Having a Go At It ! 
Kevin Scott         oct09   

 

Everyone has a different perspective on virtually every event or issue that becomes part of public discourse. The problem we have with resolving public discourse is that we don’t make a rational evaluation of the facts, potential solutions, and potential consequences, known or unintended. We are limited to anecdotes, sound bites, talking points, selective reporting, etc.,  filtered through “talking heads’ or bias of various communications media. We therefore are left with little choice, other than take bits and pieces and put them together ourselves.

 

An example is the legislative movement of profound impacts to our society such as health care reform. A proper path would let congress follow their traditional path to create a consensus bill, and then allow maybe 30 days for public evaluation of the final bill, prior to going to the president, which would be available to all. This would allow all sorts of pundits to add their opinions, debate the bill within the congress, and after 30 days, pretty much have a total consensus of what is best for America  , having had the opportunity to tell congress our concerns, and have congress consider the public inputs relative to reality.

 

Well, without going into the details, this is not how we do things. People forget that Obama wanted a bill on his desk by July 4th. Why the rush? Because he wanted to subvert a deliberative process that included evaluation of a real bill, with real cost analysis and impacts determined. (witness the stimulus bill that nobody read) And why did he not want this evaluation? Because the more you know, the less public support would be there. His agenda would be subverted by the transparency he promised as a candidate.

 

So why any rush to a bill? Why exaggerate the problem by claiming 47 million people being deprived of some right? (It took him 8 months to admit to 30 million and that has been proven incorrect by about 15 to 20 million) Don’t we have Medicaid for poor people? Aren’t there people who feel they don’t need insurance because of age and health status? Aren’t there people in America that are illegally here and don’t contribute to paying for any social services that some believe they deserve just because they are here? (Note that nobody is rejected in the case of an emergency regardless of status) Aren’t there people that have done all the right things all their life, who are barely making ends meet? Aren't there people who believe everyone else owes them privileges, goods, and services, for which they won't work themselves? And there are dozens of other questions like these that all relate to what we do, why we do it, inclusions, exclusions, etc. So what would be a plan if political agendas were removed?

 

  1. Setting Goals- This would require having a relatively accurate number of people in each category of required coverage. This would also require determining options based upon the categories, driven by total payments into the system, existing programs-do they continue or are they moved into the new system, determination of eligibility of citizens with existing company coverage, union/negotiated coverages, non-citizen temporary residents, people here illegally, medical issues like pre-existing conditions, temporary interruptions in the ability to pay,  and so forth, determining extent of emergency, humanitarian coverage.
  2. Address Waste and Fraud, which are not synonyms for each other . Fraud is a criminal offense, but waste is generally a function of external drivers set to solve one problem by causing another problem. Example would be blood tests ordered by one physician, not shared with other physicians needing the same information. Some hospitals share orthopedic X-Rays or MRI’s, from a data base storage, so at least for this example , waste can be addressed.
  3. Re-examine programs that have any degree of subsidy. Example medicare rates are less than rates paid by insurance companies via plans for businesses. At first glance, you might ask why, but the history of the practice is where the answer lies.

Medicare was not intended as  insurance in the normal definition of the word. It was more an entitlement, recognizing that seniors had paid into a system for years, and had supported and continue to support via taxes, other programs that benefit all citizens. The cost to seniors would not be free, but it would not single them out as a medical group, which would make their premiums higher than others because of its smaller size and health prognosis. So from this, the plan was created. The medical community signed on to this where most doctors just accept what Medicare pays, as do the hospitals etc. If there are any shortfalls, the costs are spread over the larger group of everyone else. This is equivalent to a business tax that increases slightly the cost of everything to everyone, including seniors.

Is Medicare free?  Not close. For a couple=

·        Part A is no cost
* Part B is about $200/month
* Part C is about $400/month
* Part D is about $80/month
* Co-pays for important medicines are about $40/prescription/month/person
* Social Security – pay taxes on ½ amount of payment which  is your money  
   collected in taxes over the years with no interest paid to you.

·        Medi-gap starts at $2400/year per person, which is the cost of the medicine to the government minus the co-pay. Getting to $2400 is quite easy for most seniors.
* This does not cover cost of travel, non-prescription medicine, many prescription medicines, vitamins, etc.

·        It is not unusual for a couple to have over $1000/month related to medical related expenses. That is equivalent to  the average Social Security payment.

 

  1. Having addressed some of  the major points, waste and fraud, and subsidies  (not all here) you can go on to what options are available. Besides making a universal basic plan that all insurance companies can follow for cost comparisons, what about the following points.

·        Tort Reform- the Democrats ask all Americans except lawyers to help solve the problem. We all know why, but still – why not?

