Healthcare Reform - Follow the Money

Whenever a major piece of legislation is being rushed through a legislative body, we are reminded of the immortal words of the Great Philosopher; Deep Throat. "FOLLOW THE MONEY!"

We have already postulated that the Senate and House Healthcare Reform legislation will yield the benefits of revenue enhancement by the government skimming off the top of all the cash flow of 1/6 of our economy, reduce overall costs of Medicare and Medicaide by rationing, and reduce the costs to the Social Security system by hastening the death of unproductive citizens.
Link

The American Hospital Association announced an agreement with the Obama administration to reduce costs $155 billion over 10 years if congress will pass comprehensive healthcare reform. This begs the questions: Why $155 billion? Why not, oh I don't know, $500 billion? Nobody will audit this number anyway. Why not cut the costs now? WHAT'S IN IT FOR THEM? Follow the money.

The legislation will grant them a government licensed monopoly by "restrictions on physician self-referral to hospitals in which they have an ownership interest". The two page press release is linked here.

So much for the AHA commitment to quality healthcare at lower cost for everyone.

The American Medical Association supports comprehensive healthcare reform. Of course; the AMA represents fewer than 1 in 6 doctors in this country, but don't pay any attention to that. Why would a doctor organization support legislation that will require them to work for the government following procedures dictated by faceless bureaucrats? Follow the money.

In an interview with the Houston Chronicle; James Rohack, President of the AMA said the most pressing need is "Congress fix the 21 percent Medicare cut coming in January 2010" adding "people may find it difficult to find doctors to care for them because many doctors will close their practice to Medicare patients". Link

At this point we suffered an intellectual whiplash from the cognitive dissonance created by the AMA endorsement of legislation that would cut $500 billion in Medicare reimbursements. It seems the doctors have been promised that $250 billion will be added in before the $500 billion is cut. And besides; congress never cuts funding for ANYTHING. (I hate being lied to.)

The American Association of Retired Persons is endorsing comprehensive healtcare reform in spite of overwhelming evidence that this will reduce the number of physicians accepting medicare reimbursement. Why? Follow the money.

AARP sells medigap insurance. People who can afford it will be forced to purchase medigap insurance to guarantee prompt access to healthcare. Of course; medigap insurance may well be considered a cadillac plan and therefore there will be some kind of hidden tax or surcharge in addition to the premium on the insurance that AARP sells.

The Service Employee International Union, United Auto Workers, and other unions are strong proponents of universal health care with the government being the single provider. Why? Follow the money.

Most unions and many large employers are facing HUGE unfunded liabilities with their retiree healthcare plans; therefore they are anxious to dump the liability onto the Federal government. Problem solved.

Dear reader, consider this: Your retirement healthcare fund is bankrupt. I don't care if it is your union, your employer, or Medicare. It is bankrupt so deal with it.

The following two links are two opposing viewpoints of the same fact:

Feel free to read this well researched and footnoted report by the Heritage Foundation or you could join this fellow in Egypt and live along denial.

Either way, the result is the same. Your retirement healthcare is assured only to the point of your personal wealth and the generosity of congress. Good luck with that.

As for me and my house; I will trust the Lord.

Why Do You Hate Sarah Palin?

Progressives in this country have a visceral hatred for Sarah Palin that defies logic. It is remeniscint of the Bush Deragement Syndrome that still afflicts the Obama Administration. Just yesterday, November 19, the Secretary of the Treasury tried to blame the continuing decline of economic activity on President Bush. They are such children to blame all their failures on somebody else.

The hatred for Sarah Palin cannot be related to anything she has done on a national level because she has done nothing outside the state of Alaska. Do you hate her for what she accomplished for the citizens of Alaska? She tore down the good ol' boy club the Republicans were running in Juneau. She muscled more royalty payments from the oil companies and passed it on to the citizens of Alaska. She successfully negotiated a treaty to bring natural gas from Alaska to the rest of the United States through Canada.

Perhaps you hate her because she talks funny. Hope you are not one of those diversity freaks who believes that diversity is our greatest strength and ebonics should be an official language. It is interesting that even with her unfamiliar inflections she is still a very articulate person. It is impossible to missunderstand her. Best of all, she would never be so rude as to suggest that you talk funny.

