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.
Publicly-funded health care
After receiving one too many e-mails, post cards and other marketing pitches to extoll the virtues of ObamaCare, I felt compelled to send the following letter to Congressman Tim Bishop.
Dear Congressman Bishop,
Judging by the e-mails and mail pieces the marketing program now begins. To tell the 50%-60% of Americans who adamantly opposed ObamaCare, now that it has been signed into law, what good medicine it really is. Before I point out the areas on which we disagree, I would first like to call for a sense of honesty in the debate on healthcare. I applaud you for such honesty where you say on your glossy postcard that it was prepared, published and mailed at taxpayer expense. I challenge you, however, on your opening sentence.
You begin your piece by stating, “On March 21st, we stood up to big insurance companies and passed health care reform.” Really? How is using the full coercive power of the federal government to unconstitutionally force millions of Americans to buy the products of these big insurance companies, whether they want to or not, standing up to them? I’ll bet Wal-Mart wishes you would get tough with them and require all Americans to shop there on Thursdays. Are you next going to get tough with GM and Chrysler by passing legislation forcing us to buy a Malibu or a Ram pickup truck? Of course you will probably smack them around and make them comply with tougher CAFE standards, but hey, that’s what big government is for, no?
I am still waiting to find out how spending $1-$2 trillion dollars results in reducing the deficit by $143 billion in the first decade. This may be presumptuous but I have a suggestion on how to lower the deficit by $1-$2 trillion. Repeal ObamaCare and start over.
Nothing in this legislation actually goes to the root cause of reducing the cost of delivering health care. It’s all giant shell game about hiding whose pocket the money is coming from to really pay for the same old broken system. Here are some of the “benefits” you point out in your mail piece:
- Free Preventive Care Under Medicare – this eliminates co-pays and deductibles under Medicare. This doesn’t reduce what it costs medical professionals to deliver preventive medicine, it just lowers the price to consumers. Economics 101 says when you decreases the price the demand goes up. By eliminating co-pays and deductibles, someone has to make up this modest difference. It is either the medical professional who has to eat the cost, driving up rather than reducing the cost of preventive care, or it will be subsidized by the rest of us through taxes. You are betting that if every senior gets preventive care, more expensive treatments will be avoided later. The real question is: how many seniors are not getting preventive care because they don’t have a $20 co-pay and of that group, how many turn out to have a serious disease that could have been prevented? This is a much smaller group than all seniors. You cannot make seniors go to the doctor for preventive care if they don’t want to, whether it is free or not.
- Free Preventive Care Under New Private Plans– When I had my own small business, I provided our employees with healthcare. I chose a plan that provided free preventive health care. When I left that business and went out on my own, I tried to buy the same plan privately. It had a high deductible, HSA account, and free preventive care. Such plans are available, but not in New York unless you have poverty level income. The marketplace has these plans available. Government regulations prevent me from buying them. Why do we need to spend $1-$2 trillion to give me a plan that the marketplace already provides if government will just get out of the way?
- Ensuring Value for Premium Payments – This is where you require plans to spend a certain percentage of premium dollars on medical services. How does this control costs? If the underlying costs increase 100%, does it make us feel warm inside that the 100% increase in premiums that will follow will go 80% toward medical expenses? It’s still an increase in premiums of 100%.
Let me stop analyzing your mail piece here. Doctors are threatening to leave the medical practice because of this legislation which will lead to rationing. This plan does not address the underlying problem.
There is a simple way to reform health care by controlling the underlying cost of delivering medical care, rather than mandating more and more coverage and expense paid for by someone else. We all pay in the end. Here is a simpler way that does not cost $1-$2 trillion dollars but may take some of that courage you boasted about in your opening sentence.
