Rights 4 Sale

There is a discussion about whether health care or other benefits provided to individuals by the government are natural human rights or entitlements.  Right or privilege.   It’s a subject that people will probably debate for decades or centuries to come.

Without getting into this part of the discussion, let’s just talk about it from the dollars and cents point of view.

If you look at the federal budget, one thing jumps out.  The combination of mandatory and discretionary spending is more than the revenue causing a deficit.  So, we are already spending more than we make.  If we want to our government to give more, then we have to find a way to get some more money or spend less.

Just borrow the money?  The only problem with that is we pay more interest when the debt goes up.  Interest is part of the mandatory spending.  When interest spending goes up, there is less to spend on other mandatory items, like Social Security or Medicare or less to spend on discretionary items like defense, education, roads or law enforcement.

We could just print the money, but that would cause inflation which would defeat the whole idea of having more.

The only other alternative is raising taxes so there is more revenue.  Every time this approach has been tried, increased taxes lowered productivity or caused inflation.  Current estimates say that personal income taxes would have to be increased to 60% to cover the expected growth in Social Security, Medicare, Medicaid and interest spending.  It is doubtful that most people would put up with a 60% rate of income tax.

So, it’s back to square one.  Whether health care is a right or an entitlement, it is really junior to the question of whether we can afford it or not.  If we are going to pay for heath care, then we need to take something out of the existing budget or raise taxes. 

Proponents of the health care plan that is currently in the House and Senate say that we can pay for the new benefits by cutting existing costs.  Government programs have never been successful at lowering costs.  One might ask, if it’s so easy and so fiscally important, then why haven’t we done it already?

Let’s say that the typical person makes $1,000 per paycheck.  The taxes are approximately 20% or $200.  This leaves you $800 for necessary expenses like rent, utilities and food.  If you are lucky, these necessary expenses are less than $800 and you have some discretionary money to spend, invest, give away or save.

If government adds new benefits without reducing spending then they need more from you.  Suppose your fixed expenses are $800, then raising you taxes to $300 means that you need to make more money or reduce your expenses to $700.

So, let’s take it from the top.  As long as the government is taking in more than it spends, then it can spend the surplus on whatever benefits the people think are OK.   But, whenever the government spends more than it takes in, it needs to reduce services or increase revenue.  Translated, if you want more benefits, then you will pay more in taxes or government will have to spend less on some existing benefit.

The example above represents a typical American except that a typical American spends $850, but only brings home $800.  That means that the typical person has to borrow $50 per pay period through the use of a credit card or some kind of line of credit.

In the past, growing spending was obscured and hidden hidden behind a growing economy.  The same is true for individuals.  Growing credit card limits, growing debt or growing equity in real estate hid the fact that people were spending more than they made.

Now that we have an economy that is in recession, home values are decreasing and credit limits have has been reduced.  Meanwhile, federal spending is increasing while federal revenues have decreased.  The result is that there is less money in the federal coffers just like there is less money in your pocket.

Whether health care is a right or an entitlement may be purely an academic subject because there just isn’t enough money to pay for it no matter what it is.

 

 

It is deserving of a whole study by itself, but it is probably clear to most that communication is the most important ingredient in peoples’ relationships. 

Actions or things that stop or that block communication cause us to dislike the thing with which we can’t communicate.  A good example would be the tax code.  It is 7,500 pages long (if printed 60 lines to a page, which it isn’t) and there is probably not a CPA or tax attorney on earth that understands all of it.  The average citizen understands a fraction of a percent of the tax code and, guess what, doesn’t like it at all.

The same is true of the heath care bills.  They are 2,00o pages and people, even congress men and women, don’t know what’s in it.  It’s so complicated that the average citizen can’t communicate with it and, guess what, doesn’t like it at all.

There are many more examples.  Cap and Trade legislation.  Financial practices regarding complex investments.  Federal statutes.  They are all complex and hard to communicate with.

So, if you want people to dislike something, just be sure to block their communication in some way and they will not like it, won’t agree about it and will not understand it.