Do you hate her because she is beautiful? She is an attractive middle aged mother of five who has spent a lot of time outdoors in a harsh environment; yet she remains quite attractive without resorting to exotic mud treatments, botox, or cosmetic surgery. Apparently nothing is more appealing than confidence, clean living, and an active lifestyle.

Is your hatred based on her education from a state university? The current occupant (of the White House) has a degree from Harvard University. Surely we must elect the smartest people possible who graduated from the best universities. Of course, the current occupant has never actually gotten his hands dirty and someone else paid for his college degree. Ms. Palin not only paid for her education by working; she is not afraid to wait tables, chop wood, or work a commercial fishing boat.

Pro choice people hate her because she did not abort Trig when she could. After all, when you have the right to choose you are not allowed to choose life. Especially when you give life to a person who is differently abled. What is the point of being able to use science to identify less than perfect persons if you cannot select those persons out for the betterment of society? That is why we must have smart people control every aspect of society.

You need to do some serious soul searching. Why do you hate Sarah Palin? Her harshest critics have never answered this question; therefore one must conclude that it is a mental illness like Bush Derangement Syndrome. People who suffer from BDS are at risk of contracting Palin Derangement Syndrome.

If you are unable to answer the question, "Why do you hate Sarah Palin" rationally; then perhaps you should stop watching and reading the main stream media. Time to take a vacation and ask yourself "What are my values? What do I stand for? What are my priorities?" Once you have satisfactory answers to these questions you will be in a position to change your behavior to reflect those values and priorities.

Then you will be thinking for yourself. You will be able to discern what people say and one day discover that you have been freed from slavery to PDS.

Not All Faiths are the Same

On November 5, I got into my car to drive home from a meeting and heard the news that someone had opened fire at Ft. Hood TX. They reported 9 persons dead and at least 28 injured. My first thought was "The religion of peace strikes again".

I teach preventing workplace violence and marvel at the fact that these incidents have lots of warning. People don't get up in the morning and say, "Hmm.. This is a good day to kill someone." They always give plenty of warning that they are unstable, unhappy, and may eventually resort to acts of violence. We teach employees to be alert for these signs and to report them so that these events may be prevented. Maj. Hasan is no exception. Based on what has been reported it would seem that Maj. Hasan gave plenty of indication that he would resort to homicidal violence. However, in our politically correct culture, nobody did anything to intervene because they didn't want to be accused of discrimination.

Now, thirteen people are dead because nobody wanted to offend Maj Hassan or followers of the prophet. There are apologists worldwide who will go out of their way to argue that all faiths are equivalent and this was just a misguided person. Bullarky! All faiths are NOT equivalent and we need to learn how to discern life affirming beliefs from life destroying beliefs. We need to stand up to those who would tyrannize in the name of religion, or government, or anything else.

The first amendment to the Constitution states that 'Congress shall make no law establishing religion or the free expression thereof'. I would never suggest that any religion, however loony, should be outlawed simply because it is not life affirming. Conversely, I strenuously object when the government tells a student that they cannot pray publicly at their own graduation.

Compare how Maj Hasan's faith has shaped his worldview with the worldview of my friend, Maj. X. Maj Hassan is a middle aged Muslim and strenuously objected to being sent to Afghanistan to fulfill his contractual obligation to the US Military. Maj Hasan taught that Islam means 'submission' and demands dogmatic obedience. Islam teaches that violence is an acceptable means to get persons to confess faith in the prophet. Islam allows the faithful to tax nonbelievers into subjection. Maj Hasan has publicly stated that Muslims love death more than you love life. (Link)

Maj. X is a Christian who has also been called into active duty to be deployed to Afghanistan. He is middle aged and not excited about entering a war zone; but he recognizes his obligation to fulfill the terms of his contract with the Military. Christianity teaches that God wants all, even Maj Hasan, to come to salvation through faith. Christianity teaches that all people are created in the image of God. We are all free in Christ and the fruits of the Spirit include peace and self-control. Jesus has tasked Christians to go out and make disciples (students) of all the world, not kill them.

It is ludicrous to say that a philosophy of death is equivalent to a philsophy of life. Our nation is ill served by people who are so afraid of giving offense that they refuse to recognize evil when they see it. We must reject moral equivalency and moral relativism to return to the values and principles that made our country great. Failing that will destroy our freedom and our prosperity.

