Health care reform in the United States

Tim Bishop’s Mediscare Reelection Strategy

by Bill O'Connell on July 29, 2011

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Judging by the two mail pieces I just received from my congressman, Tim Bishop, it looks like he has settled on his reelection strategy. After all, he doesn’t want to run on his record (ObamaCare, bailouts, Stimulus, trillions in deficit spending); with the demise of earmarks he can’t say he’s bringing home the bacon; since he is facing a re-match in his reelection bid, using the same smear tactics this time around will be harder; so let’s scare the bejeezus out of the seniors.

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The Assault on Paul Ryan’s Medicare Plan

by Bill O'Connell on May 18, 2011

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Newt Gingrich may have just killed his presidential bid in less than a week after announcing it. Aside from his support of ethanol subsidies, the old commercial sitting on the couch with Nancy Pelosi, he tops it off by attacking Paul Ryan’s budget that was approved by all but four Republican members of the House of Representatives.

He says the Ryan plan is too radical. Compared to what? ObamaCare?

While Medicare savings under the Democrats’ health care law and pending proposals would come mainly from reduced federal payments to doctors, hospitals and insurance companies, the budget put forth by House Republicans would cut spending by turning Medicare into a system of vouchers for future beneficiaries to buy private insurance, but in amounts that would not keep pace with the projected inflation of health costs.

The Democrats’ plan is to pay doctors, hospitals, and insurance companies less. How does that work in the real world? Doctors will refuse to accept more Medicare patients as will hospitals. So Medicare recipients may have coverage, but won’t have a doctor to serve them. You cannot bring down the cost of medical care by government fiat.

Ryan’s plan actually brings the free market into play by putting the decision making in the hands of the consumer. Of course, the Democrats say that amount Ryan proposes will not keep up with the rising costs of medical care. Aren’t these the same people who said if we did not spend nearly a trillion on the stimulus, unemployment would rise to 9%, wheras if we did, it would go no higher than 8%?

Paul Ryan showed the courage to tackle entitlements and with a credible plan. It may not be perfect, but it is a solid start. The Democrats’ “plan” is just more politbureau control from Washington dictating to the rest of us their failed solutions. It’s time for a change.

As for Newt, he can go back to the think tank, and re-think some of his positions.

 

That’s my opinion; I’d like to know yours. Please comment below.

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This is from today’s New York Times:

“Fearing that health insurance premiums may shoot up in the next few years, Senate Democrats laid a foundation on Tuesday for federal regulation of rates, four weeks after President Obama signed a law intended to rein in soaring health costs.”

With the ink barely dry on ObamaCare, Democrats in Congress are scrambling to keep their masterpiece from unraveling.  As I have pointed out repeatedly, there is nothing in the ObamaCare plan that helps reduce the cost of delivering health care.  It is all about controlling what doctors, medical service providers, and insurance companies are paid.  All the underlying pressures on health costs (tort reform, 3rd party payer, etc.) are still in place.

“We Have to Pass the Bill to Know What’s In It”

Nancy Pelosi’s stunning but famous words are coming into play.  Let’s see what has the senators panicked.

  • To hoodwink the American people that this abomination is cost effective, ObamaCare warms up by hitting us with four years of taxes before the expensive benefits come into play.
  • Every American will be required to purchase health insurance or pay a penalty.  That penalty will initially be $95 per adult in 2014, rising to $695 per adult in 2016 and $2,085 for a family.  This money will be collected by the IRS, not by insurance companies
  • Americans cannot be denied coverage for an existing condition

So here’s the scenario.  If you compare the cost of the penalty of $2,085 for a family vs. the cost of insurance for a family of $10,000, coupled with the inability of insurance companies to deny coverage for pre-existing conditions, healthy people will start dropping insurance coverage left and right.  Why not?  On the way to the hospital, you can call an insurance company and say you want to be covered for the pains in your chest and you cannot be denied.  So insurance companies will only have sick people as clients.  With only sick people that they constantly have to pay claims on, their only course of action if they want to stay in business is to raise premiums on all those sick people.  If they start doing it now, they may be able to raise them less than if they wait until 2016.

So the insurance companies are acting rationally to this mess the Democrats dragged across the finish line and now they are shocked, SHOCKED, that they should do this. 

Grace-Marie Turner, president of the Galen Institute, a research center that advocates free-market health policies, said the Democrats’ proposal was unlikely to succeed in lowering insurance costs.

