and at the end of the day, painful though it may be, rationing of services and procedures is inevitable.

Where's the debate on how that should happen? Even Brooks doesn't discuss it. Everyone prefers to talk about incentives, disincentives, access and quality. The only point that gets close to the need for rationing is changing the fee-for-service system to something that rewards quality. Those are code words for rationing. If doctors and hospitals don't get paid for procedures and tests, they won't do them. That's a form of rationing.

"Not everything is compatible with everything else. But the point is that you have rhinos at the door! You’ll try anything that works. You want a political class that no longer perpetuates the myth that people can get everything for nothing. You know that it was political pandering that got us into this mess in the first place.

Obama is right. Things will be bad if we don’t tackle the problem this year. Things will be worse if we add to the costs without beating the rhinos."

A hero in the war against fiscal irresponsibility is David Walker, former Comptroller General of the United States for many years. Here's what he had to say about health care reform recently on MSNBC.

Visit msnbc.com for Breaking News, World News, and News about the Economy

We Have No Choice But to Ration Health Care

Why We Must Ration Health Care - NYTimes.com:

After reading the first few paragraphs of this piece, I was convinced that Singer is absolutely correct that health care rationing MUST be part of the equation in revamping our U.S. health care system. I have believed this from the onset of the debate a few years ago. Those who don't believe that rationing is essential are in denial.

Those who contend that 'health care is a basic human right' are obliged to answer the question: how much care and at what cost?

We should demand that our politicians talk about this reality. If they avoid it, they are disingenuous or dishonest or both. We simply cannot afford to treat every person for every possible condition with all possible means.

Of course, the devil is in the details. But without a discussion of rationing in the U.S. before we commit to an enormous change in the system, we will have done ourselves a terrible disservice. Without cost controls, including rationing of services and care, not just in the hard cases that Singer uses as examples, but more generally, we will have built a system doomed to fail.

We should demand that our politicians, particularly those supporting single-payer health care to explain their position on rationing. In addition, we should ask them to explain to us how the proposal now in Congress deals with rationing.

TeamObama and others have a basic responsibility, as does the media, to put this subject on the table now.

Kudos to the times for giving the issue 'front and center' treatment.

"The case for explicit health care rationing in the United States starts with the difficulty of thinking of any other way in which we can continue to provide adequate health care to people on Medicaid and Medicare, let alone extend coverage to those who do not now have it. Health-insurance premiums have more than doubled in a decade, rising four times faster than wages. In May, Medicare’s trustees warned that the program’s biggest fund is heading for insolvency in just eight years. Health care now absorbs about one dollar in every six the nation spends, a figure that far exceeds the share spent by any other nation. According to the Congressional Budget Office, it is on track to double by 2035."

"Rationing health care means getting value for the billions we are spending by setting limits on which treatments should be paid for from the public purse. If we ration we won’t be writing blank checks to pharmaceutical companies for their patented drugs, nor paying for whatever procedures doctors choose to recommend. When public funds subsidize health care or provide it directly, it is crazy not to try to get value for money. The debate over health care reform in the United States should start from the premise that some form of health care rationing is both inescapable and desirable. Then we can ask, What is the best way to do it?"

Kudos to Obama

Obama Speaks at N.A.A.C.P. Celebration - NYTimes.com:

President Obama delivered the right message focusing on personal responsibility. All Americans, not just blacks, need to absorb it and recognize that the 'victim society' that has been created in the past couple of decades is a drag on the greatness of America and on far too many individuals.

"Aides said he intended to make the case for personal responsibility — a frequent theme of his presidency — in the context of the civil rights movement and how it has shaped his own life. But he also wanted to send a message to black parents, and especially to black children.

“They might think they’ve got a pretty jump shot or a pretty good flow,” Mr. Obama said, “but our kids can’t all aspire to be LeBron or Lil Wayne. I want them aspiring to be scientists and engineers, doctors and teachers, not just ballers and rappers. I want them aspiring to be a Supreme Court justice. I want them aspiring to be president of the United States of America.”"

Colchester July 4th Celebration

I finally got around to uploading a few pics I took at the Colchester July 4th celebration and the events associated with the 400th anniversary of Champlain's discovery of our beautiful lake.

Google Voice

I finally received my long-awaited invitation for Google Voice. Yesterday, I chose my number and have been quietly playing with it to better understand the ins and outs from a personal perspective. I have linked my home phone and cell phone to it.

It's powerful and easy to use. So far I have set up my voicemail, sent SMS messages from the browser interface, made a local call (they are free). I will soon test the voicemail transcription feature and then move to more sophisticated functions.

The feature set is strongest for inbound calls to the new number, which I intend to distribute on my next batch of business cards. I am reluctant to display it on my blog because I don't want a bunch of junk phone calls.

