Health-care in 3,200 Words or Less

The Democrats still have the upper hand. If they don’t support a bill it can’t pass, but their total control over the legislative process has been broken by the election of a Republican senator from Massachusetts. So those we elect to represent us now have a choice. What we have had for the last year was World Wide Wrestling. Now it is time for chess. My question is, are the Democrats and Republicans going to play politics or statesmanship?

Both parties acknowledge we need health-care reform. There is a legitimate issue as to whether now is the time to pursue it. We have an unprecedented budget deficit, severe unemployment and a shaky economic recovery to deal with. All three of which are arguably more urgent than health-care reform, unless you don’t have health insurance and are or become sick. On the other hand, health-care is on everybody’s mind now. This may be the time to pass a reasonable plan to improve the health-care environment. But are the members of either party willing to set aside extreme positions and pass something reasonable, at the risk of giving the other party a partial victory? I have a few suggestions.

First of all, there needs to be some kind of tort reform. Between malpractice insurance premiums and the need, whether perceived or real, to practice defensive medicine, the cost of litigation drives up the cost of health-care. Actual damages certainly need to be covered, but there ought to be a limit on punitive damages.

Drop the barriers to cross-state purchasing of medical insurance. Let the money flow to where the best coverage, services and prices are. The market will reward those who do well and punish those who don’t.

Make all health insurance premiums tax deductible to the payer of those premiums.

Make it illegal for an insurance company to drop somebody for other than non-payment of premiums, or to deny coverage.

People need help in paying for medical care, but if they are responsible for the cost of care, they will make better health-care decisions. Therefore, make it easier for anybody to buy a high deductible health insurance policy in conjunction with a Health Savings Account (HSA). For those below a certain income level have the government make an annual deposit into their Health Savings Account equal to the premiums plus a portion of the annual deductible. As their income increases above a certain threshold phase out the government paid deposit into their HSA at the rate of $1 lost for every $4 earned over the threshold. Mandate that health-care providers accept payments at low or no interest from patients below some specified income level. These provisions will address the adverse selection problem posed by the mandate to take all comers, as well as eliminate the need to force people to buy insurance that is in the current bill.

Allow insurance companies a reasonable and generous profit, but require that they pay out a certain percentage of revenue in benefits in order to participate in the cross-state sale of their products.

Get rid of the absurd taxes that have been proposed on health-care devices and insurance plans. If you want to hold the cost of something down, you need to lower the cost, not increase it.

There you go. In less than 3,200 words I have just written a comprehensive health-care plan that addresses cost and availability. It does not put the government in the health-care business and it does not gut a system that has produced many of the greatest advances in health-care anywhere in the world. I don’t know what the cost of this would be. It is possible that it could not be implemented until we get the economy rolling better, but it is a whole lot better than what has been proposed to date.

Politically Correct Racism

In January, 1988, Jimmy the Greek Snyder said, "The black is the better athlete. …and he's bred to be the better athlete because this goes way back to the slave period. The slave owner would breed this big black with this big black woman so he could have a big black kid. That's where it all started." The comment, which was supposed to have been off the record, stirred up a great deal of controversy and got Jimmy the Greek fired from CBS.

In December 2002 then incoming Senate Majority Leader Trent Lott, speaking at Strom Thurmond’s 100^th birthday party said that the United States would have avoided "all these problems" if Thurmond had been elected president in 1948. Thurmond had been a supporter of segregation, though that was clearly not one of the problems Lott was assuming would have been avoided. Despite Lott’s apologies to Jesse Jackson and the black community, and the fact that few people, if any, really thought that Lott was referring to racial issues when he made the statement, his career was effectively ended because of a kind remark to an old man.

In 2003, Rush Limbaugh worked briefly for ESPN on their NFL pregame show. He gave his opinion that Philadelphia Eagles quarterback Donovan McNabb was overrated. He expressed his belief that McNabb’s status was due to the fact that there were those in the NFL and the media who wanted to see a black quarterback succeed. An uproar developed and, under pressure, Limbaugh resigned his position with ESPN. Last year Limbaugh was part of a group seeking to buy the Rams, and was swiftly chased out of the hunt.

