Health insurance for some

March 13, 2017

This Times Union story is disheartening, but not surprising.  It’s about legislators hiring rich cronies for part time jobs that pay little but provide State-subsidized health insurance, which is top-of-the-line and costs the employee very little (full disclosure — as a full-time, non-political State employee, and now as a State retiree, I too enjoy this benefit).

What the story doesn’t address, and what should be of broader concern, is the pricing policy for employees and retirees, who are required to pay a share of the cost of their policies.  There are two prices — for individuals with no dependents, and a higher family price for those with any number of qualified dependents.  Thus, the employee with a spouse and no children pays the same premium as the employee with a spouse and 15 children.  I do not know whether the cost to the State is the same regardless of the number of the employees’ dependents, but I do know that State employees with small families are paying a lot more per person for their health insurance than State employees with large families.  While this policy is great for State employees who have large families, it’s not so good for those making up the difference.  Even worse, it’s not a transparent policy — those who are making up the difference are not aware of who they are or how much they are paying.

I’m not saying the policy is indefensible; for example, where government jobs sometimes pay less than the private sector, the family insurance plan may make it practicable for someone with a large family who is an attractive candidate to take a lower-paying State job, which could benefit the public. And it is a way to make health care more affordable to those with larger families and, presumably, less disposable income (though that may not be the case of the part timers in the TU story, one of whom claimed a net worth of over $8 million). What I am saying is that it also presents apparent fairness issues and, as the TU story indicates, an incentive for abuse.  Open discussion of the issue — one that most taxpayers probably are not aware of — might benefit everyone.

 

 


Health care conundrums

February 17, 2017

As I advance in age, I am exposed more and more to the health care industry, despite having enjoyed relatively good health until recently.  As a retired New York State employee, I am blessed with excellent health insurance that covers most doctor visits, medical tests and procedures, as well as prescription drugs, with only a relatively modest co-pay. Here are a few observations:

First, it appears that many of our health problems are what a friend of mine calls “diseases of affluence.”  More appropriately, they should be called “diseases of lifestyle,” since they affect people of all socioeconomic strata.  A lot of these are directly influenced by government policies.  For instance, our auto-centric physical infrastructure minimizes the opportunities for and pleasures of walking and cycling, and cannot help but contribute to obesity and other problems based on lack of physical activity.  Our government subsidies to cane sugar and corn (the main ingredient of high fructose corn syrup) help make junk food and sugared soft drinks attractively priced.  This is especially so for the poor, since the SNAP program (formerly known as Food Stamps) allows their purchase with SNAP benefits.  If we collectively spent more on complete streets that were friendly to pedestrians and cyclists, as well as cars, how much could we save on health care (not to mention on school transportation)?  How about if we stopped subsidizing sugar?  I think it would be worth a try.

For all the criticism leveled against it, the Affordable Care Act (“Obamacare”) has achieved something great — it has shifted the dialog from whether health care insurance should be extended to many of those who don’t have it to how the present system should be replaced or improved.  Neither Trump nor his minions are suggesting that those who obtained health insurance through Obamacare should lose it, meaning that they recognize that there is no going back on government’s commitment to growing numbers of its citizens.  Whether things actually get better or worse remains to be seen, but at least no one is talking a bout a pre-Obamacare “reset.”  To me, that is yuge.


Casino smoking update

December 29, 2016

I recently visited Turning Stone, which just completed alterations to its gaming areas.  I think it did a really good job to accommodate both smokers and non-smokers.  It enclosed in glass walls and allows smoking in about a quarter of its main gaming floor, an area that includes a bar and a self-service area from which patrons can get free coffee and soda.  The smoking area contains a large variety of slot and video poker machines and table games.  Also enclosed in glass and reserved for smokers is a separate, small high-limit table games area (there also is a non-smoking high limit table games area next to the high limit slots area).  While there are openings in the glass walls enclosing the smoking areas to allow patrons and staff to enter and exit, there does not seem to be a lot of leakage of smoke into the non-smoking areas.

