In one of my earliest posts, I examined the arguments of those who insist that healthcare is a basic human right. Proponents of this position tend to misunderstand the difference between rights and needs, and to base their arguments on compassion rather than logic. In Healthcare Is Not A Right, I point out that a right cannot exist as long as it creates a corresponding obligation that someone else is required to satisfy. We cannot simply declare that healthcare is a right without trampling the rights of our healthcare providers.

The key to any successful healthcare reform effort will be the development of effective cost control measures. Politicians are reluctant to discuss rationing of medical services, but no nation can provide universal coverage without some sort of rationing mechanism in place. Revisiting The Oregon Plan: The Future Of Healthcare In America examines the issue of rationing, and takes a look at one of the most efficient methods devised to date for the allocation of health services. The original Oregon Plan was reviled by critics for its technocratic approach, but it will not be possible to provide universal coverage unless we adopt a rational system for the allocation of medical resources.

Conventional wisdom tells us the problem with our current system is that too many Americans lack health insurance. What If No One Had Health Insurance examines the question from the opposite perspective and suggests a return to a traditional fee for service model. Modern health plans encourage over-consumption of health services, and provide no logical connection between the price we pay and the services we receive. The most effective way to reduce healthcare costs may be to restore a direct relationship between consumers and healthcare providers.

The bankruptcy of Chrysler and General Motors has focused national attention on the crushing cost burden of employer provided health benefits. While many credit GM with introducing the concept of employer provided healthcare, it is becoming increasingly obvious that a new approach is needed if American companies are going to remain competitive in the global marketplace. With workers changing jobs more frequently, UAW Workers Really Do Make $71.00 Per Hour re-examines the logic of tying health and retirement benefits to our fleeting relationships with employers.

Healthcare reform has the potential to transform our government and our economy more dramatically than anything since the passage of the Social Security Act in 1937. There is no doubt that our current system is badly broken, but we owe it ourselves as a nation to engage in an informed debate rather than basing our positions on partisan talking points. No one knows what form it will take, but major reform of some type is almost certainly inevitable. If we allow the debate to be dominated by lobbyists and partisan operatives, we will have no one but ourselves to blame when the final solution is worse than the current problem. I encourage you to join the conversation here and make your voice heard before it’s too late.

Healthcare Related Posts

Healthcare Is Not A Right

Revisiting The Oregon Plan: The Future Of Healthcare In America

What If No One Had Health Insurance

UAW Workers Really Do Make $71.00 Per Hour

Obama Is Wrong To Declare Healthcare A Right

Is Obama’s Plan A Backdoor Attempt At Single Payer Healthcare

President Obama believes that the political and economic climate of the moment presents the perfect opportunity for him to accomplish what his predecessors have been unable to achieve, but his current proposal falls short of government run universal coverage. This has enraged many of his most liberal supporters, who believe he is their best chance to achieve their utopian ideals. At the same time, it has caused some conservatives to soften their opposition since it does not represent an outright nationalization of the largest sector of our economy. Regardless of our political views, it is essential that we all recognize Mr. Obama’s plan for what it is; a backdoor attempt to impose single-payer universal coverage.

The central point of the President’s program is a government run plan to compete against private health insurance companies. He claims that this is necessary to encourage competition in the marketplace. With over 1300 health insurance companies operating in the U.S., it’s hard to believe that lack of competition is the biggest problem we face. The long-term goal of the government plan is not to encourage competition, but to ultimately put the private insurers out of business. At that point, the government plan will be our only remaining option.

Before you call me an alarmist, I ask you to consider this question. Is it truly possible for private companies to compete on a level playing field against the federal government, when the government has the ultimate authority to determine the rules of the game? Once the government plan is in place, what is to stop the Feds from stacking the regulatory deck in their own favor?

The business of insurance is based on the concept of actuarial risk. Individuals or groups pay premiums based on the risk they represent. In a rational system, young healthy individuals pay substantially lower premiums than older individuals or those with pre-existing conditions. This strikes many as fundamentally unfair, but the business of insurance is not about fairness or need. It is about precise statistical modeling, and the private insurers cannot exist without the ability to place a price on predictable risk.

