Watch This or Else

The Publisher (Jeb Bladine) of my local newspaper (The News-Register of McMinnville, Oregon) writes a weekly column called Whatchamacolumn.  This week he decried the lack of honest debate about health care reform and he recommended that everyone should watch a video he had recently seen.  It takes 30 minutes but has more logical, honest discussion of the issue than has come from Congress at any time since the debate began.

To become better informed about the health care debate, this video is the best half hour you will spend.

You can see the Dr. Ben Carson interview at http://www.wlos.com/template/healthcare_reform/videos/vid_8.shtml

(This is from ABC-TV channel 13 in North Carolina)

Please let me know what you think after viewing it.   Better still – send it on to your Senators and Member of Congress with your comments.

Thanks.

Read the previous four posts, Please

Please take the time to read the previous four posts:

Government Takeover

Price Fixing Does Not Work

It’s time to Quit the AARP and AMA

and

Draft Health Care REAL Reform Act of 2009

I won’t likely do any further posts until I have had time to respond to comments to these, unless, of course, Congress does something else stupid to make me want to spend the time to write another post.  Thanks for taking the time to read and comment.

Tom

Draft 1 – The Healthcare REAL Reform Act of 2009

Here is my first stab at the reform I would like to see in health care in America.  I would appreciate your comments, suggestions, and questions.  Thanks.

Section 1.  Health care Insurance Reform:

Part a.   Ability to Sell insurance across State Lines.  It shall be legal, notwithstanding any State law, for insurance providers to offer and sell insurance against the costs of health care services and supplies in any and all states.

Part b.  Individual Ownership of Insurance Policies. Regardless how a policy is purchased (as part of a group or as an individual), each policy of health insurance shall be owned by an individual and may be kept in force under the contracted terms and conditions of such policy by that individual regardless of whether or not the individual remains part of the group that originally contracted for the insurance coverage.

Part c.  Mandated Coverage.  No state law shall mandate that Insurers include or exclude any specific coverage within policies offered for sale in their State except such mandates as are required by federal law.

Section 2.  Medical Services Legal Liability Reform:

Part a.  Medical Malpractice Liability.  Medical Practitioners shall be protected from excessive liability for their actions or inactions in the following manner:  The burden of proof of liability shall require prosecution to prove “gross negligence.”

Part b.  Pain and Suffering Awards.  Damages shall be limited to proven actual damages, not including “pain and suffering.”

Section 3. Health Savings Accounts and Incentives:

Part a.  Tax Incentive to Own Health Care Insurance.  A program of Health Savings Accounts will be devised that will allow individuals to put aside money to pay for Health Insurance premiums with pre-tax dollars.

Part b.  Tax Incentive for Employers to Offer and Pay for Health Care Insurance.  A program will be devised that will credit employers with a percentage of the amount that the employer spends to subsidize health insurance for employees and their families.

Section 4.  Government Sponsored Health Plans:

Part a. No person who is not a legal resident of the United States shall be eligible for any government sponsored, subsidized, or paid health care services except as such individual shall be responsible for all costs associated with the provision of such healthcare services.

Part b.  No person who is covered by a government sponsored, subsidized, or paid health care service shall be prevented from contracting, separate from the government service, with any provider for medical services of any type.

Part c.  No Medical provider who participates in any government sponsored, subsidized, or paid health care service shall be prevented from contracting, separate from the government service, with any patient for medical services of any type for which that provider is licensed.

Section 5.  Wellness Plan:

Part a.  Healthy Lifestyle Incentives.  The government shall devise programs of incentives to encourage individuals to lead healthier lifestyles.  For example,  programs should be considered to subsidize or give tax incentives to people enrolled in smoking cessation treatment plans, or substance abuse resistance and rehabilitation programs.

Part b. Incentives for Regular Health Screening.  The government shall subsidize the cost of regular disease prevention and early diagnosis which are proven to save costs and lives.  For example, screenings for know causes of certain diseases should be subsidized to the point where the majority of the population has access to such medical screening.

Section 6.  Making Medical Providers more effective.

