Common Sense & An Open Mind

Advocating freedom of thought

  • Stay updated!

  • Quote

    "You must lay aside all prejudice on both sides, and neither believe nor reject anything, because any other persons, or description of persons, have rejected or believed it. Your own reason is the only oracle given you by heaven, and you are answerable, not for the rightness, but uprightness of the decision." T. Jefferson

Archive for the ‘Health care’ Category

A dangerous precedent

Posted by Free to Think on June 29, 2012

Today’s Supreme Court ruling on Obama’s mandated healthcare program has left me shocked and speechless. As stated by the Institute of Justice, “the Supreme Court has failed in its most basic duty,” abdicating  “its responsibility to enforce constitutional limits on government power.”

Possibly the saddest part about the willingness of Americans to relinquish their freedom and to expand our government is that it will not even achieve their intended goals. Our government has a 0% record of ever reining in the costs of anything, or ever creating a program with long-term economic sustainability.

 

Posted in curtailing freedom, Debt, Detrimental policies, Health care, Intrusive government, obama, Politics, supreme court, taxes | Tagged: , , , , | Leave a Comment »

A Compulsory Contract is an Oxymoron

Posted by Free to Think on March 28, 2012

I apologize for not having an opportunity to write my own pieces lately, but I do have a backlog of excellent articles that I feel are important to share. Here is one by George Will that sums up the problem with “Universal Healthcare” well.

 
Obamacare’s contract problem
By George F. Will, Published: March 25

On Monday the Supreme Court begins three days of oral arguments concerning possible — actually, probable and various — constitutional infirmities in Obamacare. The justices have received many amicus briefs, one of which merits special attention because of the elegant scholarship and logic with which it addresses an issue that has not been as central to the debate as it should be.

Hitherto, most attention has been given to whether Congress, under its constitutional power to regulate interstate commerce, may coerce individuals into engaging in commerce by buying health insurance. Now the Institute for Justice (IJ), a libertarian public interest law firm, has focused on this fact: The individual mandate is incompatible with centuries of contract law. This is so because a compulsory contract is an oxymoron.

The brief, the primary authors of which are the IJ’s Elizabeth Price Foley and Steve Simpson, says that Obamacare is the first time Congress has used its power to regulate commerce to produce a law “from which there is no escape.” And “coercing commercial transactions” — compelling individuals to sign contracts with insurance companies — “is antithetical to the foundational principle of mutual assent that permeated the common law of contracts at the time of the founding and continues to do so today.”

In 1799, South Carolina’s highest court held: “So cautiously does the law watch over all contracts, that it will not permit any to be binding but such as are made by persons perfectly free, and at full liberty to make or refuse such contracts. . . . Contracts to be binding must not be made under any restraint or fear of their persons, otherwise they are void.” Throughout the life of this nation it has been understood that for a contract to be valid, the parties to it must mutually assent to its terms — without duress.

In addition to duress, contracts are voidable for reasons of fraud upon, or the mistake or incapacity of, a party to the contract. This underscores the centrality of the concept of meaningful consent in contract law. To be meaningful, consent must be informed and must not be coerced. Under Obamacare, the government will compel individuals to enter into contractual relations with insurance companies under threat of penalty.

Also, the Supreme Court in Commerce Clause cases has repeatedly recognized, and Congress has never before ignored, the difference between the regulation and the coercion of commerce. And in its 10th Amendment cases (“The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people”), the court has specifically forbidden government to compel contracts.

In 1992, the court held unconstitutional a law compelling states to “take title to” radioactive waste. The court said this would be indistinguishable from “a congressionally compelled subsidy from state governments” to those who produced the radioactive waste. Such commandeering of states is, the court held, incompatible with federalism.

The IJ argues: The 10th Amendment forbids Congress from exercising its commerce power to compel states to enter into contractual relations by effectively forcing states to “buy” radioactive waste. Hence “the power to regulate commerce does not include the power to compel a party to take title to goods or services against its will.” And if it is beyond Congress’s power to commandeer the states by compelling them to enter into contracts, it must likewise be beyond Congress’s power to commandeer individuals by requiring them to purchase insurance. Again, the 10th Amendment declares that any powers not given to the federal government are reserved to the states or to the people.

Furthermore, although the Constitution permits Congress to make laws “necessary and proper” for executing its enumerated powers, such as the power to regulate interstate commerce, it cannot, IJ argues, be proper to exercise that regulatory power in ways that eviscerate “the very essence of legally binding contracts.” Under Obamacare, Congress asserted the improper power to compel commercial contracts. It did so on the spurious ground that this power is necessary to solve a problem Congress created when, by forbidding insurance companies to deny coverage to individuals because of preexisting conditions, it produced the problem of “adverse selection” — people not buying insurance until they need medical care.

The IJ correctly says that if the court were to ratify Congress’s disregard for settled contract law, Congress’s “power to compel contractual relations would have no logical stopping point.” Which is why this case is the last exit ramp on the road to unlimited government.
© The Washington Post Company

Posted in constitutional rights, Detrimental policies, Health care, Intrusive government, obama, Politics | Tagged: , , , , , | 1 Comment »

Quick…change something!

Posted by Free to Think on March 25, 2010

I’d like to address a reply that I received regarding my last post, because I think a lot of people probably have similar thoughts.  I’ll break his comments down into two parts.

