Sidney™

My friend, Huli, is right. The biggest problem with healthcare in America is cost, and it’s a whopper. In 2008, $2.3 trillion was spent on healthcare by all sources in our Country. And the amount grows higher each year. In this Part of Healthcare Ideas From Us, Huli and I will share our thoughts, and Riley’s, about fixing the cost problem while maintaining quality.

Huli, what are the consequences of our growing healthcare costs?

Huli: The increasing price tag is making healthcare unaffordable for many, even the Federal Government. The CBO reports that the biggest threat to the stability of our economy in the coming decade is the amount budgeted for Medicare and Medicaid. And that doesn’t include the staggering cost of ObamaCare.

Sidney: Let’s talk about why healthcare is so expensive. Advances in medical technology account for 50% of the increase over the last 10 years. This is unlike other industries where technology reduces cost through improved efficiency. What’s different about healthcare? Many of the new procedures require expensive, cutting-edge drugs and equipment, and specialized medical skills.

Huli: Other factors boost cost, too. A profit motive in overdrive. An overburdened delivery system that will only worsen with our growing population. And, too many of our increasing numbers with bad health habits and lawyers on speed dial. Then there’s the waste of administrative inefficiencies and the opportunities for fraud it creates. And, like other industries, inflation raises costs over time.

Sidney: Let’s face facts. Healthcare will always have a cost angle unless we’re willing to dumb-down the technology and the people who administer it. How many of us want “free” healthcare from humans who graduated at the bottom of their medical school classes? And who will raise her hand for rationed care?

Huli: But, what about Rational Care? My blue pencil can slash the fat to make treatment affordable while keeping high-quality care. Like, cutting administrative waste and fraud by using information technology infrastructures to modernize that ugly step-sister of healthcare. And motivating us to eat healthy diets and follow good exercise programs.

Sidney: Rational Care must also scrap the costly procedures used only as check-box defenses in malpractice actions. Shouldn’t medical science decide what procedures and medications are needed rather than personal injury attorneys paid by the case? If greed wasn’t good even for Gordon Gekko, we sure don’t want it in healthcare.

Huli: Similarly, there’s no demonstrated correlation between high cost and the quality of care in our system. How about incentive bonuses for developing superior treatment regimens delivered at low cost?

Sidney: And the biggest change of all? Turn all hospitals, insurance companies and pharmaceutical houses into tax-exempt non-profits requiring them to plow their former profits back into reducing costs. Let Rational Care go a long way to financing itself.

Huli: We still want to highly compensate the people who make healthcare happen, because we want to attract the best to do their best.  But, at the same time, it’s obscene for companies to profit from the ills of others.

Sidney: Rational Care will require oversight by an independent, qualified board, with judicial review as a last resort.  And the board members must be appointed by a competent panel of experts, with politicians nowhere in sight.

Those are our broad-brush ideas. Thanks for letting us share them.

See you on the left-side.

The President unveiled his response to the Massachusetts voters on Monday in his revised healthcare proposal, ObamaScare Redux. Rather than starting over or even paring down, the President upped the ante by billions of dollars – it’s like millions, only with a very large “B”. He also added more penalties, higher taxes for many and expanded Government regulation. You can almost see the choppers of voter disapproval closing in on D.C.

Please understand that I’m not against healthcare reform. But like my friend, Huli, a Golden who lives on the next street, says, it has to be fixed in another way. We need considered business deliberation to meet achievable objectives rather than wild and woolly political machinations.  More about that in a later blog. Perhaps Huli will write it.

Right now, ObamaScare Redux makes the Senate’s version look tame. In fact, Redux is very much an “in your face” retort to overwhelming public opposition to the Democrat healthcare proposals. What is Obama thinking? Apparently, that he can get away with it because he’s tied his Presidency, and his Party, to enacting expansive and invasive government ownership of healthcare.

What are some of the ObamaScare changes? First, cost. The Redux price tag, according to the Administration, is $950 billion, an admitted $79 billion north of the Senate bill’s tab. But the CBO rates the Senate version’s actual cost at over $1 trillion, which means Redux is even higher. Second, penalties. Rather than an annual fine of $750 for failure to buy health insurance, individuals will pay a yearly penalty of 2.5% of their income. So, if you make over $30,000 annually, you’re in the crosshairs.