Part a.  Medical Record Management.  The government will set standards of medical records management

Part b.  The Department of HEW will work with the AMA to set-up a committee to study the cost/benefit of the current Federal and State Mandates on the Medical Industry.  The committee will report their findings to the nation and will make recommendations to Congress to eliminate excess regulation and add needed regulation.  Industry and Government will be equally represented and will have equal voice and power within the committee.  -  Add a third leg?  Patient Advocate Groups?

Section 7.  What else would you add?

Yes this plan has heavy reliance on market forces and attempts to take government out of health care.  Challenge my ideas.  Give me new ones.  Don’t lie down and take the politically motivated drivel that the House and Senate call health Care Reform.

It’s Time to Quit AARP and AMA

First lets talk about the AARP, the American Association of Retired Persons.

From the AARP Membership page:

“AARP is a nonprofit, nonpartisan membership organization for people age 50 and over.

AARP is dedicated to enhancing quality of life for all as we age. We lead positive social change and deliver value to members through information, advocacy and service.

AARP also provides a wide range of unique benefits, special products, and services for our members.

These benefits include AARP Web site at www.aarp.org, “AARP The Magazine,” the monthly “AARP Bulletin,” and a Spanish-language newspaper, “Segunda Juventud.”"  - from the AARP”

The AARP has come out in favor of the Democrat  proposals for Health Care Reform.  That is the same package that will take away from Seniors the Medicare Advantage Program, vital to the needs of about 25% of those on Medicare.  It will “save” money for the expansion of coverage in other areas by cutting $150 Billion from this program.    How could AARP possibly work against their constituency in this way?

AARP gains about half its over $1 Billion in revenue from royalties on “Medigap plans.”  Medigap plans are insurance policies to fill in the gaps in Medicare.  Ever since the Medicare Advantage Program came on the scene in 2003, it has spawned competition for AARPs gap plans.

Mr. Obama and Congress need the AARP (the largest lobby – based on a constituency of seniors 50+) to pass their Government Controlled Health Reform.  So they made a deal with the AARP – give us your support and we will kill your competition.

Sweet deal, except for about 11,000,000 seniors who now use Medicare Advantage.

Then there’s the AMA, the American Medical Association.  

From the AMA home page – about the AMA:

Mission:
To promote the art and science of medicine and the betterment of public health.

Core Values:

1. Leadership
2. Excellence
3. Integrity and Ethical Behavior. (my emphasis)

Vision:
To be an essential part of the professional life of every physician.

The American Medical Association helps doctors help patients by uniting physicians nationwide to work on the most important professional and public health issues.

AMA policy on issues in medicine and public health is decided through its democratic policy-making process, in the AMA House of Delegates.

The AMA’s activities with for-profit entities are directed by AMA guidelines for corporate relationships, and its Internet products follow AMA guidelines for health and information Web sites.

Together, we will play an active role in shaping the future of medicine.

The AMA has also come out in favor of the House Health Care Reform bill.  It is obvious that they have not used their “democratic policy-making process” noted above, since the AMA House of Delegates doesn’t meet until this weekend in Houston.  So How could the AMA work against its physician members without following their own policy?

MR. Obama and Congress feel they need the AMA to pass their Government Controlled Health Reform.  So they made a deal with the AMA – give us your support and we will increase the Medicare Reimbursement Amounts.

It’s a sweet deal for Mr. Obama and the Democrats.  It only slightly slows the complete takeover of Medicine.

If I were a member of either group (which I am not), I would immediately resign and work to form or empower an alternate group to work on behalf of the same constituencies.

Price Fixing Does Not Work, Especially not in Medicine

So why do many of our politicians think that price fixing will work for medicine?  And why are they not being prosecuted for attempting to fix prices to eliminate competition?

Throughout history, when governments have fixed prices for any service or product, that service or product has fallen into short supply.  It seems ironic that with all the history proving beyond a shadow of a doubt that price fixing creates shortages, that our political leaders would be attempting to fix prices on medical services.  But, that is what they are doing.  Both the Senate and House proposals on “Health Care Reform” will fix prices to a government formula.

In most countries of the world, Price Fixing is criminal behavior and subject to huge fines and even jail time.  Typically, Price Fixing is used by those who want to corner a market and want to drive prices (and Profits) as high as they can, or by competitors who work together to try to put another competitor out of business.  Price fixing is one of the key actionable features of the Sherman Antitrust Act.  It is the reason we have a FTC.