Comparative health

‘Bryan’ wrote: “You said you agreed with the statement by Dick Armey who said the president’s plan will “destroy the most creative, innovative health care system in the world.” As a biological engineer, I can certainly agree that we have some of the most innovative medicine in the world, but this is different from a health care system. From a results standpoint I’d say our health care system is rather ineffective. We pay more money on health care per capita than just about everyone, and to what ends? Are we more healthy than other modern countries? If one compares the standard metrics of life expectancy, disease morbidity, etc., it doesn’t seem so.”

Americans ask a lot of their health care system. We want knee replacement surgery so we can still play golf, we want to be treated for infertility, sexual dysfunction, acne and other quality of life problems. We want no stone left unturned when faced with life-threatening illnesses. We want to keep our elderly loved ones cared for and comfortable as long as possible. We want insurance to pay for it and we don’t want to think about what it costs. I’m not making a judgment call on this, I’m just pointing out the facts.

It’s tough for statistics to compare ‘quality of life’ health between countries. And statistics can be slippery. Life expectancy is also affected by personal choice, which is not a factor in health care quality.  Obesity rates in the US are among the highest in developed countries, which can lead to many health problems and early death. In addition, if you remove the homicide rate and motor vehicle death rate from life expectancy statistics, US citizens have a longer life expectancy than any other country on earth.  For more on this read this very informative article.

Another example of misleading statistics is our high infant mortality rate. But when you do the research, you find that the vast majority of American babies that die are very premature. And most of the time premature birth fit into two categories:

1) babies of unhealthy women in poverty (obese, cigarette smokers, no prenatal care.) In its infinite wisdom, the Medicaid program often does not cover prenatal screening.

2) Besides that, it is primarily high-risk pregnancies that end in premature birth. The US is a leader in fertility treatment. According to a 2006 Institute of Medicine report, the numbers of women using assistive reproductive technology doubled from 1996 to 2002. Women who may not be able to get pregnant at all in other countries, such as older women and women suffering from complications like endometriosis, do conceive here. But their pregnancies are much more likely to end in pre-term deliveries.

I just read an interesting article that speaks of another quandary. Amanda Bennett writes about her husband’s last 24 months of life fighting cancer. After kidney surgery bought him 5 years of healthy remission, his cancer metastasized. When asked what to do, of course they chose action. The insurance company and her family paid over $410,000 for drugs and treatments for those final two years, with no definitive proof as to whether any of it actually prolonged his life. In retrospect she agonizes over that cost, especially considering his suffering at the end. Yes, this ratchets up the price of insurance for us all, but there is no easy answer here. Who’s to say where we draw the line? Obama has not, and of course cannot, offer his opinion on tough choices like this.

Government fixing health care

Bryan also writes, “Personally I think this is more a state’s issue than it is a federal one. If it does pass, I expect there to be a lot of fat in it. However, I think it’s true to say our current health care system is very very broken. Reform needs to happen…somehow.”

Firstly, yes you are correct. As defined by the 10th amendment, powers not granted to the national government nor prohibited to the states by the Constitution of the United States are reserved to the states or the people. Health care is not within the jurisdiction of the federal government. But constitutional restraints haven’t stopped them before. As I mentioned in my last post, I believe it’s now up to the states to defend their rights.

I happened to see a quote today by Albert Einstein. He said that “insanity was doing the same thing over and over again and expecting different results.”

I thought this was a perfect summation of the situation at hand. I agree with Bryan that the health care system is flawed. But from a purely logical standpoint, it makes no sense to believe that handing it over to the government will do anything but create more problems. The government’s track record definitively demonstrates that they cannot solve economic or societal problems. The issues with health care are business problems, and politicians are lousy businessmen. Medicare is broke. So is Medicaid and the Post Office. Social Security, which was supposed to be self-supporting, perpetually sustainable program, has become a giant ponzi scheme. The military is known for spending thousands of dollars for a single screwdriver. As a matter of fact, I challenge anyone to point to a single government-run business that’s managed efficiently and economically. We’re talking about the same people who didn’t know that the lending policies they were endorsing would lead to the housing bubble.

Yet some Americans continue to have blind faith that the government has the answer now. Many of us have been convinced that we have to do “something…somehow.” So we have just passed a 2,700 page law that takes control of the lives of Americans in a completely unprecedented manner. There was no time for Congress to read or review the 11th hour changes that were made to the bill, let alone get public opinion. No one is quite sure what’s in it, how much it will cost or how anyone will be affected.

A smiling House Speaker Nancy Pelosi explains to us, “We have to pass the bill so that you can find out what is in it, away from the fog of controversy.” To me this is scarier than anything I ever read by Orwell.

The bill passed by a slim 219-212 only after months of arm-twisting and insertions of pork-barrel bribes to Democratic dissenters. Contentious debate continues among the people.

Is it safe to say that we rushed into this in a less than responsible manner? What was the mad urgency to pass the bill before Obama sprinted off to Asia? “This is what change looks like,” the White House website jubilantly declared when the bill finally passed this week. Oh I see. Pushing this bill into law proves that Obama lived up to his campaign slogan. That certainly trumps widespread support or time for adequate debate. To be fair, all Obama did promise was change, not necessarily positive or conscientious change.

