Sunday, March 28, 2010

ObamaCare; Why America is in Trouble

Healthcare in the US is in trouble. ObamaCare as it now sits will probably bankrupt the United States, without really making quality healthcare more available. ObamaCare has been structured more like fascism than socialism. In this case, Socialism probably would have been better; at least we would have had more available healthcare; that is until the money ran out. Unfortunately, what we ended up was Healthcare through the same Healthcare providers that caused the country to focus on healthcare reform in the first place. Another reason is the Republicans also ignored the problem for 8 years. The American public will now be forced to buy Health Insurance from these same Insurance providers with few price controls and still no competition. It turns out Senate Bill was written by a Insurance provider former vice-president, Elisabeth Fowler, now a council for Sen Baucus, so it’s no wonder many have come to the realization that ObamaCare is a bill that was written by the Insurance providers for the Insurance providers; take ObamaCare, remove the public option, and you have a Healthcare Insurance bailout.

There are many, including myself that believe that, the nature of how Health Insurance evolved, is the basis of the problem. Originally, Health Insurance worked like most Insurance. It was like Auto Insurance, you paid in case you had an accident and the Insurance companies made money because more money was paid in than needed to pay of claims. However, in the 30’s, when single payer first showed it’s head, the Insurance companies took notice that health insurance could be treated more like a business then a relationship between doctor and patient and the HMO was born. “Health Maintenance”, Healthcare Insurance is now the equivalent of an auto maintenance and extended warranty plan. You pay more because the maintenance service is expected, but the warranty company still makes money because again more money is paid in than needed to replace the more expensive major components. That fact is very few auto maintenance plans are purchased because they are prohibitively expensive. The reason is simply, the 60,000 mile maintenance on a Honda Accord can cost over $2000. Because car owners have to pay cash for this, they usually don’t go full boat on vehicle maintenance, knowing periodic oil change and tune up (maybe a timing belt) and the car will usually last over 100,000 miles. So a service maintenance plan usually results in higher maintenance costs overall.

The same goes for Health Insurance. If you only go when it’s necessary and pay cash the price would be less. But Health Insurance hides the real cost of healthcare and as the saying goes, “if something is very free, it has no value” or in this case, if healthcare prices are believed to be the deductible or co-pay, then it’s true value is hidden. Many doctors say they could charge much less, if they didn’t have to deal with insurance or Medicare. The other problem is those who have insurance, pay for those that don’t. In the United States, healthcare is not a right, but it is an obligation, so no one is denied medical care for lack of insurance or money. But, when an un-insured person is treated in a hospital, the hospital needs to charge more for medical care paid for by Insurance to pay for it. Further, since the States regulate Healthcare Insurers, the Insurance companies can not sell popular plans, such as catastrophic medical. The Insurers are also forbidden to sell across state lines, which diminishes competition. Another poison pill is that lack of tort reform. While not a major medical expense ($10 billion), it is another hindrance to the quality of care a doctor can provide, as it is an additional barrier between the doctor and patient.

As I mentioned before, the problem with Singlepayer, or socialized medicine, is socialism has no mechanism for generating capital, beyond taxing the public. What has become apparent in every singlepayer system in the world, is the cost of socialized medicine’s never stops increasing and without restrictions leads to tax rates that are so high that business can not survive and/or the country will become insolvent. The answer to this is rationing care, known in ObamaCare as Comparative Medicine. The reason Comparative Medicine does not appear in the ObamaCare bill recently signed into law by President Obama, is it was signed in earlier as an attachment to the stimulus bill. Like Britain’s N.I.C.E, Comparative Medicine is Health Care based on a cost analysis pitting cost against effectiveness and age. NIH Chairman, Ezekiel Emanuel writes, When implemented, the "complete lives" system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated”. In other words, if a costly procedure will not result in a significant extension of life, it will be refused and according to the most recent HealthCare bill (now law), the Comparative Effectiveness Panel’s decision is final and un-appealable.

One of the most cherished and repeated lines from the Declaration of Independence is, We hold these truths to be self-evident that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. The concept that is most misinterpreted is “the pursuit of Happiness”. When Thomas Jefferson wrote these words, he was borrowing the heavily from the English Philosopher, John Locke’s writings such as, "no one ought to harm another in his life, health, liberty, or possessions”. The concept of the “pursuit of happiness”, does not obligate the State to do anything, but mandates the State get out of the way and not hinder the right of man to improve his station in life. As I said before, Healthcare is not a right, because a right, according to our founding fathers come from god, Healthcare is rather an obligation of the State, but unlike a right, can be given or taken away by the whim of the State. What really needs to be looked at is how this obligation can be fulfilled without standing in the way of the American people. In my next blog I will discuss some options.