Someone can make a rational decision not to like or support something after learning about it, but the key word here is rational.  Open communication and people can make a self-determined, rational choice.  Cut communication and you guarantee that people will not like it.

In a sane, open and democratic society, those things that increase communication are good and those things that cut communication will cause us to succumb.

 

Often politicians say that something must be done and they need something else before they can do anything about it.

For example, there are numerous examples where someone is denied health care because of this problem or that loophole and the solution is an all-encompassing heath care bill that creates sweeping changes in all health care in order to solve some of these problems and loopholes.

In this case, the politician says that we need the health care bill in order to solve the problem.  We have to have something in order to do something.

But, a common sense question would be, “Why not just solve the problem by changing the rule or regulation?”  Why not change the health care provision so that the person is not denied coverage.  It doesn’t take a new health care bill to effect a change.

It’s the same in a number of areas.  Laws are on the books that would solve a lot of problems if law enforcement or prosecution would just enforce them.  We don’t need a new law before we can do something.  Just follow the laws we already have.  Borders and immigration.  Guns and their misuse. 

Quite often, the request for new laws means additional restrictions and a lessening of liberty by having the new law go further than the existing law in order to solve the “problem”.

So, be suspicious when you hear that we need the have this in order to solve that.  There is usually a simpler solution or even an existing solution that is being ignored.

 

The factions that argue for universal health care coverage point out that we are all humans and part of the human condition and that all humans get sick now and then, so sickness is part of the “human condition”.  Further, it is argued, if it is human to get sick, then it is natural to offer health care.  The continuity of the logic is subject to your view point, but some people believe that humans are naturally entitled to government provided health care.

If that is the case, then it is appropriate to extend the natural right one more level.  Since we all die at some point, it can be deduced that death is part of the human condition.  Therefore, the government should provide life insurance in amounts adequate for survivors to live in a manner to which they have become accustomed.

This would include burial costs, of course.

It is suspected that the same logic is true for food, employment, education and general happiness, to name a few areas of concern.

 

The heath care plan, in almost any iteration you pick, is really the best pratical program for reducing carbon emissions.  Look at it this way:  increased debt will mean less discretionary spending on a personal level encouraging people to have smaller families.  This lowering in reproduction will mean less people putting carbon dioxide into the air in the future.

Looked at from a different point of view, health care rationing will decrease the number of people using the health care system.  This reduction will cause a corresponding reduction of people living longer and thus will bring down the level of carbon dioxide being released into the air.

As a green program, nothing holds a candle to health care in reducing the carbon footprint of humans.  For those who survive a delay or denial of health care, cost will rise dramatically, but the air will contain lower levels of carbon dioxide.  Since trees and plants use carbon dioxide, we will have to watch their tendency to flourish and prosper from the presence of more carbon dioxide.  Perhaps, as a prudent kind of “thinking ahead”, we should be prepared to kill targeted trees and plants keeping the precarious balance between carbon dioxide and oxygen.

Health care could be the ultimate answer to carbon dioxide.

 

Some of the criticism of health insurance companies is based on a gross misreading of the financial statements.  Service and manufacturing businesses have different ways of ways of reporting profit and loss based on understandable differences in how they operate.

A manufacturing business reports gross or net sales and then subtracts the cost of manufacturing the units that were sold.  The manufacturing cost is the sum of material, labor and factory overhead and is called the cost of goods sold.  What remains after subtracting the cost of goods sold is the gross profit.  The operating expenses would be subtracted from that leaving the net (per-tax) income.

A service business would report gross income and subtract payments and expected outlays to customers to get gross profit.  It doesn’t have a cost of goods that can be measure in material, labor and overhead.  Just like a manufacturing business, it would then subtract operating expenses to get net (pre-tax) profit.

The people who are most vociferous about health insurance profits typically take the insurance company’s gross profit number and misleadingly hold it up as the net profit number and then impute guilt for profiteering to the insurance business.  Leading people to think that the gross profits of a company are the net profits of a company is extremely dishonest.

