Health Care

This video demonstrates that when the principles of free enterprise are applied to healthcare, miracles happen.

Quality care can cost as much as 80% less when waste, carelessness and greed are replaced by good business principles, honest competition and informed consumers.

Yes, we have the finest healthcare in the world but there is plenty of work to do to make it fair and affordable.

Start with Medicare for example:

  • Medicare is fixated on price instead of cost.  Don’t underestimate the damage caused by this insidious short sightedness.
  • Competition is not just discouraged it is outlawed!
  • The best and worst, the most efficient and the biggest wasters all get paid the same.

Pressing needs include:

  • Insurance reform
  • Tort reform
  • Universal Electronic Medical Record
  • Fair treatment for the working poor who are not eligible for Medicaid but cant afford private insurance.

Please consider our diagnosis and prescription for preserving the good in our system and fixing only that which is broken:

Patient Centered, Free Enterprise Health Care Reform

The video below illustrates some of the lunacy of our present healthcare system and has a little fun doing so.  What if air travel (that paragon of efficiency) worked like our health care system?  Hmmmmm…

I am having a very difficult time understanding many of my “fellow Americans”.

I look around me and see the “American Way” quickly becoming something I am less than proud of.   I see that corruption in our federal government has risen to extreme levels that I never thought possible.

Radicals, socialists, communists, crooks, thugs and automatons pervade the highest levels of our government.

I see a huge power shift from the people to our corrupt government.

I see Black Panther bullies given a pass for outlandish intimidation of voters at a polling place.  By the way, my concern has NOTHING to do with race, it has only to do with America and our law.  I wonder how Mr. Holder would have handled guys in white sheets intimidating black voters in Mississippi?  (I would hope he would stow them under the jail as he should have done with the Panthers. Now I have insulted both the panthers and the clan.)

I see a health care law enacted that creates many more problems than it solves and a US Army unit training in Georgia to handle “domestic unrest” with in our own borders.

I see terrorists being called ill instead of hateful and Americans who cherish traditional American values being ridiculed and mocked.

I see presidential promises broken with a wink instead of an apology (and America winks back).

Speaking of apologies, I see POTUS apologizing to the world for everything that is good in America.

I see our government trashing our relationships with our closest allies and sucking up to those who hate us.

I see our economy being trashed and our children’s future being squandered.

I see what has been a worthless media, rising up and becoming a malignant force that seems to be bent on our destruction.

And our congress! when did it become the enemy of America?

I feel like Rip Van Winkle!

It seems that bad has become the new good and good has become outdated, uncool, and stupid. (Props to Isaiah the Hebrew prophet for warning us this would happen)

The point is, I see these things and think: Germany, circa 1936, Argentina, circa 1955 (or North Korea, circa today).  Whereas, millions of my fellow citizens, see a great new hero who is leading America to its glorious destiny.

And, when I try to talk to one of these citizens who refer to themselves by the euphemism “progressives”,  I begin to see how much trouble we are really in.  Trying to talk to these “progressives” about our founders and the constitution or freedom and its price, is worse than trying to talk to a fence post.  At least the fence post can generally be counted upon to be free from body odor and refrain from spitting on you or clubbing you to death with nonsensical sound bites and mantras.

It is more like trying to teach a pig to fly.  It is a complete waste of time and it annoys the pig.

In reading this, you may conclude that I hate Mr. Obama, but that is not the case.  I hate what he is doing to the America i grew up in.  The one that was created and preserved by the blood and sacrifice of my ancestors.  The one that I have served and struggled to pass on to my posterity.

But I do not hate Barack Obama.

I believe he is simply being himself and doing what he sincerely thinks is best for himself and those he cares about.  There are no surprises with Mr. Obama.  He is exactly what he seemed to be before he was elected and he is behaving exactly as he told us he would (for example: why should he prove he is ineligible for this great job when he can get a pass and keep feeding at the trough?).

When he reminded Republican law-makers that “Elections have consequences” shortly after his inauguration, he was simply setting the tone for his presidency.  He brought his friends and associates with him to Washington just as Jimmy Carter (the last president whose stupidity we almost didn’t survive) did.  It just so happens that rather than being a bunch of “crackers” (and I mean that in the kindest possible way.  Some of my best friends are from Georgia) Obama’s cronies are a bunch of thugs, crooks and radicals (ooops, now I have insulted Chicago).

I don’t hate Barak, I just want the USA to survive him and get back on track.

And I should say this:

Our country has been off track since long before Mr. Obama bounded onto our stage.  In fact, we have been the proverbial “frogs in a pot” for decades.

