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Firefighters air grievances at South Hill meeting

Nearly a year after members of the South Hill Volunteer Fire Department ousted longtime fire chief Rosser Wells, members of the department say he and town officials are harassing them…

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Losing a neighbor

SoVaNow.com / May 21, 2009
An old neighbor, Fred Martin, the longtime pastor at St. John’s Episcopal Church in Halifax, died Tuesday after a lengthy struggle with leukemia and other illnesses. The majority of the Martin clan relocated to Richmond years ago, but prior to that point our two sprawling families —five McLaughlin kids, nine Martin children—grew up together as next-door neighbors in Halifax. As one of the few adults in the fray, Fred was the sharp-tongued presence at backyard get-togethers, beer in hand and a slightly owlish look on his face, unless he were laughing at something, which was often, in which case his visage more closely resembled that of the Cheshire cat. Although it wasn’t as evident during those childhood years, Fred made his mark on the world as someone who could be quite outspoken on the great issues of the day. He famously sermonized against the Vietnam War at a time when that sort of thing simply wasn’t done, and on questions of race relations, equality and justice he would challenge the conscience even as others held their tongues. Whether motivated by his faith or an abiding fearlessness or just plain old orneriness is hard to say — one would guess a combination of all three — Fred Martin made this community a better place during the time he lived here and forever after. He will be greatly missed.

****

Turning to the news of the nation and our place therein:

General Motors and Chrysler sent out notices last week informing thousands of auto dealerships around the country that their services would no longer be needed. South Boston was untouched by the automakers’ pullback, but in South Hill the Boyd Automotive Group dealership, which carries GM as well as Honda products, received a non-renewal letter from the ailing automaker. Brandon Boyd, the owner of the firm, responded to the news from GM by touting his dealership’s success with Honda — Boyd Automotive sold some 300 new Hondas last year compared to only 76 General Motors vehicles, according to Boyd. Detroit is in such terrible straits that you really have to wonder whether GM and especially Chrysler will stay intact through the current downtown. At any rate, Boyd Honda will move forward in the future and still service its legacy GM vehicles. Good luck to them and to the GM dealerships that survive.

Of all the projects that President Obama has taken on, turning around the American auto industry would seem to rate near the bottom of the list in terms of likely success. After all, the misfortunes surrounding Detroit have been decades in the making. But I’ll give the new administration this much: they’ve made a decent start in forcing the automakers to clean up their collective act. It’s long been understood that the Big Three is saddled with too many dealerships, but for a variety of reasons GM, Ford and Chrysler have been unable to make headway in reducing their dealer networks. Only the threat of bankruptcy has allowed GM and Chrysler to make progress on this front. Yet without guarantees from the federal government, it’s unlikely the car makers could have avoided bankruptcy, though it may yet come to that. One can always argue that bankruptcy is what the doctor ordered for GM and Chrysler, but aside from thinking this would be ruinous for the companies and the tens of thousands of people they employ, I also don’t get how anyone can blame the feds for putting auto dealerships out of business when everyone in Detroit knew it was necessary for survival but couldn’t make it happen on their own.

Obama also announced this week that the federal government will institute a single, stringent standard for fuel efficiency in cars and trucks (the average for passenger vehicles will rise to 39 mpg by 2012). This could turn out to be another pivotal step in getting Detroit back on its feet, if for no other reason than the requirement should boost sales of new cars to replace the gas guzzlers now on the road. I like what the administration is doing with the auto industry: not telling them how to run their business, but laying the ground rules to spur the innovation that represents Detroit’s only real hope for a comeback. Whether Detroit can or will seize the opportunity is another matter, but I don’t think we should worry about complacency being a big problem as the industry steps into the future.

Another big Obama priority is reforming health care. We’ll have to see what the details look like, but the entrenched interests and their free-market amen choir aren’t waiting around to launch their pre-emptive strike. Already there’s a great deal of talk floating around to suggest that government involvement is ruinous to any business — as though Medicare and Medicaid have been disastrous to the health care industry, which they have not. A word you’ll be hearing a lot of is “rationing” — the presumed desire of the federal government to deny health care to sick people. Matthew Yglesias, a blogger for the Center for American Progress, wrote a good rejoinder to this on his website this week (yglesias.thinkprogress.org):

…. The proposals currently before congress would not, of course, create a government-run health care system. There is, however, a proposal to create a health care system that would include a widely available public health insurance option. The point of this would be to try and see if private industry actually can do better then a government-run insurance plan. After all, if the public option offered rationing and low-quality care, why would anyone sign up for it? Nobody would. That kind of low-quality public option would give private insurance nothing to fear. But what they really fear isn’t that a public option would be bad, it’s that it would be good—putting effective cost-controls in place without compromising patient care, thus threatening private industry’s business model.

That, however, is one of the best ways at our disposal to make health reform really work. A public option that strives to achieve public goals—quality care at an affordable price—will challenge private industry to do a better job. Then competition between plans will drive improvements in quality and efficiency. Without a public option, the risk is that private plans will compete by trying to screen out sick patients. That’s a viable [route] to private sector profits, but it does nothing to improve quality or control costs.

A commenter on Yglesias’s website posting under the name “Alan” also did a fine job of summarizing the key issue here:

[I]t is foolish to think that a plan that needs to make 15% [p]rofit can ever offer consumers as much as one (like medicare) that only needs 3% for administration fees, unless you assume large amounts of public works fraud, but no amount of private fraud.

However, there needs to be a day when we come to realize that there is already healthcare rationing. As a physician, I could order MRIs on every single child in my office. [I]f this were done nationwide, hundreds, maybe thousands of children could survive what will become terminal brain [cancers]. BUT, insurers won’t let doctors do that, AND THEY SHOULDN’T, [because] the cost would be so [exorbitant], that soon as a society we [would produce] nothing except healthcare.

Rationing of healthcare is a [necessity] when we have the technology to do more than we can afford to do. The question becomes how will we ration, and who will decide on the rules. Currently, rationing is haphazard, based on patient income, insurance, local availability of technology, etc… Everytime that you wait 2 weeks for a doctors appointment you are experiencing healthcare rationing. Everytime your pharmacy plan states that one medicine is covered but another not, you are experiencing rationing. It seems to me that a more productive way would be to have a national discussion among doctors, ethicists, researchers, medical economists, and consumers about what we as a society will and won’t pay for. That is much more likely to happen in a government setting (even imperfectly) than in a setting where additional parties are looking for a profit.

At some point, healthcare rationing needs to stop being a dirty word, and start being used as a description of how we as a society choose to best and most universally allocate our healthcare resources.

This is exactly right (even if “Alan” is a horrible speller, hence all the brackets in the above passage.) As we move forward on the health care debate, it will be interesting to hear what the defenders of the status quo say about the efficacy of our current system. Just to cite facts: the United States is the richest nation in the world but the only industrialized country without universal health care, and on the whole our health care outcomes lag behind most First World nations. There are some excellent aspects to our health care system but others that most anyone should find appalling. Why exactly government-funded health care should be considered toxic, given the widespread popularity of Medicare and even alternatives such as VA care, is a mystery to me. Could it be the insurance companies and their defenders don’t want people to have alternatives?

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