The choice is yours.

Insurance or Entitlement?

The current debate about health care reform wavers from insurance to entitlement. Is healthcare an entitlement to be provided by government or is healthcare insurance an obligation to be mandated by government? The topic of debate changes so frequently that it is impossible to determine the real agenda.

First; we have already determined that health care is not an inalienable right granted by the creator, nor is it a right granted by the constitution, nor is it a biblical mandate. (Link)

It would be appropriate to ask if health care should be an entitlement paid by the government. We would point out that virtually nobody is denied at least a minimal level of essential health care services. Medicare, Medicaid, the Veteran's Administration, and federal government employee insurance pay for medical services for over 40% of the population today. In addition, all hospitals are mandated by law to treat anyone who comes to their emergency room regardless of their ability to pay. Therefore, healthcare has become an entitlement in spite of the fact that this may be unconstitutional.

Political posturing notwithstanding; it seems that the progressives in congress and the President are determined to increase government involvement from 40% to 100%. It is all about revenue enhancement. (Link)

This effort is so unpopular that the proponents have shifted their focus from entitlement to insurance.

Insurance is when a group of people pool their resources to indemnify each member against a future occurrence of an uncertain event. Our culture has done a severe disservice to us by allowing us to believe that we should insure against first dollar loss.

For example: Everybody needs to go to the doctor from time to time, just as everybody needs to eat and drive to work. We don't expect someone else to pay for our food or our commute to work. Why do we expect someone else to pay for every penny that we spend on healthcare? It is a colossal waste of money to insure against every little expense.

We should insure against the future occurence of an uncertain event. Visiting the doctor is certain. Hiring a surgeon to remove our colon is uncertain. Not everyone requires such surgery (praise God) so this is an uncertain event against which one could purchase insurance.

The most cost efficient method is to purchase insurance against something that would cause a severe financial loss. One should purchase insurance against catrastrophic losses and budget for ordinary expected expenses. Unfortunately, our culture gives employers and insurance companies incentives to provide more and more perks so that we have lost our perspective of the role of insurance.

My uncle was a sales manager for an international distribution company. As he interviewed a prospective sales representative he said, "You pay your own expenses. They are lower that way."

When a third party, like your insurance company, pays for your medical expenses; you have no interest in what they are. A redundant test? No problem, bring it on. A tummy tuck, breast implant, or viagra? YOU BET. My self esteem demands it. Premium or generic drugs? Hey, I deserve the best.

My wife and I subscribe to our employer's flex spending accounts that allow us to divert pretax money into a medical flex spending account. This is not insurance but tax advantaged forced savings which allows us to set aside funds for day to day medical needs. This system has several flaws; but it is a good start.

There is limited access to Health Savings Accounts. These too are nothing more than tax advantaged forced savings accounts that allow participants to save for their medical expenses. The HSA includes a provision for high deductible health insurance to pay for catastrophic health expenses. The progressives in congress hate HSA's and have deliberately placed restrictions on these to limit access to a common sense approach to health care reform.

The progressives and their synchophants in the mainstream media will not tell you that the Republican party has proposed a number of creative healthcare reform innovations that would lower costs, improve access, and put the responsibility for your healthcare in your control. Follow this link for more information.

My personal preferrence is a Health Savings Account coupled with the Wal Drug Plan (Walgreens, Walmart, and others offering generic prescription drugs for $4).

It is NOT in the public interest nor is it constitutional to require everyone to have health insurance. This is not the same thing as driving a car. Driving is a priviledge. All states require that you demonstrate financial responsibility before you can exercise the priviledge of operating a motor vehicle on public roads. The key here is "demonstrate financial responsibility";i.e., carry liability insurance or post a bond with the government.

Health care is a personal responsibility and you have a constitutional right (10th Amendment) and a biblical right to behave irresponsibly (Romans 1:28 through 32).

It is estimated that as few as 70% of licensed drivers carry liability insurance. Those that get caught are fined or imprisoned.

What evidence do you have that mandated health insurance will be any different? What are you going to do when someone gets caught without health insurance? Put them in jail? This is reminiscent of the debtors prisons from the eighteenth century.

We need to keep health insurance in it's proper perspective in our society. We need to allow insurance companies to offer innovative health coverage plans. We need to find a way to allow them to offer these plans in multiple states.

