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.

The Medicare system is going broke. Medicare consumes 10% of GDP today and is forecast to consume 15% of GDP in twenty years, that’s growth of 50%. Tim Bishop says we need to cut spending. Okay, Tim, we’re listening, what would you cut? …Tim?…Anyone out there? Nothing.

Seniors will pay more for care – Tim Bishop

Tim Bishop says seniors will pay more for care. If you are currently on medicare or are over the age of 55, nothing will change. So why is Tim Bishop lying about that? Tim Bishop voted for ObamaCare which has already taking $500 billion away from Medicare to pay for ObamaCare. Remember how they were struggling to get the cost of ObamaCare under $1 trillion? This is how they did it. What Tim Bishop, I believe, is trying to say without telling all the facts, is with regard to future generations, starting in 2021. But Tim Bishop doesn’t want to change Medicare at all and as the table below points out, Medicare will be bankrupt by 2021. So other than scaring people what is Tim’s plan?

In his mail piece Tim Bishop says that “according to the non-partisan Congressional Budget Office, a private health plan as good as Medicare will soon cost $30,000 per year.” Wow! But a little math will show how that is ridiculous. Total spending on all health care in the US runs around 16% of GDP. Total GDP for the US is about $14.6 trillion, so total health care spending comes out to about $2.33 trillion. There are 46.5 million people on Medicare. If they each paid $30,000 just for health care premiums, the premiums alone would total $1.39 trillion. So Tim Bishop wants us to believe that private health insurance premiums for seniors would cost 60% of all health care spending. It just doesn’t add up.

One of the techniques from ObamaCare to “bend the cost curve down” is to pay Medicare providers less and less. It is the same static thinking that the government can do what it wants and nobody will react to it. But in fact, here is one of the chief actuaries of Medicare testifying that 40% of service providers will stop serving Medicare patients. That means rationing and long waits. Who will decide? Not you, but a unelected panel of bureaucrats, accountable to no one.

http://www.youtube.com/watch?v=n1igPowGu6M

Seniors forced onto for-profit insurance market — Tim Bishop

Tim Bishop makes his plug for socialism by quickly pointing out “for profit” insurance companies. Horrors. Just think of all the damage those “for profit” companies have done to us.

Yes those, for profit companies have made our lives hell compared to the altruistic, benevolent government enterprises. But we all know what happens when a free market is allowed to operate. Calculators that used to cost hundreds of dollars when first introduced are now throw away items; mobile phones that hit the market at $4,000 per copy are now $39; GPS systems that used to cost thousands and require a substantial unit be installed in the trunk of your car, are now a standard feature on your phone. Costs come down, features go up, service improves. Here is the actuary Mr. Foster talking about this.

http://www.youtube.com/watch?v=Z__m5IYoJBg

The True Cost Drivers of Medicare

Despite Tim Bishop’s scare tactics that costs will continue to skyrocket, let’s look at the true drivers of Medicare costs.

• Spending other people’s money. No one is going to spend a lot of time looking int to waste, fraud, and abuse if it is not directly affecting you. But it is about $2,150 per person per year. It is not going to get someone reelected to Congress to fix it, and the individual doesn’t care. If it affects the spending power of their premium and the profits of the evil “for profit” company, you can bet it will be attacked aggressively.
• The Government keeps expanding the goods and services covered by Medicare. I have seen quite enough TV advertisements for “The Scooter Store” telling me how I can get a “free” scooter completely paid for by Medicare.
• The Prescription Drug Plan passed by President Bush had no revenue stream associated with it, so this is all deficit spending. Let drug companies compete for the seniors’ business
• Medicare overpays for many items, because it sets prices higher than the free market would. Are you listening Congressman Bishop?
• Fee for Service – this encourages providers to deliver too many services. When in doubt, add it.

Where “for profit” companies are involved they watch the bottom line. A dollar saved in fraud, waste or abuse, goes straight to the bottom line. The company can decide to either increase profits or cut premiums to grow market share. Medicare is now soviet style centralized planning where a bunch of bureaucrats set prices on 30,000 items and somehow we are to believe they are smarter than all the doctors, hospitals, drug companies, and other health care providers.

Tim Bishop wants to kick the can down the road. Instead of making a contribution and working to fix the problem, he would prefer to scare seniors into voting for him so he can continue to draw his $174,000 salary and keep a low profile. It’s time to retire Congressman.

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

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 21^st, 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. 

1. Eliminate 3^rdparty 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?
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.

“We have to pass the bill so that you can find out what is in it” – Nancy Pelosi 

The White House claimed, incredibly, that most Americans support ObamaCare.

