UBHC

Universal Basic Health Care (UBHC) yep, this is a tough subject for anyone to broach and for a lot of reasons...so of course I have opinions!!!

So let's start with why I am calling it UBHC? Simple answer is UHC is United Health Care and I don't want confusion.

So what is UBHC? Some will call it "Single Payer Health-care" others will call it "Socialized Medicine" in a sense both are correct, but they are loaded terms. Due to...let's call it "propaganda." Basically we have pundits and politicians that usually have no idea what they are talking about spouting

• "DEATH PANELS!!!"

• "RATIONING!!"

• "DO YOU WANT THE PEOPLE RESPONSIBLE FOR THE IRS CHOOSING YOUR HEALTH-CARE!!"

• "SOCIALISM!!"

Is any of that justified? Maybe, maybe not. Now let's look at this from the point of view of someone who admits I have no idea what I'm talking about, but I have the internet!

Let's begin with the Elizabeth Warren faction "Medicaid for all." No, just no. Medicaid has a veritable plethora of known issues:

• Not all doctors will take Medicaid patients

• The system is gain-able

• Apparently teeth are not a part of your body

• Hearing aids are apparently not a medical device for most

• It varies from state to state because each state administers their own semi-autonomous variant

How about expanding the VA (Veteran’s Administration Health-care) system? Again NO. The VA system is stretched and is completely dependent on the whims of Congress

So where do we start? As any good engineer would tell you, if the system is too bad to save, don't.

Each state regulates health-care independently, for single payer this won't work. We are a transient nation it isn't odd for someone to live in say Illinois yet work in Missouri. So if they have a local doctor the doctor is bound by Illinois law, but their insurance is bound by Missouri law because their job is located in Missouri. Again each state regulates health-care and health insurance locally. So how do we stop this? The Interstate Commerce Clause of the Constitution.

Uh oh! Maura just suggested Federalizing something. Yes I did. Why do we have 50+ (States and territories) different sets of health regulatory agencies? 50+ sets of insurance regulations. 50+ sets of medical regulations. 50+ medical licensing boards. Then there are the federal level regulations.

We could streamline this entire system by moving all the regulatory system under one agency. Now I bet someone out there is going "But Maura, another federal agency?!" No, we have one already but we need to do a little shuffling:

• First we change a name the Food and Drug Administration becomes the Federal Medical Agency or FMA

• Move Food regulation out of the former FDA to only the USDA (United States Department of Agriculture)

• Now we move licensing doctors to prescribe medicine from the Drug Enforcement Agency (DEA) to the FMA

• We move medical licensing from 50+ jurisdictions to the FMA

• Moving licensing to a central point also eliminates sub-par doctors from jumping state to state and puts their malpractice records in one data base—I admit this is not a major issue but it is a bonus

• We move medical insurance regulation from 50+ jurisdictions to the FMA

• We move hospital and surgical facilities regulation to the FMA

• Now all those state level workers that are out of work? We move them to the FMA to deal with local offices and inspections

Now that we have done our federal shuffle, what's the next step?

We start the process of building the new UBHC system. We need to set a few solid ground rules up front:

• UBHC should not be allowed to force or mandate treatment for ANYTHING, that decision should be strictly between the patient and provider

• UBHC should cover end of life costs (including long term care facilities), but be prohibited from mandating or paying for assisted life ending

So what should the new system cover?

• Everything from the top of your head to the soles of your feet

• So teeth are a part of health care—ever hear of Temporal Mandibular Joint Disorder? Apparently your jaw is a weird anomaly as health insurance says it is a dental issue and dental insurance says it’s a health issue

• Orthodontics regardless of age

• Glasses and eye-care

• Hearing aids, dentures, and other prosthetics--yes this would include implants be they dental or breast, I know why?  Because too many women suffer emotionally with underdevelopment issues, and reconstruction from cancer, if we try to micro-manage we will in the end cut out nesacerray treatments to stop a few people from being happy.