This is not a realistic, apples-to-apples comparison with other companies.  Gross profits are good for measuring the strength or performance of a company within an industry, but gross profit is never a metric used in the financial market to measure the performance of the company, especially one business in one industry versus a business in another industry. 

Health insurance companies reported net profits in the 7% and 8% range which is below the average net profit for typical companies in the US which is about 12% (pre-tax).  Health insurance companies are not the most or least profitable in the public sector.

The statistics show that insurance companies are not making excess profits.

It is interesting that health insurance companies have a limited exemption from antitrust activity for 70 years.  While it would be illegal for other companies in other industries to do so, health insurance companies can get together and set prices or operate as a monopoly in a given state.

Health insurance companies have territorial protection, state-by-state protection and regulation, territorial restrictions, antitrust exemptions, medical malpractice considerations, waste and fraud issues and widespread pharmaceutical misuse.  It seems like a confused, contradictory word-salad.  It is hard to take any slice of the health insurance industry and hold it out as representative of the whole.  It is really important to view the industry as a whole and not fall for the demonizing propaganda based on half-truths that makes it into the mainstream press.

Is there any wonder that costs are escalating?  It’s time to throw out the system and build a new one.

A lot of people assume that they know what a co-op is.  Co-ops have been around for two centuries and the knowledge of how they work is extensive.  There are quite a few co-ops in existence for everything from electrical power production to grain sales to health insurance.

Co-ops have a reputation for not working very well for most activities and working well for just a few specialized needs.  There are many different structures for co-ops.  If we assume that a government run health co-op would function a certain way, based on a past definition of co-ops, then it’s jumping off a cliff without looking.

With regard to the current discussion about health care co-ops, there are some drawbacks to the co-op solution.

While the current structure of co-ops favors its own members with group discounts and not-for-profit operation (which reduces costs), nothing says that the government can’t put new rules into place.  The government could regulate who owns the co-op, how it’s operated and how it goes forward.   There is no rule that prevents the government form controlling the operation of the health care co-ops.

The second concern with co-ops is that they need all of the elements of competition for the market in which they participate.  A power plant co-op needs a way the generate power (power plant), a means of distribution, sales and marketing and executive, management and administrative functions.

When we think of health care co-ops, the same applies.  To be competitive with private insurance companies, a co-op would have to have a network of doctors and providers, a defined schedule of service and a means of distribution, sales and marketing and executive, management and admin functions.

Thirdly, statistics say that insurance companies reported an average of 3% after-tax profit.  A co-op is operating without profit (or the profit is distributed to the members), but probably has the same operating costs as a private company.  It can be deduced, then, that a well-run co-op would have a 3% financial advantage over private insurance companies.  If it was not as efficient as a private company, the co-op might have the same or higher costs.

A co-op can be whatever the lawmakers want it to be.  The congress can determine how it will be financed, how it operates and all of the rules regarding the services it delivers.  Given the desire to reduce cost and increase efficiencies, there is little doubt that the lawmakers would not heavily regulate the whole area.  Assuming that it operates as efficiently as a private company, it would have a 3% advantage in costs.  Murphy says it will be less efficient as a government organization compared to a profit-motivated company and will have the same or higher costs.

With so little advantage, one wonders why we would want to introduce co-ops into the health care mix.  Lowering the cost of health care and expanded coverage could be addressed through regulation, tort reform, Medicaid extension and increased fraud enforcement.

 

The Health Care debate can probably be distilled down to a few words: costs, coverage, fraud, access, exclusions and rationing.  There you have it.  The whole debate in a nutshell.  Let’s look at the individual words.

Rights – the Constitution has no provision for medical health coverage.  It is not enumerated as a right and requires considerable extrapolation to infer heath care as a right.

The argument for coverage is that people don’t choose to have diseases and that having a disease is part of the human condition and, therefore, deserves coverage.

It’s a philosophical tossup, but it probably defines what your point of view is.  If you think healthcare is a right, you probably favor the public option.  If you think healthcare is an entitlement, you probably favor keeping and improving the current system.

Both sides agree that the system needs improvement, now.