“Capping premiums without recognizing the forces that are driving up costs would be like tightening the lid on a pressure cooker while the heat is being turned up,” Mrs. Turner said.

The Democratic fix is to have a new bureaucracy that will provide a check on unjustified premiums.  I think you can look at this in one of two ways, both plausible.  The Democrats were stupid enough to believe, as they typically do, that Americans don’t act rationally to their government policies.  It’s also why they don’t understand that when they raise taxes they never collect as much money as they thought, and when taxes are cut they can’t believe how much money flows into the Treasury due to economic growth.  The second scenario is this new commission will cap premiums to the point of driving private insurance companies out of business and then the Democrats will say, “Geez, we didn’t want to do this, but I guess we have to put in place a public option that, by the way, will be the only option.”

Senator Lamar Alexander of Tennessee, the No. 3 Republican in the Senate, said: “Health insurance companies’ profits for one year equal about two days of health care spending in the United States. So even if we were to take away all the profits of the so-called greedy insurance companies, that would still leave 363 days a year when health care costs are expanding at a rate our country cannot afford.”

Now that I think about it, it is probably the second scenario that is more likely, that is, force the public option.  Your government is about to swallow up another big chunk of the economy if  we don’t turn them out in November.

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Let The Sun Shine In

by Bill O'Connell on March 27, 2010

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In their pledge of openness and transparency in government the House of Representatives takes some pride in putting the health care bill online for 72 hours before voting on it.  Sounds like a good step, no?  Well… that is until you to the math.  If the bill they are voting on is 2,500 pages long you would only have 1.7 minutes to read each page provided you did not eat, sleep, rest your eyes, use the restroom for three straight days!

We have Nancy Pelosi’s famous cry for support, “we have to pass the bill so that you can find out what is in it”.  Turn one-sixth of the economy over to the government, first, then find out what’s behind door number 1, door number 2, or door number 3.  If you remember from that game show, what was behind one of the doors was a real stinker.  The problem here is we got all three doors.

AT&T reports that they are writing off $1 billion to pay for compliance with the new health care bill.  Guess where they are going to get that $1 billion?  That’s right watch your phone bill.  You are going to be paying for this health care monster in places you never imagined.  Caterpillar announced they were writing off $100 million, John Deere $150 million, and AK Steel $31 million.  So look for more expensive roads, farm equipment (food), and more expensive cars.  This is from companies that have figured this out in less than a week.  It will take time for thousands of other companies to tally up the cost.

Henry Waxman to the Rescue

But don’t worry folks, Congressman Henry Waxman is riding to the rescue:

Representative Henry A. Waxman, Democrat of California and chairman of the Committee on Energy and Commerce, said he would hold a hearing next month to investigate the effects of the law on big companies. He asked the chief executives of Caterpillar, Deere & Company and Verizon for financial data to document the projected impact of the law on their companies, and he asked them to explain their accounting methods.

“The new law is designed to expand coverage and bring down costs,” Mr. Waxman said, adding that he would be concerned if it drove up costs.

I’m sorry to have to say this, but he has to be the dumbest man in the House of Representatives.  Members of the House are supposed to REPRESENT  the people.  The people have been screaming their opposition to this for months.  Obama dared his opposition to campaign on repealing his prized piece of…er, work.  Here’s news for you Mr. President, according to a Rasmussen poll 55% of Americans favor repealing this monstrosity.

But let me get back to Mr. Waxman, who is surprised that health care costs could actually increase.  Listen to the American people:

Most voters still believe cost is the biggest problem with health care in America today, but most also think passage of the health care plan proposed by President Obama and congressional Democrats will drive costs even higher.

A new Rasmussen Reports national telephone survey finds that 54% rate cost as the biggest problem, a finding that has been consistent for months.

If Mr. Waxman got his head out of the sand or wherever else he conveniently parks it, and out into the fresh air, he might have realized that he is among the very few who actually believe this was going to lower costs, because there is nothing in this bill that addresses costs.  It’s all about tweaking reimbursements to health care providers, which will accomplish nothing but drive doctors and other providers out of business, ration health, and expand government control.  Oh, but wait, that is the Democrats plan.

The Silver Lining

But there is a silver lining.  Communist dictator Fidel Castro loves it! 

Cuban revolutionary leader Fidel Castro on Thursday declared passage of American health care reform “a miracle” and a major victory for Obama’s presidency

Bill O’Reilly, do you still think President Obama is not  a socialist?

