Making the Best Better on the 4th

Holidays, especially the 4^th of July, are great opportunities to reflect on where we have been, where we are, and where we are going. Our great nation has accomplished much, yet still has far to go.

Here are the most important areas where I think we, as the United States of America, can improve so that our children and children’s children will have a better future.

Education – All should be able to get a good education regardless of their economic situation. Well-educated citizens are critical for a successful democracy. Education helps our nation make the most of its human resources. Public education and libraries helped build the foundation that made our country great.

To improve our educational system we should greatly increase teacher salaries, reward teachers based on performance, measure performance in ways beyond just standardized tests, and remove tenure for elementary, middle school, and high school teachers.

Prisons – We should minimize the number of people that must go to prison by ensuring they are educated and prepared to get whatever job they are best suited to do. Prisons should work on reforming and educating criminals to become productive citizens rather than be warehouses for punishment that foster criminals teaching crime to other criminals.

Housing large numbers of prisoners is expensive and a drain on society when those people could be productive citizens. The prison system should be rewarded based on reducing criminals and maximizing good citizens rather than locking them up indefinitely. We cannot afford this. Some resort to crime because there are no other good alternatives.  Better education is a good place to prevent criminal behavior. Reform and education must be emphasized for those who slip thru while indefinite lockup is reserved for those that cannot be reformed. The death penalty should be abolished because it is far too expensive as well as error prone with no recourse.

Health Care – Everyone should be covered by basic healthcare so valuable human resources are kept healthier (in better working condition) and are treated through less expensive preventative or timely curative treatments rather than expensive and last ditch emergency care. A stitch in time saves nine.

The Affordable Health Care Act was a step in the right direction. Encouraging Health Maintenance Organizations over traditional health insurance is even more cost effective and efficient.

Taxation – Taxes are not evil. They are investments in our government and our shared infrastructure so we can enjoy a more stable, safe, and productive community and society. We must embrace reasonable taxes and not keep dodging them at all costs. Endless tax cutting ends up hurting all of us. The wealthy have automatic advantages over the poor and also benefit immensely from a stable society that consumes their goods and services. It is a good thing for the wealthy to pay proportionately more in taxes than the poor.

To better use tax revenue, we need to balance our budget and put performance metrics in place so our government is naturally rewarded for effectiveness and efficiency. Legislation should focus more on outcomes rather than the hows. Let government professionals figure out how to maximize results just as we let the free market economy figure out how to best satisfy demand.  The City of Sunnyvale is a good example of performance metrics as well as a balanced budget in action. Please also note that the vast majority of government workers are middle class and few if any are wealthy. Tax dollars directly employ a larger number of people in government than concentrating wealth in the hands of a few.

Civil Rights – Everyone is entitled to equal rights and equal protection under the law. We are close to achieving this beautiful vision as embodied in the Declaration of Independence and our Constitution.

Yes, any two consenting adults should be entitled to marry and enjoy the economic, legal, family, and child rearing benefits of such a union.

Democracy – This is the most sustainable form of government yet invented. A “government of the people, by the people, for the people” is the only practical way to govern people as they do it through their own choices rather than being told what to do by others.

We need to have positive policies to foster democracy abroad as well as encourage our populace to participate actively in our own democracy. The legal system that supports our democracy is the best defense we have against corruption.

Sustainability – Our resources are not unlimited. Resources include energy, materials, space, and time. We all must strive to budget ourselves so we make the best use of the limited resources we have and hold ourselves accountable before nature itself forces us to be accountable.  Reduce, reuse, recycle.

Our government is in the best position to put checks and balances in place to ensure we do not overly abuse our environment. Protecting our environment is extremely important yet too long term an objective to be otherwise factored into our free market economy.

Poverty – This is really the bottom line. Better managing all of the above will help reduce poverty and the inequitable distribution of wealth. When none of us want for basic needs, there will be less war and less crime. Having wealth widely distributed benefits us all. It only stands to reason. No one should want for adequate food, clothing, shelter, or health care.

What a wonderful ride!!!