The uptake may be slow, but the phone companies should be worried in that Google is inserting itself at the top of the phone pyramid...and it's tough to beat free and very inexpensive overseas calling.

Op-Ed Contributor - Chrome vs. Bing vs. You and Me - NYTimes.com

Op-Ed Contributor - Chrome vs. Bing vs. You and Me - NYTimes.com

Cringley gets it right in describing the strategic positioning between Microsoft and Google. Nevertheless, I think new products and services from both companies do benefit the consumer. The techie fringe may be all atwitter about Google's 'FUD' announcement about a Chrome OS in 2010, but most users have little concern and enterprises will not jump to it without some significant benefit. The Google brand will not be sufficient to persuade big companies to switch.

Bravo for TeamObama!

Quote from the NY Times, July 12, 2009

"No business wants to invest in a place where the government skims 20 percent off the top, or the head of the port authority is corrupt. No person wants to live in a society where the rule of law gives way to the rule of brutality and bribery. That is not democracy, that is tyranny, and now is the time for it to end."
PRESIDENT OBAMA, on the need for reform in Africa.

Google Chrome: Redefining The Operating System

Google Chrome: Redefining The Operating System

Inertia is on Microsoft's side. The people who pay them money will be reluctant to move to an online-only world for all their apps. The trick for MS will be to manage their revenue streams during the transition to a 'fully' online world. It's clear that Google wants to penetrate the enterprise marketplace for its Apps and this new OS aims for it, but that process will not go quickly.

I'l bet my dollar to your donut that MS has their own version of an OS that is geared to online browser-based use of hardware. They'll introduce it when the timing is right. Meanwhile, Windows 7 will launch this fall. My guess: Google's OS announcement is timed to interfere with the uptake of Windows 7, reportedly a very solid OS, due for release this fall, a resort to the old IBM FUD (Fear, Uncertainty and Doubt) approach.

Pay-for-Chat Plan Falls Flat at Washington Post - NYTimes.com

Pay-for-Chat Plan Falls Flat at Washington Post - NYTimes.com:


Could we have some outrage from the Times editorialists, please? This is a travesty at the Washington Post, not a PR fiasco as the Post's public editor would have it. This is a deep breach of journalistic ethics. In fact, this is unbelievable! What have the politicians to say? Are they ashamed or afraid to castigate the 'fifth column?'

The older I grow, the thinner is my trust of politicians, the media and those who have a responsibility to to right by us. I don't think this is cynicism, rather a conclusion based on evidence. What say you?.

Why should we trust what management of the Post may say? To their credit, the Post's newsroom was appropriately concerned and said so.

"The revelation of the parties early Thursday morning by Politico.com appalled members of The Post newsroom and put the paper squarely in the cross hairs of journalism ethicists. In response, Ms. Weymouth canceled the first dinner, scheduled for July 21.

A flier describing the events promised corporate sponsors conversation (“Spirited? Yes. Confrontational? No.”) at the Washington home of Ms. Weymouth. Sponsors were asked to pay $25,000 to attend an event, or underwrite a series of 11 for $250,000.

The July 21 event, focusing on health care reform, “guaranteed” a “collegial evening” with health industry advocates, Post journalists covering the field and administration officials involved with its policies."

States Plot New Path to Tax Online Retailers - WSJ.com

States Plot New Path to Tax Online Retailers - WSJ.com

A Supreme Court ruling now provides the upper hand for online retailers to avoid collecting and remitting state sales taxes unless they have a locus, or 'physical presence' in the state. I believe it's only a matter of time before this will change, either by Congressional action or by a case in which the Supreme Court will abandon its 'locus' precedent. The reason is simple: there's too much foregone tax revenue and it's growing. In this day of 'online everything' and excessive government spending the states are clamoring for this lost money. Consumers (voters), hopefully, will resist.

Consumers are legally obligated, at least in my home state, to report online purchases on their tax returns and pay the state sales tax rate. In practice, few do and enforcement is negligible or non-existent. Meanwhile, online retailers like Amazon and others continue to resist states' attempts to coerce them into collecting and paying these sales taxes.

"Amazon.com Inc. and other e-commerce companies are winning some skirmishes against cash-strapped states that want to force them to collect sales taxes, but their victories may be short-lived.

Several states are contemplating new laws or revisions to existing law that could eventually force online retailers to pony up. North Carolina, for instance, has a two-pronged approach to going after online retailers. If its current efforts to tax online sales fall through, the state's revenue secretary plans to interpret existing laws to require companies that have marketing affiliates collect sales taxes.

State Sen. David Hoyle on Thursday called the effort "a fairness issue." Collecting sales taxes from out-of-state sellers could bring between $150 million and $200 million annually in additional tax revenue, he said. Mr. Hoyle said current law allows the state to force online retailers retroactive sales taxes."