BLOGS FROM US

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.

Most everyone criticizes the healthcare proposals from Obama and Congress. Many believe the remedies are far worse than the ills they’re supposed to cure. So, Sidney and I have come up with a couple of thoughts about how to fix things. You know, some healthcare tires for folks to kick.

I’m going to write about the first part – the problems we could try solving and the approach we might use. Next week, Sidney will present some solutions.

The first thing to do is decide what we really want to accomplish in healthcare. Forget about the politicians and their syrupy, self-serving speeches. What’s important? Doing nothing? Doing something? How about this: solid, affordable healthcare that covers all Americans, including our pre-existing conditions.

Is this a good idea? If you’re right-brained like me, you’re in favor because it makes you feel good. And if you’re left-brained like Sidney, you want it, too, because it makes sense.

What’s so sensible about it? A healthy population goes a long way to keeping a country’s economy purring. Isn’t it better to have hale and hearty, productive citizens rather than a society of sick ones? And if preventative medicine is any good, healthcare for Americans will end up saving money in the long run. You know, an ounce of checkups is worth a ton of medical procedures.

The next thing we need is the right approach to meeting our goal. How do we get there? For starters, without the politicians. We’ve seen how they behave. Doling out pork to each other. Secret wheels and deals with industry leaders. Huge deficits that we’ll never pay off. Slow death by government. To be successful, we must separate self-interest from the solution process. That means no politicians.

There’s another reason to just say no to politicians. Congress is not qualified to develop a comprehensive healthcare plan.  Of the 535 voting members, over 450 have lived lives saturated in politics. They’ve been state legislators, governors and lieutenant governors, former congressional staffers, White House aides, cabinet secretaries and town mayors. A lot of political jobs. Not a lot of real-life experience.

Politicians don’t even try to fake the necessary expertise. How many bothered reading the thousands of pages in the House and Senate bills before voting along party lines? According to them, almost none.

If we have any doubt about how bad politicians are at creating healthcare systems just look at Medicare and Medicaid. According to the CBO, current federal spending for those two entitlements is the “biggest single threat” to budget stability. It will grow faster than the economy over the next 10 years. And politicians have zero inclination to do anything about it, except spend more.

But, eliminating the politicians is not the end. It’s the beginning. Who will develop a solution? A group with proper expertise and no financial stake in the outcome. A combination of medical scientists and business people with experience in the healthcare industry, but not beholden to it. Both are needed to develop a common sense, workable solution. And next week, we can read about one.

See you in the mirror.

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.

Now that Obama has completed 12 months in office, it’s time for his annual review. Turns out, his job performance is like a song. Five of them, actually. The Obama hit parade of 2009.  So grab a boom box and let’s give a listen.

1.            Promises, Promises

Obama got elected because he wasn’t Bush and because he made several come-hither promises. Not being Bush was a no brainer since the real George is an old white guy living in Texas. So, score Obama an “A+” on that one. But what about those promises, like See-Through Government, A Better Buddy System, Death To Pork and Yes To Health? How did they play? Stay tuned.

2.            Dirty Little Secret

The See-Through Government thing turned out to be a total bust. Obama’s style is secrecy-as-usual. His private bribe sessions with leaders of industry and closed-door-democrat-only wheels and deals threw mud all over transparency. And when was the last time he held a press conference? July 22. Bye-bye commitment to monthly conferences. But, then, not having them is way better than letting the press lift the rhetorical rock you’re hiding under.

3.            My Way

How about that Better Buddy System? You know, renewed bipartisanship? Obama started out by crowning more Czars than three centuries of Romanoff rulers combined. Why? To consolidate unreviewable power in the White House. Then there was the $787 billion Bank Bailout.  Obama stood silent as Nancy Pelosi crowed, “We won the election. We wrote the bill.” Later, he slammed the door on Republicans in final healthcare negotiations. In fact, Obama didn’t orchestrate a single bipartisan piece last year. He didn’t even try.

4.            Been Caught Stealing

Deficit spending is spending what you haven’t got. It’s stealing from the future, from taxpayers who will do the time for today’s crime. And Obama is pulling a colossal caper. In just his first year, $1.675 trillion, or more than 15%, was added to the national debt. According to his Administration’s own estimates, he’ll run up almost as much debt in four years as the old Texan did in eight. Of course, he’s promising to take from the “rich” to break even. Trouble is, his heists are so huge that, within ten years, every American who earns a living will be one of the rich. Welcome to the land of opportunity.

5.            Roll Out The Barrel

Before the election, Obama pledged to review bills “line by line” to dump the pork.  He must have been kidding because he’s pushed so much pork on the Country that barrel makers are having difficulty keeping up. Just take the Bailout Bill and the 2010 Defense Appropriations Bill. They contain almost ten billion dollars, and over ten thousand pieces, of pork.

And how about Obama’s same-song-second-verse entitlements packages? Back in the day, welfare was a temporary measure to put folks back on their feet. But, it’s long since become a way of life, generating a fierce sense of entitlement and turning welfare into a public pork trough.  And just like the pork needed to pass bad bills, entitlements are the pork that keeps bad politicians in power – and eventually will send us to the poor house.

So, that’s Obama’s hit parade. A bunch of very sour notes. On the bright side, he couldn’t complete the discordant healthcare bill he wasted so much time orchestrating. But, he did leave the economy singing the blues. He has to be totally tone deaf. About his performance – score it in the key of “F Minor”.

See you in the mirror.