Sunday, March 21, 2010

Healthcare: Break It Down - For Me, Please


You know, like most people, I don't normally engage in political discussions in my day to day life as such discussion is generally viewed as rude and polarizing. In business or even social settings, it is a generally accepted rule of thumb that politics is an unwelcome guest and is considered a faux pas. Instead, the general consensus is that we should maintain a high degree of political anonymity so as not to be seen as intolerant of anyone having an opposing view point. So political discussion is not really appropriate unless you are in your home among family or friends, and then they should share your view for the discussion to be appropriate, so politics has been privatized.

Someone once told me that the last virtue of a scoundrel is tolerance. This is because once a scoundrel has extracted all other virtues, he preaches tolerance because that is how he justifies his lack of virtue. I think in some ways, this is how I see political correctness. It is basically the belief that your opinion must not infringe on anyone's feelings, since feelings are the ultimate measure of truth in our generation. In the name of political correctness, we have demonized or discouraged direct and frank dialogue on any number of issues of great importance. Keep important matters of opinion private or else you might hurt someone's feelings, which is intolerant and unacceptable. It does not matter how wrong the person is. No, they must go on in blissful ignorance. Well, I for one believe that all ideas and truth claims do deserve an equal voice (freedom of speech) but does not infer, nor would it be logical to infer, that equality of speech is the same as equality of merit or truth. In fact, this cannot be so. In logic, this is called the law of non-contradiction, meaning two statements that contradict cannot be equally true. One idea is superior to other when it has passed the appropriate tests for truth claims. As with all truth claims there is such a thing as exclusivity.

I am not a politician and I have never claimed to be. I am not a medical professional nor a lawyer. In fact the majority of us are none of the above. This makes us all somewhat less than qualified at fully understanding the nuances of the 1000+ page Healthcare Bill. I am not exactly sure how long it would take to read such a bill, much less understand the language it contains. It seems to me then, that the amount of time allotted to review such a document (72 hours) is a bit insufficient. If someone told me to read a 1000+ page book in 72 hours, I could probably do it, but I would likely internalize very little of it and I would probably not get much sleep in the process. This is not a criticism of the bill but it is, I think, a fair criticism of the process.

Beyond this, I find the logic for the socializing of our Healthcare system a very poor one. We all agree the current system is in need of reform. So the option is to reform or not to reform. Agreed. The massive jump in logic for me is when the term "reform" has been equated with only one option: government run healthcare. Why is that? Generally when there is a problem, there are many potential solutions to that issue. I see no difference in this case. To assert the notion that there is only one solution to the reform of US healthcare, and that solution can only be to socialize it is, for me, degrading to my intelligence. I would compare this with the following illustration I have come up with: "Hey doc; my leg is broken. Can you fix it? Well yes, it is broken and you can't keep walking on it while it's broken. Well, it looks like the only solution is to chop it off and replace it with a prosthetic one which I can get from the government. Doc, you mean there are no other options? Nope. If you don't cut it off, it will just stay broken. The only person who can fix your leg is me and the only place to get a new leg is the government. Outside of this, there can be no fix. But Doc, can't we fix it without chopping it off? Can't we fix the broken bone and keep the rest of the good things about it? After all, it is mine. Besides having a broken bone, isn't there a lot of up-side to keeping my own leg? Nope. Nurse, please bring the government in to vote on whether the patient should purchase a new leg or keep his broken one."

I know I have just over simplified a very complex issue, but this is how government run healthcare seems to me. This is how it has been sold and quite frankly, it ticks me off. Brand the bill and its objectives whatever you want, but it is step one for a single payer option. It is a massive new entitlement which will be just as poorly run as Medicare, Medicaid, and Welfare. The independent government research offices have now estimated that 56% of all Americans will be forced to abandon their current healthcare benefits and opt for the government run version. Those who are uninsured, must be insured or face stiff penalties. In addition, since no one can be denied benefits for preexisting conditions, private insurance providers will be forced to offset this cost somehow. This will either require higher premiums or government subsidy, which will be funded by the American people. This will effectively break the back of the private system as we know it. Explain to me what I am missing and why government run care is the ONLY option??  Love to hear from you on this one.

