MIT experts on the future of health-care reform: Congress should still think big

From MIT News – web.mit.edu/newsoffice

The Future of medical insurance in the US.

Just over a week ago, passage of a landmark federal health-care bill seemed a dead certainty. But the flip of a single U.S. Senate seat has changed all that, leaving the Democratic Party highly uncertain about how – or whether – to proceed. Given the current flux in Washington, a panel of MIT health-care experts assembled yesterday to assess the situation, often hammering home the idea that political half-measures will yield little in tangible health-care results.

“You can’t break this bill apart and have it work,” said MIT economist Jonathan Gruber. “It’s all or nothing at this point. The Democrats, and essentially the president, have to decide if they’re willing to go for it all, or are willing to live with nothing.”

First, though, Gruber, a central architect of the Massachusetts health-care system that has served as the model for the congressional legislation, acknowledged his extreme chagrin over the political reversal that accompanied Massachusetts Republican Scott Brown’s victory last week in the special election to replace the late Sen. Edward M. Kennedy. “My kids are like, ‘Why are you so sad, daddy?’” said Gruber, speaking at The Stata Center. “I explained, ‘Imagine you worked on a term paper for a year, and you were about to hand it in, when someone turned off your computer and you lost all your work.’”

Brown’s victory has caused multiple fractures among Capitol Hill Democrats. Some legislators want to drop the health-care effort entirely; others say Congress should only pass popular portions of it, such as making it illegal to deny insurance based on pre-existing conditions; and still others want to reconcile the existing, separate health-care bills already passed by the House and Senate.

Gruber made it clear he favors the last position, telling the audience the healthcare plan is like “a three-legged stool,” and “doesn’t work unless you have all three legs.” Those three pieces are reform of insurance markets (including banning those denials of coverage based on pre-existing conditions), the existence of an individual mandate requiring everyone to have insurance, and subsidies to make insurance affordable for low-income people.

For instance, simply allowing people with pre-existing conditions to sign up for insurance, Gruber argued, would be ineffective by itself. In that scenario, more people with pre-existing conditions would have coverage, rates would rise and lead healthy people to drop out of the insurance markets, and to compensate for those healthy people dropping out, insurance companies rates would raise rates further.

A hidden benefit of health insurance: Innovation

Yet even if a large-scale health-care bill passes, cutting health-care costs remains the “$2 trillion question,” said panelist Joseph Doyle, an economist at the MIT Sloan School of Management. Many observers have noted in the last year that regional disparities in health-care expenditures around the U.S. have nonetheless yielded similar patient-care results. But Doyle’s own research in Florida suggests otherwise. The city of Fort Lauderdale spends 30 percent more on heart patients than West Palm Beach, he stated, but has a mortality rate that is 30 percent lower. Instead, Doyle said, we would perhaps be better served by, among other things, incentives for hospitals to avoid care problems like re-hospitalization for the same illnesses: “Nobody likes to go back to the hospital.”

Still, as MIT economist Amy Finkelstein pointed out in her remarks, the value of universal health-care coverage goes beyond the medical services rendered. The introduction of Medicare in 1965, a subject she has studied in detail, produced “a dramatic decline in the share of the elderly with large out-of-the-pocket payments,” Finkelstein said, meaning that it left more senior citizens in better financial shape than they would have been without Medicare.

Moreover, Finkelstein argued, Medicare went hand-in-hand with an increase in technological innovation in the health-care sector (from procedures to devices to drugs), a scenario that could be repeated if a serious bill is passed by this Congress. “If you have insurance, the idea that whatever happens to people who are uninsured isn’t going to affect you is a very misleading notion,” Finkelstein explained. “When you increase the share of the population with insurance, you increase the market size for these technologies, and you almost surely increase the pace of development of these technologies in the future.”

But will any bill at all emerge from Congress? Political scientist Andrea Louise Campbell sounded a skeptical note. “The American political system is very status-quo-oriented,” she said, with a lot of “veto points,” such as the current Senate convention that the Democrats need 60 votes to pass the legislation.

Those 60 votes would not be necessary if Congress elected to use the reconciliation process, which would essentially mean that the House would pass the Senate bill, then have both branches of Congress modify it, which would require just 51 Senate votes in the end. Yet as Campbell noted, that would still be difficult: 47 Democratic House members represent districts that the Republican nominee, Sen. John McCain, carried in the 2008 presidential election, and may be unwilling to back any health-care bill at this point.

Alternately, Campbell suggested, those representatives might prefer to pass popular-sounding segments of the health-care bill, like lifting the pre-existing conditions blockage, even if the policy results seem dubious. “What might be feasible politically, might be disastrous economically,” Campbell said. “They might pick out certain features without the counterbalancing features that make the whole package work. That might end up accelerating the unraveling of the system.”

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How To Fight Traffic Tickets Advice

Nothing can interrupt your driving excitement like a traffic ticket. Since I love to drive…fast that is, the general problem with it is called speeding tickets. I hate speeding tickets! That’s why I pay much attention to contesting traffic tickets.

I got a speeding ticket once off the Oregon Coast for going 65 in a 30mph zone. Unfair I tell you. I am not the only person who has gotten one of those “infractions” for speed limit signs that are unfairly posted; such was the case on a road trip with my friend a while back. You need some knowledge on how to fight speeding tickets to handle this.

Obviously this did not matter to the cop who pulled me over. I cannot even begin to tell you how annoyed I get too when they ask why they pulled you over. I think they get enjoyment out of asking that stupid little phrase. Apparently they have to ask you this to get you to confess to your “crime.” It is not a crime! If you weren’t meant to speed then why do they make cars that go faster than the average speed limit? I tell you it is a government conspiracy! They force you to learn how to get out of a speeding ticket.