The Sherman Antitrust Act was written in 1890.  It only had 7 sections and used less than 900 words.  They weren’t trying to hide anything like you can in a 1990 page piece of legislation.   Here are the first two sections (the first 200 words):

Section 1. Trusts, etc., in restraint of trade illegal; penalty

Every contract, combination in the form of trust or otherwise, or
conspiracy, in restraint of trade or commerce among the several
States, or with foreign nations, is declared to be illegal. Every
person who shall make any contract or engage in any combination or
conspiracy hereby declared to be illegal shall be deemed guilty of
a felony, and, on conviction thereof, shall be punished by fine
not exceeding $10,000,000 if a corporation, or, if any other
person, $350,000, or by imprisonment not exceeding three years,
or by both said punishments, in the discretion of the court.

Section 2. Monopolizing trade a felony; penalty

Every person who shall monopolize, or attempt to monopolize, or
combine or conspire with any other person or persons, to monopolize
any part of the trade or commerce among the several States, or with
foreign nations, shall be deemed guilty of a felony, and, on
conviction thereof, shall be punished by fine not exceeding
$10,000,000 if a corporation, or, if any other person, $350,000, or
by imprisonment not exceeding three years, or by both said
punishments, in the discretion of the court.

Since the actions of the Democrats in both the House and the Senate have clearly been conspiring to fix prices and eliminate private competition, why has no group sued them under the Sherman Antitrust Act?

My next post (time permitting) will be my 1000 word or less bill to effect reform of our health care system.  It really doesn’t take 1990 pages when you aren’t hiding anything.

Government Takeover

There are many on the Right who say that the government is taking over our economy.  Most on the Left scoff at this and say it could never happen.  They say that all the new regulations, laws and taxes are just to regulate and steer the economy since they feel markets don’t do a good job.  Much of this steering comes from the Left and much of it was caused by overreaction to the great Crash of ‘29.

So, do the folks on the Right have a point or are they just using scare tactics?  I think they have a point, and, it does scare me.

Take a look at the world of Real Estate.  Real Estate Assets are key to much of the economic activity in our Country.  The huge Construction Industry depends almost entirely on real estate assets.  Witness the great drop in construction activity that has gone along with the foreclosure crisis and the illiquidity in the real estate market.  What is it that makes the real estate industry and the construction industry thrive?  Cheap mortgage money.  When cheap mortgage money is available, that frees up money for construction projects.  The current tight money has badly hurt the real estate market and lowered real estate values dramatically.  In turn, the construction industry has taken a big hit because many projects can no longer be justified based on the new lower real estate values.

The government has taken over the real estate mortgage market and has steered (controlled) it over the past 40 years.  Anyone who doubts that the government has taken over the real estate market needs only to look at the backing behind their mortgage and the security behind 90% of all mortgages in the country now.  Fannie Mae and Freddie Mac now fund (secure) well over 50% of all home mortgages.  Ginnie Mae funds most of the rest.  Between them, over 90% of all mortgages are now government controlled.  This chart gives a quick overview of the past 9 years and is from a very interesting article in Seeking Alpha.

So what happens when a market is controlled by the government?  What will happen if the government loses interest or wants the money for something else (Health Care?) and does a fire sale of its mortgage assets?  I don’t think it is too different than when someone corners a market and can control prices.  It is not a pretty picture.  I have recently read predictions that our real estate values still have up to 40% more to decline before they hit bottom.  Until I realized the depth of government involvement in the pricing of mortgages, I would have thought that a joke.  Not now.

H.R. 3962 “Affordable Healthcare?” – Playing Games

On September 9, 2009, President Obama said, “Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do.”   Did he mean it or did he mean to say, “The time for Republican games has passed”?  It must have been the latter, to wit:

Senator Harry Reid has just come forward with a health care plan that has a “public option” with an “opt out provision.”  It is an  obvious joke, a game.  The only problem is it will be the law of the land, and will be financed by all the taxpayers.  So who will want to opt out and only pay for the new government bureaucracy while getting no benefit from it?   The real intent is for the government to step in and “compete” with a plan that is less expensive than what can be offered by the highly restricted insurance companies.  The government can do that since it sets the rules and the rates.  It doesn’t have to worry about the market pressures.  Like it does now with Medicare, it short pays for almost every service and the cost is passed on those who are insured privately and to taxpayers in general.