5 comments:

  1. First of all, you have already come to the crux of the matter when you admit you are not a lawyer or a politician ... nor a physician. That declaration in itself is one that could be made by all on Capitol Hill. At least as far as I know not one member of Congress can say he or she is all three. There are a few who are both physicians and politicians. There are many (way too many) who are both politicians who have also passed the bar. Therein lies the truth in the fact that government has little reason to be in our doctor's office, a physical rehabilitation setting or in the operation room. I would no more want a democrat (nor a republican for that matter) ... any politician ... to cut me open for exploratory surgery anymore than I would want a cardiologist to draw up, introduce, argue, persuade and obtain votes for a bill on a law that governs the utilization of wire taps to listen in on potential home grown terrorist. Now since I feel like most Americans who give Congress an approval rating of 19% (or less) I'm not even sure any more if I could want them to decide on any legislation any more. But I certainly would have vast more confidence in a cardiologist exploring me for heart abnormalities than a congressman writing and passing any law these days. The federal government should not be deciding who, when, why, where and for what purpose I see a doctor of my choosing.

    Should they pass laws that say my doctor needs to be properly educated, assessed and licensed? Sure. And would I be pleased if they can eliminate excess charges by both the physicians, the hospitals and health insurance companies so that I am not paying $18 for a bandage? Absolutely. Those in favor of what is specifically known as Obama Care like to say that the over whelming majority of Americans want health care reform. Yes, that is true. It is true as it applies to my previous examples. We all wish to pay less for any medical procedure if on our bill we see charges that are a thousand times more than the Walmart cost for a single band-aid. And we do not want for some insurance company to be able inform our doctor that they will not pay for an MRI when our doctor knows he needs that further look inside of us to be able to make a proper and thorough diagnosis of our ailment. We don't favor insurance companies that tell our doctors our doctors' business. Nor do we want our private, trusted physician to have to pay enormous monthly premiums for malpractice insurance. They do so now because law suits against doctors and hospitals have run amuck and politicians refuse to put a cap on medical law suits. So, yes, we want and need health care reform.

    Yet, those who are in favor of Obama Care never admit that what we want in reforms are what I just mentioned. They act as if what we want is what the Democrats in Congress have proposed and are apparently about to approve and pass. They tell us that our health care will not suffer but instead will be better and more affordable and that it will, in fact, be a savings to both us as individuals and to the country as a whole. And they tell us we will be able to keep our doctors and our current health care plans. Yet, they also tell us this new bill will cut a half a trillion dollars from Medicare. Although delayed for now it will also cut Medicare reimbursements to doctors by 21%. All private health care insurance providers must accept all patients regardless of preexisting conditions. Union members with so called "Cadillac policies" will be exempted from paying higher taxes on those policies. Every employer and every company must provide health care or pay fines. Individuals so as myself who are self -employed must also buy a health insurance policy or also pay a fine ... or even go to jail. Caterpillar announced this past week that Obama Care will cost them $100 million. Anywhere from 30% to 51% percent of physicians say they will not only get out of medicine altogether if Obama Care passes but most of that group will encourage their own children to not become doctors.

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  2. Uncle Mike continuedMarch 21, 2010 at 9:40 PM

    I could go on with fact after fact but I think that is enough to dispute that our health care system will not be better. It will, in fact, suffer. And with time it will get worse. I do not say this as an opponent of Obama. I say this with the knowledge of all I have read by those in the medical field and insurance industries. And since it will become mandatory for the private health care industry to accept all preexisting conditions then it has been predicted that all but the largest insurance companies will go out of business within ten years after Obama Care begins. Most all who now pay for private insurance will not be able to pay for the rise in premiums. The private companies will have to charge us more because they will now he covering the costs of all preexisting conditions. That is simple math. And like many of you, I have heard and seen Obama clearly state that his objective is single-payer public insurance. If Obama Care runs the private insurance industries out of business then he will get just that.