Our entire family (2 parents, 2 kids and 2 dogs) participated in the 2010 Challenge Bicycle Ride today -- 24 miles of quiet residential street bicycling on a beautiful Sunday morning through Sunnyvale, Mountain View, Los Altos, and Los Altos Hills. While the ride is over for this year, I hope more from our community will participate at next year's event.

For more please see:
http://www.challengebicycleride.org/

Health Care Bill Passes!

History has been made. Obama, Pelosi, and the Democrats have accomplished an amazing feat -- a health care bill has now passed the Senate and House. Along with Social Security and Medicaid/Medicare, this is one of the biggest accomplishments by the government for social justice in the US in the past 100 years. If implementation goes well, the Republicans (the Party of No) will be in the dog house for a very long time. If not, then the Democrats will suffer. I believe that passage of this bill is a huge positive outcome for the US and will go a long way to improve the productivity of our human resources in the US as well as reduce costs.

For more see: http://news.yahoo.com/s/ap/us_health_care_overhaul

Health Care -- Make it Naturally Sustainable

Here is my simple perspective on health care reform in the US: establish a health care system that has simple natural incentives to keep people healthy.

The current US health care system is too expensive, is not able to cover everyone, and has many inefficiencies. The US spends more per capita on health care than any other UN nation (http://www.who.int/whosis/whostat/EN_WHS08_Table4_HSR.pdf) yet does not achieve the quality of care available in many other countries (http://content.healthaffairs.org/cgi/content/abstract/22/3/89).

We all know that an ounce of prevention is worth a pound of cure but that is not how most of the health care systems in the US work.

Our current systems either have lots of government regulation to tell the system how to run and what to do (lots of rules, slow to adapt) or have big bucks insurance companies competing against big bucks medical companies. In the government controlled case, the operative goal is to follow laws and legislation. In the insurance industry vs medical industry case the operative goal is to maximize profits on one side or the other. Neither system has natural incentives and tight feedback loops to keep people healthy. And most of the money is spent at the end of the health cycle when expensive health care is required. It is not spent to keep people healthier up front.

At a recent gathering at Harvard, a health care professional and fellow classmate pointed out that traditional health care is responsible for only about 10% of a person's overall health. Yet that is where most money is spent. Another 10% is attributable to the environment. 40% depends on a person's eating, exercise, and life style habits. The remaining 40% is dependent on a person's socioeconomic status. Spending money on improving healthy habits and educating people has an enormously bigger and more effective impact on improving health while consuming fewer resources (money, etc).

Another of my classmates noted, and I agree, that it is critical for any new health care system to have direct incentives to keep people healthy -- rather than incentives to deny them care (current insurance) or incentives to give them expensive treatments with high profit margins (many medical/drug companies). One of the best current day examples of the way things should work is Kaiser Permanente and some other Health Maintenance Organizations. Kaiser has extensive programs to keep people healthy -- and Kaiser makes more money the healthier it keeps its clients. Kaiser's doctors and staff are reasonably paid without necessarily needing to have patients undergo expensive therapies. It is far cheaper to have them participate in wellness programs. Patients can also reduce their own costs by staying healthy. And both Kaiser and their patients have thorough health data to track what works best.

We need a health care system that naturally balances patient goals (good health), medical provider goals (income), and resource conversation (keeping costs down). Systems like Kaiser are succeeding at this. We need health care plans available to all in the US that can have a similar and sustainable balance.

It is my hope that the Obama administration's efforts will result in such sustainable systems with effective and natural checks and balances but with little or no government intervention required (small government). There are certainly a number of other implementation details to work out -- like how to fund health plans for those who cannot otherwise afford them -- but hopefully we will end up with a plan that achieves a natural balance and is sustainable.

A Better Solution Needed for Diabetic Students in California

A California state judge's ruling on the California Nurse Practice Act determined that only nurses can administer insulin to students in California. I think this act needs to be amended because that does not make practical sense. We do not need professionals to do every slightly dangerous thing for us. Driving a car is far more dangerous yet are we going to require everyone to have a professional chauffeur? Millions of regular people can can administer insulin safely. All that is really needed is to offer some simple training to those who administer insulin. Requiring a nurse for this is overkill.