We have been steadily pursuing a slide down the slippery slope we started in 1962 when prayer was first banned in schools.  This slide was certainly accelerated in the decade beginning in 1965 during which we sacrificed 50,000 American lives in a futile war in Vietnam for which we had no clearly defined objective and no commitment to “win” (whatever that meant to the politicians), then again in 1973 when Roe v. Wade paved the way for the legal slaughter of over 50,000,000 unborn babies so far.

I thought the slide was over when Ronald Reagan was Elected in 1980.  Unfortunately, that merely just a pleasant delay, but it made me feel optimistic about our country again after the Carter fiasco…er… administration.

When you think about it, If the Obama regime serves as a wake up call to a sleeping American populace (who have been enjoying the warming water in the pot for at least five decades) before we actually boil to death, Mr. Obama could be the best thing that has happened to America in fifty years!

Yep, Vaughn was exhausted, but we had set the date with Glenn Beck in March and even having nearly crossed the country twice in a day already wasn’t going to stop us now! He emptied his luggage and threw in some clean clothes being careful not to forget the Patrick Henry shirt given to him at a town hall meeting we had attended. I never really know how to prepare for trips where we fly stand-by. It could just be a trip to the airport and back, but this time we felt unusually assured that things would work out. With everything all set and grandma here, we said our prayers with the kids and confidently headed into the eye of the gathering storm.

We arrived the morning of 9/11. We picked up our rental car and drove to the hotel. It was raining and I was worried because the weather station had predicted heavy rain for the following day. We made our way thru the gloomy weather and after checking in exceptionally early (6am) without any problems (our original plan had us arriving at usual check in time) we gratefully threw ourselves on the bed and slept.

After recovering (we had to fly from Salt Lake City to California and THEN to D.C.) we decided to head in to see the sights before the big day. The rain had stopped, but it was still overcast reminding us of the solemnity of the day. Thankfully it is always exciting to pull in and drive down Constitution Avenue and see all those historic buildings, monuments and memorials. It brightens the mood to think of all the wonderful people who came here and sacrificed so much to start something so great. After finally figuring out where to park we got out to do some bi-pedal touring. It was a peaceful day and it surprised us how quiet the streets were. It was lovely to visit and we especially enjoyed the WW II monument, reading every engraved quote. But as day turned to evening we began to worry that the turn-out tomorrow would be minuscule. Finally I spotted a bold red “Tea Party Patriot” t-shirt crossing the street towards us! Immediate joy! Anxiously I asked her if she was here for the rally tomorrow and that’s all that was needed to become new best friends. She and her son had come from California a week ago and had participated in several gatherings already. We walked and talked for almost an hour and she gave experienced information about how to ride the metro in the next morning. We said good-bye and promised we’d find each other the next day. Walking back to the car we spotted two other small groups with identifying markers(Freedom Works cap and patriotic shirts) and talked to them about where they had come from and what had brought them the distance to participate. Exchanging concerns we again made more friends from strangers. Funny how comforting it is to find others who are as deeply concerned as you are.

ap1

That night I could hardly sleep. Gratefully the alarm noted it was time to get out of bed. We got ready quickly, grabbed a fast-food breakfast, we made our way to the metro. Parking there turned out to be frustrating. Again we saw some “ralliers”, this time the marker was their hand-made signs. We called to them and they said they were just heading into I-HOP for breakfast. Maybe we could beat the crowd and take the car all the way in! Dare we? Well, we are dangerous right-wing extremists! As we drove in we tensed a bit as the streets were already lined with cars and buses. Miraculously a moment later we saw a spot and pulled in! It was 4 hour parking, but we didn’t care! Go ahead, ticket us! We are on a role of rogue behavior! Anyway, we were less worried about a parking ticket then the thought of increased taxes. Had we known how overwhelmed the police would be that day, we wouldn’t have given it another thought!

ap2

As we got out and our attention wasn’t on parking anymore, we began to really notice large groups assembling. We started following the crowd to Freedom Plaza. It was already making me very emotional to see the crowds filing in. Clapping my hands and jumping up and down like a teenager, I said to Vaughn hopefully, “I think this is going to be big!” I had no idea! We got as close to the stage as possible where a program of speakers and patriotic music was beginning. We climbed up on a ledge to get a look at the crowd and were fortunate enough to stay there the next hour or two as we watched the crowd multiply. It was thrilling beyond description to behold. I couldn’t believe the difference a night made! Where were all these people yesterday?