We do not need to:

Demonize insurance companies

Place the federal government in competition with insurance companies.

Place more mandates on insurance coverage.

Irrational Pricing Increases Health Care Cost

I have reached a certain age where my primary care physician recommended a colonoscopy. He referred me to an outpatient facility owned and operated by an LLC whose primary shareholders are the physicians. The appointment was scheduled in three weeks on the Monday of my choice. In and out before lunch missing only one day of work.

The bill for these services was $3400. The insurance company paid $875, my share was $75, and the physician group wrote off the rest. If the physician would do it for me for $950 I wouldn't need the insurance company. One must ask: WHY?? What has created this irrational billing system? What is the lowest price they would accept? Why do we need a layer of bureacracy/cost to get the best price?

It all started with Medicare in the mid sixties. The federal government created a health insurance plan for citizens over the age of 65. The government was bringing a large group of patients and demanded anyone providing health service to these patients accept a discount. Medicare covered less than 10% of the population so that was accepted.

Succeeding Congresses established Medicaid for poor people; then raised the definition of poor to include families earning up to $80,000 annually. Every congress has saved money by increasing the discount.

Healthcare providers increased the price of their services to offset the losses from treating Medicare and Medicaid patients. Congress then demanded they prove that they have made a good faith effort to collect their posted fees.

So Congress increases the discount and health care providers raise their prices in self defense.

Insurance carriers got into the game in the late seventies by creating managed care. Billions of dollars were made by middlemen whose only contribution was giving healthcare providers a means to provide discounts to their patients. Those who do not qualify for one of the federal programs or private managed care plans are trapped in paying full price for services. Government rules require them to pay inflated prices so providers can get acceptable reimbursement from the government. The healthcare providers write off the unpaid bills as uncollectible or the local government pays the costs.

NOTE: NOBODY IS DENIED NECESSARY TREATMENT FOR LIFE THREATENING ILLNESS. The treatment may be delayed or scaled back; but TREATMENT IS NOT DENIED.

Today the government pays for over 40% of the health care provided in the US and the progressive politicians in congress are maneuvering to increase that to 100%. The apparent purpose is to enhance the revenue of the federal government to cover the trillions of unfunded liabilities from Social Security, Medicare, TARP, and the economic stimulus.

Insurance companies are supplementing the income shortfall to healthcare providers created by the government. When (not if; WHEN) the government becomes the sole provider there will be nobody to cover the losses imposed on healthcare providers by congress. This will cause them to cutback on services or go out of business altogether.

Lower reimbursement = fewer healthcare providers. Fewer healthcare providers = long waits. Long waits = National Coordinator of Health Information Technology (aka Death Panels). National Coordinator of Health Information Technology = rationing. Rationing = denial of care.

BONUS: Sick people will just die, thereby reducing the unfunded liability of Social Security and Medicare. Remember, when they are talking about pulling the plug on Grandma; someday we will all be Grandma.

Here are three things that would reduce the costs of healthcare.

1) Charge for procedures and not fees for service. For example:birthing has been bundled into one price from prenatal through year one and includes professional services and hospital charges in many locations.

2) Allow people to purchase pharmacuticals in Canada or Mexico. Drugs are cheaper in those countries because of government price controls and consumers in America pay more to subsidize this practice. Big pharma will stop playing that game if we could purchase our drugs in these countries too.

3) Put a cap on damages for pain and suffering in malpractice cases. It has worked in Texas and would work nationwide.

Here is the one thing that will NOT reduce the costs of healthcare:

Allowing the government sell insurance in competition with private insurance companies. The government will most certainly engage in predatory pricing as they tax private insurers to pay for the cost of providing health insurance at a loss. This will force private companies out of business and then the government will have a monopoly on health care.

Monopolies NEVER work. Never.

What is Wrong with Health Care Now

Progressive Democrats have wanted to impose nationalized health care on the United States for as long as we can remember. It has always been posed as compassion for sick people; but it looks suspiciously like the human need to control other people in an effort to provide meaning to one’s existence. This drive for control has taken on an unusual urgency because the progressives now control both houses of congress and the presidency and this is viewed as a way to salvage the bankrupt Social Security and Medicare programs.