    The CBO says on the surface it appears that Obama Care will cut the deficit. That is because the CBO must be totally objective and crunch the numbers as they appear in the bill. Many in congress who have agreed to vote 'yes' have said they would do so because they have been promised they can rewrite the bill after voting on it. Accounting sources outside of the CBO says when all of the revisions are added on later then Obama Care will not be deficit saving but instead budget breaking with figures anywhere from a trillion dollars to twelve trillion dollars added to our deficit. One source even states that Obama Care will bankrupt the United States in less than fifteen years. By then both Medicare and Social Security are also predicted to go bankrupt.

    Now, to expand on your illustration, it is 2010. Your roof leaks and you decide to do the work yourself because it's not that big of a job and you enjoy a little hard work. You fall from your ladder. Your leg is broken and you go to your private physician. Thanks to the money you and his other patients have paid to him, though those payments seem excessive at times, he has been able to purchase a state-of-the-art X-ray machine so he can perform a better diagnosis there in his office. So you are helping to pay for that piece of medical apparatus but you are fine with that because you are not being sent off to somewhere else to see someone else ... both of which would have added to your doctor's fees. You are also aware that those fees have to be a bit higher every time your doctor's malpractice insurance soars. One physician told me, and this was four years ago, that her private practice of four pays $250,000 in premiums just for protection from malpractice suits.

    So there you are in your chosen doctor's office. He comes back with the X-rays which he read without having to call in a radiologist ...another fee you would have paid elsewhere. Yep, you have a broken leg and nurse Mary will be in shortly to apply a plaster cast. You should miss work for a day or two at the most but that is optional. And luckily ... well not really ... your health insurance will cover all fees but your deductible. After all, that's why you made those monthly payments. You're not completely happy with all that it has cost you but it beats walking around with a broken leg, huh?

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  3. Uncle Mike continuedMarch 21, 2010 at 9:51 PM

    Then came Obama Care. The year is 2015. You broke your leg. You had a leaking roof. You needed to do the repairs yourself because all of the roofing industry now is unionized and even a small repair job would be too much. You slipped off the top rung and fell. In the past you would have called your insurance guy just to make certain that all you need is the insurance card you carry in your wallet to get you in and taken care of. But it has been difficult to reach your agent lately since he lost his house and his office. He got caught up in the housing bubble fiasco and when he went for a new loan he discovered that the fix that Obama claimed would have solve all housing loan problems back in 2010 was a lie and practically no bank is giving out housing loans now...especially someone in his line of work because everyone knows that the last job a person wants is selling private health insurance. And the last person a bank is going to loan money to in these tough times is a guy who sells private health insurance. So after the phone rings for the umpteenth time you hang up.

    You need someone to drive you to the doctor's office but your wife is at her second job because her main job dropped her back to part time because they are now mandated to purchase health insurance for all full time employees. Unfortunately for the company she works for that won't make much difference much longer because soon what will be worked into the revised Obama Care bill (seventh revision) is that all employees, even part time ones must be afforded full health care insurance coverage by their employers or pay more fines. Luckily for you your next door neighbor, Sam, is home. He used to work full time in the auto industry but soon after Obama took over that industry the bottom fell out. It's a shame he worked in the manufacturing sector and not in the repairs business. The repair business is doing well these days ... with all of the recalls and all. Sam's sweet Cadillac insurance policy he had when he worked for the UAW will expire soon since the union he was so loyal to for most of his adult life has decided that those no longer working would be better off with Obama Care. So the UAW dropped Sam and his health insurance. All of those premiums that came out of his paychecks for health insurance and union fees are worthless now.