While private companies have to make a profit in order to remain in business, the government operates under no such constraint. In spite of countless trillions in unfunded future obligations, the willingness of our elected representatives to spend borrowed money apparently has no limits. This fact alone will make it impossible for any private company to compete against the government plan. The government can simply undercut the rates of the private insurers, and our lawmakers will be perfectly happy to add the annual shortfall to our already incomprehensible national debt.

Once the government plan is in place and the regulators do their predictable mischief, the situation for the private insurers will only get worse. It is not hard to imagine new federal regulations that require all plans to offer the same level of coverage as the government plan, or to require private insurers to offer uniform pricing without regard to obvious risk factors. Over time, the increasingly onerous burden on the private insurance companies will drive them out of existence.

President Obama has not put forth a single payer plan because he knows that he cannot muster the political support to nationalize our entire healthcare industry in one fell swoop. He has learned from the mistakes of the Clinton’s, and he is savvy enough to realize that what he cannot accomplish directly through legislation, he can achieve indirectly through so-called competition. If the government plan becomes a reality, it’s a safe bet that a single-payer system will not be far behind.

What I can’t quite comprehend is just what all of the extra weight I’ve been carrying around looks like on its own. If I could suddenly just take off the extra weight the way a soldier takes off a fully loaded backpack, what kind of burden would I be shedding? After all, we’re talking about 2 times the recommended weight gain for a healthy expectant mother. I’ve been thinking about this for the past few days, and I did some quick research to get a better idea of what 60 extra pounds looks like. After seeing this, I’m more determined than ever to get rid of the extra weight. All of the items below are the equivalent of my 60 pound weight loss goal.

A full grown Afghan Hound.

Five 12 pound bowling balls.

7.2 gallons of water.

Fifteen 64 ounce tubs of lard.

46 large thin crust pizzas.

60 pints of beer.

240 sticks of butter.

523 Krispy Kreme donuts.

1440 strips of bacon.

Five months may seem like a long time to lose 25 pounds, but I’m finding the slow and steady approach is far more effective for me. In the past I’ve been able to lose as much as 4 or 5 pounds a week in short bursts, but I’ve never been able to stick with a program like that for very long. I’ve also found that the weight tends to come back as quickly as it comes off. I’ve been losing about a pound a week steadily since September, and I feel confident that the lifestyle changes I’m making are something that I can stick with for the long haul.

One of the frustrating things about weight loss is that the pounds don’t come off in a linear progression. I weigh myself first thing every morning, and some days I seem to be taking giant steps backwards. A lot depends on fluid retention from one day to the next, or what I ate at what time the night before. The important thing to remember is that the long-term trend line is moving downward. If I had the discipline to only weigh myself once a week I could see that more clearly.

Another reason that my progress seems slow is that I am building substantial muscle mass at the same time I’m burning fat. Even though I’ve taken nearly 4 inches off my waist so far, my chest, shoulders, arms and legs are all substantially larger than when I started. Given my age and sorry physical condition, I would not have believed it was possible to achieve the results I’ve seen so far. I will be in far better shape at 48 than I was at 28.

It’s hard to go for a day without hearing some reference to the number of obese and overweight people in the U.S. population. While there is no question that there are way too many fat people among us, I’m beginning to doubt the numbers. The statistics are based on Body Mass Index, which is a simple formula that divides a person’s weight by the square of their height. It does not take muscle mass or bone density into consideration, so it produces misleading results for anyone with above average muscle development. At my current height and weight, I am still considered borderline obese based on BMI alone, and even when I reach my target weight of 175, I will still be considered overweight. Neither of these results paints an accurate picture of my true physical condition. Body fat percentage is a far more reliable indicator.

Perhaps the most surprising aspect of my improved physical condition is the change in my personality. I’ve always been an introvert, and I still prefer to spend the majority of my time alone. I’m finding that as my body changes, so too does my ability to tolerate social situations. Maybe I’m less self-conscious, or perhaps the exercise has activated some long dormant sociability hormone. I know I will never be a social butterfly, but if I stick with the program at least I will be slightly less reclusive.

In the interest of protecting the public, states have put in place strict licensing requirements for certain occupations. This is particularly true of the medical, legal and accounting professions. When you see MD, JD, or CPA behind a name, you can usually rest assured that this person has years of specialized professional training, and has passed a rigorous licensing examination.