You know what else I hate about speeding tickets? Contesting them; not only does it take time out of your day it is usually at the most inconvenient time like during work hours. How much sense does it make? It is like a double whammy because your $100.00 ticket has now turned into a $200.00 ticket because you missed a day of work. We gotta stick it to the man and fight speeding tickets!

True story; I got off with a warning for going 90mph in a 30mph zone, passing on a double yellow in front of on coming traffic, which just so happened to be a green cop car, in a car registered in California, a drivers license issued in Washington and insurance in Arizona. I suppose if you are women and are lucky enough to get pulled over by a man, your have a better chance of getting just a warning then an actual ticket.

Now I was all dolled up at the time, which I thought influenced the cop’s decision to let me off the hook. However I am going to have to say that the cop could not prove I was speeding because it would be pretty hard to gauge my actual speed even if the cop caught me by radar since I was coming towards him. So there is a reason I got off with such obvious violations.

Thank goodness I got lucky that time, but other times, I have been not so lucky. Anyways I found this book on contesting speeding tickets; which is really good because now I know that bikinis will not really get you out of a ticket and now I know how to get my traffic tickets reduced if not completely thrown out!

I am not likely to get that lucky again and my driving record is not exactly good, so I have to pay fortune to keep my car insured and I cannot stand driving school. When a light turns yellow, what does it mean? Good gosh it is like being in elementary school again. Besides I know the traffic laws I just have a problem when it comes to obeying them.

Obviously to avoid speeding tickets you probably should not speed, but 1. I cannot stand being behind some old man with an oxygen tank in the back of his car; and 2. Most speed limits are too slow. I got a speeding ticket in an alley once for going 10 mph. Gimmi a break! My Grandma can walk faster than that.

In short, contesting the infamous speeding ticket is easy if you know where to find the information you need to beat it.

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Sites and Fun in Washington DC

There is so much to see and do in our country’s capital, Washington, DC that it is kind of not possible to see them all in one visit. However, that did not stop my other half and kids from making an attempt to cover everything on our recent vacation. Here are only a few of the highlights we experienced on that vacation.

Our first challenge before we even left home was finding an affordable place to stay in the Washington, DC area. For the most part, hotels are pretty high priced in that area and make it difficult to locate a good place for a family of five to remain without totally blowing the old budget. We ended up selecting the American Hotel in Bethesda, MD and are very pleased with our choice. It is not the most glamorous hotel in the region but extraordinarily convenient, clean and affordable. So, we highly reccomend it when looking for Bethesda hotels.

Then, on to the traveller sites we enjoyed. Of course we started with the famous National Monuments and Memorials. These included the Lincoln Memorial, the Jefferson Memorial,the Washington Monument, and the Arlington Countrywide Graveyard . There were many more as Washington is a city of monuments and memorials. Many are found on the nation’s Mall but others are pretty spread out so that you will get a very good walk exercise if you intend to visit them all on foot as we did. (I admit I had to visit my Sacramento podiatrist when I got back home to deal with some foot pain from so much walking)

Next came our tour of the three different branches of official Executive buildings.When sightseeing in Washington, D.C, the regime, the Capitol and the high Court are key places to go to. Touring these galvanizing buildings will help you understand more about our government and its history. Plan ahead and learn about schedules and special events. The regime is the home and office of the President and is found at 1600 Pennsylvania Avenue, NW. To arrange a tour you must make a request through one of your members of Congress. Group tours are held Tuesday through Saturday from 7:30 a. m. through 11:30 a. m. and are lined up one month in advance.

At the east end of the National Mall stands the majestic U. S. Capitol Building. Due to heightened security, the Capitol is open to the public for steered tours only.

The one thing you will want to do for sure is take plenty of photographs as you have a tendency to remember everything as you are going to remember everything as you are so impressed at the time but believe me, your memories have a tendency to fade and it is always better to have some pictures to help bring those memories into sharp focus. I’m not a Commercial Photographer but wish I was to have better captured some of the beauty we saw on ths trip

Also, in addition to the typical tourist attractions discussed above, you may find the Washington, DC area has some of the best restaurants in the country. I suppose this may be due to all of the important politicians that live there as well as the many dignitaries that visit the area and need to go out to eat.

Well, that rather sums up our trip and I can only hope that you get the opportunity to visit the Washington, DC area.

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Why You Should Get Great Furniture

Shopping for furniture can be a very demanding thing, especially if you need to drive from one furniture shop to another. Although there are pockets of similar stores close by to each other, there are always more stores to visit that can be miles away from each other and unfortunately by the time you get to the final store, you are more confused than ever as to what it was when you first left home.

There is a better way to go shopping and that is by looking for what you want on the internet. Good furnishing stores all have a web presence and Craig’s Furniture Rockingham is no exception. Craig’s Furniture has a very comprehensive website called home-furnishings.com.au and it has all types of home furnishings and more.

If you are a resident of Rockingham in WA, or live in the surrounding suburbs, then you will be able to go online and look for furniture, whether it be Dining Furniture, Lazyboy Furniture, Lounge Suites or anything else. Then you can go to the shop itself and know exactly what it is that you want.

Alternatively, if you want other home furnishings and you don’t live in the area you can shop online and also order your furniture and it will be shipped to you. How good would it be to be able to buy furniture online and not have to move outside of your home! Imaging the petrol you will save by not having to drive miles and miles and miles to find the furniture you want.

Anyhow, be assured that if you are looking for furniture Rockingham, then you can simplyshop online first at home-furnishings.com.au before stepping outside of your home. What a great way to buy.

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