Letter to Congress

Posted: under Business of Healthcare, Healthcare System, Politics.

I urge all of you who support healthcare reform to write your U.S. representative and senators. You should write even if you do not support reform, because that is how the system works. Of course, political forces can do only so much to reform healthcare, but it is a good start.

Our representatives are facing a lot of pressure from interest groups and need to know they at least have the support of their people at home. Here is the letter I sent to my congressman:

Dear Fred Upton:

I would like to write to you about healthcare reform. This issue is very close to me as I work in healthcare and have struggled with a chronic illness for four years now.

Although I am a conservative and have voted Republican my whole life – including for you last November – I am convinced that President Obama has it right on this issue. Small government is a good policy when the private sector can do it better than government can. However, having dealt with insurance companies, physicians, and administrators as a patient, businessman, and child of a physician, I can tell you with certainty that government can do it better.

Physicians are so ingrained in procedure that they ignore results. Private insurance companies have every incentive to write confusing policy contracts and statements. What is worse is that it is almost impossible to get decent care without insurance, even for those who can afford to pay. HMOs sometimes accept only those patients who are in their network. Hospitals and physicians charge more for the same services to those who do not have insurance.

I read a compelling article about how government involvement in healthcare has caused many of the problems that exist today. Indeed, the federal government has subsidized healthcare in the form of Medicare and Medicaid without exerting sufficient control over its investment. Thus, we might expect improvement in healthcare delivery with either more government involvement or less.

However, as you well know, Medicare and Medicaid are not going anywhere, so that leaves us with more government involvement as the only viable solution. Exactly which proposals are the best is an open debate, but I really like Obama’s public option proposal. It would be easier than doing business with private insurers. And I would not mind paying the entire premium without a federal subsidy, so long as there is no medical underwriting.

Because of the committees you are on, your involvement in the issue of healthcare reform will simply be an up-and-down vote, I would imagine. However, when you do vote, please be open-minded about healthcare reform and about Obama’s plan.

Sincerely,

Alexander Typaldos

Comments (0) Jun 15 2009


Millennium Bridge Syndrome

Posted: under Philosophical Discussion.

The Millennium Bridge of London was completed in 2000, hence its name. However, the bridge is better known for a lesson it provided in synchronization. Opening day for the pedestrian-only suspension bridge saw thousands of visitors crossing at once. Unexpectedly, the bridge began to sway back and forth, or oscillate sideways.

Videos of the event are surreal because you can see thousands of pedestrians walking in step as they cross the bridge – rocking left and right in unison to keep their balance. The reason for this synchronization is that each individual pedestrian, when he walks, contributes a little force that causes a slight oscillation. Because each pedestrian’s steps are random at the beginning, more pedestrians will inevitably step in one direction than another at various times. When this happens it causes the bridge to sway slightly in the direction of greater force.

A few more people will recognize, perhaps subconsciously, that the bridge is rocking and they themselves will rock back and forth to keep their balance. It so happens that the same motion that keeps an individual balanced also powers the oscillations, increasing their amplitude. This process accelerates until all individuals are synchronized, therefore maximizing amplitude.

In the case of the Millennium Bridge, oscillations were so forceful that pedestrians might have fallen down had they not walked in step.

Individual Rationale

The most crucial point to learn from the example is this: The decision that is in the best interest of each individual opposes the good of the aggregate; and that, in turn, harms each individual.

This is exactly the situation we have in healthcare at present. Physicians, insurers, employers, hospitals, and patients all want changes. They are swaying back and forth in a shaky system, perpetuating its inadequacies just to keep their balance. Yet they are powerless to change the system as individuals or even as entire interest groups.

A Coordinated Response

If the pedestrians on the bridge had formulated a system of two groups – each walking in sync and opposing the other group’s side to side steps – oscillations could have been reduced. This would never have really worked, though, because Londoners enjoyed shaking the bridge! (And that is perhaps another lesson in itself.)

Instead, the builders installed dampers to absorb shock. And they succeeded at eliminating all noticeable oscillations.

Alexander Typaldos

Comments (0) Jun 15 2009