• Mental health coverage can be equal and we can begin weeding out the bad providers

• Quality of life medical issues, joint replacements, hormone replacement therapy, adaptive medical devices ie: hand operated controls for a car or a power lift for a wheel chair

• Prescriptions

• Chronic illnesses should be cured if possible not just treated--UBHC would be a needed push on this as it would suddenly be way cheaper to say cure cancer or diabetes than to keep treating the symptoms

Now how do we bring it in? Well not all at once because that would be asinine. So to prevent asinine actions here is my idea to phase it in and believe me this is going to sound odd but follow along as I lay this out from our randomly chosen start year of 2025

• Wave one 2025, every person born between the years 2015 and 2025, why? Because statistically this group is of the lowest cost to insurance companies so by default allows the first group to not strain the new system.

• Wave two 2026, every person born between 1985 and 2014. Again low cost to cover, not a huge slam on the new system.

• Wave three 2027, every person born between 1970 and 1984. Now we start tightening up as this age group is beginning to use more health-care. Diabetes begins to show up. Heart disease, cholesterol issues, back strains, hernias, etc, this will be the first real stress test of the system

• Wave four 2028, all persons born between 1960 and 1969. We now are hitting the era of persons in there 60s to pushing 70s. At this point we are no longer adding people to Medicare as they are on UBHC

• Wave five 2029, we transfer people on Medicare and VA to UBHC and the Medicare/Medicaid and VA systems are finally taken off-line as they are no longer needed.

Now why did I phase it in over five years? Like all major roll-outs you never do all at once or mistakes that could have been minor become major as they cascade fail. By beginning with the least likely to need care and gradually working our way up we find flaws at a lower rate. If we flipped it we suddenly have a lot of people who need typically the most care stressing a system to it’s limits immediately. This is as much a tech issue as it is people issue. For the most part people already above 65 at roll-out are already on Medicare so no real reason to swap them out in the Beta phase either.

“Maura, this will cost a fortune and why do we need UBHC?” Yes it will not be cheap, but neither is Medicare/Medicaid/VA or no insurance and bankruptcy.

Why do we need this? (Questions below are rhetorical so no I am not seeking answers)

• Because everyday people die from treatable ailments

• Everyday people lose jobs and by default health-care

• Everyday people have to choose between do I buy food or see the doctor

• Because we live in a transient society and people constantly move from place to place and with every job change comes the 30 to 90 day no coverage gap

• How many of you worked a job you couldn’t stand because it offered health insurance?

• How many young people age off their parents plans only to be without for years and end up in the Medicaid system?

• How many people with marginal employment are told to use the Exchanges only to find the payments are higher than what they bring home?

• Most of our country is one major illness away from insolvency and losing everything at any given time.

So how do we fund this? For starters:

• This should be an 80/20 plan so UBHC covers 80% of a hospital bill

• Emergency room visits should have a steep fee if not admitted much like traditional insurance say $1,000 or 20% (whichever is lower) of an Emergency Room visit, but $50 for Urgent Care

• It needs to have an out of pocket cap to prevent bankruptcy so let’s set it at say $5000

• The system will have to negotiate prescription pricing to reduce costs

• Prescriptions could be on a tiered co-pay system let’s use $5 generics, $15 brand

• Medical providers will have to understand that much like the U.S. Dollar is accepted for payment so is the UBHC

• Doctor’s should not have a co-pay, honestly it just adds to the cost associated with patient care. Instead the doctor’s office files that John Doe was in my office on____, for medical code ____, and submits for payment—this encourages people to use a doctor’s office instead of urgent care facilities

Tune in for my next unscheduled episode when we see what hair brained scheme Maura is pushing with this to help fund it.

“The true measure of any society can be found in how it treats its most vulnerable members.”

— Mahatma Gandhi

Dreams are often most profound when they seem the most crazy.

—Sigmund Freud

For all things Maura MauraAlwyen.com

Where have we failed

A mutual on twitter recently posited this question:

"What do you think the leading causes of mental health issues are in today's society?"

Now I responded but twitter only allows for 240 charecters so let's expand a bit off my original answer.

Lack of family structure.

I don't care what the composition of the family is, It can be the standard nuclear family model, dad works, mom is a homemaker.  It can be the alternative of that, mom works, dad is the homemaker.  It could be two adults of the same sex.  It could be cis and trans.  Who earns the cash and who does the homemaking is irrelevant, children should not be alone when they get home from school.

As adults decompress from a hard day at work, children need the love a parent gives when they get home.  A parent available to get them a snack, see how their day went, learn who is bullying them and call the school, help with homework...instead "Here's some food, a TV, the internet, and don't leave the house."

