Iran in Trouble? Health care; and more musings...

1) One of the truly positive aspects of the plummeting oil prices is the effect on the Iranians.

Research indicates that Iran needs oil above $100/barrel in order to balance their budget. With prices now in the 60's and heading downward, the current government, already struggling with their economy for the last several years, may be in greater trouble.

On of the biggest failings of the Bush administration was the failure to continue the work of promoting the nascent democracy movement in Iran.

As is true in much of the middle east and Persian Gulf, many of the most radical governments have the most moderate populations, and vice versa.

There is still a segment of Iran, that while hating the Shah, enjoyed a Western style economy and daily life.

The only question is, will this economic pressure cause further radicalization, or force Iran back into the world community.

I hope the President elect uses these forces to pressure the Iranians to behave.

2) One of the very big positives, maybe the only one, of the spike in oil and gas prices this past year, was that we in the United States have cut our usage of gas by 10%.

Here in NY, we pay more at the pump than just about anywhere. My car takes Premium gas and I topped out in the $4.50 range.

Today, filling up, I paid $2.80. It was the first time in almost a year that I got change from a $50 after filling my tank.

What I fear, though, is that this positive conservationist impulse, brought on by prices, will diminish.

Let's hope not.

In addition, the high prices were what was causing the drive toward alternative fuels. Let us hope that the pressure on the new President and the new Congress is not lessened at all to actively and aggressively seek real, effective alternatives.

3) One of the truly important ideas floated by John McCain in his campaign, was the idea of severing health care from employment.

I fundamentally do not support single payer systems. As a Docs kid, and with many friends and contacts in the medical fields around the world, it is my distinct sense that individual care suffers under these systems.

They do even out coverage, but rather than bringing every one up, they tend to find a below median universality.

Worse, the government is incapable of running simple national programs. The waste, incompetence and cost of the government being the insurer of 50 million plus Americans is something I don't even want to consider!

The profit motive continues to drive innovation, both in equipment, research, and medications here in the States.

But, we have two insurance systems in NY that could be models for national systems to address two huge problems with the current system.

First: We have a universal child health insurance plan. They are not the best docs, but it guarantees all children coverage at very reasonable rates. I certainly think this can be recreated nationally.

With the obesity epidemic among children running rampant, I think this is crucial.

In addition, we here in NY have an auto insurance program which uses a private company (currently Allstate, I believe) to cover "high risk" drivers. i.e. those whose prior insurance companies have dropped them due to tickets or accidents. I also think this can be replicated nationally for health insurance..

Finally, getting back to McCain's idea. We currently operate with a program called "COBRA" which allows you to carry your previous employers insurance for 18 months after leaving their employment.

I think that an easy fix to a lot of the lack of coverage issues would be legislation mandating that COBRA be extended indefinitely.

There is no reason for coverage to be tied to current employers. If you are part of a group (which as you know, significantly reduces cost) at one time, you should always be able to be part of that group.

4) Many do not know this, but it has been discussed in some circles recently. The President elect, and his transition team do not have any official position. As such, they do not have security clearance.

In this election, this was somewhat mitigated by the fact that both candidates had Senatorial clearances.

However, for example, John Podesta, one of the chief architects of Obama's transition, would not have had security clearance in years past. Same with Valerie Jarrett and other important figures.

In 2004, President Bush signed an executive order establishing that the President elect and his designated transition team, be rapidly cleared and thus fully briefed on all matters of national security and other issues. Thus allowing the new President to "hit the ground running" so to speak. Kudos to him for this important innovation.

5) Finally, in 40 years of watching Presidential politics, I have never seen an election victor hold a Press conference standing at a podium with "Office of the President Elect" as an official sign.