Third, taxes. They just get bigger. And people making over $250,000 will be hit in two ways. Higher income taxes, of course. But now the Medicare payroll tax will be applied to their unrealized investment earnings. So, the funds people are trying to grow for retirement have a government drain. Redux does provide for oversight of insurance premium rates. But, that can be done without any of the other provisions.

The text of Redux was released on the eve of tomorrow’s health summit with congressional leaders. It incorporates none of the Republican proposals to fix the healthcare mess. Obama has, in essence, stuck out his jaw and dared the opposition to take a swing so he can paint them as partisan. And if they don’t eventually co-operate, he’s threatening to misuse the reconciliation process to ram his plan through with bare majorities in Congress. Can you hear the choppers?

Why, in the face of public opposition, would Democrats even consider voting for Redux? The argument being made for their support, in addition to the usual pork barrel madness, goes something like this. “Since you’ve already squandered so much time on healthcare this term, you’d better have something to show for it in November.”

They must be kidding. Where is the logic in expecting to benefit from actually taking an action that the electorate abhors? Long gone is the lesson of Clinton’s mid-course correction after the 1994 elections. The choppers have them in their sights.

See you on the left-side.

Today’s healthcare bill is so full of pork that “health” really shouldn’t be part of its name. And the funny thing is, no one disagrees. Not that they could. The “Cornhusker Kickback”, the “Louisiana Purchase”, the unions’ skate on the Cadillac tax, the closed-door-democrat-only wheels and deals are paint-by-the-numbers pork.

But why is there so much of it? Because, these days, pork is necessary to get most bills passed. In fact, the worse the bill, the more the pork. Looking at it that way, pork doesn’t make a bill bad so much as tell you how bad it is.  Pork is the new barometer of bad.

How did our politicians get so greedy? Through the enormous sense of entitlement that power breeds. Nothing is too good for them. No perk, no bribe, no excess. And the longer a politician stays in power, the larger his sense of entitlement becomes. So, when you get a whole room full of them together, the pork feeding frenzy is uncontrollable.

And now they’re very confident that ordinary Americans are about to be hooked on entitlements, too. In fact, they’re betting their political futures on it. Why are they so sure? Take the healthcare bill as a perfect example. We may want healthcare reform, but we don’t want that bill. Just look at the outcome of the Massachusetts Senate Race. Or the gubernatorial races in New Jersey or Virginia. Or the number of Democrats who have announced their retirement from Congress. Or poll after poll that screams “no”.

Even though every type of “vote no” communication we can send has been sent, the people who hold the reigns of power ignore it.  Every bit of it. They slam their doors on our wishes, horse-trade in secret and pass out pork like it’s none of our business. We might as well be bound and gagged for all the attention we’re getting.

What makes politicians this bold? Why are they so dismissive of their electorate? They’re convinced they have the upper hand. And it’s a two-fisted smack down: votes and a very big hook. As far as votes go, they only need 218 Members of the House and 60 Senators to ram through any legislation they want. And that hook? We may not like the healthcare bill now, but, after we get used to it, we’ll love it. Why? Entitlements are addictive.

So, that’s it. That’s their grand scheme. Force-feed us entitlements until we’re hooked. And, unlike their healthcare haggling, they don’t bother keeping this one a secret. They’re very upfront about it. And, if they’re right, they’ll win a lot more than their next election. Like junkies, we’ll have to keep the dealers around pretty much forever just to keep those fixes coming. And like junkies, it will cost us our way of life.

As addicts themselves, politicians are certain Americans will absolutely love entitlements. And the plan is to have us loving them before the fall elections. But, will we be hooked? Will we allow a sense of entitlement to replace our work ethic and swap an avalanche of debt for a “free” ride?

The answer may resound from Massachusetts in January all the way across the country by November.

See you on the left-side.

“Dear Nancy,

I received your Christmas wish list last week and, I have to tell you, I’m more than a little surprised. You’re old enough to know by now that only good boys and girls get gifts. Naughty children find coal in their stockings. And, really, it doesn’t look good for you this year. To show you what I mean, let’s review some of your deeds in the past twelve months.

In January you allowed yourself the automatic annual pay raise that Congress set up for itself in 1989. You could have, and should have, declined it, considering the multi-year economic meltdown that your Country finds itself in. But, while record numbers of your people are out of work, your government salary continues to increase. In 2009, it reached an all-time high of $217,400. Very, very naughty.

