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If Everyone had to Buy Their Own Roads

The issue of healthcare continues to be politically potent, owing mostly to the fact that Republicans continue to politicize it while Democrats continue to push for universal healthcare.

The current healthcare system has five main insurance components:

  1. Employer-provided insurance (including government employees) ~50%
  2. Private insurance (purchased by the consumer) ~7%
  3. Medicare ~14%
  4. Medicaid ~20%
  5. Uninsured ~9%

One can imagine a society where everybody has to buy their own roads more directly, rather than having the government work it out. Employers, needing to have employees get to work, needing to ship goods, would form group plans where various roads would be available to employees and the company.

One can imagine that older folks, no longer working, would be subsidized in their road access by the government. Some private plans would be available for freelancers. Eventually, the poor might get some access to roads.

And then you would have the roadless. Folks that maybe had a single road to work, but their employer doesn’t need broad transportation, and has few employees, so the road options for those people are limited.

And maybe, if you don’t belong to a road access plan, you could still use a road. But they would charge you more. You’re extra traffic not accounted for in the planning and budgeting. You aren’t one of a hundred cars in a group that uses the road, so you don’t get a bulk-traffic discount.

And maybe, if you don’t belong to a road access plan, you can’t use some roads. They’re built for the members. The members don’t want you slowing them down. You’re excluded entirely. You can use the dirt paths, only. You’ll still get there, covered in dust and smelling like it.

Americans love the open road (it’s even called the open road). They love their cars. They would never stand for limitations on their ability to cruise. We should not stand for it for healthcare.

The friction that would be caused by having to have special maps to figure out which roads you could use, filling out forms at intersections, constantly worrying about making a wrong turn, are mirrored in the healthcare system where Americans are constantly dealing with red tape from provider networks, drug coverage conundrums, and claims processes.

It’s long past time to open American healthcare.

It’s about 14 weeks until the midterm elections.

Healthcare is Jars of Jellybeans

Insurance functions on risk pools. Think of this as the old jar of jellybeans, where you guess how many of each type are in there. In this case, each person pays to put their jellybean in a jar. There are all kinds of jellybeans, and insurers pay the sum of what’s in each jar, using the money people paid to add their own jellybeans. You want a nice mix of lots of low-cost jellybeans and fewer expensive ones, so that your total doesn’t cost too much.

The individual mandate required people with low-cost beans to add them to the jars. But the Republicans want to do away with that provision, because they believe people should be free not to add their jellybeans if they don’t want to. Fine. But without the mandate, there has to be some other way to balance the mix of jellybeans, if the system is going to work. The Republicans haven’t offered a good solution there.

The main pre-ACA way to deal with the known expensive jellybeans was to set aside jars just for them. The government would subsidize that jar, trying to keep the main jar cheaper. But the government would underfund the high-risk pools, meaning not everybody could put their beans in the jar.

The ACA tried to move the pre-existing jellybeans into the main jar by balancing them with young, healthy jellybeans. Again, the jellybean jar is the main thing to think about when you think about insurance, but the Republicans seem to not know about it. Their plans do not reflect an understanding of this jar and jellybean system.

Under Medicaid, poor peoples’ jellybeans are put in the Medicaid jar, which is cost-shared between states and the federal government. As most poor people are still healthy, and only a small amount are expensive, it works out pretty well even though it’s all paid through government spending.

The ACA expanded that jar in most states, with the federal government paying the overwhelming difference, but some states decided to keep the old jar, meaning there is a gap between jars, with those peoples’ beans just sitting on the counter, not getting covered.

Healthcare is not as complicated as the president claims. It’s only complicated when you deny the essential model of healthcare, when you pretend it’s not jars of jellybeans. When you recognize it is, and you are honest and willing to do what’s needed to make the system work, it becomes a hell of a lot simpler. The Republican reluctance here is all about explicitly not wanting to fix the ACA or do anything that actually works. That’s sad. Maybe they should get them some jars and jellybeans and let the Democrats show them how it works.

Analogies for Tech: The Web as Houses

I am examining potential analogies for explaining technology of various sorts to laypersons in the hopes they will grasp the relationships of the world they use every day. Today’s analogy is how building a web page is like building a house.

One of the historical patterns we see is where a specific field or part of life moves from being expert to common.  That’s been true with reading over time, for example.  It’s been true with automobiles in some countries.  There was a time when only women had babies….okay, you got me there.

But over time there’s an expectation in the computer industry that average people will learn technology to a greater degree, even if not to the same depth as a computer scientist or computer engineer.

I am examining potential analogies for explaining technology of various sorts to laypersons in the hopes they will grasp the relationships of the world they use every day.  I’ve already given part of the explanation of why, but here’s the other part:

Until you see the cracks in the walls with the sunlight slicing the darkness, and until you see the bubbles rising to the edge of the universe and ask what if it isn’t the edge at all, you have very little reason to jump out of the water or break into the day.

With that I hope to, from time to time, examine potential analogies for bits of technology.

The Web

The metaphor for the web is moving to a house you are building. In this, HTML is a set of special boxes.  You have some like title that are meant for very particular contents. You don’t put your china in a box with your hammers.

You have other boxes like html itself, which are there to hold everything you put in them. You put your china in one box, and your hammers in another, but both of those boxes can fit in a third, bigger box. That bigger box is actually the truck, in this case, but you might have palettes that hold many smaller boxes, as with something like div.

Then you have CSS, which are tags you attach to the boxes to tell the movers where they go. “This is a very dark brown room.” Or, “all of the windows should be blue, but after you have looked through one, it is purple.”

If you’ve seen that last bit, it’s the style applied to links using the default styles of most web browsers.

That’s right. There are default styles that come with the browser. They are there so that if you don’t specify, there’s a good base to work from.

Now, additional styles let you override those defaults, but there are also some amount of styling implied in the way you pack your boxes.

If you put some text in one box, then it will end up together in the house unless the styles applied are very explicit.

You also have peculiar boxes like script, which tell the builders that they contains fixtures or robots that will respond to visitors to the house in some way. They might be faucets that will, when turned on, create or delete whole rooms. They might be spy cameras to watch the visitors and tell the owners of the house what they did in the house.

Extending the metaphor out, the creator of the document packs everything up in their boxes with their blueprints and send them up to a server. Then you visit the server and it spits out the boxes with the blueprints, which your builder, the browser, assembles.

Some of the documents aren’t made in that way. Increasingly, the houses of the web are made in factories called applications. Think about some service like Google Search. They have thousands of computers working to find the content all over the internet, and when you search those computers shove that content into the right boxes with the blueprints and styles and deliver them to you.

Anyway, I guess that’s enough about the web for today. Did this analogy make it clear how the web works?