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Pass the Lipstick, Mr. President

by Bill O'Connell on March 3, 2010

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As President Obama said while campaigning to be President of the United States, “You can put lipstick on a pig, but it’s still a pig!”  How true.  Yesterday President Obama reached for the lipstick to dab on four proposals suggested by the Republicans to the massive pig of a health care proposal clinging to life.  The four proposals are:

  1. Use undercover medical professionals to conduct investigations to fight waste and fraud in Medicare, Medicaid and other Federal programs.
  2. “Demonstrations of Alternatives” to the current malpractice mess.
  3. Increasing doctor reimbursement for Medicare.
  4. Expanding Heath Savings Accounts (HSA).

The pig smiled.  She thought she looked beautiful.  Just don’t try to put a bikini on her because, as President Obama famously said, she’s still a pig.  Let’s look at the President’s magnanimous attempt at bipartisanship in detail.

1)  Undercover Medical Professionals to Uncover Fraud

It is estimated that somewhere in the neighborhood of $100 billion is lost or stolen each year from Medicare and Medicaid.  This program has been in place for 40 years.  If those numbers are consistent over that period, that’s $4 TRILLION.  Gone. Stolen from you and me.  How much better shape would we be in if we had that money back?  That’s government efficiency for you.

The President of the United States is the chief law enforcement officer in the country.  The amount of Medicaid and Medicare losses each year are four times the entire budget of the Department of Justice.  How’s this for a proposal?  Create a Medicare/Medicaid fraud unit within the FBI and fund it so that we can stop these losses.  If you stop the fraud, it’s free money.  What you save in fraud should more than pay for the FBI funding.  Why take medical professionals and give them law enforcement duties.  Are you going to ask police to operate on you?  Mr. President it’s your job to enforce the laws and prevent this widespread fraud.  You don’t need a new act of Congress.  Just Do It!

2) Tort Reform –No; “Demonstrations of Alternatives” — Yes

Trial lawyers are one of the biggest contributors to the Democratic Party.  Do you think such “Demonstrations of Alternatives” will amount to anything other than hush money?  “Shut up , we’re looking into tort reform.”  The counter argument is that Americans have a right to their day in court when they have been injured.  True enough, and I am reluctant to arbitrarily limit their awards through a fixed dollar limit.  I would take aim squarely at the lawyers.

John Edwards, one-time Senator and presidential candidate, was involved in about 63 cases as a personal injury attorney and amassed a fortune of about $70 million.  In one particular case, he stood before the jury and took on the persona of a child in the womb crying out for oxygen to appeal to the emotions of the jury and win the case.  Oddly enough he voted against a ban on partial birth abortion.  Gee, in the once case it’s a child who can actually speak while still in the womb!  But on the other hand it is just a mass of tissue at birth that can be disposed of with the trash.  We have learned a lot about the moral character of John Edwards.  He is the poster boy for the old joke, “How do you know a lawyer is lying?  His lips are moving.”

Here is a simple solution to tort reform.  Fixed fees for attorneys and loser pays.  The lawyers should set their hourly rate and bill according to hours worked, not how much they can squeeze out of the jury.  The award should be for the benefit of the injured party, not the lawyer.  The second part is to prevent frivolous lawsuits.  The loser pays the legal fees of the winner.  The argument here will be that the tables will be turned and no one will sue corporations for damages because of the risk of paying their legal fees.  Right now lawyers are running a lottery fishing for lawsuits of any kind because they know that most corporations will settle for less than it would cost to defend the suit, even if they know they are right.  All customers of that corporation pay more for their products (e.g., drugs, medical devices) and the lawyer gets rich.  I am sure that if such a proposal as this gets passed a new market for “legal fee insurance” will open up where a plaintiff with a strong case can buy insurance to cover the cost of the other sides legal fees if they do lose.

3) Increasing Doctor Reimbursement for Medicare

So much for bending the cost curve down.  The real way to curtail spending on health care is to eliminate 3rd party payers.  (see It can be done).

4)  Increase Health Savings Accounts

These plans exist today, however, they are not all available across state lines (see It can be done).  I had such a plan in New York while employed by a company, but when I went out on my own I could not buy the same plan in New York State.  We don’t need ObamaCare, we just need states to allow these plans to exist within their borders or allow individuals to buy across state lines.

The Pig Lives!

Three of the  four Republican proposals that President Obama likes don’t cost anything.  But he $1 trillion to $2 trillion health care catastrophe is still alive and until we slay that beast and start over we will go from a serious health care problem to a fiscal crisis and end up with both.  If you don’t believe me, read how the model for ObamaCare is working in Massachusetts.