An interview with Obama demonstrates how frustratingly difficult it is to get straight answers from the President. Obama alleges that Congressmen who don’t vote for his bill are satisfied with the status quo and don’t want change. But he knows that Republican and even some Democratic members of Congress are advocating free market solutions, which Obama doesn’t want to even consider. What I think we need to see is Obama explaining why his strategy will work better than theirs with specific and concrete details. But as this interview illustrates, he himself is not clear on everything that’s in this new law. But you can read about some of the terrifying implications here.

I should also point out that the socialized programs of other industrialized nations offer good care but are currently bankrupting their countries. They too are seeking to alleviate strangling health care costs.

What must be addressed

The problem is, no matter who puts the bandaid on the wound, the infection will continue to worsen until the cause of the ailment is treated (an appropriate analogy, eh?). Why will astronomical prices go down just because the “government” (i.e. the taxpayer) is footing the bill? The answer is: it won’t.

So why DO Americans spend more per capita on healthcare than the rest of the world?

As I’ve talked about in earlier posts, the way the system works now, there is no incentive to lower costs.

The best analogy I’ve seen was in a 20/20 television segment comparing health care to food. If we all bought food insurance to pay for our food, then went shopping with our insurance card and our $20 co-pay, would anyone bother to check the prices? No, we’d simply buy the fancy prepared meals and the filet mignon. We’d buy a little extra to be on the safe side even if it meant throwing out what we didn’t use. Why not? The effect would be that food costs per capita would go up.

When we go to the doctor for a routine problem and he orders a battery of tests, we don’t ask what those tests cost. Often the doctor himself doesn’t know, nor does he care. Ordering a CAT scan, or physical therapy for an injury, or an appointment with a specialist to confirm that it’s nothing serious, costs him nothing. In our litigious society, doctors want to take no changes, even when they know that extra treatments are probably unnecessary. One lawsuit could ruin their practice. You may say that this keeps doctors on their toes and very thorough, but studies show that more tests and procedures don’t necessarily equate to healthier patients.

We as patients are happy to go along. Why not? We’re not paying for it. But ah, we are. When the insurance company pays the bill, their costs go up. They pass those costs back on to the consumer, most likely your employer. When disgruntled patients sue their doctors, the insurance companies foot that bill too, and raise the doctors’ insurance rates. The doctors are forced to charge more, which once again escalates costs of consumer insurance.

When I was a kid and my dad was a self-employed house-painter, he could afford to buy health insurance for his family. It didn’t cover a lot of things, including routine doctor’s visits, but he could afford it. He wrote a check to the doctor when I had chicken pox, but knew that if I needed surgery he was covered.  He knew just what Dr. Jones costs for an office visit compared with Dr. Smith.

Those days are gone, and the reasons are long and disputable. We can’t say that our free market system is broken, because we really don’t have much of a free market system. Only 35% of total health care expenditures today are paid for by private health insurance.  Medicare and Medicaid spending grew by 7.2% and 6.4% in 2007 alone. That to me doesn’t illustrate the ability to control costs. What will change now? Solutions that the Obama administration has been silent on: tort reform to control lawsuits and easing regulations to allow more competition within the insurance industry.

The point is: whether it’s our employer or our government who insures us, the basic cost of health care won’t change without the root problems being alleviated. As the track record shows, costs always RISE when the government is in charge.

Car insurers aren’t affected by the same types of government regulations and don’t compete with government entitlement programs.  Ads for cheap car insurance are ubiquitous. If you have a clean driving record and just want basic catastrophic coverage, it doesn’t cost much. If you smash your fender, however the bill is on you.

Regarding health care, the awful truth is that we can’t afford to give everyone everything they want all the time. You won’t hear Obama say that either.

As I’ve talked about in another post, if I wanted to open Joe’s Discount Health, there would be too many federal regulations standing in my way. Now there will be even more. There is no option for families to choose a high deductible, catastrophic plan that’s more affordable. Doctors don’t compete for prices, nor do hospitals offer competitive prices for diagnostic tests. There is no insurance discount for healthy people. A family can’t choose to save money by going to a large clinic and paying out of pocket to see whichever doctor is on call. These are solutions that have not been discussed by the current administration.

My final point: forthrightness and transparency are already out the window before our new healthcare program even begins. The cost for this new program is probably going to be twice what the American public has been told. As Michael Cannon says, “If someone sold you a house, or a car, or a mutual fund this way, we would put them in jail.”

For more detailed information on all these issues, please refer to my earlier posts.

I’d be very interested to hear anyone’s thoughts.

Posted in Health care, Politics | 1 Comment »

Why is the Healthcare Program being pushed again?

Posted by Free to Think on March 19, 2010

President Obama is postponing his long-scheduled trip to Asia for yet another attempt at passing his health care agenda. Meanwhile, leading Hill Democrats are scurrying to resolve disputes through a host of rewrites. Yet to be decided is how to subsidize health insurance coverage, and whether there are sufficient votes to pass the bill.

If Obama’s healthcare plan failed to pass just a few short months ago, why put the press back on again?

Because this time the administration is trying to muscle the law through using two new tactics. The first is called “budget reconciliation”. This requires only the approval of a simple majority in the Senate and prevents opponents from killing the bills through filibusters. In the Senate’s customary procedure the time for debate is unlimited, and if a minority of 40 senators refuse to stop talking, then you need 60 others to vote to shut them up so the bill can come to a vote.

