Rage against the system

In case you didn’t know, becoming a health care provider isn’t cheap. The six to fifteen years of school and/or supervised practice isn’t cheap. The professional organization memberships aren’t cheap. The malpractice insurance isn’t cheap. The equipment isn’t cheap. Continuing education and the reading and travel that go along with it aren’t cheap. And that’s just talking direct economic costs.

I wish we could talk health care without having to talk about money. I wish we could all offer our services for free. Unfortunately, if all health care providers offered their services for free, we’d soon have no health care providers. It costs too much to become a health professional and to maintain professional standards as a health professional to not get paid. So somehow, we’ve got to get paid.

The majority of payments that come to health professionals come through insurance companies. They decide what they’re willing to pay for and how much they’re willing to pay for it–sort of. The sort of is because most insurance companies use Medicare and Medicaid as the basis for making their decisions regarding payment. If Medicare or Medicaid covers it, private insurance is sure to follow.

If Medicare/Medicaid covers Medical Nutrition Therapy (MNT) for a disease, then dietitians get paid. If the government isn’t willing to pay a dietitian for Medical Nutrition Therapy–neither will the private sector. So if dietitians want to get paid, they have to convince the government to foot the bill. It’s bad enough that money makes the world go ’round–even worse, too often it’s government money that makes the world go ’round.

I sat through Community Nutrition tonight biting my tongue and swinging my legs and wondering why it felt like I was being told to sell out. Contribute to the ADA-PAC. Sell your vote for support for nutrition-related legislation. Campaign for somebody on the basis of dietetics. Bribe your congressman. Join the lobby. Sell out.

I want dietitians to get paid for what they do. Why? Because they provide an invaluable service to health care. Dietitians have the knowledge and skills to prevent disease rather than just managing it. Medical Nutrition Therapy is incredibly cost effective from a medical standpoint. It prevents the occurence of disease in the well and prevents the development of complications in the diseased. Medical Nutrition Therapy means fewer drugs, fewer diseases, fewer costly medical interventions, and ultimately fewer deaths. That’s a lot of bang for a little buck.

The problem is that if dietitians are going to get paid for what they do, the government is going to have to pay it. Congress is going to have to approve MNT for Medicare/Medicaid patients if MNT providers are going to get paid by anyone for any of the work they do. Which puts me in a very difficult situation.

I’m a fiscal conservative. I’m a true believer in free market. I much prefer the invisible hand to the “Wonderful Wizard of Washington”. I don’t believe that throwing government money around solves anything. The Robin Hood complex is a mental illness, not benevolence. Stealing from the citizen to support the system isn’t my way of going about things.

So what am I to do about dietetics? I want to get paid. I want my profession to get paid for its legitimate work. I just don’t want the government to be doing the paying.

Our economic system depresses me. We’ve messed it up so much that it’ll take a MASSIVE restructuring to return us to free market principles. Unfortunately, when even the conservatives start throwing government money around in an attempt to “save” the economy, how can we hope to ever have a stable economy?

I almost think it’d be best to just never mind the short-term consequences. Knock off all government intervention in the economy and wait for things to equalize. Then, once we’re dealing with a free economy, we can rebuild the way the American economy was first built–on hard work, civic responsibility, and innovation.


Going Green? All the Way, Baby. Voting Green? Okay, not that far.

I think I might qualify as an environmentalist. I am very concerned about my impact on the environment. I care about what kind of earth I leave to the generations behind me. I believe, as C.S. Lewis suggested, that expectation for a better world (heaven) should make me even more inclined to make a difference in this one.

To this end, I do my best to work towards eco-friendliness. I’ve made myself some shopping bags and take them with me faithfully. Paper or plastic? I go with cloth. I don’t even use their bags to put my produce or bulk items in–I bring in my own heavy duty bags (recycled from work.) I recycle everything I can–and if I can’t recycle it at the city recycling center, I find a way to reuse it at home (or to not buy it at all.) I use every bit of white space in my paper before sticking it in a bag to recycle it.