“If you take the last 12 independent polls, and you throw out four by Rasmussen, whose results the White House doesn’t like, and you throw out six others that show a wide margin of opposition, then you have two polls with results consistent with the Washington Post poll showing a fairly small margin of opposition to the Democrats’ national health care plan. And that is Benenson’s case. By the way, the headline of his article? “Most Americans want health care reform.”  – Byron York, National Examiner

Governor Ed Rendell of Pennsylvania, gushed on Fox News last night, about how ObamaCare was good for Pennsylvania.  Why?  Well, he said, today Pennsylvania is only reimbursed 50% for Medicare while under ObamaCare Pennsylvania will be reimbursed 90%.  Very cool.  Er, who’s picking up the tab for that extra 40%?  That question goes to the heart of the Liberal/Progressive movement which is basically you are too damn stupid to recognize a shell game when you see one.

Unless the plan is to have ObamaCare paid for with the profits from GM and Chrysler, the only thing the government does for a profit, it is all a giant shell game.  The giddy governor of Pennsylvania knows that this is a shell game and that extra 40% will either come out of Pennsylvanians federal tax pocket instead of their state tax pocket or it will be subsidized by citizens in other states through their taxes.  Oh wait, no, there is always those evil drug and medical device companies to tax.  But where do they get their money?  That’s right taxes are built into the price of their products, so expect drugs and medical devices to cost more.

The Evil Health Insurance Company Myth

Obama & Co. jumped all over a 39% premium increase by Anthem Blue Cross in California as Exhibit A justifying their takeover of the health care industry.  This is not going to be fixed with ObamaCare but only made worse.  An example is given by a doctor who says for the last seven years he has been reimbursed $50 for an office visit under Medicare.  In that time his expenses have risen 30%. (Quick check — if the good doctor gives his staff a 4% raise each year for 7 years that comes out, compounded, to about 30%).  Under ObamaCare they are proposing a 21% reduction in Medicare reimbursement, so the doctor will now get a $40 reimbursement for an office visit.  The doctor can do one of two things.  He can stop seeing Medicare patients, or he can charge his other patients more to make up the difference.  If he chooses the latter course of action, then private insurance companies, like Anthem, will have to pay for the increase.  How do they recover their costs?  That’s right by increasing premiums.

Just like you never hear statists blaming government polices of HUD, Fannie Mae, and Freddie Mac for the housing bubble that triggered the financial crisis and recession (it was all those greedy, evil bankers), you won’t hear them mention their policies regarding Medicare as triggering the premium increases.  It was all about greed.  So government will need to step in and make sure those greedy insurance companies cannot increase prices like they have.  So expenses rise, premiums are capped, insurance companies fold, and voila you have a public option, which becomes the only option.  Next to keep expenses from rising, health care will have to be rationed because there are no market mechanisms in ObamaCare to actually reduce costs.  No tort reform.  No elimination of 3rd party payers.  No true insurance that protects against catastrophic costs while you pay for the routine, like all other insurance.  Just government fiat.  Obama can no more order health care costs to decline than he can turn off gravity. 

News flash to people around the world living under socialized medicine who travel to the United States for critical care when they need it, that door will soon be closed.

Who Is Really Stupid?

Statists believe the average American is too stupid to make decisions, or should I say the right decisions, about their lives, health, safety, etc.  We need the really, really smart people in government to tell us what is good for us and follow their instructions.  Or…in November we can send them the message that they were really, really stupid to ignore what the American people were screaming at them, STOP!!!! If Jefferson, Madison, Washington, Adams, Hamilton, et al, thought Americans were smart enough to look out for their own best interests, who are Pelosi, Reid, Waxman, Boxer, Rangel, Schumer, Dodd, et al, to say otherwise?

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.

Two Doctors Operating. A Lawyer, A Bureaucrat, and An Insurance Agent Oversee the Procedure

In the category, be careful what you wish for, Ted Kennedy should be careful about pushing through Universal Health Care reform.  It has been reported that this effort has taken on a sense of urgency because of Mr. Kennedy’s brain cancer.  But what if we already had national health care?

Would Kennedy Receive Treatment?

Ted Kennedy will be 77 on Sunday.  I wish him well.  However in an opinion piece by Betsy McCaughey, she quotes Tom Daschle, who nearly became the architect of health care reform before his tax problems derailed his nomination.