The reconciliation process, by contrast, limits debate to 20 hours. It was instituted to ensure that minority obstruction couldn’t block important business like passing a budget or reducing the deficit. Many on Capitol Hill agree that it’s been misused. But House Democrats and the White House quickly seized on it as a way to advance a top administration priority that lacks the 60 votes needed to clear the Senate otherwise.

According to Judd Gregg, ranking Republican on the Senate Budget Committee, “That would be the Chicago approach to governing: Strong-arm it through,” he said. “You’re talking about the exact opposite of bipartisan. You’re talking about running over the minority, putting them in cement and throwing them in the Chicago River.”

The second method Obama is using is the popular practice of sweetening unpopular programs by attaching them to completely unrelated bills that are believed to have majority support. In this case, the health care bill is being combined with a student aid measure.

The student aid bill would require the government to originate student loans, eliminating the role of banks and other private lenders in government loans. Just last week Obama proposed that this measure would save the government billions of dollars, which could then be used to award higher Pell Grants. But a Congressional Budget Office report indicated that this measure would actually not save the government any money at all, and Thursday Democrats changed their proposal to include no increases in Pell Grants over the next two years and only a modest increase over the following five. Nevertheless, Democrats are confident this will be a popular program, particularly since they are taking the power out of the hands of bankers, who are not in danger of winning any popularity contests.

With many of the crucial details of the health care plan still under consideration, this situation is a perfect illustration of two big problems that I’ve address before: 1) passing gargantuan laws without adequate time for research and reflection by Congress nor public engagement, and 2) combining two unrelated subjects into one bill in order to pass unpopular measures.

Currently, President Obama is pulling out all the stops. On Monday, he marched out Natoma Canfield, a cleaning woman who has leukemia and had to drop her health insurance because she couldn’t afford it. Listen, this is a tragedy no doubt, but certainly not proof that his healthcare proposal is the solution. I can easily find a young person who was orphaned and crippled at the hands of a drunk driver. He would be a pretty sympathetic character, but not evidence that Prohibition should be reinstated and automobiles outlawed. I really do believe that Obama is sincerely, fervently convinced that he has the answer. But he has yet to address that there are alternatives he refuses to consider, or to show any serious deliberation as to the ways in which his plan could make things even worse.

According to the White House, the new legislation would restrict how insurance companies dole out coverage to customers and require most people to carry policies. MSNBC reports that the government would finance extended coverage to 30 million uninsured Americans by slowing the growth of Medicare and raising taxes. Wait, am I missing something? Exactly how do they plan to slow the growth of Medicare unless they cover less for current recipients, or if they cover fewer recipients? Will we “finance coverage to the uninsured” by creating more people in need?

If the White House forces this legislation through, is there nothing to be done?

 

No, the fight will not be over. Georgia joins Ohio, Florida and a number of other states considering state constitutional amendments to effectively nullify any future national health care plan.

New Hampshire recently introduced a bill proposing a state amendment that confirms the right to “enter into private contracts with health care providers for health care services and to purchase health care coverage.” It would also prohibit the state legislature from requiring health insurance or imposing any fine or penalty for not having coverage.

And Governor C.L. Otter of Idaho became the first state chief executive to sign a measure requiring his attorney general to sue the federal government if Congress passes health care reform that forces Americans to buy insurance. Similar legislation is pending in 37 other states.

So, will this latest attempt at a federal healthcare program pass?

Former House Majority Leader Dick Armey says, “They can probably force this through,” but predicts that it will be at a steep political price at next November’s elections. He argued that the president’s plan will “destroy the most creative, innovative health care system in the world.”

I agree, and believe what I’ve been predicting for at least a decade is finally coming to pass. The general public is waking to the realization that what we need is more political choice and more responsible laws that do not rely on government intrusion in our private lives. According to a Fox News poll, “Four in five voters disapprove of the job Congress is doing — and the voting public’s ire is not reserved for one party.”

Let your legislators know how you feel!

 

Posted in curtailing freedom, Detrimental policies, Health care, Intrusive government, Uncategorized | 1 Comment »

Make a difference

Posted by Free to Think on November 11, 2009

I know that in my last post I pledged to begin writing on a new topic. Sunday morning, as promised, I began a post unrelated to healthcare. Then I read the news about the healthcare bill passing in the House late Saturday night. So I must renege on my pledge for at least one more post.

As I’ve said before, my goal is to encourage readers to think for themselves, and not let the media or public relations spin doctors tell you how to think. Let’s take one article that covered the latest news, and use some journalistic training to read between the lines:

From the Washington Post: “Democrats have sought for decades to provide universal health care, but not since the 1965 passage of Medicare and Medicaid has a chamber of Congress approved such a vast expansion of coverage.”

Translation: Politicians, who are primed to believe that more government is better government, have needed over 40 years to finally garner enough public support to extend their reach into the heart of healthcare.

“At the Capitol, Obama urged the few Democrats who were still wavering on Saturday afternoon to put aside their political fears and embrace the bill’s ambitious objectives.”

Translation: Democrats who wanted to vote according to their conscience and the wishes of their constituents, were strong-armed to vote the party line, knowing that party support, and their own political future, counted on it.

“The House legislation would for the first time require every individual to obtain insurance, and would require all but the smallest employers to provide coverage to their workers.”

Translation: Unprecedented in the history of the USA, citizens will be required to purchase something as a condition of living in their own country. It has not occurred to anyone in the House of Representatives that the practice of tying health insurance to jobs is part of the problem. Has anyone in the House read the Constitution lately?