In February, 2007 Joe Biden said, “I mean, you got the first mainstream African-American who is articulate and bright and clean and a nice-looking guy, I mean, that's a storybook, man.” The statement was labeled as racist because Biden, it was argued, meant that it was unexpected for an African-American to be articulate. Biden was forced to apologize for the insensitivity of his statement.

In 2008 we learned that for the past 20 years Barak Obama had been attending the church of a racist minister who has uttered innumerable anti-American and anti-white sermons. Obama told us that his minister, Jeremiah Wright, was a close friend and like a member of his own family. When confronted with the views of his pastor, Obama told us that he never heard those things said. Wright sells video tapes of his sermons in which, among other things, he blames white Americans for committing acts of terrorism and of creating the AIDS virus to kill off blacks. Obama continued to support and defend him until Wright accused Obama, on national television, of doing what he has to do as a politician; At that point, Obama severed ties with Wright. Obama was elected President later that year.

A few days ago we learned that Senator Harry Reid has written that among Barak Obama’s political strengths are the facts that he is a “light skinned “African-American who does not speak with a “Negro dialect, unless he wanted to have one.” Senator Reid’s remarks are being characterized as racist and some, particularly on the right, are asking for his head on a platter.

We see an interesting pattern here. Except for the behavior of black men, each example here is not actually racist. Senator Lott said nothing about race whatsoever, but because he said a kind thing while talking about a man who had had racist ideas a generation earlier, he was accused of being racist himself. Jimmy the Greek, Rush Limbaugh, Joe Biden and Harry Reid were merely acknowledging the elephant in the room.

Jimmy the Greek was commenting on the obvious fact that slave owners had treated their black slaves like animals. He was not condoning this despicable practice, but acknowledging that it existed and expressing his, not illogical, view that those practices of slave owners a century earlier resulted in certain physical characteristics in the decedents of their slaves.  Rush Limbaugh acknowledged that there are those who want to see black people succeed. Is there something racist about noticing that? Wasn’t that what affirmative action was all about?

If somebody refers to me as articulate, I assume I have been paid a complement. Characterizing Joe Biden’s comment as racist is racist in and of itself, because it presumes that we need to be sensitive to the lack of good speech present in the African-American community. Well, some black people speak well and some don’t. Much like every other group of people. Calling Ronald Reagan the “Great Communicator” was a compliment. What is the difference? The difference is that Barak Obama is ½ black and we have to pretend not to notice, except in the most glowing and least stereotypical terms.

Senator Reid was guilty of three things. One was to notice that Obama is a lighter skinned black man and to further notice that that will make a difference in the way some people see him. Do we not know that to be true? Is it racist to notice? Second was to notice that Obama does not, generally, speak like a black urban man from the streets. Third was to use a term that is no longer in use. When I was growing up, calling a black man a Negro was the polite way to refer to him. There are plenty of reasons Harry Reid should be replaced in the Senate, but his remarks, if dated, don’t sink to the level of racism.


 How careful do we have to be? Are we not allowed to notice what we all see and know? How does that help anybody? Why does it offend anybody? I am overweight and I stutter. I neither pretend nor assume that people don’t notice those things about me. If they are pertinent to a conversation about me, I expect them to be brought up.

Now the example of Jeremiah Wright and Barak Obama is another matter. We have previously looked at overreactions by the hypersensitive to innocent remarks or factual comments about a state of affairs. Wright, on the other hand, repeatedly made inflammatory remarks apparently designed at class warfare, while a future President used him as a spiritual leader. I was asked a while ago if I thought Obama was racist. I don’t know what is in the man’s heart, but when I see the people he surrounds himself with and the policies he espouses, and his rhetoric, it doesn’t look good.

In a climate when a white man can’t observe that some people might want to see a black man succeed in the NFL, how in the world did we elect a President who has so thoroughly immersed himself in a sea of racial divisiveness? Has political correctness brought us to the level of fulfilling George Orwell’s prophecies in “1984”?

