"Failed State".....

That's a term most of us associate with disintegrating, lawless places like
Somalia, Sudan, Pakistan's Northwest Territories or, quite possibly, Afghanistan.

But it's always interesting to see how those abroad see us. Here's a link to an article by a Brit who questions whether California is becoming a "failed state":
http://www.guardian.co.uk/world/2009/oc ... state-debt

Stay tuned.

Julius Young
www.boxerlaw.com

It didn't fly.

24-hour care, that is.

Advocates of 24-hour care would like to merge workers comp medical care and regular health insurance, perhaps adding in medical coverage under auto insurance. It's an idea that has been discussed for years.

Senator Jay Rockefeller (D-West Virginia) advanced such a plan this year as part of the healthcare reform debate. Rockefeller is a member of the Senate Finance Committee, chaired by Max Baucus of Montana, that has taken the lead in Senate deliberations on a plan.

Rockefeller's plan was one of over 500 amendments considered by the committee in it's deliberations, known as the "markup".

A coalition of property and casualty insurers opposed the bill. No hearings have been held on Rockefeller's amendment, but it appears that the 24-hour concept is not making it into the Senate Finance Committee's final version, which will probably be unveiled this week.

It's not surprising that the concept is not catching fire at this time;, after all, it would federalize elements of programs (auto insurance and workers' comp) that are the province of the states. That's not something real popular at the moment.

The idea could be resurrected in further negotiations, but it appears that it's a concept that has little political juice at this point.

Stay tuned.

Julius Young
www.boxer;aw.com

Going Dutch.....

Is that where we're headed? I'm not talking about that ritual which occurs as two friends fight for the check at dinner. And though my office is a block from Oakland's "Oaksterdam University" , where there are classes on how to grow better marijuana, I'm not talking about those Amsterdam coffeeshops.......

And I'm not talking about their "Supperclub", where you can eat on loungey white pillows while half naked servers swing from ropes and trapeezes to serve you while you listen to deafening music and watch videos that were appropriate for San Francisco's 1967 "Summer of Love".....

No, I'm talking about the Dutch healthcare system.

I was in Amsterdam about a week ago, bookending my Croatia trip.
The Dutch look quite healthy, bicycling by the canals. What's up with their healthcare system?

For starters, there is no public option there. Instead, everyone is required to obtain insurance offered by private insurers. There are income based subsidies. Jonathan Cohn notes that 2/3 of the population get some assistance.

In his article in The New Republic, Cohn analyzes the Dutch approach.

What appears to be working in the Dutch system (which was revised in 2006) is that insurance is made available to everyone. There are no exclusions for pre-existing conditions. Cherry picking young and healthy subscribers is not allowed. Plans are audited. Those with a high proportion of unhealthy members get subsidies while those with a high number of healthy young adults get dinged with fees. Cohn notes that it's a "risk equalization scheme".

Insurers can't charge higher premiums for older folks or for those who have riskier jobs or lifestyles.

Insurers are heavily regulated. There is a high degree of transparency.
Information about insurers and medical providers is made readily available.

There are aspects that might be politically unpalatable here, though. Cohn says the Dutch government is involved in setting prices (sounds like Medicare?) And the government defines the medically necessary services to be provided (sounds like Medicare?).

Cohn notes that the "public option" appears to be on life support.
Senate Majority leader Harry Reid was quoted today as claiming that a public option will be in the final bill, so perhaps the Democratic leadership is prepared to risk parliamentary tricks to get a bill.

But if there is no public option? Many progressives and activists on the left believe that without a public option, healthcare reform will be worthless. Some labor unions may be ready to abandon support for any plan that does not have a public option. Columnists wonder why democrats are so timid in defending the public option:
http://www.realclearpolitics.com/articl ... 98532.html

Cohn's article is a reminder to progressives that there may be other ways to promote a better system.

It's a reminder to progressives that they need to be considering a Plan B. What works in other countries, and how to adapt it to what we have here?

Cohn's article:
http://www.tnr.com/article/health-care/going-dutch

Stay tuned.

Julius Young
www.boxerlaw.com

Recently I did a post on the controversial "regulations study" recently unveiled by the Governor's "Small Business Advocate":
http://workerscompzone.com/index.php?en ... 923-222650

Today there's a fascinating article by John Howard in the Capitol Weekly on the back story behind the regulations study, "Smoke and Mirrors: One
Bill's Path in the Capitol's Labyrinth":
http://www.capitolweekly.net/article.ph ... eglc1h1rz7

Stay tuned.

Julius Young
www.boxerlaw.com

There's mounting evidence showing that football players are at increased risk for dementia.

Today comes word in the New York Times that the University of Michigan's Institute for Social research has completed a study of former NFL players.
Further studies will be undertaken, but the Michigan study is said to document a vastly higher rate of memory problems and dementia than would be found in the general population.

The reason would appear to be concussions suffered in the sport.

The Times article by Alan Schwarz is here:
http://www.nytimes.com/2009/09/30/sport ... ia.html?hp

A handful of firms handle the California workers' comp cases for NFL players. I expect we'll see increasing claims focused on the cognitive effects of the sport.

Here are some earlier posts I did on the topic:
"Pro Football's Walking Wounded":
http://workerscompzone.com/index.php?en ... 202-073901

"Pro Football Player Injuries":
http://workerscompzone.com/index.php?en ... 204-124330

Stay tuned.

Julius Young
www.boxerlaw.com