“Though some people would receive no benefits — the bill would virtually close the coverage gap for people who do not have access to health-care coverage through their jobs.”

Translation: Taking careful note of the word “virtually,” we are told that this exorbitant program with vast implications to impede the liberty of all citizens is not even reaching its basic goal of providing healthcare to everyone from the get-go.

Even if it did, is 1,900 pages and $1.2 trillion truly necessary to accomplish this? As stated in earlier posts, an identical result could be achieved with relatively simple, substantially less expensive legislation that would not impact the approximately more than 280,000,000 Americans who are actually happy with their healthcare.

From USA Today:

“To pay for the expansion of coverage, the bill cuts Medicare’s projected spending by more than $400 billion over a decade.”

Translation: The fact that $400 billion is a drop in the bucket is not mentioned. Whether we’re saving $400,000,000 in waste that the government has been spending for thus far, or giving $400,000,000 less in future coverage to Medicare patients, this doesn’t say much for the program. And who’d like to mark their calendar for 2019 and see whether $400 billion was truly saved? How exactly will this be proven, when it’s easy to point to “rising costs, inflation and situations that could not have been anticipated”?

 

Out of 1,900 pages, there’s one good thing to come from this legislation: the insurance industry would lose its exemption from federal antitrust restrictions on price fixing and market allocation.

The powerful public relations campaigns of the current administration have convinced the public that the private healthcare system is “completely broken” and, despite the dismal record and financial problems  of  government-run Medicare and Medicaid, and federal bureaucrats are the ones qualified to reinvent it.

Is our healthcare system really broken to the point of needing unprecedented trillions of dollars, government intrusion and thousands of pages of new laws and regulations?

Could we all be headed for Medicare-quality healthcare in the very near future?

So what can you do? How can you make your voice heard? Take a moment to contact your Senators if you don’t want this bill to be put into law as is. It could be the most important thing you do today.

I’ll make it easy for you. Here’s the contact information for senators in the area. Feel free to cut and paste any portion of my posts or simply tell them:

HR 3962 violates the 9th Amendment protection of individual liberty, and the 10th Amendment’s requirement that federal power be limited to only those functions listed in the Constitution. You swore an oath to obey and protect the Constitution. Please honor that oath.

 

New York-

Gillibrand, Kirsten E. – (D – NY)  478 RUSSELL SENATE OFFICE BUILDING WASHINGTON DC 20510 (202) 224-4451 gillibrand.senate.gov/contact/ Schumer, Charles E. – (D – NY) 313 HART SENATE OFFICE BUILDING WASHINGTON DC 20510 (202) 224-6542  schumer.senate.gov/new_website/contact.cfm

 

Connecticut-

Dodd, Christopher J. – (D – CT)  448 RUSSELL SENATE OFFICE BUILDING WASHINGTON DC 20510 (202) 224-2823 dodd.senate.gov/index.php?q=node/3130

Lieberman, Joseph I. – (ID – CT) 706 HART SENATE OFFICE BUILDING WASHINGTON DC 20510 (202) 224-4041  lieberman.senate.gov/contact/

 

Pennsylvania-

Casey, Robert P., Jr. – (D – PA) 393 RUSSELL SENATE OFFICE BUILDING WASHINGTON DC 20510 (202) 224-6324  casey.senate.gov/contact/

Specter, Arlen – (D – PA)  711 HART SENATE OFFICE BUILDING WASHINGTON DC 20510 (202) 224-4254 specter.senate.gov/public/index.cfm?FuseAction=Contact.Co…

 

 

 

Posted in Health care, Politics | Leave a Comment »

The best way to help the uninsured

Posted by Free to Think on September 30, 2009

Who are the uninsured?

Basic, decent health care should be available and affordable to all Americans. Now we must ask ourselves whether the best answer is to have government control the heath care of every citizen because some of us are uninsured.

Studies have shown that uninsured people are more likely than insured people to die prematurely, to have their cancers diagnosed too late, and to die from heart failure, a heart attack, a stroke or a severe injury.

Though the uninsured can go to an emergency room, by the time they do go, many are much sicker than they would have been with routine and preventive care. Emergency rooms are costly, and if uninsured patients cannot pay for their care, the hospital or the government ends up footing the bill.

Who are the ‘Uninsured’ anyway? Why are they uninsured? How many are there?

The most frequently cited estimate, 45.7 million in 2007, comes from an annual census survey. Are these 45 million poor people who fall between the cracks, ineligible for assistance, but unable to pay for insurance on their own?

In actuality, the Congressional Budget Office refutes the widely disseminated figure.

The figure of 40+ million more closely approximates the number of people who are uninsured at a specific point in time during the year, not the number who are chronically uninsured, according to the CBO. They point to surveys which put the number of people who are chronically uninsured at between 21.1 million (the Survey of Income and Program Participation) and 31.1 million (the Medical Expenditure Panel Survey).

“For example,” the CBO states, “nearly 50 percent regain health insurance within four months.” http://www.policyalmanac.org/health/archive/health_insurance.shtml

The CBO also found that roughly one quarter of those counted as uninsured, 12 million people, are eligible for Medicaid and the State Children’s Health Insurance Program (S-CHIP), but haven’t enrolled. Approximately 5.6 million are illegal immigrants.