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Pick My Pocket. Please!

by Bill O'Connell on December 28, 2009

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Who doesn’t love a freebie?  Who does not get a thrill of good fortune by finding money in the street, no matter how insignificant the amount?  We may not believe in the Tooth Fairy, but many of us believe we have a rich benevolent uncle, Uncle Sam, who is willing to lavish upon us his wealth if only we would ask.  The sad truth is that Uncle Sam is not rich, but penniless and is running a ponzi scheme that would make Bernie Madoff blush.

Health Care for $20

One of the major reasons that health care costs are rising out of control is that no one is minding the store.  While Washington twists itself in knots to rearrange deck chairs on the Titanic of health care, we have little to no say in how our health care dollars are spent.  Our health care “insurance” system is not really insurance.  Insurance is meant to protect us from a financial catastrophe.  Going to the doctor for a checkup is not a catastrophe.  Paying a $20 co-pay for that checkup is like finding money on the street.  There is no way anyone can get a physical exam, except by a hooker, for $20.  It is a good idea to get a physical checkup every year?  Yes, then pay the bill and ask what you are paying for and make sure you need it.  You take your car in for service don’t you?  Do you file an insurance claim when you do?  Can you get it done for $20.  Let’s get real.  What we have is called third party payer and when someone else is picking up the tab, do we care what it costs?  Really?  But someone is picking up the tab.  Look in your other pocket, because you are.  If you are generally healthy and you get your annual checkup, your insurance premium (here in New York at least) will probably run around $10,000 per year.  But, hey, you only paid $20 for that physical!  What if you paid the full amount for the physical, say, $500.  What if your insurance premium was cut to $5,000 because you would pay most routine medical costs out of your pocket and what if you could put the $4,500 left over ($10,000 original premium, minus $5,000 current premium, minus $500 cost of checkup), into a tax free account that can be used for future medical expenses or retirement if you don’t use it?  If you are a young person and stay healthy into your mid-40s, you would have accumulated over $90,000 in your medical savings account and you still have catastrophic insurance coverage and the government stays out of the picture.

Retirement for Free

Like many well intentioned Government programs, Social Security, enacted during the Great Depression, seemed like a good idea at the time.  When enacted there was about 15 workers paying in for each recipient drawing out.  Today there are about a little over 3 workers paying in for each beneficiary.  Bernie Madoff would blush at the audacity of it.  On top of that the money that is paid into Social Security can only be “invested” in Treasury Securities so the return is lousy, but safe.  People reacted to Social Security by saving less because the government safety net was there.  Had people been encouraged to save for their own retirement, they would not be leaving their children this legacy of a ticking time bomb.  So today, many young people feel the government’s hand in their pocket when they look at the FICA line on their pay stub, but don’t believe they will ever get a penny back.  Nice concept.

Bring Home the Bacon!

What’s the measure of a good Congressman or Senator?  Bringing home pork for the district, no?  If you are like me, you get flyers every year or several times per year, touting how Congresswoman Jones obtained federal funding for that pier at the amusement park.  With 435 Congressmen you can count on this, for each $1 that your Representative brings home $434 leaves the Treasury for each of the other Congressional districts and probably more, depending on the power and seniority of your Representative.  Guess who’s paying for that Turtle Crossing in Florida?  that bridge to nowhere in Alaska? that airport in Johnstown, PA that no one uses?  That’s right, you are.  What if we decided locally if we really needed a pier at the amusement park, and if we did, pay for it ourselves?  Then we could let the people of Florida decide if they want to build a turtle crossing, the people of Alaska decide if they wanted a bridge to nowhere and the people of Pennsylvania decide if they wanted an airport that no one used.  Then we could cut federal taxes by an equal amount to keep them out of mischief and help us pay for these projects if we really wanted them.

Let’s Get Organized

There was a time in our history where labor unions performed a valuable service.  In those times when many industrial jobs were unskilled or semi-skilled, employers could dismiss someone on a whim and replace them within the hour.  Unions gave those workers some counterbalancing power and fairer treatment.  Today, we have a much more sophisticated economy and workers have more skills and mobility.  Union membership has declined accordingly, in the private sector at least.  Why is union membership still growing in the public sector?  What is different about workers in the public sector that they still need unions?  Are we suggesting that all government workers are unskilled?  Why do teachers need a union?  Are they not skilled such that they could sell their services to the highest bidder?  Why do unions fight merit pay for teachers?  Why are school principals, the de facto CEO of the school and who in New York easily make six figures, unionized?  Do you get an idea why our K-12 public school system is trailing the world in performance?