ap3

Finally it was decided that the march would have to begin early because the crowd had reached “critical mass”. I wanted to stay up on the ledge to see the parade begin. With music pouring from the speakers, I watched as a sea of flags and banners from this massive assembly of patriots rolled down Pennsylvania Avenue. I have never witnessed anything so grand! I was awestruck! It wasn’t a noisy crowd either. In fact, even though people were smiling and talking and laughing, it seemed to have the feeling of reverence. Vaughn felt he had stepped into the scene in from “The Ten Commandments” when the Israelites were leaving Egypt! He was anxious to belong to that family, so we jumped down and began making our way along side our conservative brothers and sisters. We laugh now because at the time we thought we were somewhere near the middle to end of the parade. We were NO WHERE NEAR the end, or even the middle! Vaughn looked like a freedom super hero as he wore like a cape his large “Don’t Tread On Me” flag given to us by our fabulous neighbor. As we walked we noticed people streaming in from all the side streets too and the crowd began to grow and grow and grow.

ap4

As we approached the Capital Building, capital police began directing us to the side yards on the right or left of the capital steps. We turned and made our way up on the grassy hill. I was hoping to be near a tree so we could sit and lean up against it as we had already been on our feet several hours. Even though the area was already covered with astroturf, you know grandmas and stuff, Vaughn was able to find a small spot near a tree and we parked there. Inspiring messages could be heard through large speakers. Anthem singing brought tears and cheers. We sat there for several more hours listening, learning, cheering and sharing ideas and experiences with the kind people near us. We were so grateful too that the sky had remained overcast, but it never rained as predicted. It was the perfect temperature for such a large gathering, and it didn’t go unnoticed or unappreciated. Vaughn and I so totally enjoyed watching the crowd, reading the signs – laughing at the funny ones and nodding and the serious ones. Such creativity on display! We were revved up when the crowd chanted “Can you hear us now?” or “Freedom,freedom, freedom!” and “2010, 2010”. As I looked out through the trees, I was overwhelmed at the crowd that had mobilized. I really couldn’t tell where the crowd began or ended. It was obvious that this was the largest assembly I had ever been in attendance with. It was deeply moving.
At one point we decided to get up and start walking through the crowd to get a sense of its enormity. Vaughn and I were so impressed that as we walked through the maze, everyone was so polite and thoughtful with an “excuse me” or a “sorry” if there was a slight bump. One girl was laughing saying that CNN was reporting that there were “thousands” of people here. She joked, “they must just mean the line for the bathroom!” The crowd was so large that sometimes we would hear spontaneous cheering from a section afar off. That was cool! We spent the next few hours walking through the crowd, enjoying the patriotic mood from largest congregation of devoted and resolute conservatives ever assembled here. As the last speaker said her good-byes, we looked around as the crowd began their procession homeward and noticed that the area around us had been treated with respect. Later it was reported that we left virtually no trace besides trampled grass. And, it was also reported that there were no arrests. It was peaceful from beginning to end.

ap5

The numbers may never be officially revealed but those who were there can confidently proclaim that hundreds of thousand if not over a million would not be an exaggeration. We didn’t even know then all the places people were standing until we saw pictures of it days later. Vaughn and I made our way back to the car and eventually out of D.C. and back to our hotel. As we put our heads down again, we prayed in thanks for the opportunity we had had that day to be a part of something so amazing. As we nodded off, we reminisced about some of our favorite signs like, “Nancy Pelosi’s ATM machine”, “Not the party of No but the party of Hell NO!” and “My dog makes two shovel ready projects a day” or “Part of the angry mob” adjacent to a picture of a family holding hands. We fall asleep with sore feet and smiles on our faces.

We recognized that this was just the beginning and that we would still have our work cut out for us at home, but now that our batteries had been recharged, our hearts lifted, and our hope in God and country revitalized, we knew we would be able to meet the challenge. Our thanks go out to all those volunteers who made it possible and all those flagwavers who made it unforgettable!

In many ways our U.S. health care system is the best in the world despite its numerous flaws. In reforming it we must be careful to change only the flaws and leave what’s working well alone. This article is in two parts. Part one is “Diagnosis: Critical but treatable” and Part two is The Prescription: Patient Centered, Free Enterprise Health Care Reform. The parts may be read separately or together.

Part 1: Diagnosis Critical but Treatable
A discussion of the flaws in our current system that must be addressed in any reform.