We used to have "free range kids" I'd wager more than a few of my readers were themselves free ranged.  You could hit the door get the attention from a parent and in an hour be out with your gaggle of buds so long as you were home for dinner, and even then so long as you called from a buddies house and say you were asked to stay you just had to be home before the street lights kicked on.

We now treat our children much as we do our pets.  Their attention is provided by a screen (you do leave a t.v. or a radio on for your cat or dog right?) their nourishment (treats) come wrapped in cellophane with descriptions that defy logic (fruit tortillas? flaming hot fried cheese and cornmeal?) and we keep them safe inside a fancy crate (house, apartment, etc).  We have the gaul to wonder why school bullying is an issue.  Why mass homicides at school campuses are at the level they are.  Why, kids seem to be having intercourse at younger ages.  Then in a few short clicks on the internet you can find where children are having intercuorse with teachers.

How does a child end up having sex with a teacher?  Well we are entrusting those adults or barely adults themselves, with the care of our children 30 to 40 hours a week while we are at work.  So the teacher becomes a focal point and if they give the child the attention they need and crave while the child's parents are not, where do you think this will lead?  The child will bond with the person giving them attention, but a teacher is not a biological relative and therefore the "ick factor" that keeps at least 50% of parents from sleeping with their children is not there and a bond can go too far.

Are video games with titles like Guns Blazing Combat, Stalker of the Night, World War Armageddon, Civil War Reenactment Battle Simulator, to blame for the mass homicides?  That is an open issue, but to me they aren't helping.  The closer to reality graphics get the closer to desensitization we get as well.  The more the non-playing characters that you kill look like actual humans to some the less real humans actually look.  Many will say "violent video games have no effect."  Okay, in a laboratory or how large a sample group are you using?  MIlitaries around the world use age eighteen as a recruitment age, why?  Because at eighteen the human brain and especially those of male presenting humans has not finished maturing and is as moldable as modeling clay.  So militaries can mold a killer with lightning fast reflexes, why can't a contiously played video game where you emerse yourself in a well thought out, well animated, world that was designed for whatever game play is intended?  How many militaries now use video games for training?  Do they know something the video game industry pundits do not?

We have become detached from our food origination points, people no longer equate the cow they see as we zoom past at 60 miles per hour (what's that about 120 kph?) with the burger, the cheese on the burger, or the milkshake, that they are eating in the backseat...I kind of doubt very many even understand their french fries were once potatoes.  I actually used to know someone who absolutely hated onions but loved onion rings and swore they were not made from onions and it was just a name...no joke.  When I was a kid meat still had blood inside that cellophane wrapped styrofoam plate.  Cookies from the store meant one of about four types--I still love windmill cookies--Hostess was about your choice for little cakes, now there are entire aisles of mega-sized supermarkets of premade cookies and cakes.  Now how does this figure into the discussion?  I honestly lost where I was going when I had to stop and check the wash; make of it what you will, and if you don't like it tag me to your own blog post about it :-)

I'm going to cut out now, so be kind and rewind.

For all things Maura or to donate to my shop fund, or find unique items and gifts, MauraAlwyen.com

It's been a a bit

So it has been a bit since I last wrote anything here.  Like a lot of my writing there are several drafts waiting to be completed, a couple ready for editing, and ideas that are collecting digital dust.  So why the gap?  Life sometimes gets in the way, that said let's bring you up to speed on what has been going on in Maura's life:

I took a job as a Maintenance Manager back in early April.  I am not really sure what to make of it.  The pay is about right, limited weekend issues, but it is a very different world from where I worked before.  I'm not sure what to make of my boss at this point either and that does not help things.  It is easy to screw up as far as spending more than a property owner is prepared to spend and each owner is different on what they are willing or can drop on a building at any given time.  My crew is a mixed race, mixed age, group, the older guys show up every day they are supposed to but the work they put out at times can be questionable or claimed and not done.  The younger guys seem to think they can show up or not as they see fit, that tools are an optional luxury item compared to alcohol, and have a much different work ethic than I do.  I have one new guy that like me has a work ethic, and a skill set, and his own tools!  I have also learned that our cleaning company is staffed by immigrants who speak Spanish and like to hide behind the language barrier--I am now working toward finishing learning Spanish.  I was kind of funny when I had to deal with their crew the first time and found one that spoke "English a little" and I told her that was okay I only speak a little Espaniol.  They all looked at me and stopped chattering between them...work speed was improved.

