Obama's Little Engine That CouldLet's get one thing straight from the beginning: America's health care is too expensive, too over-utilized, uneven in delivering a quality product, and too damned dependent on the Federal government for over half of it's revenues and, for most of the rest, the business community continuing to provid health insurance as a benefit to their employees.
Moreover, many people are left without access to health care insurance through their own neglect, either by failing to enroll their children, who would otherwise be covered by Children's Healthcare programs in existence, and recently extended by the CHIPS program extension in the Stimulus package and in various add-0n features of the flurry of bills passed in the first one-hundred days of the Obama presidency. Yes, there are people who can not afford health insurance and are not provided health insurance through their employer or do not meet current thresholds for assistance, "the working poor". There are also people who could afford health insurance but decline to allocate the money to buy it.
Included in the group of un-insured is the demographic age group spanning the 18 year olds to 35 year olds, who often eschew health insurance. Of course there are a multitude of illegal aliens who are without health insurance, in spite of have employment, that daily tax the health care providers with unpaid bills. There are older adults who choose not to buy health insurance that add to the number of people who are un-insured.
That a nation as rich as America can not figure out how to assure every citizen has the opportunity to be insured against the risk of disease speaks more to the will of a nation than the ability of that nation. It also audibly cries out the need for honesty in the debate.
The populists politicians sound convincing as the assess the blame for this sorry state of affairs. It is the rich corporations who pass on to much cost to the employees and paternally dole out health care benefits at an alarming increase in cost to their employees, all for the sake of profit for their rich shareholders. Big Health insurers are blamed for being profiteers. Opposition parties are cast as fear mongers and "mobs" when they loudly rally to protect the health insurance they have from falling into government hands. "The party of 'no', is the rallying cry of those pushing for radical reform.
Few would argue against a serious attempt to improve access to health care, to make it more inclusive, to be less expensive for the insurer, the sponsor, and the insured, for "cost" are different for each stakeholder. Imperfect terms lead to imperfect interpretations. One man's cost (the insurance company or the government's cost) becomes another's benefit. If we move to reduce the cost of services covered by the government or the insurance company, it has to be taken out of someone's hide. In the case of the insurance company, it means either less service covered for the beneficiary or more out-of-pocket costs to the beneficiary. Simple!
In the case of the government's drive to reduce its costs, similar effects occur: services are reduced for beneficiries (as often happens when States experiencing cost overruns in their State Medicaid programs) or when the cost of Part B benefits increase for those enrolled in Part B under Medicare to offset the annual inflationary costs of the Medicare program. Who pays? Not the Federal Government. It is the beneficiary who pays, either in more dollar costs or in reduced covered service. In either case, the beneficiary either pays or defers service. Then there are those who take the service and leave the providers with bad debts, in which case it raises the cost to the provider, burned by the bad debt. Somebody pays and it is usually the beneficiary and the trade off is in dollars or in reduced benefits. There is no free lunch.
The liberals want government heath care and are glad to spend anyones money ecept their own to achieve this goal. The conservative like the status quo, private enterprise approach filled with incentive to make the right decision (what ever the right decision is) and take responsibility for one's own health care decisions. Now this make a lot of sense! Let people, ill equiped to make life or death decisions with little to no support but the internet and the Pharmacy industry advertisments on there favorite soap oprea. Now that is improvement!
Both major parties insist that it is possible to provide low cost, high quality health care to all regardless of financial or health status. (We usually are warned, "If it sounds to good to be true, it probably isn't). We are asked by both parties to suspend disbelief. The liberals want radical reform atany cost and ditch the existing system as a failed system. The conservatives want to find cost-savings, but take serious cost savings off the table. Neither party is willing to be honest with the American public.