Part 2: The Prescription: Patient Centered, Free Enterprise Health Care Reform This is a presentation of an approach to heath reform that introduces the principles of capitalism: choices, competition, aligned incentives, supply and demand into the health care economy providing health insurance equality for all Americans regardless of social or economic status. It is funded primarily by attacking waste, shifting resources from broken programs and improving quality within the system.

An unbiased analysis of the problems within our current health care system will confirm that they are largely the result of the influence that the federal government has exercised within the system.

The problems that need to be addressed are complex and large, and would only be further complicated and magnified by resorting to the failed doctrine of central planning. A partial list of these problems includes:

  • Nearly five decades of extraordinary inflation in the health care segment. This is not due to a failure of capitalism but is the result of a lack of capitalism in health care. Its beginning can be traced to the advent and explosive growth of the third-party payer system beginning with Blue Cross in the 1940s. This is not rocket science. When a third party picks up the tab, buyers and sellers do not function in their traditional free market roles. Government involvement through Medicare and Medicaid as well as various unfunded mandates and increased red tape and reporting requirements compounded the problem.
  • Tremendous waste built into the system, for example:
    • “Defensive medicine” tests, images, therapies and procedures not necessary or even helpful for diagnosis and treatment of a condition, but help to document physician “diligence” in the event of a law suit.
    • Duplicate tests, images and therapies ordered by various providers for the same patients. This occurs because the providers have no way to coordinate information and care.
    • Higher cost “first visits” each time a patient sees a new provider for the first time. This is to cover the cost of the initial patient physical history that is many times incorrect or incomplete.
    • Harmful treatments and therapies that are ordered due to lack of information which generate additional expense and suffering.
    • Care that is rendered solely because a third party is paying for it.
    • Lack of competitive pressures on providers to deliver efficient, cost effective care.
    • Government rules and regulations that require extra steps, red tape and waste of manpower and materiel.
    • Out of control regulatory processes that generate great expense for providers without corresponding benefit to patients.
  • The incentives in our present systems are misaligned and confused. They reward behavior on the part of providers, payers and patients that are counter to maintaining a high quality, cost effective health care system.
    • Providers are generally rewarded to sell more services and skimp on quality and service.
    • Insurers and other payers are incented to limit coverage and challenge claims. Some insurance companies stoop to automatically denying all claims the first time they are submitted and asking the patient to provide more information. They know that a significant percentage of these patients will be confused and docilely accept the denial and never resubmitted the claim.
    • Patients are rewarded by postponing care until it is critical and thus expensive.
    • Providers with low prices are chosen by payers and patients rather than efficient providers who are able to deliver an entire episode of care for the lowest “global” cost. Global cost includes all costs associated with an episode of care. For example, in the case of surgery, the surgeon’s fee is only a small part of the global cost, which considers all pre-operative exams, tests, images, treatments, prescriptions, etc as well as the cost of the hospital room and board and ancillary services, radiologist, anesthesiologist, etc., plus post-operative follow-up exams tests, images and treatments.
    • Studies have shown that that there is often an inverse correlation between global costs and the quality of the provider. In other words, the best surgeon gets the diagnosis and treatment right the first time and performs in a highly efficient manner. The global cost of the entire surgery is very competitive even though the surgeon’s fee may be higher than average.
  • Medicare and Medicaid programs that cover the poor and the elderly are highly inefficient government run programs. There is NO COMPETITION ALLOWED! These programs rely on price fixing instead of competition to control costs. Price fixing is not only a shallow and ineffective approach to cost management; but is also highly susceptible to political influences, often to the point of being “pork”.
  • The cost of administration for the government plans is high when one considers that administrative costs are largely shifted to providers and patients and thus are not fully reflected in the costs reported by the government.

    Government plans depend primarily on the simplistic strategy of setting the fees they will pay for services rendered in order to control costs. This strategy fails to recognize the differences in quality and efficiency between providers and gives no incentives or even opportunity for providers to compete. Yes, that is correct. They pay the same fee to all similar providers in an area, regardless of quality, experience, reputation or efficiency. In considering only fees, the true global costs are ignored.

    Many top quality and highly efficient providers refuse to take patients covered by these plans because of fee limitations and administrative costs. The result is lower quality care at a higher cost.

  • The working poor. This is perhaps the most unfair situation of all. This group generally receives very limited primary care and almost no preventative care. Primary care is generally limited to that which is received only after hours of waiting in a government or charity hospital emergency room. Generally, the care they receive is extremely inefficient and of spotty effectiveness.
  • These people are generally hard working, “contributing citizens” who are not able to afford their share of the cost of employer sponsored health plans but who earn too much to be eligible for government plans such as Medicaid.