I make my own laundry soap and clean almost anything with vinegar. I’ve pretty much eliminated “paper products” from my life. I use cloth napkins, hankies, and pads. I hibernate or turn off my computer when I leave the room. I keep my shades down during the bright summer afternoons to keep from using extra energy to keep the house cool. I finally got a blanket for my hot water heater (woo-hoo!) My worms for vermiculture should arrive in the mail any day now.

I buy used instead of new, I give away instead of throwing away. I don’t buy if I don’t need. I grab the paper that would otherwise be thrown away at work to use as scratch paper. I think I probably qualify as a bona-fide green do-gooder. Or if not bona-fide, I’m at least a pretty good wanna-be.

But what I don’t do, and don’t think I’ll ever do, is vote on the basis of environmentalism. Because what I’ve seen of political environmentalism is basically the lefts version of “legislating morality”. They think that if they just make all sorts of laws protecting the environment and punishing or forbidding its desecration, that somehow that’ll make a difference. And maybe it will. But at what cost? At the cost of people’s liberties? At the cost of our economy? At the cost of an even more massive bureaucratic government?

I have the unfortunate luck to be someone who cares about what the left has co-opted as “liberal issues.” Environmentalism, women’s rights, public health, education–those are some of my concerns. I just don’t agree with the lefts way of going about those issues. Politically, I do more than lean to the right–I believe in limited goverment, fiscal conservativism, local control, strong foreign policy, and that America has both the privelege and responsibility to act as a force for freedom in the world.

So I find myself stuck in the middle of a sad little fight. The environmental blogs that I read and enjoy are up in arms about this coming election, and so am I–on the other side.

I enjoy the tips on green living–I enjoy sharing commonalities with people who also vermicompost and deal with people’s funny looks at their homemade shopping bags. I just don’t enjoy people bashing my candidate on one point (environmentalism) and then accusing conservatives of being “one issue voters.” I listed my political values a couple of paragraphs up–do those look like single issue topics?

–So at this point, I’m just ranting. Or maybe I have been all along. But come on, guys, give me a break–just because environmentalism isn’t my political litmus test doesn’t mean I’m a hard-nosed, knock-down-the-little-guys and pollute-the-water-system junky (or the Devil incarnate). I’m a citizen who cares about a deep variety of issues (that people across the political spectrum care about) and votes accordingly. So please, calm down and let me weigh EVERYTHING–instead of just your ONE hot-button issue.


I’m trying to decide whether I’m excited to receive my economic stimulus payment

I received a letter today from the IRS announcing that I would soon be receiving my economic stimulus payment. I checked my bank account and discovered that it had been deposited last week. I was really hoping I wouldn’t get it–so that I wouldn’t have to decide what I thought about it.

I think it’s a great idea in one sense–and an awful one in another. I am all about putting money back in the hands of the people–and spreading it out over a lot of people at that. The economic stimulus package does that. It’s a better plan than an alternative that might have the government artificially interfering with the economy. In general,my thought is that the closer we can get to a free market, the better off our market will be. Better that the money (and thereby the control) be in the hands of the people than in the hands of the government.

The problem is–it’s even better that the money be in the hands of the people that earned it. And that’s not me. I didn’t pay taxes last year. I earned money. I filed taxes. But I didn’t pay taxes. So the money that just got placed into my bank account? It came from somebody who paid taxes–likely someone who needs it as much or more than I do. It came from somebody who was working for a wage they didn’t get to keep. I kept all my wages.

It’s not fair, it’s not just. It’s government as Robin Hood–stealing from the “rich” and giving to the “poor.” Except that I’m much richer than many of the “rich”. I make enough to live comfortably–to give, to satisfy my needs and many of my desires. I have very little debt–which makes me pretty rich among Americans. If I don’t have enough money, one person goes hungry. If someone else doesn’t have enough, an entire family may go hungry. But I qualify, on the basis of an income bracket and a semi-random lottery, to receive $300 that someone else worked for and was forced to hand over to the government.

But what can I do? I can’t right the injustice. It was deposited into my bank account. I can’t just rip it up as I might have been able to with a paper check. I can’t return it. And I don’t want to. After all, better that the money be in the hands of the people than in the hands of the government. It’s just that it doesn’t belong in my hands. I already earned my money–and I got to keep it all.

Well, Lord, injustice or not, I have received this money. Help me to use it in a way that would bring honor to Your name.