During the aftermath of the recent financial meltdown and busting of the housing and credit bubbles, the politicians began to assess blame. First on the target, big business, big banks, and greedy executives. Having assigned the blame, their job was to come up with a solution: assign the government the job of preventing the abuses they identified, seek penalties against the perpetrators, raise taxes and impose restrictions on executive compensation. In short, re-regulate, for the Government is the only entity that can assure competency. We are to believe that these steps, imposed on the engines of growth, would have no unintended consequences. That there would not be a cost to somebody in all these actions. that banks would not figure out how to charge higher costs to offset punitive aspects of the government's drive to prevent financial meltdowns. They want us to believe that you can lower cost and not effect the quality of financial services.
What is scary, they want the same wrong-minded thinking applied to the one thing that trumps financial self interest, the health insurance system that pays our health care costs so we do not have to worry. Was the government successful in managing Fannie Mae and Freddie Mac. How about our perpetually bankrupt US Postal Service? Is the VA well managed, how much waste do they experience annually as a result of Congressional tampering? Are we getting our moneys worth out of all the Amtrak subsidies? Were is the return for all the taxpayer money invested in AIG? Can you think of one governmental program that would give you comfort that the Government can get health care right?
Well, they know better than that. All that talk from Obama and his White House advisers about squeezing the excess out of Medicare, eliminating the abusive practices of doctors and hospitals, ending fraud, and reducing the costs of Medicare and Medicaid to a sustainable level is just talk. Remember during the Obama campaign, we heard Obama say, in response to points driven home by the challengers, "these are words, just words". We now know what that means. The program laid out are "words, just words" lacking any substance and merely to move the populist notions ahead to a naive body of listeners ready to drink the "next kool-aid" of Obama thoughts.
Of cousre, the Republican party is no better at coming up with hyperbole. What they lack is any measure of a plan. Obama has words as his plan, since he delegated the process to Congress and has remained aloof in it drafting. Read that, provided no leadership. Republicans have only one word, "no". Like a two-year old going through the "terrible twos", they cry out "no". They have nothing else. No plan to improve access, cost, and assure quality. The Republican National Committee only today announced the "senior's health bill of rights". As usual, the tone-deaf body is proposing to be opposed to any move to trim Medicare spending or limit end-of-life care.
Nice move, Mr Steele! You too, like Obama and Congress, have taken any serious attempt to reduce the cost of the Medicare program off the table. You and the Obamaniks must still believe everything keeps rising, housing prices, the stock market, and your poll numbers. Do you believe in the tooth fairy? Why, Obama has even cozied up to the special interest groups (Big Pharma, Hospitals, and Doctor lobbyists) and cut deals that are meaningless to cost saving (the savings woud come anyway, Obama just put a floor on the damage at a pittance of what could be saved under existing law). Why, to get there vote, to enlist them in his campaign to shove a costly health reform plan down the throats of an unwilling public.
We have heard the clear message from a majority of Americans. They don't like the snake oil Obama is selling. They want to know the truth. They want a debate, not a freight train, Yet, Obama and the Obamanik elites want to dismiss the voices of the rabble as the bable of a mob. Un-American mobsters to boot.
Yet, we have the Obamaniks and Congress hell-bent on pushing health care reform, including a public option (the White house handlers have banned the real term Government option). They believe that Choice and Control (they have also banned the use of the real term Competition when describing their plan). The plan they envisage will result in Quality, affordable healt care (The White House has also banned the true description "Universal coverage).
You get the drift? Words, just words used to manipulate the debate and keep the naive public in the dark by choosing words that the public likes and confirmed by focus groups and polls of words that describe the plan, well chosen words to obfuscate, manipulate and deceive. But don't worry, our friends at the loyal Republican opposition have their own obfuscating words. "Patient-centered health care" is substituted for "Private/free-market health care", "health care is seriously toubled and needs serious reform" is used instead of "health care is a good system but still needs tweaks". The list goes on and anyone interested can read more about this on the Wall Street Journal Part A article entitled "Obama Allies Find Words Fail Them". Health care reform by the polls, now that is change we can believe in!