    They are thrown into a nightmarish hodge podge of overlapping systems (with wide gaps) to obtain their care. This entire system is generally demeaning, inconvenient, and unreliable.

    Funding sources include various not-for-profit providers who provide services on a charity basis (sometimes only after trying and failing to collect full balances); as well as various private and public charities, and various government sponsored programs such as state and local government health care facilities, VA Hospitals and clinics, etc. The cost of this ineffective care is virtually incalculable but possibly the most expensive, least effective care per-capita being provided in the USA.

The Prescription?

The prescription for fixing our health care system is certainly not central planning, socialization or government run health care.  It is not throwing $trillions at a flawed system.  It is also not to dismantle all the great things about our current system that blesses Americans with the highest survival rates in the world for many serious diseases.

The malaise in our present system is not a failure of capitalism but a lack of it.  The solution is quite simple really.  Apply the principles of capitalism that have made our country the richest in the world to the health care economy.  Those principles were muddied with the advent of the third party payer system in the late 1940s and were trashed altogether with the advent of the government run system of Medicare in the 1960s.  in a nutshell: infuse capitalism and free enterprise into the system, cover all Americans, Align the incentives for all participants and restrict the role of government.

Here then, is our prescription for patient centered, free enterprise health care reform:

Basic Principles:

  • Private insurance for all Legal residents of the USA
  • Competition at every level
  • Individual choices of Insurer, benefits, providers
  • Limited role of government and employers
  • Tort reform and simplified, no-lawyer claims option
  • Citizen boards to oversee and adjudicate consumer disputes with insurance companies

Provisions:

  • There must be competition at every level of the system.
    • Insurers will compete to be the choice of individuals and families by offering better benefits, lower prices, better providers, better service, etc.
    • Providers will compete to be included in insurance networks on the basis of willingness to share risk, efficiency, quality, low total costs, customer service, etc.
    • Insurers will compete to attract the highest quality, most efficient providers on the basis of contractual provisions, payment terms, patient volume, claims environment, reputation, etc.
    • Employers will compete for employees on the basis of work environment, job security, benefits offered, contribution toward benefit cost above minimum, compensation, etc.
  • We must continue progress in medical science and in extending humanity’s lifespan and quality of life.  We must not discontinue or stifle research as suggested by current administration
  • We must make new discoveries easier and less expensive to bring to the public.
    • Regulators will be limited to judging the safety not the efficacy of new drugs and procedures.  Let the efficacy be judged by physicians and patients in the market place.
    • This will eliminate $billions in costs
  • There will be adequate, portable, affordable health insurance available to every legal resident of USA
    • No individual underwriting or health questions
    • No pre-existing condition exclusion.  Standardized limitations and exclusions for all policies.
    • Minimum benefit standard.  Insurers may increase but not decrease coverage.
  • Limit the role of government in health care to setting standards, funding infrastructure, and subsidizing the cost of coverage for low income families.
  • Ignore the trial lawyers who seem to control our state and national legislatures and reform the tort process for claims against health care providers.
    • Establish regional citizen arbitration panels to settle these disputes.
    • Panel members appointed by State Commissioner who is elected by the people to one four year term.  No re-election.
    • Panel members serve one two year term.  No reappointment.
    • Simple procedures.  Attorney representation optional
  • Establish under the state insurance commissioner, regional citizen boards to adjudicate consumer complaints against insurance companies for denial of claims, coverage or care.
    • Board members serve one two year term.  No reappointment.
    • Simple procedures.  Attorney representation optional
    • Denial of care disputes handled on an expedited basis and settled within five (5) working days.
  • Eliminate all government run health care programs including Medicare and Medicaid.  Replace these programs private insurance plans, providing each participant with the choice between several competing insurers. Shift funding from these government run plans to subsidize the individual’s purchase of private insurance.  Current government run programs are very inefficient.  They do not allow competition and focus on price fixing instead of total cost of care. (Price is only one component of total cost.  Utilization, quality and efficiency have a greater impact)  They pay all like providers the same price disregarding quality experience, efficiency, or ability to deliver high quality for the lowest total cost.
  • Health insurance will be funded through a combination of employer and employee contributions, government subsidies and shifting of costs from a multitude of less efficient health care systems now in effect.
    • Point of service cost sharing.  No health care expenses will be covered by insurance at 100%.  A series of point of service co-payments will be established according to income levels and ability to pay.  The principle is that there will always be an affordable cost to be borne by the individual using the health care system.  An individual or family’s total out of pocket expense will be capped appropriately.
    • There will be a minimum employer funding mandated as a percentage of payroll.  Employers may compete for employees by funding above the minimum.
    • Coverage for low income employees will be funded by employee contributions that are limited to a percentage of income as well as a flat dollar cap. The balance of premiums will be funded by employer contributions.  Employer contributions for low income employees in excess of those funded for other employees will be recovered by the employer through federal tax credits, thereby shifting the subsidy cost to the federal government.
    • Those who are currently “uninsured” do receive health care, albeit unreliable, humiliating, highly inefficient and ineffective (thus the most expensive health care in the U.S.).  This hodge podge is currently funded by a combination of state and federal funded programs such as Medicaid and CHIP and a variety of uncompensated care delivered in hospital emergency rooms, charity clinics and hospitals, government facilities maintained for the indigent, etc.  These scattered costs will be identified and re-channeled into the mainstream system to purchase private insurance for these people that will they will be treated exactly the same and have the same choices and privileges as others having insurance.
  • Each family must have a choice of insurers independent of the funding source (employer, etc.)
    • They may choose insurer based on providers included in network, or:
    • choose providers based on participation in desired insurer’s network.
  • Those who are employed will have insurance provided through their employer with multiple insurer, benefit and cost options
    • Employer will not “sponsor” plan in the sense of today’s system and will not have liability as a plan sponsor.
    • Employer’s role will be limited to:
      • Providing information to insurers and employees
      • Providing administration of eligibility, enrollment, premium payment, etc
      • Funding employer’s share of plan costs and collecting employee contributions and government tax credits.
  • Anyone who is not eligible for insurance through an employer will also have multiple insurer, benefit and cost options as an individual or family.
  • The federal government will establish an infrastructure to enable a highly efficient Electronic Medical Records (EMR) system.
    • There are many complex technical issues that must be addressed but the following requirements are a must for any EMR system:
      • The system must reside in “the cloud” and require only a computer and a browser for a provider or patient to access and or update the system.  It must not require any expensive proprietary software or hardware.
      • The record itself must be owned by the patient who will also have power to control access to the information.
    • The benefits of such a system will be enormous.  Credible sources estimate that as much as 40% of our nation’s health care bill could be saved if such a system were employed correctly. Some of the benefits to be derived:
      • Virtual elimination of duplicate tests and treatments
      • Elimination of costly first visits to a physician that pays the physician extra for having you fill out those “history and physical” forms that you probably never fill out the same way twice.
      • Improved medical decisions resulting from all physicians working with the same accurate, up-to-date information.
      • Empowers routine screening of records by software designed to compare the treatments and medications prescribed by all the various physicians and specialists who are treating a patient, spotting potential adverse interactions and contra-indications.  This will save huge amounts of care and countless lives.
      • Data mining may hold the highest potential value.  Taking information that now exists in inaccessible paper files and a multitude of incompatible digital files and capturing it in a powerful national data base could hold the key to:
        • Determining the most effective protocols, medications chemotherapies, etc. for specific illnesses and conditions,
        • Identifying the most efficient providers and methods,
        • Identifying correlations between various conditions that have not heretofore been linked,
        • Detecting unintended effects of various medications and treatments that could be either good or harmful.
        • Identifying trends in health and care
        • Diagnosing various conditions more quickly and accurately based on analysis of symptoms and test results
        • Potential cures for presumably incurable diseases
        • AND SO MUCH MORE!

Summary

You will notice that nowhere in this prescription do we rely on central planning or governmental control.  Indeed the role of government is strictly limited.  Neither do we leave private citizens at the mercy of the large insurance companies.  All citizens are made to be equal and treated as such.

A skilled analysis of this plan will determine that it will provide health insurance to all and will be budget positive, not budget neutral.  It will not increase the deficit.  It will more than pay for itself by dramatically reducing waste, improving quality and efficiency and by diverting funds from antiquated inefficient programs into an efficient, free enterprise system driven by the principles that have made this country the richest nation in the world for more than a century.

This prescription introduces health care providers to the principles of capitalism and free enterprise for the first time since WWII. Health insurers and health care providers will have to compete on a level playing field to attract informed consumers who have freedom of choice. A novel idea!

Above all, the incentives of this system are aligned.  All parties, patients, providers and insurers are rewarded for patient focused, rational, reasonable behavior.

Block Opposing Voices

by on September 2, 2009

in Health Care

Recorded on August 31, 2009 outside Jan Schakowsky (D-IL) town hall meeting in Skokie, IL.