Muslim Protesters

A group of Muslims gathered outside the federal courthouse in Detroit Friday to demonstrate as the Christmas day airline bomber was arraigned. They were there to demonstrate against radical Islam. They carried signs saying that Islam is a religion of love not hate. One demonstrator went on camera for a national news organization to say if the terrorists want to kill him, he is there and available.

Every news outlet in the country needs to make note of these brave Americans. They know, maybe better than most, the risk they take to speak out against the desecration of their religion by jihadists. The silence from Muslims has been a concern to me and a source of condemnation of the entire religion among many. If they haven’t been silent, if it has been the lack of news coverage that has made us unaware of their protestations, then the news media is largely to blame for much of the anti-Muslim sentiment in the country. Nobody thinks that white supremacists represent Christianity. We all know enough about the teachings of Christianity, and we know enough Christians (if we aren’t Christian ourselves) to know that the ideals of white supremacy are anathema to Christians. But that same distinction isn’t as clear for Muslims. It is people like these demonstrators that will isolate radical Islam from Islam as much as white supremacists are isolated from Christianity.

These brave people should be heralded and encouraged. Their being there to proclaim to the world their opposition to the use of their faith to promote hatred and murder will give others the courage to stand up and be counted. I thank them for letting me know they are out there.

Democracy As Mob Rule

For all of its virtues, democracy can be a dangerous thing, which can easily deteriorate into mob rule. That is the genius behind the constitution. The founding fathers were concerned about a majority abusing their power at the expense of the minority. That is why we have two houses of congress which are elected in different ways. It is why we have three distinct branches of government, which are chosen differently. It is the reason behind the, often misunderstood, Electoral College, and it is the reason some states refused to ratify the constitution until the Bill of Rights was added. As brilliant as the constitution is, it is not bullet proof. It can still be abused and used to allow a majority to assert their superior numbers and impose injustices upon the rest.

This isn’t as hard to understand as we may like to think. Most of us try to live according to our belief system. That belief system may be skewed by self-interest, but skewed or not it is what we believe. Thus there was a time when many white men and women believed black men & women to be lesser humans, and as such, it was as acceptable to use them as slaves as it was to keep beasts of burden. We may look upon that now and decry that belief system to be barbaric, but people believed it and acted on that belief. The fact that it was believed primarily by people that profited from that belief, only serves to warn us to examine our motives for accepting what we may claim to be obvious truths.

The same holds true of those who believe that it is the government’s role to take care of us. If your belief system is that people can’t be trusted to make responsible decisions, you may logically believe that it is the responsibility of government to make those decisions for them. The obvious pitfall that government decisions are made by people and people who can insulate themselves from the more negative consequences of their decisions is overlooked.

So, here we are with Democrats running both the legislative and executive branches of the government ramming through a health-care bill without regard for the rights, beliefs or protests of constituents at home or Republicans in congress. The arguments originally were that we had to curtail the escalating cost of health-care and provide benefits for the nation’s uninsured. In the headlong race to get something past, we seem to have forgotten the goals.

Republicans wanted to make insurance more affordable, and therefore more available utilizing several methods to achieve that goal. And this without undermining what is arguably working right with the present system.

Much of the cost of medical care today can be attributed to litigation. Between the cost of malpractice insurance, and the need for doctors and hospitals to practice defensive medicine resulting in unnecessary tests and procedures, we are all paying for the jackpot jury awards of the few that call 1-800- SUE-SOMEONE. So it has been proposed that laws be enacted to control outsized medical lawsuits. The Democrats refused to include any such provision in their health-care bill.

Because of an anomaly of wage controls imposed during WWII, medical insurance in our country today is considered largely an employer benefit. This has been codified by the fact that an employer gets to deduct the cost of providing medical insurance as a taxable business expense, without the employee having to declare it as income. Smaller employers often find it difficult to afford to provide health insurance. Even those that can afford it, find that the options available to smaller employers are less attractive than those available to a large employer. So it has been proposed that all health insurance premiums be tax deductible, whether paid for by an employer or an individual or family. The Democrats refused to include any such provision in their health-care bill.