When you think about a government designed program for health care reform, we should all keep in mind these simple phrases: Amtrak, Fannie Mae/Freddie Mac, AIG, USPS. Each a creation of government planning gone wrong. Each a financial disaster. Can we trust them with 17 % of our GDP? With out more conscientious debate, more open and honest dialog with the American public, we are on a collision course for a major train wreck with 17% of our GDP and trillions of dollars in deficits you and me, the taxpayers, will have to pay. That would eliminate most of the artificial savings targeted by the current plan, not to mention the increase tax that a growing number of Americans will pay to adopt a poorly thought out plan.
We must insist on a careful and thoughtful debate. We need to assess the health care system in its entirety. Do we wreck a system that is working for 85 % of the people in order to solve the problems of access for a yet undetermined number of un and under insured people. What do we do to strengthen the existing health care insurance system, make it affordable, lower costs, and improve quality outcomes that would fund the access for those who need a hand in buying health insurance and mandating those who can afford insurance, but chose not to buy it. Can this be done by providing incentives, negative or positive, that incorporates the many Democratic and Republican ideas being offered, but ignored by the Obamaniks.
Can we face the need to rein in health care costs to make the system affordable and turn a deaf ear to the lobbyists? Can we understand that this will have to be a shared sacrifice by all, not just a taxing exercising aimed at the rich?
With a more open debate, an informed public, and a slower pace, yes we can achieve change. Yes we can achieve improvements. But we can not tax our future generations and leave them with trillions of dollars of debt in the name of progressive (liberal) ideology. We can not accept the status quo in the name of conservative ideology. the answer is always at the mean.
At the entrance to Zhong He Dian at the Forbidden Palace, Beijing, is an inscription written by Emperor Qianlong. It reads, "the Way to Heaven is profound and mysterious and the way of mankind is difficut. Only if we make a precise and unified plan and follow the doctrine of the mean, can we rule the country well". This was written around 1627. It is a lesson our leaders would be wise to follow. For surely, as we hear the rhetoric from the liberals on the fringe of American society, a couse of action that bypasses customary legislative protocal in an attempt to ram through radical reform, is surely a road to a train wreck. If the Obama administration truely wants to govern well, they are heading on the wrong track to nowhere. The American people know that. Hopefully they will learn that, too.
Moreover, many people are left without access to health care insurance through their own neglect, either by failing to enroll their children, who would otherwise be covered by Children's Healthcare programs in existence, and recently extended by the CHIPS program extension in the Stimulus package and in various add-0n features of the flurry of bills passed in the first one-hundred days of the Obama presidency. Yes, there are people who can not afford health insurance and are not provided health insurance through their employer or do not meet current thresholds for assistance, "the working poor". There are also people who could afford health insurance but decline to allocate the money to buy it.
Included in the group of un-insured is the demographic age group spanning the 18 year olds to 35 year olds, who often eschew health insurance. Of course there are a multitude of illegal aliens who are without health insurance, in spite of have employment, that daily tax the health care providers with unpaid bills. There are older adults who choose not to buy health insurance that add to the number of people who are un-insured.
That a nation as rich as America can not figure out how to assure every citizen has the opportunity to be insured against the risk of disease speaks more to the will of a nation than the ability of that nation. It also audibly cries out the need for honesty in the debate.
The populists politicians sound convincing as the assess the blame for this sorry state of affairs. It is the rich corporations who pass on to much cost to the employees and paternally dole out health care benefits at an alarming increase in cost to their employees, all for the sake of profit for their rich shareholders. Big Health insurers are blamed for being profiteers. Opposition parties are cast as fear mongers and "mobs" when they loudly rally to protect the health insurance they have from falling into government hands. "The party of 'no', is the rallying cry of those pushing for radical reform.
Few would argue against a serious attempt to improve access to health care, to make it more inclusive, to be less expensive for the insurer, the sponsor, and the insured, for "cost" are different for each stakeholder. Imperfect terms lead to imperfect interpretations. One man's cost (the insurance company or the government's cost) becomes another's benefit. If we move to reduce the cost of services covered by the government or the insurance company, it has to be taken out of someone's hide. In the case of the insurance company, it means either less service covered for the beneficiary or more out-of-pocket costs to the beneficiary. Simple!