Then Speaker Pelosi unleashes her 1990 page Health Care Act (H.R. 3962, the Affordable Health Care for America Act).  Tell me she is not playing games calling it the “Affordable” Health Care for America Act.  She doesn’t seem to notice the irony of adding $1 Trillion in programs for taxpayers to pay for in an act called “Affordable.”  Since CBO Director Elmendorf was dressed down by the President in July, CBO markups of bills coming out of Congress have been uncritical of the Administration position.  So, for the CBO markup of H.R. 3962 to show that it adds $1.055 Trillion in Government provided or subsidized programs, we can assume it is at least that high.  Does this make it affordable?  As Mr. Lincoln said, “Calling a tail a leg doesn’t make it a leg.”

In fact, I think the game is being played to the limit.  For example, look at pages 1441 to 1443 of the Health Care Act (sorry, can’t bring myself to call it the “Affordable” Health Care Act any more.).  ”Section 2531, entitled “Medical Liability Alternatives,” establishes an incentive program for states to adopt and implement alternatives to medical liability litigation. [But]…… a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.” This is pure “game.”   Mrs. Pelosi is paying back her biggest supporters, the Trial Lawyers.  No way this could be a law on its own, but buried 1400 pages into a 1900 page document, she is hoping no one will notice.

Somehow, I missed Mr. Obama’s speech where he he reminded Congressional Democrats that “The time for Games has Passed.”

One Brick at a Time

You have to bear with me on this one.  I don’t find my way to the real point for a bit, but I do get there.  I’m really looking for ideas.

Years ago, I read Zen and the Art of Motorcycle Maintenance.  The book was a good read and I remember enjoying it.  It made me think about some things I had taken for granted.  Only one thing from that book, however, stayed with me.  The book chronicles a cross country motorcycle trip of discovery by a father and son.  While waiting for repairs to be done on their motorcycles in a small town in Montana, the father suggests that the son draw a picture of the old Jail in town.  The son looks at the jail from where he is sitting across the street and declares (paraphrasing), “I can’t draw that.  It is too complicated.”  To which, the father replies, “Sure you can.  Just draw one brick at a time.”  Every time I am overwhelmed by the scope of a task, I remember to look at it one brick at a time.

I am currently overwhelmed by the task of being a good citizen and doing my part to right the wrongs in our country today.  The list is long and varied.  Our economy is weaker than it has been at any time in my life.  Family values, integrity and ethics seem to be only old-fashioned notions that don’t fit in our modern society.   Our country seems to be more about sizzle than steak – paying entertainers millions of dollars a year while teachers and nurses and secretaries and farm workers make little over minimum wage, it seems.  Our Constitution and our Borders and Security seem to be under constant and determined attack.  We don’t trust our government yet we continue to turn over more of our responsibilities to government.  Our public education system seems to be turning out a product that can’t compete in today’s world while the cost of providing that education soars through the roof.  We are living longer but are less healthy.  We have unprecedented communications networks and tools, yet we don’t talk to one another.  The list would fill a book.

Peggy Noonan wrote a piece for the Wall Street Journal a few days ago that talked about the discouragement of the American People.  She concludes that we, for the first time as a nation, see problems we can’t fix, not challenges that drive us to greater accomplishments.  She points the finger at our leadership in politics and business and she may be right.  Though I am often discouraged by our times, I remain an optimist and of the belief that there is no challenge too big for the American People.

So, maybe what I (we) need to do is draw one brick at a time.  If Peggy Noonan is right, maybe the best place to start is with government and political leadership. It makes sense to start here since Federal Government spending, alone, accounted for over 37% of the U.S. GDP in 2008 (far more now with Trillion Dollar Stimulus and Health care programs).  I ask my self, what is the best way to make our political leadership more responsive to the people, not the lobbiests, and how can we take back much of the control of our lives that we have ceded to government.  Let’s start with a discussion of some ideas that would change our government and our politicians into the people’s tools and assets from the current state where our government and our politicians control much of what we do and consume much of the fruit of our labors without a reasonable return.

