Insurance, Universal Health, and BS (slight repeat)

I would not be the first one to point out that this is the way things are. Hospital bills are insanely high. The birthing of my child including the subsequent 11 days of hospital NICU (neonatal intensive care unit) stay at the Stanford Lucile Packard Children Hospital resulted in a combined bill for both mom and child of $157k. And let me say upfront the staff at LPCH worked very hard to make our stay comfortable. We learned a lot about taking care of the baby there from all the wonderful nurses and Dr.’s

$175k is a lot of money: With that money I could three(3) base Model S’s. Or I could pay off of some of my mortgage. Or pay off my parent’s mortgage. At my planned saving rate of about $20k a year, it would take me 8.5 years to accumulate that amount of money, just for a single incident of child-birth(not including continuing costs after the fact). Now, being an informed modern man, I appreciate the 99.99%(estimated) success rate of child-birth that this cost buys me. And indeed my child is healthy and alive, and she may very well not be if we had her in a wilder situation where the cost is less. The peace of mind that we have knowing that there is a machine and two nurses watching over the child during those tenuous times is very much worth it.

Now there are two issues of concern. One of them is that the entire process was not 100% pleasant, there were times when we wondered if the doctors/nurses/staff were picking on us because of our minority status or apparent lack of wealth or influence. Some staff were quite obnoxious, one even dropped his badge in an inconspicuous place in order to lift my wife’s cover to search for it. what a pervert!

Anyway, that’s not the problem. This $175k bill would have put me in debt for 8.5 years if I did not have an insurance. The insurance company negotiated a different price tier and then paid for about 95% of the negotiated fees to the LPCH. Without insurance company, I may have simply taken the child home after birth and watched her stop breathing and then eventually rush her body to the hospital. Without insurance, my wife would suffer from untreated back injury from the birthing process. Without insurance, I would not be able to take the baby to a dr. about the mucky eyes she has and eating/pooping/peeing issues and various growths and spots and all kinds of weird alien things baby produce. Life would not be life as I know it without the group comprehensive insurance provided by my employer.

Recalling just a mere 6 months prior to this, I was rejected for insurance by a large PPO because I checked a box that said I snored–due to a prior condition. I am a fairly healthy person in my mid 30’s and being rejected for health insurance was the last thing I expected… it kind of ended my consulting career.

Let’s think of health insurance in more detail. Insurance is a benefit, part of my compensation package, my employee give me for my service to the company. What this means is that I must work for an employee that provides group insurance in order to continue to receive this kind of benefit.

It would seem that the pressure and flow of money is as follows: medical cost is high, insanely high, to a point that it would appear an uninsured person cannot pay for basic care. Each individual is highly incentivized to work for large corporations that provide group health insurance, because if they don’t they cannot get health coverage and because the cost of health care is high, they cannot get health care. (oh, and also in the same breath, only spouse of a heterosexual marriage can benefit under group health insurance)

I personally appreciate the role of doctors play in society. They use their life’s time and energy to become good at treating people’s illnesses so that other people can live long and happy lives. I think the medical-industrial-complex that power advanced research in science and technology that produce advanced diagnostic tools (xray,mri, etc.) and drugs, and genetic therapy, and stem cell research, all these things trying to make people’s life better are great! It costs a lot of money and require a lot of resources: universities, hospitals, buildings, power/computing infrastructure, lots of smart people to achieve advancement. So an expensive drug, expensive test, if charged by original developer, is cost to pay for past and future research. Expensive doctor is to pay for his educational cost and to maintain his alertness, dedication to the unbiased professional medical treatment of his patients. I want them to make more money because I don’t want to have to wonder if my Jewish doctor treat Jewish children better than my child or if my Russian doctor treat his Russian patients differently from my wife. I want to receive good treatment and I believe that most doctors are paid above other people not only because of their unique skill sets but also because they rise above all that, ethically, and heal their patients any human patients to health.

BUT, that fact is being exploited by large corporations. Only large corporations can afford group health insurance. Therefore only they have access to people who want health care. Fundamentally, there is nothing wrong with this. But practically it forces all health-conscious people to subscribe to corporate culture. We do not have a choice in how we contribute to society, but as long as we want to see a doctor when we need, we must be part of a large organization full-time.

Some additional aspects of this arrangement: If I had a serious prior condition that requires constant treatment, then I must be employed at a large company in order to survive with life. If there are any bias in corporate employment then the same bias would occur in availability of medical treatment. If I stop working or have never had insurance, I must work for a company because I will not be able to get insurance having a break in health coverage. I cannot leave the company for injustice or corruption immediately and in the duration of dispute, I may not be able to continue with insurance, and the interruption in coverage will result in the impossibility of my getting health insurance.