Different states require different provisions in health insurance plans sold in their jurisdictions. The tighter the provisions the more insurance companies have to charge to cover the cost of those benefits. Also, because insurance companies have to apply to each individual state for the right to sell insurance in that state some insurers may decide to market their products in some states and not others. So it has been proposed that we be allowed to buy any insurance policy offered by any insurance company anywhere in the country. This would cause the money to flow to those policies and companies that offered better costs and services, increasing competition and lowering costs. The Democrats refused to include any such provision in their health-care bill.

Democrats have been claiming that they want a bi-partisan bill, but what they apparently mean by that is that they want Republicans to support their bill without using any of their ideas. Their solution is to mandate changes from Washington D.C. Studies have concluded that instead of lowering the cost of health-care, their provisions will increase insurance costs. The Democrats want to provide coverage for all Americans, but they are raiding Medicare, which is already going broke and underpaying for benefits. The Democrats have been vilifying insurance companies, who we can replace with another company if unhappy. Can we expect better from the government which we can’t change and who has the force of law to impose their decisions? The Democrats claim that their bill will not increase the deficit. However, they are using tricks of timing and hiding expenses in other bills to cover their deception.

The majority in congress and the White House are about to take away from us our right to control our health-care. They, aparently, do not think any idea put forth by the minority party worthy of considering. Power does indeed tend to corrupt. Not even the constitution can protect us from all abuses of power if the majority we elect are hell-bent on imposing their rule on the rest of us.

Rumors

Remember when senators, congressmen and celebrities stood up and declared that President Bush had lied about weapons of mass destruction in Iraq? I was not a fan of President Bush, but I remember how angry I was when liberals claimed that he lied about WMD. He was wrong. He may have been more eager to go to war against Iraq than he should have been. His idea of spreading democracy in the mid-East may have been naive, arrogant or both. But he had not lied about the weapons. Many in our intelligence agencies, as well as intelligence agencies around the world, let alone Saddam’s own generals, believed he had WMD. And Saddam did nothing to dispel that impression. Those that claimed he lied were lying themselves. It convinced me that they were not patriots, but partisans. They were willing to say or do anything for political expediency. They let their hatred for the President dictate what they chose to believe, or say about him. They knew, or should have known, the difference between lying and making a mistake. They seemed to be so blinded by partisanship, that they deemed the Bush Administration unworthy of either honesty or critical thinking. The way President Bush was treated was unfair, and won few, if any converts.

I have been getting emails for some time now showing President Obama standing with his hands folded in front of him, while men and women in uniform around him are saluting. The email accuses the President of showing lack of respect to the flag. If you watch a video of that scene, you will see that the President has just taken the stage to the band playing “Hail to the Chief”. It turns out his behavior is absolutely appropriate.

That is one example of many accusations circulating on the Internet. When I get these I usually do some research before passing them on. I often find them to be ill-founded and they go into my deleted files folder. I can give a litany of things I believe the President has done and is doing badly. With all that ammunition, why do we bother with accusations that he isn’t an American by birth, or that he is a Muslim. When these or other hate filled accusations are circulated, it may fire up the converted, but only puts the more provable and substantial arguments in a bad light. Let’s assume that he is a Muslim, communist, who was not born in the United States. If you don’t have multiple credible sources, which cannot be impeached by his defenders, circulating those accusations just gives those who are on the fence less reason to believe the other, more mundane arguments against the President’s policies. You know…those things that would sway the undecided.

When Senator Kennedy stood up in the senate & called President Bush a liar, he only proved to me that he was not honest in his criticism. Michael Moore may get something right every now and then, but I will never know it, because his bazaar accusations keep me from ever giving him an objective hearing. He past that point in 1989 when he produced “Roger & Me”.

If you think that President Obama is bad for the country, stop spreading rumors that only inflame his defenders and damage your own credibility. You may be right, but if you are too quick to pass on rumors and emails that don’t pass the smell test, you hurt your cause.

The Ecology of Economy

In my college days I learned how a hunting restriction on a deer herd in Southern Utah resulted first in a spike in the number of deer and then the collapse of the population due to overgrazing and starvation. It turns out that people had eliminated the natural predators and than eliminated man as a predator. We had thrown that ecosystem out of balance. By trying to do a good thing, people had caused more harm.