First Brick:  The mayor of the small town of Silverton, Oregon may be on to something.  He is proposing that the State legislature meet, not in the Capital city of Salem, but, in public teleconferences with each representative remaining in his or her district and participating in a space accessible to the public.  What would this do?  Well, currently, if a private citizen wants to participate in a legislative discussion, he or she must discover when and where (in Salem) the hearing/debate is to occur, must drive there (as much as a 12 hour drive, each way), sign up for a two minute comment period (if any are available after all the Salem residents – read lobbiests – have signed up), and then drive home.  With a remote site teleconference legislature, if a person wanted to lobby your local legislator, he, the lobbiest, would need to go to where you live and get in line behind you to make himself heard.  The technology is certainly available and would likely cost less than physically getting all the participants to Salem for each meeting.  What do you think?  Give me your thoughts pro and con about this idea.

Second Brick: Make politicians “pigs” not “cows” or “chickens.”  The old tale is told of the farm animals who loved their farmer so much they decided to prepare a big breakfast for him as a thank you.  The cow suggested that she, the cow, would contribute milk and butter to the feast, the chickens could donate some eggs,and the pig could give some bacon.  Only the pig really has any skin in that game.  Why do we have a ‘pigs and chickens’ system where politicians pass laws by which we must abide while they operate under different rules?  The pig would never suggest having bacon because it is his flesh.  What would happen to you if, like Treasury Secretary Timothy Geithner, you were caught not having paid over $25,000 in taxes for a two year period?  How do we get politicians to live by the laws they create?  How do we make them live with the consequences of their actions?

Third Brick: What would happen if Members of Congress had a strictly limited budget for their offices?  Much like England used to do with its House of Commons, where each member of Parliament had an 80,000 pound stipend for staff each year, the member could hire one highly qualified assistant or a few lesser qualified people.  The staff of today’s U.S. Congress member is theoretically limited to 18 while Senators have no limit on the number of staff they can employ.  Members of Congress spend around $2,000,000 on average for their offices while Senators spend more like $3,000,000.  Does this make sense?  Does anyone have a better idea?  Could their be a staff pool that all legislators would share?  Is this even a significant cost to taxpayers?

Interesting discussions of similar ideas here and here.  Any thoughts?

Stimulate Me, Please.

The White House today, proudly announced that the Stimulus Bill and the funds disbursed because of it have created (or saved) 640,000 jobs.  The White House claims that this is based on some $150 Billion in spending, or, about $234,000 per job.  As a side note, they say that there have been $339 Billion drawn down from the $787 Billion Stimulus Act to date.

Let me get this straight.  First, we must assume that the Stimulus Act has actually been responsible for creating or saving 640,000 jobs.  Then we must accept that these jobs have been created by spending $150 Billion of the Stimulus Funds.  That works out to $234,000 per job.  Seems a bit much, doesn’t it?  I’m guessing the job holders aren’t getting close to that amount.  But wait.  The White House also says that $339 Billion of the Stimulus Funds has already been doled out.  So doesn’t that mean that each job “stimulated” actually cost $529,687.50?

Oh, I see.  Of the $339 Billion, over 10% ($35 Billion) was spent by the Department of Health and Human Services and was actually transfer payments.  And another over $30 Billion went through the hands of the Labor Department, and $22 Billion through the hands of the Department of Education, etc.  Transportation, remember “shovel ready” and “infrastructure”, got to spend almost $4.5 Billion.  Check out the list and see where your money went.  I don’t know about you, but when I see three times as much money going to the Social Security Administration as to Transportation, I start to think that there may be a bit of pork in this spending and maybe all the talk of “shovel ready” projects was a bit disingenuous.

Now if the government would send me $234,000 (or $529,000) I’d create a few new jobs right now and still have a little left over for my own entertainment. I bet you could do the same thing.  Am I the only one who would fire anyone who worked for me who spent $234,000 to create a $40,000 per year job?  Come to think of it, I do employ these people.  Think I’ll fire as many as I can next November.