Costs – it is obvious to anyone that cost for medical services is spiraling up every year.  A major contributor of the increasing costs is the premium associated with malpractice insurance.  Further, it is often said that Americans spend more for health care than people from any other county.  What is often missed is that Americans have more health services provided and, accordingly, pay more.  It is also true that we spend about the same as other countries when it is measured by percentage.

It goes without saying that anything that reduces unnecessary costs is a welcome change.  While there may be differences of opinion about what to change or how to change it, there is universal agreement that cost should be contained or reduced.

We already pay for uninsured citizens and non-citizens to get medical attention.  The Emergency Medical Treatment and Active Labor Act (42 U.S.C. § 1395dd, EMTALA) is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act and ensures transportation by ambulance companies and treatment by hospitals to anyone regardless of citizenship or ability to pay.

Public – most people do not want public or universal heath care.  The resistance to government run health care programs is centered on issues like liberty, rationing, efficiency.  Mandated health care takes away the freedom to choose for the individual.  Most people believe that the government has never demonstrated an ability to run anything efficiently and would be vulnerable to continued rising costs and consequent rationing of services.

Private – a private, market-based solution this is still favored by many because many feel that the only way to contain costs is to expose it to open competition.  Proponents of universal coverage rail against insurance company profits and executive pay and prefer a governmental solution

Regulation – most people do not want over regulation of the medical (or any) industry.  At the same time, many of the problems that exist in the heath care business could be solved by enforcing existing regulation.  Supporters for reform would endorse the current (1,000 pages, more or less) proposed legislation as necessary additional regulation to improve the system.

Fraud – there is universal agreement that fraud should not be a part of the system.  Only a criminal mind would condone fraudulent activity.  The cost for fraud is enormous and solving it would significantly lower the cost for health care.  While there is enforcement action in place, the correction or elimination of fraud is often overlooked as a worthwhile solution for the cost issue.

Coverage – arguments for a public option say that a new program would widen the coverage to include “everybody”.  In actual fact, there will always be somebody who is missed.  Arguments against a public option point out that, while this sound altruistic, cost can be reduced only by rationing health care and that older people might be denied coverage.

There is also considerable spoken misinformation about who is covered and who is not.  One popular viewpoint says there are 46 million people with no health coverage.  We know that 9 plus million are illegal aliens and not eligible for coverage.  Another large percentage includes people who choose not to have coverage, either by self-assessment of need or financial consideration.  Some people with money chose to self insure and some people without money can’t afford health insurance.

There are currently 170 million people that are covered by employer coverage.  It is estimated that 120 million would be forced to transfer to public heath insurance leaving the private insurance industry to collapse on itself.

Caps – one method of reducing or containing cost is to cap or limit what coverage for which a person is eligible.  A cap can be a limit on the dollar amount of coverage of a limit on the types of coverage. 

Exclusions – is another way of saying Caps.  It also includes exclusions for pre-existing conditions.  Insurance companies are reluctant to take somebody with a pre-existing condition because they will probably pay more as supported by statistics.  It is more profitable to insure someone who is healthy and young.

Philosophically, most people against exclusions and have sympathy for people who have pre-existing condition.

It seems this could be handled via regulation enforcement or change.

Liberty – while it is considered to be an academic issue for some people, it should be remarked that many of the issues contemplated by the Founding Fathers, Continental Congress and the Constitutional Convention were decided in favor of liberty over perceived and sometimes potentially substantial advantages and benefits.

Those opposed to a public option say that the reduction in choice represents a reduction of Liberty.

Proponents of government run health care say that heath care is a right and the is no lessening of Liberty by delivering what people are entitled to receive.

Security – part of the cost reduction plan for health care is to take the system “paperless”.  By computerizing health records, doctors and practitioners will have fast and accurate access to an individual’s health records.  Part of the logic is that tests will not be duplicated because electronics test results for previous tests will be easy to see online.

Opponents of public run programs say that this will give the government unprecedented access to our detailed private information.  Further, they are skeptical of the government’s ability to protect this information form hackers.  Witness the number of times hackers have stolen information or identities from secure digital storage systems.