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

In other words, sorry Ted, since any treatment is not likely to significantly prolong your life such that the expense would be justified, no treatment will be paid for.  You will just have to pay it yourself or die.  I guess the good news is that Senator Kennedy, like Senator Dascle, and most of the ruling class who pass these commandments down from Mount Capital Hill, are rich enough to pay for private treatment, if it is allowed by law.  If not, they are rich enough to take a “vacation” to, say, India and while on vacation wander into a facility their for treatment by American trained Indian doctors.

But what about you and me?  Oh dear, you better get your affairs in order.

Health Care Reform You Can Believe In

As long as the treatment received by a patient is paid for by someone other than the patient, the patient really doesn’t care what it costs.  The liberal solution is to have the government take it over, and a bunch of bureaucrats will “act on your/our behalf” and make those decisions.  The outcome of which is that you better stay healthy.  Because if you don’t, you may not get treatment until you wait a very long time for your turn, or you may not get treated at all, if the bureaucrats rule the resultant quality of life is just not worth it.

Here’s what we should really look at doing:

• Get the consumer of health care actively involved. How?  It’s being done today with high deductible health care plans coupled with a Health Savings Accounts.  The insurance company negotiates lower treatment costs and pays them only after a hefty deductible has been paid that year.  The patient is then in a position of shopping for the best health care and deciding on what treatments and tests, in conjunction with their doctor they will or will not have.  The Health Savings Account is where the patient can put funds, pre-tax, and then use those funds to pay the expenses not covered by the insurance.
• Tort Reforms.  Get the Lawyers out of the Examining Room. Too many doctors, in my opinion, are practicing defensive medicine.  They think of every possible test so that if something does not go perfectly with the treatment they won’t get sued for the test they didn’t perform.  Let’s follow the British System — fixed fees for the attorneys instead of a percentage of the settlement, and loser pays.  There are too many cases of people getting a $12 million settlement or judgment for something stupid (think of the woman at McDonalds who spilled coffee in her crotch and sued McDonalds because the coffee was too hot).  In these cases the lawyers typically ask for no money unless they get a settlement and when they do they get 1/3 ($4 million in this example).  It’s like buying a lottery ticket.  Who wouldn’t take a free lottery ticket on a jackpot of millions?  But who really pays for all these law suits and settlements?  That’s right you and me in insurance premiums we cannot afford now.
• Increased Insurance Competition. Right now most insurance is regulated by the states and in many cases policies available in one state are not available in others.  Let’s open up the competition.  If we have more insurance companies competing for our business, we are likely to get better and more creative policy choices.
• More Tailored Insurance Policies If my wife and I are beyond the point of having children, then let me buy a policy that does not cover childbearing, birth control, well baby care.  If I am young and starting out and I want those things, there are other coverages that pertain to older people that I may not want at this stage in my life.  Let’s allowed tailored policies that reflect my actual insurance needs.
• Immigration Control.  The same people who are pushing socialized medicine are, for the most part, the same people who favor open borders.  However, where do all the illegals go for the health care needs including having babies (new citizens)?  They go to the only health care provider they know, the local emergency room.  This is also probably the most expensive form of health care delivery and since they are illegal, they’re not paying for it, the rest of us are.  I think immigrants built this great country and almost each and everyone of us can point to our forebears who came here as immigrants.  I am in favor of immigration now and in the future.  I believe these are hard working and basically good people.  BUT, they have to come here legally and follow the process.  If they are not here legally, they should be deported.
• Medicare Reform.  You probably want to sit down for this one, but shocking as it may seem this massive government programs loses billions upon billions of dollars every year to fraud.  Who pays?  Right!  You and me.  In higher payroll taxes, and in higher health care costs as doctors and hospitals have to make up the shortfall somewhere else to stay in business.

More Liberty Under Fire

The government in proposing universal health care wants to mandate that everyone must have health care coverage.  You will not have the liberty to choose.  The government demands that you comply:

“comprehensive health care legislation should include a requirement that every American carry insurance.”

That’s the requirement, now comes the heavy hand of government:

“The ideas discussed include a proposal to penalize people who fail to comply with the “individual obligation” to have insurance.”

You must obey!  The government has spoken!

Here’s a novel idea.  How about implementing the above points first and fix the broken system that we have before we throw it out and install another new, massive, government program.  After all we can always go to the government solution in the end, confident in the knowledge that these programs work extremely well and efficiently. (e.g., Fannie Mae {bankrupt}, Freddie Mac{bankrupt} , Social Security {bankrupt}, Medicare {bankrupt}, US Postal Service {$6 billion deficit, while CEO get $850,00 salary}).

What Would the Founding Fathers Say?

A Constitution of Government once changed from Freedom, can never be restored.  Liberty, once lost, is lost forever. – John Adams