A study by Mark Pauly of the University of Pennsylvania and Kate Bundorf of Stanford, concluded that nearly three-quarters of the uninsured could afford coverage but chose not to purchase it. 8.4 million who do not have insurance are between the ages of 18-25, the age of the ‘indestructible’ mindset.

Even the liberal Kaiser Family Foundation puts the number of uninsured Americans who don’t qualify for government programs and make less than $50,000 a year between 8.2 million and 13.9 million.

That’s about 4% of American citizens, at most. Health policy experts familiar with the CBO report say these facts are well known to insiders but less so to the general public, whose opinions may shape policies by legislators.

Were you aware of these numbers? Would you say that these statistics have been made clear by President Obama? Would it be fair to say that his administration has been misleading in order to pursue his agenda?

Opponents of government-sponsored insurance have been portrayed as greedy and uncaring of the less fortunate. But is it possible to care about the uninsured while also having the best interest of the financial health of the country and the liberty of all its citizens at heart?

But these people need help, and we all need relief from high healthcare costs. We need government solutions!

As Michael Tanner, senior fellow at the Cato Institute says, “None of this is to suggest that many of those without health insurance do not face severe hardship, or that we shouldn’t try to expand health insurance coverage. But it does mean that we might be able to deal with this problem in a much more targeted way, rather than having a huge and expensive new government program.” Tanner advocates ending regulations that increase the cost of insurance for younger and healthier workers, eliminating costly mandated benefits, and creating more competition by allowing people to purchase insurance across state lines. He also feels we should move away from a health care system dominated by employer-provided health insurance, so people aren’t losing their insurance when they lose their jobs. That means changing the tax treatment of health insurance. http://www.cato.org/pub_display.php?pub_id=10449

“We need to think of [the uninsured] not as a group of people, but as gaps of time when people are without insurance,” says Pamela Short, Ph.D., a professor of health policy and administration at Pennsylvania State University. This amounts to a “real change of mindset.” Policies that fail to recognize the distinction between short- and long-term uninsured are liable to cost us much more and be far overreaching in scope than is necessary. One policy Short believes would be constructive would be to make the federal COBRA insurance plan, which covers workers between jobs, more affordable. http://pn.psychiatryonline.org/cgi/content/full/38/12/1-a

The website The Moderate Voice opines, “Let’s say we take the high end figure and round up to 14 million (unqualified for aid and unable to pay for insurance). Yes, that’s still a lot of people in need of help, but the figure is becoming manageable at this point. If you look at the GOP’s health care bill, currently buried in Ways and Means, you realize that we could issue them advancements and/or vouchers for five thousand dollars in coverage and you’d have accomplished the largest goal which most ObamaCare proponents claim to want to achieve.” http://themoderatevoice.com/44210/those-forked-tongue-democrats-how-many-uninsured/

Those vouchers would cost a total of $70 billion a year. Sound like a lot of money? Actually, it’s a cool $900,000,000,000 less than some estimates for Obama’s plan over the next 10 years.

At what cost?

The AP/Seattle Post-Intelligencer reports that health policy experts believe President Obama’s proposal could cost about $1.5 trillion over the next 10 years. Of course, no one knows for sure. White House spokesperson Reid Cherlin admits, “It’s impossible to put a price tag on the plan before even the basics have been finalized. Here’s what we do know: The reserve fund in the president’s budget is fully paid for and provides a substantial down payment on the cost of reforming our health care system.” http://www.californiahealthline.org/Articles/2009/3/18/Experts-Say-Cost-of-Obama-Health-Care-Plan-Could-Top-15-Trillion.aspx

True, although all those Americans who had their homes foreclosed upon in the past year had made their initial down payments too. What we need is sustainability.

Obama declares that he’s spelled out $950 billion worth of ‘budget cuts and tax increases’ over the next 10 years. If so, why haven’t these budget cuts been rushed into law with the same urgency as he’s pushed through his healthcare plan? How much will middle America be asked to contribute to these tax increases? What guarantee do we have that it will be less than we pay in healthcare costs now?

In June “one official with knowledge of the session who was not permitted to talk to reporters and so spoke on the condition of anonymity” told the Washington Post that the non-partisan Congressional Budget Office concluded that the drafted bill would cover just 16 million additional people with $1 trillion, not every American. And the report did not even include some of “the most costly and controversial sections of the bill,” according to the Post. http://www.washingtonpost.com/wp-dyn/content/article/2009/06/18/AR2009061804109

This secrecy here is a bit perplexing. Were our representatives discussing sensitive national security, or helping us get affordable health insurance?

How about lowering insurance costs for the rest of us?

The health insurance industry is currently buried in regulation and state mandates (requiring coverage of certain benefits) that increase health insurance premiums for us all.

In 1965 there were only seven state-mandated benefits in the entire United States. Today, there are nearly 2,133 varieties of health insurance mandates nationwide, according to the National Association of Health Underwriters.

When employers pay health insurance premiums that are inflated by numerous state mandates, health plans become a financial burden. If businesses can’t afford to pay benefits for their employees, more workers find themselves joining the ranks of the uninsured.

“For state legislators, [mandates are] used as a special interest tool to reward lobbyists…and let someone else pay for it,” says J.P. Wieske, director of state affairs for the Council for Affordable Health Insurance (CAHI), an advocacy association of insurance carriers.