- Eliminate 3rdparty payer. If you invite me to dinner and you tell me that you’re picking up the tab and I am handed a menu with no prices on it, look out! It’s gonna hurt. Americans are smart consumers. They will spend hours researching a car or flat screen TV before buying, because it’s coming directly out of their pocket. They play a role in how much they pay. That’s how markets work. We do not have a free market in health care. The way to do this is with high deductable insurance plans and Health Savings Accounts (HSA). If you take the lower cost of the premium for the insurance piece and add the amount to fund the HSA, the costs are about the same as the premium alone on a traditional plan. I went from a $10,000 annual premium for a traditional plan to a $5,000 premium cost for a high deductible with a $5,000 contribution to the HSA account. If you want to help people with deal with the high deductable, help them fund the HSA accounts, but keep the buying decision in their hands. Trust me, they will ask questions, they will shop around, because it’s their money and the less they spend, the more they keep. Many HSA accounts have a provision to roll money over into an IRA if the account grows large. This will take guts to implement because the public will have to be educated that they will come out ahead when they have the liberty to make their own choices. You seem tough enough to ignore the will of the people to implement what you feel is good for them, why not implement something that will actually work?
- Implement tort reform. Not an experiment here or there. If you want to show how tough you really are, stand up to the trial lawyers who fill Democratic coffers. Implement the system they have in Britain. No contingency fees and loser pays. Maybe I’ll stop seeing commercials on my TV that promote a new drug, followed by a come on from a law firm to call them if you actually took the drug because, “you may be entitled to compensation.” I have no problem with a person getting compensated when they have been harmed through the fault or negligence of a company. Human life is not perfection. We are all different. Some of us can eat three eggs a day and never have a heart problem, others may look at a pat of butter and feel pains in their chest. Lawyers shouldn’t get rich because humans are not perfect and companies can be bluffed into paying these extortionists rather than defending the case on the merits. Lawyers should get paid for the time they put into a case. OB/GYN doctors are leaving the practice in droves because they cannot afford the malpractice insurance premiums. Doctors are practicing defensive medicine ordering every possible test for fear they will be asked later, if a patient gets worse, why they didn’t order that other test. When you add the cost of malpractice insurance on top of the cost of additional tests and procedures, it doesn’t get cheaper to deliver health care and you are not necessarily delivering better health care. Let the doctors practice medicine, tell the lawyers to stop running a lottery.
- Buy insurance across state lines. As indicated previously, the plan I want to buy is available, but not in New York. The market sees a need for such a product, I want to buy such a product, the government says no. You want me to believe that now if we spend $1-$2 trillion the government will solve my problems. Get the government out of my way, thank you very much.
- Have more tailored insurance policies. Why, as I approach the golden years, do I have to buy a health insurance policy that covers pre-natal care? In vitro fertilization? Sex change operations? When I buy automobile insurance, I have about a dozen choices in every category about the kind of coverage I want. How much deductible? Do I want rental car reimbursement? Roadside assistance? Yet when choosing a health care policy, if I have a choice at all, it is a total package, take it or leave it. Who decides what has to be included? Is it me or the government regulators? If I want to have free preventive care, fine let me choose that and adjust the premium accordingly. If I want to pay the co-pay for free preventive care, give me that choice. If we had more choices, as in a free market, costs will go down. If the government says, everyone must take this, there is no competition and costs climb.
- Control illegal immigration – If emergency room costs are driving up health care costs for all, and illegal immigrants use the emergency room as their primary care provider then it would follow if you controlled illegal immigration you would drive down health care costs. Milton Friedman, the great economist, believed in open borders. However, he also said you can’t have open borders and a welfare state. It doesn’t work.
- We need to have Medicare reform. When Medicare passed the government projected that hospital coverage would grow to $9 billion by the early 1990s. It actually grew to $66 billion a 700% error in their projection. We hear again that we are going to crack down on Medicare and Medicaid fraud and this time we really, really mean it. Estimated at nearly $100 billion per year in waste and fraud, why can’t this be done without spending $1-$2 trillion?
What you and this Congress passed is a disaster. If the projections on this monstrosity “miss” by 700% like they did on Medicare, where do we go for a bail out? Who is going to bankroll that one? Your children? Your grandchildren? The six items I laid out cost next to nothing, why not try them first? You can always go back later and say we need to do more. But with ObamaCare, it could be a runaway train that no one can stop. It is a giant shell game. It doesn’t address the underlying cost of providing medical care, it only hides whose pocket is getting picked to pay the bill.
Sincerely yours,
The marketing juggernaut is just getting warmed up, but instead of standing fascinated while your Congressman plays 3-card Monty, ask him or her the tough questions. Ask them calmly, respectfully, and don’t let them dance. If they dodge your question, ask it again. If they don’t… fire them in November.





