Tuesday, November 4, 2014

Getting out the vote

It's election Tuesday. As with all such days, it's a major relief to know that holiday ads will replace the political commercials on TV. 

Case in point: They’ve been running a lot of anti-Prop 45 commercials on TV. (Proposition 45 is an initiative requiring that insurance companies get approval from a state commissioner before they make any changes affecting the rates they charge for healthcare coverage.) Their scare campaign revolves around someone dressed up as a physician or nurse intoning that letting a politician mess with healthcare decisions that should be made only by the doctor and the patient is a very, very bad, horrible, terrible thing.


I’ve no doubt that the anti-Prop 45 campaign can afford these ads; it’s extremely well-funded. Its backers include: the California Hospital Association, California Medical Association, and healthcare insurance giants like Anthem, Kaiser, Blue Shield and United HealthCare. That latter group alone have more money than God, in case you’re at all unclear about the matter. As of a couple of weeks ago, they’d spent more than $57M to defeat the measure.

(Of course, you could sweep out $57M from between the sofa cushions in the executive lounge of any of those insurance companies. But still.)

What I find interesting about this “Healthcare decisions should be made by doctors, nurses and patients—not dictated by one Sacramento politician” rhetoric is the foundational logic that this is currently the case. You know, that medical decisions are made only by the physician and patient.

When, in practice, this is a complete crock of moosemilk.

Under the prevailing payment model, healthcare decisions are in fact made by insurance carriers. Both directly—in terms of what they deem is appropriate (meaning “what we’ll reimburse you for”) treatment, as well as indirectly because providers are driven to see three or four patients per hour under terms of their insurance contracts, so they don’t have the time to properly understand patients’ needs, histories or ailments in order to make truly informed decisions.

You know—just the fact that Anthem is coughing up the kale is pretty much all I need to know about the merits of the anti-45 argument. We’ll see how successful they are at gulling the electorate.

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Also on an electoral theme, I noticed these signs for Cupertino City Council candidates.



Cupertino, as you may know, is the home of Apple. That’s where their physical headquarters are, I mean; I think most of their revenues are filtered through offices in other countries, so that their tax liability here in the US, California and Cupertino is considerably smaller that you’d have expected from their sales figures.

Anyhow—here’s the sign I found particularly interesting:


Andy clearly wants the electorate to think of him by his all-American first name, not his surname. In a city where the electorate is 44.4% Asian, I just wonder what’s up with that, because it obviously doesn't bother either Paul or Sun.


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