·        Public option- The public option is a Trojan horse. Why? Because it is based on paying insurance companies Medicare rates, which are not based on insurance risk. Therefore, they are not there for any other reason than to legislate the insurance companies out of the traditional insurance business. The only option for them to survive with their prices for everyone at Medicare levels, would be for the medical community as a whole to accept less money for their goods and services, which translates to lower salaries for all involved, fewer benefits, less overall income that will effect research and development, less capital investment because of lower expectations, and so forth, and not inconsequentially, the economy in general by less money in the hands of the consumer.

      Competition- Why do state insurance regulations prohibit the sale of policies across state lines. Many states stifle competition by limiting who can sell in their state. Why?
Illegal Aliens-
La Raza wants healthcare for Illegal Aliens The president of the National Council of La Raza, America's largest Hispanic advocacy organization, said healthcare reform should include "everyone" including illegal aliens.
His argument makes no sense, because most illegal aliens will be without jobs because of E-Verify checking. Therefore if they  register for health care, they will be identifying themselves as illegal and subject to deportation. Even without the E-Verify situation, they would be eligible for subsidies because of their low incomes, therefore they would not be making the paying pool larger (spreading the risk) 
They would be making the subsidized pool larger, therefore costs would go up for those paying for the program. Also, think about the image that potential legal immigrants see. People who cheat and break the law are rewarded with better health care, than those waiting in line for their turn. Kind of hypocritical of politicians to be considering this seriously.

     
There are many more issues that have not had public debate. Why not?

 

Summary- I could go on all day if I had approached this topic as if I was writing a book. A good outline, points in each category, etc., but I generally know all the issues and carry them around in my head. To explain it to a broad audience is a lot of work and I don’t have the desire to do it now.

 

My point in writing this to you  is to reinforce the concept of the big picture. The health debate is only a single point in the larger debate with is the destruction of the traditional American way, being attacked by socialist philosophies that are not endorsed by the American people, and have historically failed and brought societies to ruin.  Again another story, but it is pretty clear that “hope and change” is not what Americans want. They want competency of the administration of our government. We don’t need radical ideas to keep America at the levels we expect for ourselves and   generations to come. It’s all about competency. It would help if we could make congress live up to their oath of office and the Constitution. When you get to the bottom line, everything is the fault of congress, because they do not take the tri-body construction of our government or the Constitution seriously. It’s all about their personal gain. Why do they exempt themselves from much of the legislation they write?

 

Sorry to expose you to the soap box, but as years ago, my purposes were always about the big picture. Setting goals and requirements, and being successful meeting them. What I say now is no different than 30 years ago. The topics are different, and personal perspectives are different, but the resolution of issues is the same. Charlie Smith offered “hope’, “looking into eyes to see the eyes of a tiger” (you may have missed that one) , and other platitudes, but as Charles Krauthammer said “Don’t listen to what he says, look at what he does”. And for a quote from me -   “He puts the LIE  in believability”.

 

Over the history of American, change is made by having the people believing in what government says. When government hides things, they get no support. We thrive on momentum, evolution, clarity, and transparency. We do not need or want radical change to anything. All problems can and should be addresses as you would address a technical problem. Political solutions historically do not work over a long term. Ask the Vietnamese, or Koreans, Israel, and host of other countries what they feel about the changes do-gooder did as political solutions to problems. The people always pay the price.

An afterthought-

The video below is typical of government spinning reality, to enable them to attempt to mislead the public. From this video, one might tend to think that the people referenced by Obama, have supported the bills in process and agree in SUBSTANCE with them. Nothing could be farther from the truth. The people referenced support REAL HEALTH CARE REFORM. That is a concept based upon providing affordable access to all Americans, and the control and cost containment of health care, not the creation of anothe bureaucracy with government running health care.

Obamacare is not a synonym for health care reform.

All of the bills when pulled together will have some form of trojan horse leading to an eventual single payer system as described above. They are all products of a socialistic approach that will eventually destroy the marketplace based system that is the envy of the world. He is claiming that the eventual plan will not cost the taxpayer a dime and  there will be no reductions in services to seniors, no rationing, you can keep your own insurance, and so forth, but if you read the above, you will see that it is unlikely that any of this will come true because the bills do not support his statements. Already, the insurance industry is moving away from earlier support as the details evolve and become known. The CBO gives preliminary estimates on preliminary bills. When final bills are created and signed, the costs are usually higher. The government always uses waste and fraud as a source of money, but it usually never materializes. We all support REAL reform, but so far, Obama is spewing more hot air, unsubstantiated by the substance of the bills, or any facts. Hold on to your wallets.

 

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