In the case of the government's drive to reduce its costs, similar effects occur: services are reduced for beneficiries (as often happens when States experiencing cost overruns in their State Medicaid programs) or when the cost of Part B benefits increase for those enrolled in Part B under Medicare to offset the annual inflationary costs of the Medicare program. Who pays? Not the Federal Government. It is the beneficiary who pays, either in more dollar costs or in reduced covered service. In either case, the beneficiary either pays or defers service. Then there are those who take the service and leave the providers with bad debts, in which case it raises the cost to the provider, burned by the bad debt. Somebody pays and it is usually the beneficiary and the trade off is in dollars or in reduced benefits. There is no free lunch.
The liberals want government heath care and are glad to spend anyones money ecept their own to achieve this goal. The conservative like the status quo, private enterprise approach filled with incentive to make the right decision (what ever the right decision is) and take responsibility for one's own health care decisions. Now this make a lot of sense! Let people, ill equiped to make life or death decisions with little to no support but the internet and the Pharmacy industry advertisments on there favorite soap oprea. Now that is improvement!
Both major parties insist that it is possible to provide low cost, high quality health care to all regardless of financial or health status. (We usually are warned, "If it sounds to good to be true, it probably isn't). We are asked by both parties to suspend disbelief. The liberals want radical reform atany cost and ditch the existing system as a failed system. The conservatives want to find cost-savings, but take serious cost savings off the table. Neither party is willing to be honest with the American public.
During the aftermath of the recent financial meltdown and busting of the housing and credit bubbles, the politicians began to assess blame. First on the target, big business, big banks, and greedy executives. Having assigned the blame, their job was to come up with a solution: assign the government the job of preventing the abuses they identified, seek penalties against the perpetrators, raise taxes and impose restrictions on executive compensation. In short, re-regulate, for the Government is the only entity that can assure competency. We are to believe that these steps, imposed on the engines of growth, would have no unintended consequences. That there would not be a cost to somebody in all these actions. that banks would not figure out how to charge higher costs to offset punitive aspects of the government's drive to prevent financial meltdowns. They want us to believe that you can lower cost and not effect the quality of financial services.
What is scary, they want the same wrong-minded thinking applied to the one thing that trumps financial self interest, the health insurance system that pays our health care costs so we do not have to worry. Was the government successful in managing Fannie Mae and Freddie Mac. How about our perpetually bankrupt US Postal Service? Is the VA well managed, how much waste do they experience annually as a result of Congressional tampering? Are we getting our moneys worth out of all the Amtrak subsidies? Were is the return for all the taxpayer money invested in AIG? Can you think of one governmental program that would give you comfort that the Government can get health care right?
Well, they know better than that. All that talk from Obama and his White House advisers about squeezing the excess out of Medicare, eliminating the abusive practices of doctors and hospitals, ending fraud, and reducing the costs of Medicare and Medicaid to a sustainable level is just talk. Remember during the Obama campaign, we heard Obama say, in response to points driven home by the challengers, "these are words, just words". We now know what that means. The program laid out are "words, just words" lacking any substance and merely to move the populist notions ahead to a naive body of listeners ready to drink the "next kool-aid" of Obama thoughts.
Of cousre, the Republican party is no better at coming up with hyperbole. What they lack is any measure of a plan. Obama has words as his plan, since he delegated the process to Congress and has remained aloof in it drafting. Read that, provided no leadership. Republicans have only one word, "no". Like a two-year old going through the "terrible twos", they cry out "no". They have nothing else. No plan to improve access, cost, and assure quality. The Republican National Committee only today announced the "senior's health bill of rights". As usual, the tone-deaf body is proposing to be opposed to any move to trim Medicare spending or limit end-of-life care.