“I personally have a problem with an in vitro fertilization mandate,” he says. “I’m convinced it’s a straight income transfer from the poor to the rich. Poor families are struggling to afford health insurance and are not interested in spending their hard-earned dollar on in vitro fertilization. It’s clearly not something that is…threatening to the individual’s health.” http://www.insure.com/articles/healthinsurance/mandated-benefits.html

How about allowing people to choose the scope of their coverage instead? We don’t all choose to pay for top-of-the-line car insurance. What if we’d like to save money by opting for clinic care for basic health issues, and insure ourselves for catastrophic illnesses only? Should we be allowed that option or should government dictate our only choice?

Universal health care proponents argue that the current plan does provide options, and that the Obama administration isn’t advocating that a government program be the only choice for health insurance. More on that next time.

Posted in Health care, Politics | Leave a Comment »

Hard questions about health care

Posted by Free to Think on August 13, 2009

President Obama says that overhauling the health care system is “essential to the country’s economic well-being.”

The course this country takes regarding this issue could profoundly affect every American as well as the financial stability of our nation.

Some proponents of Universal Heath Care would have us believe that if you are opposed to a government program, it is implicit that you don’t care about the uninsured. That you don’t care about affordable health care. I believe you’d be hard-pressed to find people who don’t care. How to achieve affordable health care is what’s creating the contention.

If we want to think logically about making these vital decisions, we should ask concrete questions, expect very specific, documented answers from our government, and be willing to consider every side of the argument.

Obama is pressing for final action before the end of 2009. This series of articles will pose some vital questions worthy of thought.

Question 1: If one is a supporter of Obama or of Universal Health Care, does it mean that one should blindly accept the current bill as is?

Question 2: With this much controversy, should it be imperative that all possible repercussions of these measures be investigated with great care?

No matter what your political viewpoint, I’d be surprised if you answers were anything other than 1) no and 2) yes. So…

Question 3: Do we completely understand all the implications of the proposed health care bill?

The problems of our existing health care system have taken many years to develop. No one disagrees that changes need to be made. But what kinds of changes?  Once public policy is established and bills are put into law, they are virtually impossible to revoke. The Obama administration is proposing a bill that runs over 1,000 pages.

According to Obama’s Organizing for America website, Republicans are making false claims that the healthcare bill will explode the deficit and take away people’s right to choose. http://my.barackobama.com/page/content/falseattacks.  Let’s examine the first claim:

Question 4: How will we pay for it? Will there be rationing?

Obama asserts that “Health reform will be deficit neutral over ten years.” We currently face an enormous deficit, a crushing debt, bailout costs, and other increases in spending this administration has initiated. We cannot afford this to be untrue.

Exactly how can we achieve a new government program of this size and scope that is ‘deficit neutral’?

President Obama maintains that with Universal Health Insurance, Americans will take better care of themselves, we will treat less sick people, and the cost of healthcare will drop. That sounds wonderful, and does seem to make sense. But unfortunately there are rules of economics and inherent human behavior that he is disregarding. “Free” healthcare will cost more than if people are in charge of their own healthcare costs.

When something is perceived as ‘free’, the demand goes up. Without a care for the cost, people will line up to get more tests, more procedures, and demand more services. Instead of individuals deciding what’s worth paying for, people will attempt to qualify for everything that they can get. A dermatologist to remove that unsightly mole, a psychiatrist to help with the stress from work. It’s only human nature. Why shouldn’t they? Hey, I pay my taxes, and I know that my pregnant cousin posted 3 separate ultrasounds of her baby on Facebook, so I want that too! By definition, if we aren’t self-regulating, someone out there will be forced to draw the line. We won’t be able to pay for everything everyone wants, always. In other words, instead of common sense dictating people’s decisions, it will have to be some bureaucratic policy that will decide whether you need that preemptive hysterectomy, whether it pays for your grandfather to get heart surgery, a knee-replacement or whatever. This is already a big problem with today’s private insurance.

And who will pay? People in the lowest economic brackets will not be contributing. Under the current proposal, union workers would be exempt from the taxes that would pay for Universal Health Care because, “The reality is, unions are in the position where they are going to get hit the hardest on that tax, and they just can’t change it on a dime like everyone else.”  http://www.washingtonexaminer.com/politics/Union-workers-would-be-exempt-from-Dem-health-care-tax_06_23-48810402.html)

With cost estimates already as high as $1.6 trillion (and we all know those estimates never measure up to the final costs), that leaves the rest of the taxpayers to ‘change on a dime’ and foot the bill.

Question 5: Have other government-run models achieved this successfully?

People often look to France as an excellent model of government-sponsored healthcare: http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/08/11/frances_model_healthcare_system/

France is at the top of the World Health Organization’s ranking for health care, and their statistics in nearly every category are impressive. However, the French themselves admit that their system is slowly bankrupting the country. http://online.wsj.com/article/SB124958049241511735.html

Why would the results be any different here than in France, without first trying to determine some of the most significant reasons for runaway costs, both here and abroad?

More questions to consider: If this multi-trillion dollar program will not affect the deficit, how much would taxes have to increase for the average middle class worker to support this program? Will the increase in taxes amount to a lot more than what most people already pay in health care costs, while we still get the coverage we’re used to with private insurance?

That question and more to be explored in the next segment.

Posted in Health care, Politics | 1 Comment »

Why Doesn’t the System Work?