Questions for Obama Supporters

If you are still defending every action of our new President, you need to ask yourself a few questions.  First and foremost is this:  Is Mr. Obama living up to his promises, and, to his promise?

If you answer yes to both his promises and his promise, I think you are deceiving yourself to keep from being embarrassed for having been sold a bill of goods.  I think you are burying your head in the sand.  If you don’t admit that he has lied and broken promises, you don’t have to face the embarassment of having been conned.   If you believe he is living up to his promises, you are acting like Bill Clinton when he said that your answer depends on what your definition of is is.  Mr. Obama has clearly broken at least seven of his campaign promises.  You need to ask yourself why he would make each of these promises and then not keep them.  Two of his broken promises involved actions over which Mr. Obama has complete control and for which he can blame absolutely no one for breaking his word.

He promised to sign no legislation (that was not an emergency) without first posting it on line for five days to give time for public comment.  On the Campaign Trail, he read from his teleprompter on many occassions, “When there is a bill that ends up on my desk as president, you the public will have five days to look online and find out what’s in it before I sign it, so that you know what your government’s doing.”  His campaign website stated, “Too often bills are rushed through Congress and to the president before the public has the opportunity to review them. As president, Obama will not sign any non-emergency bill without giving the American public an opportunity to review and comment on the White House website for five days.”   Here, he is in complete control.  He said this or approved it for his website.  It took him just two weeks as President to break that promise when he signed the Children’s Health Insurance Bill the day it was passed by Congress.  To my knowledge he has not posted any bill for five days before signing it.  I am not even sure if he has posted ANY bill in its final form, for any period of time, to the White House Website prior to signing it.

Is this just a minor thing?  Is it really important?  Obama supporters will say it is not, that Mr. Obama has commented on all the bills before signing and that is the same thing.  Not so.  This is important.  This is like buying a product that says if you don’t like it, you can return it for full refund in five days but then when you return it they say, “Sorry, we told you all about it before you bought so we didn’t need to honor our promise of a return of funds.”  In short, Mr. Obama bought votes with this promise but his check has bounced.

Of a similar nature, Mr.Obama said on many occassions that one major change he would bring to Washington would be to have the most transparent government ever.  And, this was not just a campaign promise, about which the Obama supporters like to say, “Nobody keeps campaign promises.  Everyone knows they are just speeches to make people feel good.  No President in history has kept all his promises.”   He even signed an Executive Order to make it happen, sort of.  Mr. Obama even said that the debate about health care would be in the open and televised on C-SPAN.  The fact is that most of the debate is in Congress and almost all of it is behind closed doors, and, for Democrats only.  But that is Congress, not the President, you argue.  If Mr. Obama chose to honor his commitment, he need merely tell Congress (and Mr. Reid and Mrs. Pelosi in particular) that he will sign no bill that is not debated with full committees, in public.  Simple.  Why has he not done this?  Why has he not kept this promise?  Is it that he doesn’t want the debate in public?   Does he feel it would reveal all the conflicts of interest for all the players (from both sides of the aisle)?

If you are an Obama Supporter and you feel this is unfair to hold Mr. Obama to this standard (one he set, by the way), then please ask yourself the following questions:

Did you distrust Mr. Bush because “he lied” about WMD in Iraq?  In light of Mr. Obama’s “lies” why do you still trust him?

If you were a foreign government and Mr. Obama promised to protect you, would you believe him?  How would you feel about that promise if he chose to pull out of Iraq and Afghanistan?

If you believed his promise to post any legislation for five days before signing, why are you not pressing him to live up to his promise?  Why would you believe any other promise he has made?

If you believed that the healthcare debate would be broadcast on C-SPAN, are you not just a little disappointed in your President and Congress?  Why would you believe any other promise he has made?

If you believed that the Promise of Mr. Obama was great, based on his promises, how do you  feel now?  If he doesn’t stop breaking his promises, will he ever be able to live up to his Promise?

I was taught as a kid that it takes a lifetime to build a solid reputation for honesty and a single lie to tear it down.  If the people can’t trust what the President says and our Allies can’t trust what he says, what will be the result for our country’s reputation?

If you make excuses for someone who breaks promises, are you just as bad, or, just unwilling to face reality?