Turning Stone’s solution, while the best I have seen to balance the preferences of smokers (who seem disproportionately represented among casino patrons) and non-smokers, is not perfect.  The main smoking area is very smoky, since almost everyone in it is a smoker (I didn’t go into the high limit table area, but I assume it’s also pretty smoky).  Though the smokers are there voluntarily, that may not be true of all the staff. The high limit slot area is outside the close and is now in the larger area of the casino in which smoking is prohibited.  I believe the live poker room and keno and bingo areas also are completely non-smoking, so players of those games who are smokers may not be accommodated.

All in all, though, management at Turning Stone deserves praise for responding to the complaints of non-smokers in a meaningful way, while preserving its competitive advantage over the non-native American venues in New York that will not be able to allow smokers to gamble and smoke at the same time. Now, if only management would turn its attention to the noise issue . . .


Let’s see how long it lasts

November 8, 2016

As I suspected, the new State-regulated casinos in New York (as well as those in Massachusetts) will almost all be smoke free.  This good news was reported by the Times Union in a recent item about what Turning Stone is doing to meet the new competition.

While I and many other casino patrons would welcome a completely smoke-free environment, maintaining a ban on smoking may not be economically viable.  There is a high correlation between gambling and smoking, and a complete ban in Atlantic City sent too many customers elsewhere and had to be rescinded.  Smoking will continue to be allowed at Turning Stone and in the Connecticut casinos.  Their customers may stay loyal to those establishments that allow them to smoke, even if new, non-smoking casinos are closer to where they live.

I think the best way to accommodate everyone is to make all public areas of casinos non smoking, with separate (but equal, in terms of games offered and other amenities) gambling rooms for smokers and non smokers.  Foxwoods has a separate non-smoking casino, but unfortunately for me it does not have any of the full pay jacks or better video poker machines I like to play at that establishment, so I have to put up with some smoke to play the better games.  Casino management also should consider accommodating those who are sensitive to noise by establishing some quiet areas.  The more a business can accommodate those with competing likes and dislikes, the better for everyone.


Albany bike path update

May 1, 2016

Yesterday, I rode on the Albany County bike path from its beginning on South Pearl St., and I was pleased to find that its western end had been extended from central Delmar (behind the Stewart’s on Delaware Ave.) to New Scotland Avenue in Slingerlands, almost doubling its length.  On a beautiful Saturday, a lot of people were using the trail for walking and riding.  This type of project always gets a lot of use, and it makes surrounding properties, residential and commercial, more valuable.  It’s a low-cost, high-yield investment for government, that pays off in better health for citizens enjoying expanded recreational opportunities, as well as financially.  I hope the rest of the path opens  while the weather is still good, and I hope local governments throughout the region decide to make similar investments.


Too loud and too sweet

August 12, 2015

I just returned from a trip to, among other places, Las Vegas, and I was very bothered by the volume of sound in several places I visited.  While I may be over-sensitive, I can’t believe that ear-splitting sound levels are good for the health of either the patrons or the employees of these loud establishments, and I question whether they are good for the bottom line.  When time permits, I’ll look for studies, but I find it hard to believe that sound levels I find uncomfortable to be present in are enjoyed by anyone.  Loud noise in other public places has become endemic — in addition to the dreaded airport CNN monitors, about which I’ve previously written, I often find televisions — usually competing with other background music — blaring in restaurants and bars.  In an age when everyone has a smart phone or other device that allows them to listen to whatever they want, is it really necessary for airports and other public places to bother those of us who prefer silence?

My trip exposed me to another of my pet peeves — screaming babies on airplanes.  Ear plugs are not a complete solution; what also would help would be to ask families who travel with young children, in exchange for the preferred boarding and the ability to bring infants along for free they now get, to sit in the last few rows of the plane.  It astounds me that Southwest, the airline I usually fly, will require a “Customer of Size” to purchase an extra seat if he or she intrudes on the space of one other passenger (the cost of which is reimbursed if not every seat on the plane is taken), while a screaming infant can terrorize dozens of people with impunity.  If the airlines really care about the comfort and well-being of their customers, they will pay more attention to the screaming baby issue.  I for one will gladly shift my patronage to any airline that does.