Abortions – most people believe that liberals will try to include coverage for abortions in public option health care programs.  It is currently illegal to use public tax money to fund abortions. 

Profits – proponents of public run programs say that insurance companies make too much profit and that executives are paid excessive amounts.  While the executive pay issue is subject to stockholder review, insurance companies reported approximately 3% in profits for recent years.  During the same time period, these same companies paid about 6% in taxes.  That doesn’t seem excessive.

What people often forget is that a free market (and excessive profits) will encourage competitors who will offer a lower price when someone inflates their prices for goods and services.  It’s only natural.

Rationing– as discussed above, notwithstanding other ways to reduced rising healthcare costs, rationing is the obvious way to offer services to more people while spending less.

Compensation – free markets level themselves.  Unless a monopoly exists, an individual or company who has an excessive profit is picked off by competitors who will “work for less”.   It has always been that way.

Proponents of public run programs are in favor of regulating compensation to doctors, executives and practitioners.

Inflation– health care cost are rising for a variety of reasons.  One is inflation which is best controlled with good fiscal and monetary policy.  The government can contribute by keeping borrowing to a minimum.

Malpractice – many people believe that victims of real malpractice should be compensated in legitimate cases of malpractice.  It is complicated by frivolous lawsuits for malpractice and the resulting sky-high insurance costs to doctors.

Some states have addressed the subject by limiting or capping legal judgments for malpractice.  California has a cap on $325,000, for example.  Some countries have handled the problem by having laws that say you pay if you lose.  The threat of having to pay legal fess for both sides limit the risk someone is willing to take when filing a lawsuit. 

Torts – directly related to malpractice is the subject of tort reform.  Trial lawyers support leaving the system the way it is allowing individuals to bring suit against individuals and companies without restriction.

Opponents say that court awards and penalties should be limited. An example would be medical doctors who pay approximately $170,000 in malpractice insurance premiums a year.  This drives up the cost of services to the user.

Disability – disabled people should not be excluded from coverage and some proponents of social support say that people with disabilities should be given financial support commensurate with their inability to earn a living income for themselves.

There is a system in place to cover disabled people through the Social Security process.  This system is vulnerable to fraud.

Medicare – most people with Medicare are satisfied with their coverage and services.  From the fiscal point of view, Medicare is an abysmal failure racking up billions of dollars in operating losses every year.

An overlooked solution would be to use the Medicaid model to cover currently uninsured people.

Drugs – another philosophical disagreement revolves around drugs.  Certainly there have been some miraculous discoveries and real advances regarding medicines.  It has also been often remarked that the medical field is quick to prescribe drugs for everything form depression to a hangnail.  Said another way, doctors are over-using drugs as a first line of treatment for almost everything.

Pharmaceutical companies are contributors to political campaigns and have influence with the Administration and Congress sometimes using lobbyists.

Pools– some states and companies have risk pools where insured can be “pooled” to spread the risks lowering the cost of healthcare costs.  Regulations prevent this form being used more as a solution to the high cost of healthcare.

Children – uninsured children have been provided for through the SCHIP (State Children’s Health Insurance Program) program which covers children of lower income families

Indians – IHS (Indian Health Service) was established in 1954 to take over health care of American Indian and Alaska Natives from the Bureau of Indian Affairs.

It has had mixed reports for the service it provides.

Military – the military provides health care to active and retired members and their family.  Current plans rumor that health care for non-active military will be eliminated.

FEHBP – Federal Employee Health Benefits Plan is health care for government employees.  This is the program that covers the members of congress. Which has been described a the “gold plan”

Portability – Heath care coverage is not very portable.  Insurance regulations exist at the state level and insurance is generally not portable form one state to another.

Proponents of state-run heath care say that a government program would solve the portability problem.

Both sides probably agree more than they disagree about portability.  It makes (common) sense that people should be able to take their health care with them when they change jobs or relocate.

COBRA – related to portability, the COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) program provides extended (18 month) health care coverage to people who lost their jobs.  The main problem with COBRA is its prohibitive cost.

