Rationed Health Care

Thoughts in progress.

I find it interesting that in the current debate, the reporters and congress are carefully using the term "Health Care" while most American's think "Health Insurance".

There is an enormous difference between the two.

"Health Care" can be compared to "Car Care" or "Home Care": all the things an individual or an owner does to keep up their car or home. And everyone does it differently. My cars tend to be older - I haven't paid more than $5,000 for a car in 20years - but we keep them running, somehow. I use my knowledge and it saves me money.

I try to do the same with "Health Care": I chose the Health Savings Account at work and a "Health Insurance" policy with a high deductible. The total bill is much less than I would pay for traditional insurance - and we have more freedom. The high deductible covers us for any real health care crisis: colds, flu, broken bones are easily handled by the health savings account.

In the discussion going in the halls of congress, I'm afraid that we might be getting managed health care rather than my personal version of health choice. Managed health care is where someone else chooses what procedures are available and what doctors are on the list and how much the doctors will be paid for what procedure. Instead of me making a choice and paying for it, someone else is doing so.

That is rationing. Just because this is the "full health coverage" offered by big business, demanded by unions, and granted to government workers, doesn't change the basic fact that it is rationed health care. Some just have a fatter ration book than others.

A basic economic observation about anything that is rationed is... (you can fill in most the blanks and I bet they are not positive) people will try to maximize their use of the rationed goods. Thus creating shortages, black markets, etc., etc.

Think about it.

So You're Fat - Face It!

Warning - preaching ahead!

This is advice from a skinny guy who has never been overweight - since I was about 3 years old that is... All of us have to watch our weight - some of us have just been more successful than others. My step-dad told me that the most important exercise I could learn was push-ups - from the table.

So what is the novel insight? Nothing new or revolutionary here. This should be common knowledge.

First, be honest. Americans are overweight and lying about it. I have a friend who went for a health screening and was told he was obese. He explained to me that the charts don't apply to someone his height. He's lying to himself. Most of us are lying to ourselves. I bought a cheap fat percentage measurement device that told me I was 10 percent more fat than I thought I was. I didn't think the device worked. But it was right. I took ten seconds to figure out that I have gained 20 pounds since my 180 pound in-shape days - and the extra weight doesn't appear to be muscle.

Second, measure. Honesty requires it. It is easy to mislead ourselves without a standard. What to use? A pair of pants or a favorite dress. When they don't fit, it's not because they shrank! The easy answer is to buy a new dress or a new pair of pants and rationalize about changing shape, or stress, or busy lives. Trust the measurements - they are better than memories.

Next, eat normally. What I mean is, eat the kind of normal, boring diet taught by grade school teachers, departments of health, grandmothers, and common sense. Skip the fancy diets, the pills, the special sections of the grocery store. Not that there is anything wrong with those special foodstuffs, they are just another lie: There is no magic method to lose weight.

Expect hunger. Everyone experiences it, fat or skinny. Live with it. Ignore it. Realize that not being completely full at the end of a meal should be normal rather than unusual. Hunger is not bad. As my wise but blunt step-dad would say - it won't kill you.

Finally, tiredness and sweat are good. Very good. Quality-of-life critically good. Be active. Exercise and more. Our bodies were designed for motion, yet we fill our lives with immobility. Walk, run, bend, sway, jump, play. Use it or lose it. The germ of this rant came as I walked up and down O'Hare, while nearly every one else minimized the distance from the airplane seat to the airport seat.

Our bodies - the wonderfully complex and adaptive system that they are - will optimize to the lifestyle we choose. If we choose to sit - we will have comfortably fat rear ends. I play basketball regularly, and still painfully re-discover muscles whenever I try another sport. Don't let your body optimize for something less than the optimum you want.

You know what you want your body to look like. And I believe you know what you have to do to get it to look that way.

You will sweat and you will be hungry - but you will be happier and healthier.

And no, not every single one of you has a special health condition that prevents you from removing those pounds.

Good luck!

Bases of Estimates

Some things are more apparent from a different perspective.

I open this blog with disclaimers, which are not necessarily gripping literature, but are needed to start a discussion. In engineering, I was taught to call disclaimers 'bases of estimates' as in the plural of basis. These are the known facts and assumptions needed to complete a given problem.

And that is my first basis, i.e. I am an engineer, and because of that, I look at things and people differently. I admire things that work, and want to fix things that don't. I don't know how to emphasize that enough. I am conservative - in that I want to know why something works before trying to fix it. I am suspicious of opinions and theories - even and especially my own - until lots of data is collected and key experiments conducted.

But I am not a scientist. I hope my fellow practitioners of both broad disciplines will forgive me when I generalize: Scientists seek complete understanding; Engineers have to make something work with current, incomplete knowledge - and make money while doing so.

So that leads to a second basis: I will use correlations and analogies when data is lacking. Engineers have spent a lot of time, trouble and effort collecting and correlating data for many and varied situations. These are presented in handbooks, papers, memos, and owner's manuals. In absence of directly applicable data or correlations, engineers go and find something that might fit and provide the needed insight - all the while being skeptical of the tool they are using.

Which leads to a third basis: I try to always examine the overall balances. Maybe the details aren't known, or an approximation is being used, or a correlation from another field is being tried - so the engineer will check for overall reasonableness. That is, calculations are made on the larger scale, often called order-of-magnitude, or maybe the engineer checks the goes-intos and the goes-outofs, or perhaps high school Newton physics are revisited, just to make sure that whatever logic was followed to do the details, the big picture still makes sense.

Which leads to a fourth basis, which is really the first basis stated another way: I seek to understand the underlying structure. I need to satisfy my engineering intuition. Perhaps that statement needs further explanation. There is a Dilbert animated short film that implies that engineers are born. Which is largely true from my experience. Engineers like things, understand things, and study things. "Things": mechanisms, equations, objects, doo-hickeys, contrivances, systems, software, etc., are understandable to engineers as well as fun and enjoyable. These "things" resonate with an engineers soul, align with their training, match their experience, and are simply beautiful. I seek such moments of insight - of resonance - of beauty...

On the other hand, we sometimes have trouble with people. And thus my blog...