Certifications and credentials have never been sufficient to identify the most talented practitioners in any field, and that has never been their purpose. Two physicians or attorneys with identical training will not produce identical outcomes in the court room or the operating room. The most talented practitioners will rise to the top of their fields based on their skills and their professional reputations. What credentials are intended to provide is an assurance that the individual possesses a minimum level of competency.

Professional credentials used to be fairly rare, and were typically limited to a small number of occupations. In addition to the medical, legal and accounting professions, academics, architects and engineers were about the only people whose titles included widely recognized designations. Even to the people who didn’t know what the letters stood for, their presence lent an air of respect and credibility. That is no longer true today, due to the widespread use of meaningless designations and credentials issued by organizations representing a wide range of professionals and pseudo-professionals.

Today, many professional credentials are less about protecting public safety, and more about creating an aura of professionalism where none would exist otherwise. Real estate sales is perhaps the best example of this kind of credential proliferation. Earning a real estate license typically involves nothing more than a two-week training course, followed by a two-hour examination. A high school diploma is not a requirement. Considering the fact that a home purchase is the largest and most complex financial transaction that most people will ever make, the licensing standards are incredibly lax.

In an effort to compensate for these low standards, the National Association of Realtors offers over 20 professional designations for real estate agents that result in a virtual alphabet soup of meaningless gobbledygook. The fact that most of these designations can be earned without closing a single transaction is proof of their limited value. Pity the misguided home buyer or seller who falls for this nonsense and selects an agent based on worthless designations rather than a proven history of results.

Real estate sales is a classic example of the 80-20 rule, where 80% of the sales are made by 20% of the agents. For every productive agent, there are at least 5 part-time wannabes and hacks who move in and out of the industry as predictably as the tides. These are the folks who are most likely to have a string of meaningless designations after their names, in an attempt to compensate for their lack of experience or talent. The real producers have no need to hide behind pseudo-professional credentials, and no time to waste on earning them.

While scam artists can be found in virtually every profession, they are particularly drawn to those fields where licensing requirements and professional certifications are nonexistent. The only real talent many of these people possess is the ability to pass themselves off as experts in a field where their expertise is difficult to verify or to challenge. For this reason, these people are often drawn to fads and emerging fields where the ability to rattle off a few impressive sounding buzzwords is all it takes to be viewed as an expert.

Every so often, a new fad emerges that brings with it a flood of self-proclaimed experts. Think back a few years when life coaches and feng-shui consultants peddled their services to anyone foolish enough to take them seriously. Today, most of these so-called experts have found promising new careers in the fast food industry, but they have been replaced by an army of SEO consultants, green experts, and social media gurus. How do we distinguish the true experts in these fields from the poseurs and the frauds?

The promise of achieving top rankings on Google and other major search engines is a temptation that many businesses can’t resist. Unfortunately, search engine algorithms are some of the most closely guarded secrets in the universe, and anyone who claims they have the knowledge required to manipulate them to produce page one results is either a fool or a fraud. In either case, hang onto your wallet. There are a few legitimate SEO practitioners out there, but for every true expert, there are 10 wannabes, phonies and frauds.

Given time, a handful of talented SEO practitioners will rise to the top and gain the recognition they deserve as true experts, but only after the incompetents and frauds are exposed for what they are. The same cannot be said for the small army of self-proclaimed social media experts who have come out of the woodwork to offer their consulting services. While no one can deny the value of improved search rankings, there has of yet been no demonstrable benefit to businesses using social media sites like Facebook and Twitter. There are no case studies that prove a return on investment, so by necessity these so-called experts speak in abstract terms and focus on intangible results. That may allow them to fool a few people for a short time, but sooner or later they are going to have to demonstrate that their clients can actually profit from the use of social media. When that time comes, they better hope that McDonald’s is hiring.

Whenever we meet someone for the first time, one of the very first questions we ask is what do you do? It may be shallow to form our impressions on the basis of a job title, but it’s something we can digest more easily than what really matters about a person. When was the last time someone you just met asked about the sum of your experiences and beliefs that make you the person that you are?