Deficit – the main barrier to providing unlimited coverage to all Americans is the cost.  Together with other government spending, there is no way to fund universal health care without deficit spending.  In other words, we would have to borrow the money.

Proponents of public programs say that offering universal health care will create efficiencies that will pay for the system.  People will practice preventative health care and treat problems before they become expensive problems.

Opponents of the reform program say that deficit spending takes resources from other programs and causes increased debt service expenses and inflation.

Bankruptcy – it has recently surfaced that the majority of bankruptcies have large medical bills as an underlying cause.

There is probably some shared opinion that no one should have to declare bankruptcy because of medical bills.  A change in the bankruptcy laws would be a solution.

Dental – most health insurance in the US is a part of an employer provided health insurance program.  Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries arising from railroad and steamboat accidents. Sixty organizations were offering accident insurance in the US by 1866, but the industry consolidated rapidly soon thereafter. While there were earlier experiments, the origins of sickness coverage in the US effectively date from 1890. The first employer-sponsored group disability policy was issued in 1911.  As compensation packages become more competitive,  coverage has expanded and dental has become a standard benefit.  People decide on a position with a company based on salary and benefits.  Most competitive compensation plans include dental and Vision.

HAS– health savings accounts are another pre-tax way to pay for health care.  Neither fish nor foul, HSAs will probably go away with public health care.

Emergency – as we covered earlier, The Emergency Medical Treatment and Active Labor Act makes ambulance and emergency medical service available to everyone regardless of citizenship or ability to pay.

Proponents of public health care point out that we already pay for uninsured people who use the emergency provision as a loophole to get medical service.

Opponents say that is true, so there is no savings for giving them what they already get.

ADD – accidental death and dismemberment is like dental and vision.  Most companies offer it as part of their compensation plan or offer it as supplemental insurance at attractive group prices.

Uninsured – the number of actual uninsured has been a controversial subject.  Easy to find information shows that 46 million people are uninsured in the US.  Approximately 9 million of that number are undocumented immigrants (not eligible) and a significant portion is made up of young people who do not want any health insurance or wealthy people who pay for their own medical service and don’t want insurance.

There is probably no objection on either side to having everyone covered in some sort of basic program.  It would seem inhumane in these abundant modern times to withhold medical services from anyone.

Research – functions best in a profit driven environment.  Proponents of public health say that efficiencies gained in administration will leave more time for research.

Opponents point out that advances in technology have never flourished in a government controlled environment and are almost the exclusive province of profit operations.

Euthanasia – no one admits to supporting euthanasia, but the current proposals for health care reform include provisions for end-of-life counseling and financial analysis suggest that rationing cannot be avoided.  Rationing implicitly implies euthanasia.

Incentives– profit, salary and financial support are different forms of incentives.  Most government programs do not offer incentive plans and most government workers are examples of preserving the status quo (apologies to government employees with a work ethic). 

Retirement – high medical cost is preventing people from retiring with a living wage.  Some retirees are forced to choose between health care and food.

Mental – treatment for mental health has crept its way into our medical care system.  With pet maladies like depression, ADHD and post __________ stress syndrome (insert your favorite item), mental health has created a multi-billion dollar industry based on iatrogenic (doctor caused) actions.  Further, the most common solution in mental health care is to prescribe questionable drugs.

Many believe that mental health should not be covered in medical care plans.

Quality – it is assumed that the once uninsured person who now has health care has improved his position and the quality of his/her health care.   Making health care available to more people improves the overall quality of the system.

Opponents point out that doctors and practitioners who are motivated by profits or returns on investments are likely to give better service and be interested is patient satisfaction.  Doctors and practitioners who work for scheduled plan (predetermined price for a specified service) tend to have a “hands off” attitude about their patients.

Access – there is little disagreement that people should have access to the system.  We are too advanced in technology and humanitarian condition to think otherwise.  No one should suffer from lack of medical attention.

Doctors – there is a need for a continuing supply of doctors.  The investment of time, effort and money means that fewer students will make the commitment to become doctors if the rewards are limited.

In a free market system, monetary rewards mean more people will pursue a career if the payback is good.  Certainly people have motivations above money and a desire to help people will always win the day.