Sunday, March 21, 2010

The House Delivers Healthcare to the Insurance Companies

There is a misdirection of Obamacare that almost no one has discussed. While the President has done much to demonize the Private Healthcare insurance industry, strangely there has been nary a peep from them in response. The only backlash has been from Medicare Advantage providers who are looking at a $500 billion cut in patient benefits. Although President Obama and the Democrats continually read letters from the victims of Private Healthcare providers, whom the say needlessly remove tonsils and cuts off feet for big profits, endlessly raise rates and deny coverage, the Healthcare insurance industry remains mute. Something here doesn't make sense. What is starting to come to light, is there was never any intention for congress to pass the public option. However, government mandatory health insurance has remained on the table. Then, when Healthcare seemed doomed after Scott Brown was voted into the Senate and the Senate lost their super majority, something of unimaginable stupidity occurred; or not. During this time, when the state of Healthcare was teetering on the precipice, Anthem Blue Cross increased some of it's policies in California by a whopping 39%. Here, when the Healthcare bill was as good as dead, Blue Cross kneels down, gives Healthcare CPR and brings it back to life; this was only unimaginably stupid if it was not the desired result. The only logical conclusion, is along with President Obama's back room deal with Big Pharama, there is also a deal with the Private Healthcare providers; that Obamacare will mandate health insurance to Private Healthcare Providers. Therefore all Americans will soon be directed by law, to buy health insurance from private health insurance companies. So, as the President maligns Private Healthcare as Satin's spawn, Private Healthcare will be crying all the way to the bank.

This is not an idea formulated in my brain, this is a statement from Rep Dennis Kucinich (D-OH) after he voted no on the first House bill,

“But instead of working toward the elimination of for-profit insurance, H.R. 3962 would put the government in the role of accelerating the privatization of health care. In H.R. 3962, the government is requiring at least 21 million Americans to buy private health insurance from the very industry that causes costs to be so high, which will result in at least $70 billion in new annual revenue, much of which is coming from taxpayers. This inevitably will lead to even more costs, more subsidies, and higher profits for insurance companies — a bailout under a blue cross

Further Howard Dean, former Democratic National Committee Chairman said,

This is a bigger bailout for the insurance industry than AIG...A very small number of people are going to get any insurance at all, until 2014, if the bill works...This is an insurance company's dream.."

Even more to the point, the Senate bill (aka the Baucus Biil, for Senator Max Baucus) was a response to the House bill and eliminated the Public Option. One of the bills authors is a senior counsel to Sen Baucus by the name of Liz Fowler. Fowler is an ex VP for Wellpoint, an umbrella company for many Healthcare Insurers. Fowler has also been one of the loudest critics of the public option. The public option turned out to be a double sided sword. While the Republicans rightfully decried the public option as unfair competition to private insurance, without the public option and without ending the prohibition of buying across state lines, there is still the mandate to buy insurance, but with no competition whatsoever.

Now that Senate bill has passed, I'll bet you think you'll get something after all this worry. But as Dean said, your not going to get much until at least 2014, but we will pay the $50 billion a year in new taxes and Medicare will be cut by another $50 billion a year. Further the 32 million without Healthcare insurance will not get any relief until 2018. Three of the immediate provisions are the removal of caps on lifetime benefits, an end to arbitrary cancelling of policies and a band-aid addressing pre-existing conditions. Of these three, being turned down for coverage for pre-existing conditions effects the most; but you won't be able to choose the plan you want. The government is going to create a pool of so-called high risk citizens with pre-existing conditions (ala assigned risk) for $5 billion. You will then end up with whatever plan is being offered, at whatever the Insurance Company wants to charge and have to live with it. Pre-existing conditions will not really be covered until the Healthcare providers are compensated with a mandated 20% increase in clients, most of whom will be low risk, healthy young adults. Does that sound like a plan you would want to block if you were a Healthcare insurer? We will have to pay 10 years of taxes for 6 years of Healthcare. And you have to wonder what Congress is going to do with the first 4 years of taxes collected; hopefully they'll put it in a lock box and not borrow against it. I would also like to go for a ride in a alien space ship before I die, but I don't put much stock in that either.

Wednesday, March 3, 2010

Letter to the Editor on Obamacare

What Are the Democrats Thinking?

When it comes to Obamacare, you have to wonder, what are the Democrats thinking? Obamacare is clearly unpopular, but Nancy Pelosi and Harry Reid seem stuck in ramming it through. Conventional wisdom says they have no choice. With nothing to show for a years work, they have to produce something, even if it is the most hated bill in memory. Another reason Democrats refuse to admit defeat, seems best summed up by NPR's Juan Williams, "they will love it after they get used to it... after all, Americans love entitlements". He bases this belief on polls that show, if you break down Obamacare, most Americans like some of the components it has to offer. I don't think this is in dispute; the issue has always been, what form Obamacare is going to take, and "Can we afford it right now?" Most Americans want healthcare reform, but not as an entitlement and/or under the control of Washington. Most Americans work for what they get and don't need Washington upping their taxes, just so they can return a portion back as a so called entitlement. Even using Williams logic, it will not save the Democrats if they push through Obamacare. Apparently he forgets that the billions in new taxes and Medicare cuts will start immediately, but none of the so-called entitlements will start for three years! That's right, for three long years there will be tax and no spend on healthcare. But don't worry, Cap and Trade is already in the Presidents 2011 budget, where he expects to tax America for an additional $650 billion over the next ten years. I can hardly wait.