At various times, I had been able to tell people that I was a student, a soldier, a sales executive, a corporate VP, or a small business owner. This information didn’t necessarily tell people anything meaningful about who I was, but it allowed them to form a critical first impression. For the first time in my life, I found myself unable to answer the most basic question about myself. I’m still trying to figure out what I want to be when I grow up isn’t a very good answer when you’re 47 years old.

I began blogging during this period of uncertainty to keep myself occupied, and to put in writing a number of thoughts and ideas that had been bouncing around in my head for years. I found the writing process therapeutic, but I also became fascinated with the underlying mechanics of the website. As I became more proficient at customizing WordPress themes, people began to approach me for advice, and eventually with freelance projects. I discovered quite by accident what I wanted to do for the next phase of my career.

I’ve always had an interest in design & architecture, but the fact that I can’t draw a straight line prevented me from pursuing either of these fields in my youth. I did study graphic design and typography as part of my graduate degree in Printing Technology, but that was in the pre-Mac days when drawing was still an essential skill. For the first time in my life I’ve got tools at my disposal that allow me to turn my visions into reality.

I’ve kept myself fairly busy with freelance assignments lately, and now I’m facing a new identity crisis. As I attempt to turn a part-time business into a full-time career, I’m struggling with how to create a new professional identity that will allow me to promote my work more effectively. While this site is an interesting demonstration of my ability to customize WordPress themes, it’s not necessarily the first thing I want prospective clients to see. It might be the only place on the internet where you can discuss religion, national health care policy and barbequed ribs, but it’s probably not a great idea to throw business into the mix.

Back in the old days, creating an identity for a small business was a relatively simple matter. You came up with a catchy name, created a logo, and printed up some business cards and letterheads. If someone in another part of the country or the world operated a business with the same name, it usually wasn’t a big deal. The internet has changed that, and creating an identity today is a much more difficult process. This is particularly true for businesses that promote themselves on the web.

Coming up with a catchy name is the easy part. I’ve come up with hundreds of them over the past few months. The problem lies in finding a name that is also available as a domain. It doesn’t do you any good to come up with a great name if someone else has already registered yourgreatname.com. I’ve lost track of the number of times I’ve gotten out of bed in the middle of the night lately to check the availability of a domain name. No matter how great or original my idea may seem at the time, someone else has already thought of it.

For the time being, I’m like the cobbler whose children have no shoes. Until I can come up with a great idea for a name that someone else hasn’t already registered, I can’t turn that name into a concept, or turn that concept into a website. Without those things, my business won’t seem quite real to me, no matter how busy I stay. At least I don’t have to tell people I’m still trying to figure out what I want to be when I grow up anymore.

Since the initial presentation in April, I’ve had the chance to discuss my plan with economic development officials from Roanoke City, Roanoke County, as well as the leadership of the Regional Partnership and the Roanoke Regional Chamber of Commerce. On Monday, I had the opportunity to share my proposal at a joint meeting of the Economic Development Authority and the City Council. I’m working to arrange a meeting later this month that will allow all of us to discuss the concept in greater detail and determine the feasibility of the plan.

In preparation for that meeting, I would like to get as much input as possible from my readers. Please take a few moments to look over the following plan summary, and share your thoughts in the comments. I need your ideas, suggestions and constructive criticisms.

Introduction

In his book, The Rise of The Creative Class, regional economic development expert Richard Florida stresses the point that creative class workers are unlikely to migrate to an area on the basis of a single job opportunity. Instead, they seek out those localities that provide access to the widest range of career possibilities. The regions that are most successful in attracting the creative class are the ones that offer the greatest variety of Plan B career alternatives. With the exception of the healthcare sector, the Roanoke Valley simply does not provide the range of opportunities needed to attract creative class professionals in numbers required to sustain a critical mass.

The changing nature of the relationship between employers and employees adds to the challenges we face in attracting and retaining members of the creative class. Workers in virtually all fields change jobs more frequently, and the expectation of job security has become an antiquated notion. This lack of security makes the availability of alternative employment options all the more important in our efforts to create a more robust regional economy.