We have already shown how the public option will allow the government to increase revenue by skimming money from 1/6 of the economy, control costs by dictating reimbursement and access to treatment, and reduce demand by accelerating attrition.

Congressional committees have been introducing legislation written by progressive organizations with no thought to the real problems of our current healthcare system. One can only conclude that there is no real interest in solving problems. Congressional committees used to hold public hearings to solicit testimony on what problems exist and possible solutions; but that is not the case in this congress. This congress seems intent on simply jamming down a progressive agenda to grab private wealth and enhance the power of an elite corps.

Members of Congress and Federal employees will be exempt from the constraints of these programs because, as George Orwell wrote in ‘Animal Farm’, “some are more equal than others”.

Let us assume this is a perfect world and congress will hold public hearings to discover what, if any, problems are endemic to the health care system as currently constituted.
We would testify to the following problems that congress could address to the benefit of everyone.

Access to affordable health insurance is tied to one’s employment. It makes absolutely no sense. The reason for this custom wage and price controls imposed by the Federal Government during World War II. Companies could not pay competitive wages for superior employees; but they were allowed to offer benefits at no cost to employees and deduct those costs from the company’s income. Bonus: government contracts were based on cost plus profit so the higher the costs, the higher the profit.

The prices of health care services are not based on the cost of delivery. Prices are determined by Medicare reimbursement. When Medicare was introduced, it was a small percentage of the total health care industry and reimbursement was based on a percentage of local reasonable and ordinary charges. Over the years, the percentage of reimbursement has declined; so service providers simply raised their fees. The result is private insurers are subsidizing Medicare and Medicaid. These two programs pay nearly half the income received by health care providers. We will explore the negative effects of these policies in a separate blog. The most informative article we have found on this subject was written by Loren Steffy in the Houston Chronicle on Sunday, September 13 and linked here.

Federal and State laws mandating certain services. For example, hospitals must treat anyone who comes to the emergency room. This is by far the most expensive means of health care delivery and most people who go to the emergency room do not pay full price for the services received. The result is the local taxpayer, through the hospital district, pays the cost shortfall for operating the emergency room thereby subsidizing the cost of healthcare for uninsured and indigent clients.

You will notice that the top three problems with the delivery of health care in our country were caused by government. It seems incongruous to expect more government involvement to solve the problems that government involvement has caused.

Is Healthcare a Moral Imperative?

Approaching a coworker, I asked, "Do you know where I can find G.?"

"It’s not my week to monitor her." was the humorous reply.

I am reminded of Genesis 4:9 and 10. "Then the LORD said to Cain, "Where is Abel your brother?" He said, "I do not know; am I my brother's keeper?" And the LORD said, "What have you done? The voice of your brother's blood is crying to me from the ground. "

You will notice that the LORD did not say that Cain was his brother’s keeper. As you read the Holy Bible, regardless of translation, you will see that God does not want us to keep each other but wants us to rely solely on Him for all our needs.

God requires us to love each other, seek justice, show mercy, and walk humbly with Him. God has promised to bless each of us so that we will be a blessing. Neither the Holy Bible nor the Constitution of the United States guarantees a right to health care.

In fact; it can be argued that it is unjust to require persons to provide medical treatment without full compensation. It is unjust to require someone to pay for the medical treatment of someone else. It is unjust to ask those who behave responsibly to pay for the consequences of poor choices made by others.

It can be argued that it is more loving to force lifestyle change upon an individual than to enable destructive behavior by subsidizing treatment for the consequences.

The hero in the celebrated parable of the Good Samaritan (Luke 10:30) showed mercy by personally taking responsibility for the comfort and treatment of the unfortunate traveler. He was just as busy as anyone else. He paid his taxes just like the previous travelers who would not make the time to help the victim of violence. Yet he had the heart to show mercy and share his blessing.

The parable makes it pretty clear that we are to take responsibility for ourselves and show mercy when the opportunity arises. We are not our brother or sister’s keeper and we should not extort others to do what we think they should.

When you go through life humbly with God, you know you are NOT God’s partner in life and death. Only a dangerous narcissist would believe otherwise.

My Thesis: The argument that we have a moral imperative to provide healthcare to everyone is specious. Anyone making that argument is either ignorant of the moral basis of our society or is motivated by greed.