In Michigan, privately owned small businesses that provided day-care services suddenly discovered that they were part of a union and union dues were being withheld from their government contractual payments.

Ms. Berry owns her own business—yet the Michigan Department of Human Services claims she is a government employee and union member. The agency thus withholds union dues from the child-care subsidies it sends to her on behalf of her low-income clients. Those dues are funneled to a public-employee union that claims to represent her. The situation is crazy—and it’s happening elsewhere in the country.

Ms. Berry, runs “The Berry Patch” a private day care center she operates from her home catering to low income clients.  The money that was once paid to her, now goes to a union that does little for her.  She is “self employed and wants nothing to do with the union.”  Don’t you think we need more of these tactics in America?  Card Check anyone?

Going Postal

And let’s not forget the Postal Service.  As postal rates are again scheduled to increase on January 4, let’s look at this paragon of efficiency, that is actually authorized by the Constitution.  In 2008, the Postal Service lost $3 billion, and the Postmaster General John Potter pulled down $800,000 in compensation including $135,000 in incentive bonuses.  What do we have to pay this guy if he actually breaks even?  Also, let us not forget this is also a very heavily unionized operation.

Don’t Worry, You Won’t Feel a Thing

During World War II, FDR needed to raise more revenue to pay for the war.  Fearing a backlash, his team hit upon the idea of payroll withholding.  Knowing the potential backlash that would result when taxpayers had to write that big check on April 15th, he rightly figured that if he took a little bit each week, he could take a lot more in total.  Statists in Washington have never looked back.  It’s like the tax that was imposed on telephone service to pay for the Spanish American War that is still in place today.  Instead of picking our pockets every week, what do you think most Americans would say about the size of the federal government if they had to write one big check on April 15th?  There would be no tax rebates, because there would be no tax withheld.  Do you think Americans would force Congress to sharpen their pencils and scale back the size of government?

Help is On the Way

Ronald Reagan said, “The nine most terrifying words in the English language are, ‘I’m from the government and I’m here to help!’”  But perhaps the best example of how far from our founding principles our government has strayed comes from Congresswoman Rosa DeLauro of Connecticut as she spoke during a House End of Year Wrap Up Session:

“This House–we understand, we’re there,” she said.  “You can count on us because we believe that it’s our moral responsibility to make sure that you and your family need our help.” 

I don’t know about you, but I don’t need the House of Representatives making sure I need their help.  I need as little interference as possible from them.  Their meddlesome intrusions in our lives is killing what made this country great.  It is a point we cannot make often enough.

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Health Care You Can Believe In?

by Bill O'Connell on June 25, 2009

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If you look at President Obama’s record on what he says one day and one he says later when reality sets in, are we really ready to believe him when he says,

“Whatever plan we design upholds three basic principles,” he said. “First, the rising cost of health care must be brought down; second, Americans must have the freedom to keep whatever doctor and health care plan they have, or to choose a new doctor or health care plan if they want it; and third, all Americans must have quality, affordable health care.”

He told us we absolutely had to pass his $787 Billion stimulus package or the unemployment rate would hit 9%, but if the package passed, the unemployment rate would be held to 8%.  It didn’t work.  Unemployment is at 9.1% and climbing.  He said bankruptcy for the auto companies would be disastrous for the economy.  After pouring billions into the auto companies, where are they?  In bankruptcy.  It is estimated that his health care “solution” would cost between $1 and $1.6 trillion. Why should we believe it?  What has he told us he would do that has actually come to pass?  North Korea?  Iran?

What confidence do we have that the government can do anything, other than national defense, better than private industry?  The postal service?  Amtrak? Farm subsidies? Earmarks? Speaking of healthcare what about Medicare and Medicaid?  In a report from March 2008:

“We need to act quickly and effectively to address Medicare’s fiscal health, including enacting the steps proposed in the President’s budget, which would postpone the insolvency date of the Part A trust fund for ten years,” said Health and Human Services Secretary Mike Leavitt.

A Modest Proposal

Before attempting to overhaul one-sixth of the U.S. Economy, why doesn’t the Obama Administration fix Medicare and Medicaid?  Show us your stuff Mr. President. Not your charm, not your winning smile. The campaign is over.   Prove that you can make these government programs work before you take on any more massive health care undertakings.

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