In addition to frequent job changes, current trends indicate that younger workers will actually change career fields between three and seven times. Many of these changes will be involuntary, resulting from downsizing or obsolescence. In between jobs, an increasing number of creative class professionals will find it necessary to work as independent consultants or freelance agents on a temporary basis. This will be especially true during periods of declining economic activity such as we are currently experiencing.

While some of these people will ultimately decide to stick with consulting work for the lifestyle advantages it offers, the majority will continue to prefer the security of full-time employment. These people will move in and out of the freelance market on as needed basis at different times in their careers. The challenges they face will be daunting, and the resources available to assist them are limited. By providing a mechanism to assist these independent consultants in their efforts to connect with potential clients or employers, the Roanoke region could benefit in many ways.

The following plan proposes a public/private partnership between the City of Roanoke, Roanoke County, local business and economic development organizations, and the consultants and freelance professionals living and working in the Roanoke Valley. The ultimate objectives would be to prevent the outward migration of skilled professionals from the area due to job loss or lack of opportunities, and to make the Roanoke region a more appealing career destination for creative class professionals seeking to relocate.

Challenges Faced By Freelance Professionals

We tend to think of freelancers as being engaged primarily in fields such as journalism or graphic design, but the realty is that independent consultants can be found in virtually every profession. Regardless of their occupation, they face a wide variety of challenges. The knowledge and skills required to perform their primary job functions are only a fraction of what they need to become successful independent practitioners. In addition to a mastery of their billable skills, they must also be adept at marketing, self-promotion, networking, bookkeeping, collections, and more. Lack of these secondary skills is a major obstacle to success for most independent professionals.

Limited financial resources are also a major problem. People tend to enter the freelance market after the loss of a job, and they often lack the start-up capital required to equip an office or to advertise their services. As a result, many would-be consultants simply give up before they ever get started. Others remain underemployed for extended periods.

The market for connecting independent professionals with potential clients is highly inefficient. Not only do the majority of consultants lack the talent and resources to promote themselves effectively, but clients in need of freelance services often have no idea where to find qualified practitioners. Developing a mechanism to streamline this connection process would provide substantial benefits to the regional economy.

Roanoke Regional Freelance Cooperative Plan

This plan envision a public/private partnership whereby the City of Roanoke, Roanoke County, and a variety of local business and economic development organizations would assist in the creation of a central clearinghouse for local freelance talent. The key elements of the proposal are as follows:

• Marketing Co-Op: Freelance professionals typically have very limited resources for self-promotion. The plan calls for the creation of a marketing cooperative that would allow members to combine their resources in a manner that will draw significant attention to the organization. The objective would be to create awareness of the co-op as a one stop source for regional freelance talent. Whether a business was in need of an IT consultant, a web designer, a human resources professional, or a technical writer, co-op members could achieve first in mind position through their combined marketing efforts.
• Online Job Board: A private internet job board would be the primary method of matching co-op members with potential clients. Modeled after the Elance.com concept, clients could post project specifications and search for qualified talent, while freelancers could find projects that fit their skill sets and submit proposals for work. The site would contain a complete directory of co-op members organized by professional specialty, along with portfolio pages that would allow members to demonstrate their expertise.
• Shared Meeting Space: Freelance professionals sometimes face a credibility challenge brought on by the fact that most work out of home offices. This is not a problem under ordinary circumstances, but client meetings and group presentations are a different story. A coffee shop is not the ideal venue for a business meeting. This plan calls for the creation of a small shared office suite that would be available to co-op members on an as needed basis. The space would consist of a conference room, one or two private meeting rooms, and a small number of temporary workspaces.
• Structured Networking: Regularly scheduled networking events for co-op members would be an integral part of the program. These networking events will provide members with the opportunity to exchange leads and form collaborative partnerships to take on larger projects.
• Director: The cooperative would have one full-time employee to serve as Executive Director. This person would handle the day-to-day administration of the co-op, and serve as the liaison with the local business community. Major responsibilities would include membership recruiting and promoting awareness of the resources available to businesses in the Roanoke region.
• Governance: The group would be governed by an elected board composed of co-op members. In addition to this governing body, a marketing committee would be responsible for the creation and execution of a comprehensive advertising and marketing strategy for the group.