I have always been in favor of universal health care in America. This is not because I come from a faux-social/communist China. I am in favor of universal health care despite the fact that the medical super industry will not receive as much money from patients because the US government will surely negotiate an even better price than the private insurance companies. I am in favor of universal health care–for basic maintenance care–because health, along with wealth, is part of our pursuit of happiness. I do not believe one can be happy secured with his wealth but insecure with his health, and we should have the freedom to choose health independent of wealth. Health is life. Right of life means right of health, protection for right of life means protection for right of health–in fact protection to right of health should be on par with the right to secure one’s wealth. Health is happiness. Pursuit of happiness requires health. This is why I think universal health care–to a certain level–is a must. Even if it detracts slightly from advanced medical research.

Okay, moving on. A thought occur to me the other day on the way home from my health-coverage earning job in corporate America. I thought of the transitive action space(TAS) more. The TAS encodes actions between people, therefore should be thought of as only encompassing all endeavors regarding acting morally. Again, I justify this because the original thread of thought came form the golden and silver rules of ethics both of which directs us in how to act.

But clearly they have said more than that, for instance it has been said that one should “love thy neighbor as thy self.” Granted this a command in the TAS, but more action this is a feeling. Love is a feeling, is a state of mind that can occur without visible action in the TAS. Perhaps we should also mention the existence of transitive emotional space, TES. Subsets of TES instructs us about the moral ways to feel–whether we have control over feelings, and are they moral if we control the feeling rather than naturally feel, is an entirely different discussion. We can, in fact, specify the subspace of TES that is moral, the Bible sure does.

There are of course yet other instructions in morality that instructs us on how to “be”. “Be one with God,” “Be one with the universe,” “Being a higher being,” “Being enlightened”… and so on and so forth. Some argue that the being is creating an internal state, and therefore being moral is the moral motive force that enable us to act and feel morally. Some even stipulate that without a moral motive force a moral space in TAS is not moral. For instance, if I feed my baby with an intent driven by the perverted curiosity of seeing a grossly obese 1yr old, then the action of “feeding a baby” in TAS is entirely moral (possibly universally), but the being inside BS is immoral. Most would agree that the act is entirely immoral.

Therefore we should also seriously consider BS–Being Space that contain all the ways that we could be. The challenge of such a space is that BS is of much higher cardinality than TAS. In the real world, we can very likely specify countable discrete TAS for a certain self contained situation in which we have to make moral choices, where as I am not able to imagine the “enlightened” and “universe” beingness of BS–do they intersect? does one contain the other? What are the sets in TAS that corresponds to their intersections? Does intersection and containment make sense in the BS? How do I choice to be something BS? How do I be something in the BS?

Ultimately, the choice of TAS seem rightous at this stage of my investigation. And I beleive that even if BS is ultimately the only space where morality is true, that there is a TAS projection from BS that can be modeled. From time to time, we may need to point out the relation between a TAS set and BS but until I have the language to discuss it, BS shall remain mysterious and unexplained.

 

 

The Ethical Hiearchy III

Recall, from last time, this illustration of the Ethics Hierarchy overlaying capability sets in the space of all transitive actions:

gold versus silver 1

I should simplify terminology. The set labeled “Things I want” are “my desires”, “things Jesus wants me to do” is the Jesus way, “Things Confucius wants me to do” the Confucian way, “Things I can do” are “my strengths” and “Things can be done to me” are “my weaknesses”.

 

I should also like to begin referring to what I have been calling the Ethics Hierarchy as the Moral Hierarchy. My own postings exhibit cultural bias. I include more from eastern culture than western culture. Some comments I have received indicate that there are others out there who have looked at culture/art/literature comparisons with the opposite bias. The fact of matter is, this Moral Hierarchy itself does not imply absolute superiority of any kind. Relatively speaking, one is larger, contains more transitive actions, than the other, but bigger is not necessarily better. In fact, it is one of my hopes to understand how they are different. Reasonably speaking, I should not expect to find that one is superior to the other–quite the opposite, I feel that exhaustive investigation of this subject will reveal to us more about the way the world, humans, and our society are than about the rights and wrongs within their contexts. Because morals have cultural biases and ethics is the philosophical study of morals, I may switch back to Ethics Hierarchy when I wish to emphasize that I am trying to be objective.