    So Sam drives you to your doctor's office. It's been a while since you needed to see your doctor but you would swear it was never this crowded. As it turns out your doctor now also see the patients of Doctors Jones, Smith and Johnson. Back in 2011 they had decided to no longer see patients who paid with Medicare. First they had to lay off half their nursing staff. Then went the ability to keep and maintain their X-ray equipment so it was repossessed. With less coming in they could not longer pay for malpractice insurance but they took their chances. Unfortunately, a woman came in one day with terrible arthritis and she slipped on the recently mopped floor in the outer office area and her single law suit wiped them clean. Hard to believe that a broken hip could cost $21 million.

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  4. Uncle Mike continuedMarch 21, 2010 at 9:54 PM

    Sam tells you that as depressed as he has been lately the last thing he wants to do is to sit around for hours in a doctor's waiting room so he'll head back home and you should call him when you are ready to leave. It's 3:00 PM now and you know that Sam will be drunk by 5:00 since that's how he deals with his unemployment and depression so you tell him 'bye' and start making a mental list of who else you can call to come and pick you up later. You hobble up to the receptionist to let her know you have broken your leg. You immediately recognize that she is the doctor's wife, Emily. Between their loss in the stock market in 2008, the 21% cut in Medicare reimbursements, malpractice insurance premiums going up 50%, pharmaceutical representatives coming by less and no longer giving out box loads of free samples and the banks refusing to give the doctor a loan to allow him to build an additional wing to accompany the increase in patients due to the Jones, Smith and Johnson physicians' business collapse...Emily was needed at the office full time.

    But Emily knows you well and so she will see that her husband takes you right on in, right? After all you have a painful broken leg. It may even be a compound fracture. Yet, Emily tells you that you will have to wait and she doesn't know how long. Fact is, she tells you since your broken leg doesn't appear to be life threatening you would be better of coming back another day. Say...next Thursday. There's only a slight chance of infection since you appear to be healthy so the doctor can write you a prescription for that and you'll only miss four days or five days of work ... plus the extra day you'll have to wait in the doctor's office...if the X-ray machine has been repaired by then. The SEIU union for X-ray repairmen has been allowed through congress to bump up their fees 100%. Now, you can stay and wait but there are no guarantees he will be able to see you today. You begrudgingly hobble over to an end table and decide to sit it out there...carefully. The elderly gentleman next to you tells you not to worry. They'll probably see you and that actually you are pretty lucky. His wife, who is seeing the doctor now, had to wait four weeks to be seen. She has a lump in her neck but it wasn't effecting her swallowing so she was put on a waiting list. As long as he was there the old guy had thought about telling the doctor about his cough and blood in his urine but he doesn't want to bother the poor man. He is so busy these days and isn't looking too good himself. "Doc has enough to handle without some old man making it worse. Doc is under enough stress as it is."

    You have a broken leg. It is 2015 and you would have been better off staying at home. In fact, you would have been better off never getting on that ladder in the first place. So your roof leaks. Everybody has their problems. You should have gone next door to Sam's and had a few beers and reminisced about the old days when you could afford a roofer...and a doctor...and health care insurance.

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  5. Tonight is a dark night in America. There are so many wrongs committed here, I don't even know where begin. This healthcare bill has been passed in political arrogance and in deliberate and unprecedented defiance of the will of the overwhelming majority of Americans. It is sickening. This bill conservatively adds $1 TRILLION to an already mind boggling deficit of more than 13 TRILLION dollars. Most importantly, it has done NOTHING to lower the actual cost of healthcare - the linchpin issue that should have been the focus of legislation. From independent resources, it will undeniably negatively impact our choice, our freedom, our economy, the free market, the quality of our healthcare, job creation, pro-life legislation, and as we are now hearing, student loans, and who knows what unintended consequences not fully realized for perhaps a decade. It is a massive new social entitlement and expansion of government. The Constitution was intended to protect us from government and tyranny, not to have Government protect the people from themselves. In spite of it all, I know God is in control. The Lord has given men free will, and I think tonight they reaped what they sowed in the presidential election. Those who voted for "change" are getting exactly what they asked for by accepting such ambiguous terms because they did not think to ask themselves the basic question, "Is all change for the good?"

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