Benefits To The Freelance Community

• Creating a network of independent professionals in a variety of fields will ultimately lead to the formation of partnerships to take on projects that are beyond the capability of a single practitioner. Some of these joint ventures will dissolve as soon as the project is completed, while others are likely to form the basis for new business start-ups.
• The publicity generated by the joint marketing efforts will ultimately give co-op members exposure and access to clients beyond the Roanoke Valley.
• Participation in the co-op would allow temporary freelancers seeking full-time employment the opportunity to test-drive potential employers.
• Sufficient membership in the co-op will allow participants to pool their resources to qualify for group health and other benefits that are typically beyond the reach of most freelance professionals.

Benefits To The Business Community

• Local businesses will be exposed to a wide range of professional services that many were previously unaware of. This will be particularly beneficial to small businesses, many of which never consider the possibility of utilizing freelance practitioners.
• Taking on new employees is a risk for any business, regardless of the current state of the economy. This plan would allow employers the opportunity to test drive potential employees before hiring.
• Freelance professionals typically charge hourly rates that are several times higher than the cost of a full-time employee to perform the same task. This is necessary to make up for the large amount of non-billable time they must spend on promotion and prospecting. Membership in the marketing co-op will allow members to dedicate more time to billable activities, and to offer their services at reduced hourly rates. Clients will obviously benefit by having access to a wider range of services at a lower cost.

Benefits To The Region

• The freelance co-op will serve as an incubator of sorts to generate new business ventures.
• The co-op can help to reduce the number of creative class professionals who leave the region due to lost jobs or lack of opportunity.
• New businesses will be attracted to the Roanoke Valley by the availability of a wide range of affordable freelance talent. This will be particularly attractive to start-ups that lack the resources to hire full-time employees.
• The co-op will help to reduce the number of independent professionals operating in the shadows without proper licensing.
• The plan can help the Roanoke Valley to become a haven for freelance professionals, and it can provide the necessary Plan B career alternative required to attract creative class professionals from other regions.

Financial Projections

Based on very rough back of the envelope calculations, the startup cost for the project would be in the range of $100,000.00 to $175,000.00. This includes creation of the website, leasehold improvements, furnishings and equipment, Director’s salary, and a substantial initial advertising blitz.

Operating costs would consist mainly of advertising and marketing expenses, Director’s salary, and rent. Based on very rough initial calculations, annual operating costs would range from $125,000.00 to $200,000.00. While some annual subsidies may be required in the form of grants, it is anticipated that the bulk of the operating costs will be paid with membership dues after the initial start-up period.

Much hoopla has been made about the first 100 days of the Obama administration, and frankly, I’m pretty tired of it. There is no particular significance to the first 100 days of any new administration, other than to give our 24 hour news media something to blather about. In historical terms, 100 days is a meaningless yardstick. In the end, President Obama will be judged on the totality of his accomplishments, and no one will care if a particular piece of legislation was signed on day 99 or 999.

One thing that is clearly evident about the first 100 days is the fact that we remain deeply divided over the direction our nation is heading. The remarkable difference in the President’s approval rating between Democrats and Republicans is evidence that we don’t see eye to eye on much of anything. The divide is so deep that I’ve actually avoided writing about political topics recently because I simply don’t have the stomach for a debate in which both sides prefer name calling over logic and reason.

No matter what your political beliefs or your party affiliation, there is one thing that we all seem to agree on regarding the first 100 days of the Obama administration. Aretha Franklin flat out rocked the inauguration with her hat. Long after the over the top inaugural festivities are forgotten, we will all remember that hat. Aretha has even agreed to loan it to the Smithsonian, and eventually to donate it to the Obama Presidential Library.

In the spirit of political reconciliation, I invite you all to relive the brief moment when every man woman and child in the nation was awed by the sheer splendor of Aretha and her magnificent hat. Since we as a nation are in desperate need of a cause that we can all support, I will be holding a contest here to find the most creative use of Aretha’s hat in a photograph. Simply download the hat image using the link at the end of this post, and place it on the head of your favorite celebrity, or politician. Email your completed masterpiece by May 15th, and I will post the best entries here for everyone to enjoy. There are no prizes, but the winner will have the satisfaction of knowing they contributed to healing a political rift that threatens to tear our nation apart.

Download The Hat

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