Let’s not discuss issues. Let’s just block out opposing voices.

The 20th century’s great experiments with central planning have either abandoned the concept and injected large doses of capitalism into their economies, collapsed under the weight of their own inefficiency or maintained control of their oppressed citizens with strict totalitarian governments with reputations for brutality.  The evidence is there for all to see.  It is barely history, more like current events.

Why then, do those who now control our government turn to central planning to solve the admittedly serious problems within our health care system which represents 18% of our nation’s GDP?  An unbiased analysis of the root causes of the problems within our current health care system will confirm that they are largely caused by the influence that the government has exercised within the system.

The problems that need to be addressed are complex and large, and would only be further complicated and magnified by resorting to the failed doctrine of central planning.  A partial list of these problems includes:

  • Nearly five decades of extraordinary inflation in the health care segment.  This is not due to a failure of capitalism but is the result of a lack of capitalism in health care.  Its beginning can be traced to the advent and explosive growth of the third-party payer system beginning with Blue Cross in the 1940s.  This is not rocket science.  When a third party picks up the tab, buyers and sellers do not function in their traditional free market roles.  Government involvement through Medicare and Medicaid as well as various unfunded mandates and increased red tape and reporting requirements compounded the problem.
  • Tremendous waste built into the system, for example:
    • “Defensive medicine” tests, images, therapies and procedures not necessary or even helpful for diagnosis and treatment of a condition, but help to document physician “diligence” in the event of a law suit.
    • Duplicate tests, images and therapies ordered by various providers for the same patients.  This occurs because the providers have no way to coordinate information and care.
    • Higher cost “first visits” each time a patient sees a new provider for the first time.  This is to cover the cost of the initial patient physical history that is many times incorrect or incomplete.
    • Harmful treatments and therapies that are ordered due to lack of information which generate additional expense and suffering.
    • Care that is rendered solely because a third party is paying for it.
    • Lack of competitive pressures on providers to deliver efficient, cost effective care.
    • Government rules and regulations that require extra steps, red tape and waste of manpower and materiel.
    • Out of control regulatory processes that generate great expense for providers without corresponding benefit to patients.
  • The incentives in our present systems are misaligned and confused.  They reward behavior on the part of providers, payers and patients that are counter to maintaining a high quality, cost effective health care system.
    • Providers are generally rewarded to sell more services and skimp on quality and service.
    • Insurers and other payers are incented to limit coverage and challenge claims.  Some insurance companies stoop to automatically denying all claims the first time they are submitted and asking the patient to provide more information.  They know that a significant percentage of these patients will be confused and docilely accept the denial and never resubmitted the claim.
    • Patients are rewarded by postponing care until it is critical and thus expensive.
    • Providers with low prices are chosen by payers and patients rather than efficient providers who are able to deliver an entire episode of care for the lowest “global” cost.  Global cost includes all costs associated with an episode of care.  For example, in the case of surgery, the surgeon’s fee is only a small part of the global cost, which considers all pre-operative exams, tests, images, treatments, prescriptions, etc as well as the cost of the hospital room and board and ancillary services, radiologist, anesthesiologist, etc., plus post-operative follow-up exams tests, images and treatments.
    • Studies have shown that that there is often an inverse correlation between global costs and the quality of the provider.  In other words, the best surgeon gets the diagnosis and treatment right the first time and performs in a highly efficient manner. The global cost of the entire surgery is very competitive even though the surgeon’s fee may be higher than average.
  • Medicare and Medicaid programs that cover the poor and the elderly are highly inefficient government run programs.  There is NO COMPETITION ALLOWED! These programs rely on price fixing instead of competition to control costs.  Price fixing is not only a shallow and ineffective approach to cost management; but is also highly susceptible to political influences, often to the point of being “pork”.
  • The cost of administration for the government plans is high when one considers that administrative costs are largely shifted to providers and patients and thus are not fully reflected in the costs reported by the government.

    Government plans depend primarily on the simplistic strategy of setting the fees they will pay for services rendered in order to control costs.  This strategy fails to recognize the differences in quality and efficiency between providers and gives no incentives or even opportunity for providers to compete. Yes, that is correct. They pay the same fee to all similar providers in an area, regardless of quality, experience, reputation or efficiency.  In considering only fees, the true global costs are ignored.

    Many top quality and highly efficient providers refuse to take patients covered by these plans because of fee limitations and administrative costs.  The result is lower quality care at a higher cost.