May was an unmitigated disaster around Casa de Maura...literally it was one giant mess!  The ex spent most of the month packing and one entire end of my living room was filled with boxes from floor to almost ceiling.  There was a lot of paper work involved too as their name had to be removed from deeds, titles, bank accounts, etc in preperation for the final divorce.  I didn't keep a good track of what they took as I figured if it was important I could replace it so long as it was not my personal stuff or my tools.  I have had a perplexing time dealing with what got left behind though.  A few things have since been retrieved and other things I am boxing up as I find them.  We share children--both grown--and a grandchild so no matter the circumstances of our split we have to stay on decent terms.

June!  The first week of June saw the ex and all of their stuff leave for another state about an eight hour drive away.  The space vacated by their packing quickly filled with Doc's stuff as she had found an apartment of her own half the distance to her job.  The heat of the St. Louis summer found us with a vengeance and soon it was a hundred plus degrees with the heat index--if you are unfamiliar with St.Louis weather think Southern California heat with Florida humidity!  Cleaning that had to be neglected due to the ex working from home since April of 2020 began and may I say my OCD has been bonkers!  I have to allow the ADD to run with the OCD and bounce about with my cleaning so little bit here and a little bit there as opposed to looking at one project and being overwhelmed and depressed.  The cleaning is progressing though.

July! A month to the day after the ex left Doc moved out.  The house is still a jumbel as not everything of hers has found its way to her place yet.  Later today I will be installing two window units on her apartment so she can be better rested and able to come pack out the last of her things.

So the house is just me now.  No other people, no pets unless you count dust bunnies, a lot of flotsom and jetsom about the house.  I bought a nice vacuum that runs on the same batteries as the rest of my tools--gotta love Ryobi.  Replaced all the worn plastic dishes with white porcilin, the plastic cups have been swapped to glass, new silverware, removed a weird knee wall from the kitchen and moved some shelves around.

I splurged and bought a new ice-cream churn, now I need containers to put the ice-cream in before I make a batch.  I know, why did you buy an ice-cream churn?  Ice-cream is cheap.  Well that substance they try to pass off as ice-cream is cheap, but real ice-cream is pricey!  Plus remember I am diabetic so I need sugar free, and being almost completely Indiginous I don't digest lactose, so homemade is best for me.

I now have pretty much perpetual pitchers of lemonade and tea in the fridge, and will soon be keeping cookies and maybe a pie around all the time too.  Don't ask me why these are important to me but I think it has to do with the memories of my grandma--dad's mom--at least the pie and cookies, the lemonade and tea?  Well I was born and raised in the old South.

I plan to get back to some Cooking With Maura episodes in the near future...may have to have the kids over more often to eat leftovers.

Maura the Maker will have some episodes but they will be sporadic as I have a room to make-over including replacing and upgrading windows on that room.  Everything has to be done as weather permits though because I am far from goal money wise on my shop, and the GofundMe stalled a long time ago.  Yes the ex said they would fund it--the ex said a lot of things--and now is not in the posittion to fund it nor do I want their assistance at this point.  So even if you can't help toward the goal please share it wherever possible.  All monies go into the shop fund wich is completely separate from my general revenue.

The big news I have been told will be delayed and there is absolutely no hint of when I can reveal it from a legal perspective.  Now if you are all chomping at the bit to learn imagine it from my perspective!

I may be dusting off the first novel I wrote and seeing about what it will cost to get it edited.

My first published piece has a second volume and I am considering working on that volume as well.  And there is a book that is almost complete I have started reading on from the beginning to get back into it to finish it.  I also have quite the collection of erotic works that I am considering edit and release of under a psuedonem as well--yep I write all kinds of stuff!

Don't expect any more cross postings on Ordinary-Times, the last piece I submitted I did not agree with the editor and deleted it from their system.  Also the trolls and morons in the comments were just to stupid to deal with anymore...if it affects my personal mental health it isn't worth the trouble to me.

Twitter is kind of random if and when I get on it anymore, I found myself in a very toxic position, backed off and really don't miss it that much--the trolls from Ordinary-Times following me over there didn't help much either.

I'm off my soapbox for now.  Remember for all things Maura and links to all my sales platforms, sites, basically everything! MauraAlwyen.com