 

Therefore, to continue, let us be fair, what is drawn are idealized sets and intersections. The Jesus way is actually one of many allowed sets of actions that has an inner-bound restriction of being bigger than the my desires. Under this prescription alone, one can do everything in the universe and still not violate the Golden rule. The Confucius set, similarly is one of many possible sets fully contained in my wants set. The Silver rule has a maximum outer bound, one can only do things within my wants. Under silver rule, one cannot do everything in the world.

 

Some extreme examples might be, for instance, a person that goes around slaughtering each person with a knife is allowed under one interpretation of the Jesus way, as long as he also does everything that he wants for that person. This can be quite arbitrary, say, the perpetrator wants to be fed carrot cake, then he feed everyone carrot cake and then knifes them. What’s worse is if the person is masochist, then he is forced to act as sadomasochist. If he wants to be fed carrot cake and knifed, then Jesus way requires that he _must_ both feed everyone carrot cake and knife them.

 

On the other extreme, suppose one tries to follow Taoist suggestion to do nothing, it easily fall within Confucian way without regard to the size of my desires. While the only way for a person to do only nothing under the Jesus way is for him to want nothing. This is impossible because follower of the ways of Jesus at least want to enter heaven, so trivially Jesus way is never empty and prevents follower from doing nothing.

 

It’s interesting to think of the possibilities. Let’s look at just the Confucian way. Set D is outside of my strengths, and it is outside of my weaknesses, however, because I desire it, it is within the Confucian way. Set A are things I desire, within my strength to do and outside of my weakness to receive. These are the things that I can only give and will never receive in kind. On the opposite end, set C are within my desires and weaknesses but not within my strengths. O is the set of my opportunities–these are the things I want but am not yet capable of receiving. Set B is a sweet spot. Here, not only are we within the ways of both Confucius and Jesus, we also desire to do so. This is a region to maximize, if we had the choice to do so.

 

gold versus silver 3

 

It should be pointed out that zone B contains only actions that we can reciprocate when receiving and receive reciprocation when giving–in kind–in other words, an eye for an eye, a tooth for a tooth zone.

 

Zone U in this graph points out an area of the an-eye-for-an-eye-a-tooth-for-a-tooth zone that is outside of my own desire and therefore not recommended by either Confucius, but is allowable by the Jesus way.

 

Let’s backtrack and admire the an-eye-for-an-eye-a-tooth-for-a-tooth zone T in its full glory

 

gold versus silver 2

 

Wow! It does exists!

The problem with Transitivity

Transitive Action Space is fairly concise space containing all those actions that are divalent. These actions are the first class of actions that we consider because it occurs most frequent in interpersonal relationships. Also because the Golden Rule and Silver Rule of ethics both syntactically refer to precisely this class of actions.

Linguists have long thought of this issue and discuss the concept of valency of verbs. monovalent verbs are intransitive, transitive verbs are divalent… Other verbs are more expressive and some has multiple valencies: do and have both can be monovalent, divalent and trivalent.

The example given in wikipedia is the following American southerner statement:

I am having myself some dinner.

“I”, “myself” and “dinner” are the parameters of “have”, which in this case is trivalent.

The interesting fact about this is that the first two np’s associated with this verb are covariant (vaguely speaking). And by this I mean

He is having himself some dinner.

She is having herself some dinner.

They are having themselves some dinner.

and so on and so forth. The first two vary together. I can never have, for example

I am having themselves some dinner…

it just wouldn’t make any sense.

We should let this sink in a second. First of all there are multivalent verbs beyond transitive verbs. Second of all, some verbs may have restriction on them regarding some or all of their np’s when used in an actual sentence.

do is the other multivalent verb.

I am doing myself a favor.

Again trivalent, however in this case covariant np’s are not required.

I am doing him a favor.

I am doing her a favor.

I am doing them a favor.

etc.

In fact, not to be vulgar but these are the things that came to mind as I think about this:

I am shitting myself a bucket of golden coins.

I am making myself a bucket of golden coins.

I am shaking myself a headache.

I am driving him nuts.

I am driving him home.

ahha, so we have a pattern. These are still transitive verbs, but their third np parameterizes the content of the action or indicate a byproduct of the action.

I can shit you a bucket of gold.

To me, you the object of the action, the receiver and gold is the content of the action. I am straining but not seeing my doing anything to gold using you. similar pattern apply to the other of the previous sentences.

I’d like to include these trivalent verbs in the transitive action space by adding the additional noun phrase into the verb forming verb-np super-verbs that can be applied to the parameters of previously defined Transitive Action Space (i.e. you and me).

(shitting gold)

(making gold coin)

(shaking (out) a headache)

(driving nuts)

(driving home)

are included as trivalent transitive actions.