Nurses – whatever we say about doctors probably applies to nurses, health workers and practitioners.

Hospitals – the financial dynamics of hospitals could change dramatically.  An automated and computerized system may simplify running a hospital.  Proponents of a public system consider that hospitals make excessive profits and should operate according to scheduled (fixed by the government)  prices.

Supporters of the current system would argue for better efficiencies leading to cost reductions, but say that the profit motive ensures competitive service and prices.

Socialism – similar to the issues concerning Liberty, people do not want Socialism which can manifest itself through 100% government regulated health care.

Politics – the issue of health care is an inseparable part of politics.  Often a person’s opinions about health care are led by their political party’s position on health care.

Health care may be used as a Trojan horse to get other issues in the door or to achieve other political objectives.

Employers – are faced with a number of issues.  Health care costs have been rising contributing to the increasing costs to businesses which is passed on to customers or taken out of profits.

Employers also use health care benefits as part of their compensation package which they formulate and use to attract talent.  If businesses are relieved of the cost for health care, they lose control over wellness programs and lose a tool for attracting talent.  On the positive side, it will eliminate expense, but may increase taxes.

Economy – one sixth of our economy is based on the health care industry as it is situated today.  Changes in the economy are hard to predict.  Medicare was passed in 1965 and was estimated to cost 9 billion at the time it was passed.   Costs today are 30 or 40 times that. 

The current proposal is estimated to cost $1.3 trillion. Actual cost could be more.

Insurance – will have to compete with the government.

Those who believe in public health care say that insurance companies will become more competitive with government competition.

Proponents of keeping the current system believe that the government, which is not required to make a profit,can have artificially low prices and will drive private insurance companies out of business.  At that point, there will be a single-payer system.

~

Most of the deficiencies in our current health care system could be corrected by enforcing current regulations or passing new regulations targeted to specific areas.

The main problems seem to be summarized by coverage, cost, fraud, access, exclusions, caps and rationing.  It doesn’t make sense to restructure the whole system in order to provide solutions that are easily addressed with less severe invasive actions.  We could consider the following suggestions:

• Maybe we could include people with preexisting conditions by changing regulations.
• Maybe we could remove the barriers between states allowing portability.
• Maybe we could change COBRA to allow continued coverage at an affordable rate for people who have lost their jobs or people who are relocating.
• Maybe the government could provide or subsidize malpractice insurance for doctors if they lower their price accordingly.
• Maybe we could give a federal tax credit toward health insurance premiums so that everybody could afford health insurance.
• Maybe we could be more aggressive in going after fraud and put heads on a pike when we find it.
• We could extend Medicaid to those who are uninsured so that no citizen goes without coverage.

There is no lack of good ideas from the left, center or right.  One only has to look and listen.

The intent here is to enumerate and highlight the key issues and suggest some out-of-the-box thinking with regard to changing our health care system.  Yes, we spend more per capita than other countries, but we have the best health care system in the world and we should not be impetuous or hasty about implementing sweeping changes overnight.

 

One of the most successful ways of getting people to believe a false statement is to mix in a half truth.

If you take any information and mix in one fact that people know is true, they are more likely to think the whole statement is true. 

A good example is the current argument over health care.  Proponents of health care reform say that you can keep your current plan if you are happy with your current plan or your doctor.  Meanwhile, most of the plans on the table say that you can keep your current plan if you don’t make any changes to it.  You may keep your health care is you are fired or change jobs, but you will transition to a federal program.

So, there is an element of truth to the statement.  But, if you make ANY change to your plan, you are transferred to a federal plan.  That’s the part that is parsed around.

It sounds nice and is, in a very limited sense, true.  If you like your plan or your doctor, you will be able to keep them.  A more accurate statement would be; as long as you make no/even the slightest changes to your plan, you can keep it.  Make the slightest change and you will be transferred to a federal government plan.

Use a little truth when you want to pull the wool over their eyes.  It really works.  If the half truth (untruth) gets exposed, then find another point of truth and weave it into the story and continue.