The economy is much like a natural ecosystem. When we try to tamper with it, we are more likely to mess it up than help. There are just too many moving parts and too many unknown nuances to keep track of.

That is why attempts to manage the economy so often backfire. Whereas minor tweaks designed to influence it can help, efforts to control it often end in disaster. There are just too many variables, and therefore too many things to go wrong when we get involved in the minutia.

When the financial system teetered on the brink, the proper response was to cut taxes and let the freed up money flow to those who would use it to buy goods, pay down debt, and invest in projects that would produce jobs and rescue the system. Directing the flow of money by the federal government, is subject to political favoritism and ideologically motivated efforts to send the money where the politicians think it will do the most good. But where it will do the most good is, as often as not, unknowable. Before there was a Microsoft or an Apple, nobody knew these companies would emerge to revolutionize the computer industry.

When trying to remedy the health-care system, the proper response is to facilitate the competitive pressures of the marketplace to determine the best use of health-care dollars. Demonizing insurance companies, as the administration and many in congress have been doing lately is political gamesmanship. Of course you can find examples of abuse by insurance companies. What makes us think that the government will be more beneficent? Does anybody think the IRS is full of virtue and light? The answer is to regulate the abuses (i.e., an insurance company ought no to be allowed to cancel coverage on somebody undergoing treatment), and permit more insurance companies to compete for the business by removing barriers to buying medical insurance across state lines. When you do that, more creative solutions to the problems will be found because there will be more people and companies looking for ways to compete for the business.

Those that want government to solve economic problems want to cure inequity. But we can’t. There will always be inequity. Government isn’t a scalpel. It is a chain saw. It is big, unwieldy, and loud. It is a fine tool for what it does well. But surgery is not what it does well. We should let the government do the work of freeing up markets. Allow money to flow to the entrepreneurs who will think of ways to employ it that the beurocrats and politicians won’t. Not that they aren’t smart enough. I’m sure some of them are, but we limit the opportunities to succeed when we try to use the government to manage the economy. Bill Gates developed software, a politician didn’t. Henry Ford developed a way to mass produce cars, a bureaucrat didn’t. The government’s job is to provide very broad rules and free up money, then get out of the way

Shades of Things To Come

Like me, you may have thought it was about better statistics on breast cancer detection and survival. It wasn’t. It was a cost benefit analysis. Stay with me on this, because this article is not about breast cancer or mammograms, but we need to go there to get to the point.

It turns out the U. S. Preventative Services Task Force, which had recommended in 2002 that all women over 40 receive screening mammograms decided last week that only women between 50 and 75 should receive the tests unless there is an underlying history to indicate otherwise. Routine mammograms have reduced the incidence of breast cancer in women by 30%. According to the Wall Street Journal, 40% of patient years saved by mammograms are for women under 50, but it takes 1,904 mammograms to detect one case of cancer for women in their 40s and only 1,339 to detect a case in a woman in her 50s. Of course the number would decrease for a woman over 75, but the task force decided that she was so close to the end of her life that we would be wasting money on her. According to the op-ed article in last Thursday’s Wall Street Journal, the task force has no oncologists or radiologists, but they decided that the cost was too great to have women in their 40s or over 75 undergo the tests.

We should all make medical decisions based on our own cost benefit analysis. There are a whole host of tests and procedures that we don’t do because the cost and inconvenience of going through those tests doesn’t compute for us. But we make those decisions with our own lives and our own money. What we have here is a panel whose decisions are generally accepted by Medicare making that decision.

President Obama and many of his fellow Democrats in congress have been assuring us that there would be no rationing with their version of health-care reform. But there will have to be guidelines adhered to. It may not be unreasonable to weigh the cost of a procedure against its potential benefits, but when we put an impersonal government agency in charge of determining costs, benefits and eligible recipients of care, we are putting our vary lives in the hands of a government that does not know us personally. When that happens, you can count on sacrificial lambs as budget deficits increase and resources become scarcer.