Nice move, Mr Steele! You too, like Obama and Congress, have taken any serious attempt to reduce the cost of the Medicare program off the table. You and the Obamaniks must still believe everything keeps rising, housing prices, the stock market, and your poll numbers. Do you believe in the tooth fairy? Why, Obama has even cozied up to the special interest groups (Big Pharma, Hospitals, and Doctor lobbyists) and cut deals that are meaningless to cost saving (the savings woud come anyway, Obama just put a floor on the damage at a pittance of what could be saved under existing law). Why, to get there vote, to enlist them in his campaign to shove a costly health reform plan down the throats of an unwilling public.
We have heard the clear message from a majority of Americans. They don't like the snake oil Obama is selling. They want to know the truth. They want a debate, not a freight train, Yet, Obama and the Obamanik elites want to dismiss the voices of the rabble as the bable of a mob. Un-American mobsters to boot.
Yet, we have the Obamaniks and Congress hell-bent on pushing health care reform, including a public option (the White house handlers have banned the real term Government option). They believe that Choice and Control (they have also banned the use of the real term Competition when describing their plan). The plan they envisage will result in Quality, affordable healt care (The White House has also banned the true description "Universal coverage).
You get the drift? Words, just words used to manipulate the debate and keep the naive public in the dark by choosing words that the public likes and confirmed by focus groups and polls of words that describe the plan, well chosen words to obfuscate, manipulate and deceive. But don't worry, our friends at the loyal Republican opposition have their own obfuscating words. "Patient-centered health care" is substituted for "Private/free-market health care", "health care is seriously toubled and needs serious reform" is used instead of "health care is a good system but still needs tweaks". The list goes on and anyone interested can read more about this on the Wall Street Journal Part A article entitled "Obama Allies Find Words Fail Them". Health care reform by the polls, now that is change we can believe in!
When you think about a government designed program for health care reform, we should all keep in mind these simple phrases: Amtrak, Fannie Mae/Freddie Mac, AIG, USPS. Each a creation of government planning gone wrong. Each a financial disaster. Can we trust them with 17 % of our GDP? With out more conscientious debate, more open and honest dialog with the American public, we are on a collision course for a major train wreck with 17% of our GDP and trillions of dollars in deficits you and me, the taxpayers, will have to pay. That would eliminate most of the artificial savings targeted by the current plan, not to mention the increase tax that a growing number of Americans will pay to adopt a poorly thought out plan.
We must insist on a careful and thoughtful debate. We need to assess the health care system in its entirety. Do we wreck a system that is working for 85 % of the people in order to solve the problems of access for a yet undetermined number of un and under insured people. What do we do to strengthen the existing health care insurance system, make it affordable, lower costs, and improve quality outcomes that would fund the access for those who need a hand in buying health insurance and mandating those who can afford insurance, but chose not to buy it. Can this be done by providing incentives, negative or positive, that incorporates the many Democratic and Republican ideas being offered, but ignored by the Obamaniks.
Can we face the need to rein in health care costs to make the system affordable and turn a deaf ear to the lobbyists? Can we understand that this will have to be a shared sacrifice by all, not just a taxing exercising aimed at the rich?
With a more open debate, an informed public, and a slower pace, yes we can achieve change. Yes we can achieve improvements. But we can not tax our future generations and leave them with trillions of dollars of debt in the name of progressive (liberal) ideology. We can not accept the status quo in the name of conservative ideology. the answer is always at the mean.
At the entrance to Zhong He Dian at the Forbidden Palace, Beijing, is an inscription written by Emperor Qianlong. It reads, "the Way to Heaven is profound and mysterious and the way of mankind is difficut. Only if we make a precise and unified plan and follow the doctrine of the mean, can we rule the country well". This was written around 1627. It is a lesson our leaders would be wise to follow. For surely, as we hear the rhetoric from the liberals on the fringe of American society, a couse of action that bypasses customary legislative protocal in an attempt to ram through radical reform, is surely a road to a train wreck. If the Obama administration truely wants to govern well, they are heading on the wrong track to nowhere. The American people know that. Hopefully they will learn that, too.
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