Then there was the way the first round of stimulus money was actually spent. You hyped it as a necessary step in the economic recovery of the Country. In reality, according to a statistical analysis of where the money went, there was NO correlation between economic need and spending. None whatsoever. The only correlation was party affiliation. 73.47% of the $157 billion went to Democrat districts. Unbelievably bad.

The healthcare bill that you personally rammed through the House of Representatives is another whopper of a transgression. Why? 57% of the American public are against it and prefer that Congress do nothing rather than make your bill law. Your response? As you stated in a magazine interview this year, you don’t pay attention to what other people think. This is a shameful attitude for someone who is elected to carry out the will of the people.

Your worst behavior this year? It’s a toss-up between bankrupting your Country and bankrupting the moral fiber of its people. For the first part, you continually create greater and greater entitlements that will inevitably impoverish the Country you are sworn to serve. Seriously, there aren’t enough people making over $250,000 in the U.S. to pay for your reckless spending. And you’ve already borrowed so much money that China owns the economic futures of unborn generations of your citizens.

Then there’s the way you pass out entitlements. Like a heroin dealer on a street corner, you’re hooking people on getting what they want simply by taking it from others. The land of opportunity and hard work, of self-improvement and personal success, is rapidly becoming the biggest social welfare dump on the planet. All this at a time when other countries that have done the same thing are trying to dig themselves out.

Why are you acting out like this? In a word, power. By drugging people with large doses of entitlements, you disengage them from the political process. They don’t care what you do as long as you’re around to give them their next fix. For that, you go straight to the top of my worldwide naughty list.

And, I have to say, Nancy, your behavior must improve in 2010. I had to get a special permit from your EPA to mine the coal you’ll find in your stocking this Christmas morning. There’s not enough left on earth, or a stocking in the North Pole big enough, for what you’ll deserve next year, unless you straighten up. If you don’t, the voters in your district will have to do my work for me.

Sincerely,

Santa”

There’s been a leadership vacuum in Washington for quite a while now. You can hear the giant sucking sound all the way to the Hawaiian Islands. In fact, some say all that rushing air causes most of the hurricanes and tidal waves out in the vast waters of the Pacific.

And you’ve also heard about the list of powerful organizations that really run the Country. Like, the military-industrial complex, the tons of special interests groups with all the cash, the conspirators behind the new world order, etc.

Let’s not forget one of the most powerful. Pollsters. That’s right. Those folks who are paid to survey public opinion on everything political. At first blush, polling seems like a nice, little, unassuming business to be in. So, who put pollsters on the “real leaders” list? Politicians, that’s who.

More and more, politicians base their actions on poll outcomes. Lacking the sense of public service required to make hard, unpopular choices, our elected officials scurry under the protective cover of polls. A big part of Obama’s dithering over troop increases in Afghanistan is due to his hand wringing over what the polls say. Too often, if a poll says “no”, the President marches right along, bringing up the rear in the poll parade.

O.k., so politicians use polls as crutches to prop up their weakness. What’s really so wrong with that? It sounds like the will of the people in action. We speak. Politicians obey. Right? Not even close. Why? Let’s talk turkey about the trouble with polls.

The biggest problem is bias, with lack of clarity a close second. But, let’s just talk about the bias issue. It can permeate the questions, the survey takers and the responders. When bias is present in any of those elements, the poll results are completely compromised. Where exactly can bias creep in? Everywhere.

In the subject matter and the timing of the polls. In the chosen demographics and the number of people polled. In the questions themselves – like, which questions are asked, how they are phrased, even the order in which they are presented. And, when the questions are asked in person, suggestiveness can appear in the verbal inflections of the questioner or in her body language. And the bias beat goes on.

Surveys are so notoriously unreliable that they are avoided, if at all possible, in scientific research. Ditto for the non-profit world. Grant writers seeking funds from private foundations had better come up with arguments more compelling than “survey says”. But, not in the realm of politics. There, polls, with all of their misdirection, are our guiding light.

So, what’s the chance that pollsters will drop off the “real leaders” list anytime soon? Exactly the same as the chance that politicians will start being the real leaders. Unsure about when that might be? Let’s take a poll.

See you on the left-side.