Further on the theme of too much, why is everything over-sweetened?  I have read that a can of regular Coke contains the equivalent of 10 teaspoons of sugar, which seems objectionable on health grounds.  Why not offer an alternative containing about half as much sugar, which might be more pleasing to adult palates and less objectionable than artificially sweetened alternatives, most of which also are cloyingly sweet.  Reduced sugar drinks would appeal to those watching their calories and would result in good public relations for their makers, something the soft drink industry could use right now.

Oscar Wilde admonished “everything in moderation, including moderation.”  Time to return to the time when moderation is the general rule and not the exception.


Lessons from our neighbors to the North

September 1, 2014

I just returned from a glorious cycling mini-vacation in Montreal, one of North America’s premiere cities for bicycling. I got to see a lot, compared to what pedestrians get to see; I got to see details that those who drive around miss; I got fresh air, sunshine, exercise and contact with locals. What Montreal got from me was tourist dollars, good will, great word of mouth and someone likely to return for more.

By accommodating cyclists, in addition to other tourists, Montreal has spawned a whole industry of businesses that support them – hotels and inns near bike paths, bicycle shops, and the like. It has provided its  residents an outlet for safe, outdoor, healthy recreation. And it has created a mini-boom in real estate along the major bike routes, such as the Lachine Canal trail.

By contrast, let’s look at what our area is doing to promote tourism and economic development: a convention center and a casino resort, neither world class, and therefore neither likely to attract visitors from outside the region. Both are late-comers in declining industries that already have excess capacity. While both will create one-shot jobs while they are being built, neither is likely to spur much ongoing development in their immediate surroundings, and neither will provide ongoing entertainment or recreational opportunities for locals, except perhaps for the casino, which may not be a good thing.

Some of the major benefits of encouraging bicycle tourism are:

1.  Low cost.  The bedrock principle for encouraging people to bike is to provide an area physically separate from automobiles in which they can feel safe and comfortable.  “Sharrows,” and bike route signs, the principal things our government wastes money on to promote cycling, do not achieve this goal.  However, there are relatively easy and inexpensive ways to separate cars and bikes.  Here’s a bike path in Montreal that uses no more than a painted line to demarcate a bike lane next to the curb, with cars parked on its outside to shield the cyclists from moving traffic.

Simple bike path - parked cars separate bikes and moving cars

Simple bike path – parked cars separate bikes and moving cars

For a little more money, actual temporary barriers can be installed that can be removed in winter (in Montreal, the bike paths are open from April through November):

Bike trail with stantions

Bike trail with stanchions

For a little more, you can add fancy, permanent curbing, and even a separate signaling system, but these are bells and whistles, not essentials:

Bike path with curbing

Bike path with curbing

 

 

 

 

 

Bike traffic light

Bike traffic light

2.  Benefits to residents.  While attracting tourists, a usable network of bike trails will at the same time encourage locals to use their bikes more, which will improve their health, reduce automobile traffic and its negative side effects (pollution, accidents, use of large swaths of downtown land for parking lots, etc.).

3.  Economic development.  Bikeable cities attract millenials and others who prefer urban, car-less environments.  In Montreal, I saw a lot of new residential development next to the major bike trails, as well as renovations of older warehouses, factories and the like into apartments and condos.

Montreal has as long and severe a winter season as Albany, yet it proves that bike paths make economic sense even when used only part of the year.  One advantage Montreal does have over Albany is more level terrain, but there are plenty of potential routes here that would not require major hill climbs.  The Corning Preserve and Mohawk bike trails already here are a good start that demonstrate the local demand for off-road cycling facilities, so there is little risk that if we build it, no one will come.

Expanding our network of off-road bike routes would be a win-win for residents, tourists and local businesses, at minimal cost to government.  There are few greater opportunities for government to do so much good for so many at so little cost.  What’s stopping it?