Posted by Free to Think on August 12, 2009

Don’t we need government to control this broken health care system? Hasn’t the free market failed us?

The cost of medical treatment today has risen exponentially, as has the cost of health insurance. How are people supposed to take care of their families?

How did this happen?

Three major factors have contributed to the wild climb of health care costs: the proliferation of malpractice suits, the lack of competitive pricing for medical procedures, and the deficiency in health insurance options. Have solutions to these problems been adequately addressed by our government? Will these issues still exist with Universal Health Care?

1) Malpractice suits

Dr. Stuart Weinstein, with the American Academy of Orthopedic Surgeons, points out that the President has ignored a vital part of the wild acceleration of health care costs: the high price tag of medical malpractice insurance due to out-of-control lawsuits http://www.businessinsider.com/save-healthcare-by-muzzling-the-trial-lawyers-2009-8.

Besides the exorbitant cost of malpractice insurance, doctors also pass on to the consumer the cost of defending malpractice cases, paying compensation, and covering additional administrative costs. Insurance companies are compelled to waste money on excessive tests that nervous doctors order to absolve themselves from possible suits. When the state of Texas enacted caps on lawsuit awards against health care providers, medical malpractice claims dropped substantially. Costs declined without compromising patient care. Many believe that without torte reform, healthcare reform will be a wasted effort.

2) Lack of competition

Another reason that health care costs have escalated is that, when there is no competition, there is no incentive to lower prices. According to Nobel prize-winning economist Milton Friedman, “The high cost and inequitable character of our medical care system are the direct result of our steady movement toward reliance on third-party payment. A cure requires reversing course, re-privatizing medical care by eliminating most third-party payment, and restoring the role of insurance to providing protection against major medical catastrophes.”

In other words, a major problem with insurance today, be it private or government sponsored, is that you walk into a doctor’s office and order an exam or tests, with no shopping around, no care as to how much anything costs compared with the next medical office down the street. Often the doctor himself has no idea what things costs. Insurance used to be for catastrophic illnesses, but general health care was kept low enough that people like my dad, a housepainter, could afford to pay for his family’s basic doctors visits out of pocket. He knew exactly what it cost, and what his buddy down the street paid his doctor.

3) Few insurance options

Don’t we have a free-market health care system now? Not exactly. A complex tax code subsidizes employer-provided health care, making it impossible for individuals to find comparable insurance on their own. They are barred from shopping across state lines and are then taxed for purchasing their own health insurance.

The average annual increase in inflation has been 2.5 percent while health insurance premiums for small firms have escalated an average of 12 percent annually http://www.nchc.org/facts/coverage.shtml.

As stated by People Over Profits, a grassroots action center, “For more than 6 decades, the insurance industry has operated beyond the reach of federal antitrust laws. The McCarran-Ferguson Act, exempts the business of insurance from the federal antitrust laws. Consumers benefit through lower prices, more choices, and better services.  Why should the insurance industry be treated any differently [than any other trade]?”  http://www.kintera.org/htmlcontent.asp?cid=70424

Mergers and acquisitions have been extremely prevalent in the insurance industry in the past few decades. As a result, the large insurance companies are getting larger and smaller agencies are being forced to band together in “clusters.”

What are the best alternatives to make healthcare more affordable for everyone?

So, how to resolve these problems? Trust that government control of the industry will create affordable healthcare? But aren’t government-run businesses known for their waste, red tape, $500 nuts and bolts? History shows, both in the U.S. and throughout the world, that free markets are much more effective at lowering costs than are government price controls.  How could this government program possibly be the one exception?

Doctors who are paid by their patients rather than insurance companies, are forced to keep their prices competitive. The statistics prove it: the cost of elective surgeries, paid out of pocket, haven’t risen nearly as much as other surgeries. In a 20/20 segment, Jon Stossel advocates insurance with high deductibles, encouraging people to shop around for the best deals in basic care, but with coverage for serious, expensive illnesses. http://www.youtube.com/watch?v=E_KCLm9cekU&feature=related

Whole Foods Corporation found that by using this type of insurance, their employees continued to take care of themselves, but were smarter with their health care dollars and usually had money left over that they could keep. http://www.youtube.com/watch?v=Xsp_Jh5EIT0&NR=1 Insurance plans that work this way cost less. But if we’re tied to the insurance company at work, or a one-size-fits-all national plan, we don’t get that choice.

Positive steps have already been taken. In April, bill H.R. 1583, the Insurance Industry Competition Act of 2009 was introduced by Rep. Peter DeFazio (D- OR), which amends the McCarran-Ferguson Act to make the Federal Trade Commission antitrust enforcement policies applicable to the business of insurance. (http://www.govtrack.us/congress/bill.xpd?bill=h111-1583

What if Doe’s Discount Insurance had the ability to compete with the big guns, offering competitive prices for the little guy? What if insurance companies charged Joe Blow the same amount for health insurance as they charged Blow Enterprises, Inc. for each of their employees? What if Joe’s employer gave him the option of taking the company insurance, or taking the equivalent cash and finding his own insurance that best suits the needs of his family?

Can the health and insurance industry be reformed to enforce competition instead of putting our government in the health care business? We already have laws and policies that foster fair business practices. Can we employ them the way they’re supposed to be utilized to help bring this system under control?

Will this be enough to help the millions of Americans without health care?

More on that in the next segment.

Posted in Health care, Politics | 1 Comment »