  • The working poor.  This is perhaps the most unfair situation of all. This group generally receives very limited primary care and almost no preventative care.  Primary care is generally limited to that which is received only after hours of waiting in a government or charity hospital emergency room.  Generally, the care they receive is extremely inefficient and of spotty effectiveness.
  • These people are generally hard working, “contributing citizens” who are not able to afford their share of the cost of employer sponsored health plans but who earn too much to be eligible for government plans such as Medicaid.

    They are thrown into a nightmarish hodge podge of overlapping systems (with wide gaps) to obtain their care.  This entire system is generally demeaning, inconvenient, and unreliable.

    Funding sources include various not-for-profit providers who provide services on a charity basis (sometimes only after trying and failing to collect full balances); as well as various private and public charities, and various government sponsored programs such as state and local government health care facilities, VA Hospitals and clinics, etc.  The cost of this ineffective care is virtually incalculable but possibly the most expensive, least effective care per-capita being provided in the USA.

Coming soon: Prescription for health care reform.

www.JewishWorldReview.com Published this article entitled “What lies beneath” By Cal Thomas. It explores the deeper issues that divide the left and right concerning health care reform:

The debate — OK, the shouting match — we are having over “health-care reform” is about many things, including cost, who gets help and who does not and who, or what, gets to make that determination. Underlying it all is a larger question: Is human life something special? Is it to be valued more highly than, say, plants and pets? When someone is in a “persistent vegetative state” do we mean to say that person is equal in value to a carrot?

Are we now assigning worth to human life, or does it arrive with its own pre-determined value, irrespective of race, class, IQ, or disability?

The bottom line is not the bottom line. It is something far more profound. Our decisions regarding who will get help and who won’t are about more than bean-counting bureaucrats deciding if your drugs or operation will cost more than you are contributing to the U.S. Treasury.

The secular left claims we are evolutionary accidents who managed to crawl out of the slime and by “natural selection” stand erect and over millions of years outsmart our ancestors, the apes. If that is your belief, then you probably think health care should be rationed. Why spend lots of money to improve — or save — the life of someone who evolved from slime and has no special significance other than the “accident” of becoming human? Policies flow from such a philosophy, though the average secularist probably wouldn’t put it in such stark terms. Stark, or not, isn’t this the inevitable progression of seeing humanity as maybe complex, but nothing special?

The opposing view sees human beings as unique creations. Even Thomas Jefferson, identified by historians as a Deist who doubted the existence of a personal G-d, understood that if certain rights (life, liberty and the pursuit of happiness) do not come from a source beyond the reach of the state, then the state could take those rights away. Those who believe that G-d made us and also makes the rules about our existence and our behavior will have a completely different understanding of life’s value and our approach to affirming it until natural death.

It is between these two distinctly different worldview goalposts that the battle is taking place. Few from the “endowed rights” side are saying that a 100-year-old with an inoperable brain tumor should be given extraordinary and expensive care to keep the heart pumping, even after brain waves have gone flat. But there is a big difference between “letting go” and “snuffing out.” The unnatural progression for many on the secular left is to see such a person as a “burden.” In an age when we think we should be free of burdens — a notion that contributes to our superficiality and makes us morally obtuse — getting rid of granny might seem perfectly rational, even defensible. But by doing so, we assume an even greater burden: the role of G-d in deciding who gets to live and who must die. Anyone who has seen the film “Bruce Almighty” senses how difficult it is to play G-d.

We are now witnessing some of the consequences of attempting to ban people with a G-d perspective from the public square. If there are no rules and no one to whom one might appeal when those rules are violated, we are on our own to set whatever rules we wish and to change them in a moment in response to opinion polls. Any appeals to a higher authority stop at the Supreme Court.

The explosive town hall meetings are indications that Americans are trusting government less and less. So where should we go? The answer is in your wallet or purse. It’s on the money. Right now it is little more than a slogan, but what if it became true: in G-d We Trust.

Health care is NOT just a economic  issue, it is a moral issue. The chasm that divides us is as deep as it gets. Let there be no “Roe Vs Wade” type edict that prevents any US citizen from pursuing life, liberty and happiness.  All human beings deserve the “right to choose” whether or not to receive treatment.  The government proposes to approach this as an economic decision.  It is so much more!  There must be no government involvement in that important choice.

Read the article here:
What lies beneath


You can track the healthcare bill here: H.R.3200: America’s Affordable Health Choices Act of 2009

More Health care Coverage on Liberty’s Army

Contact Your U.S. Representative

Contact Your U.S. Senators

In a time of universal deceit telling the truth is a revolutionary act. George Orwell