Monday, August 17, 2009

Competion With Insurance Industry

The public option will create competition has been said over and over again, and Kathleen Sebelius has now stated that there needs to be competition with the insurance industry. But shouldn't the competition be within the industry? And doesn't it already exist?

Blue Cross has to Compete with Aetna, Cigna, Humana, UHC, etc in order to get market share so we do have competition within the industry, but the government wants competition from outside the industry. Say what?

Aren't they saying that competition within any industry is not enough to tempter the greed of those big bad corporations so a government option is needed "to keep them honest". This is exactly what Obama has said, that a government option is needed to keep the insurance companies honest. So he is in effect stating that insurance companies are dishonest.

How about we apply that same logic to government monopolies on ..... let's say......taxes. How about we create some competition within taxation and the application thereof. Shouldn't we have somebody other than the IRS collecting the money, just to keep them honest you know. Or how about competition with Congress for spending it? Just some good old fashioned competition to keep them honest. The American people could then decide which policies to purchase, those of Congress or those of their competition.

If we need options from outside of a specified industry to keep them honest -- because all companies within an industry meet at a summit to figure out how they can gang up against the consumer and rob them blind don't you know -- then shouldn't that apply to government monopolies as well?

Saturday, August 15, 2009

Misinformation Volume III

The third piece of so called misinformation is that the public option will put private insurance out of business. Obama says this isn't true, so I guess that's the end of the argument, unless of course we want to do the unthinkable and apply some logic and deductive reasoning to the situation. How very unamerican of me.

Competition is a good thing, it is the cornerstone of capitalism and controls costs by giving the people an option and the companies an incentive to keep costs low. Competition within the insurance industry is good as well and the industry is seeking to eliminate waste and reduce costs because there is not a current monopoly. There are several different companies all competing for the same market share and good coverage at a reasonable prices is what they are all striving for. So I'm not averse to fair competition; as a capitalist I know we need it to keep things working the way they should. But we need fair competition.

The big problem with the public option competing with the private sector is that the public option will be non-profit while the private sector needs to make a profit, therefore the private sector will not be able to compete with the public option on price, but never fear, there are other ways to compete, right?

The private sector could offer different types of plans, setting themselves apart from the public option and giving people a choice -- Or they could if HR 3200 didn't specify that they will have to offer what is deemed "acceptable" by the same people writing the public option.

The private sector could continue to work with companies who decide to be self-insured and change their line of business to administering these plans -- Or they could if HR 3200 did not give government the right to decide whether or not a company can self-insure.

So by page 24 of HR 3200 the real competitive options have already been eliminated by dictating what insurance will have to cover, and by taking the option of self-insuring from other companies. After those two options for competition are eliminated, what is left? Not much.

The bill is not written with the statement that private insurance will be eliminated, but the 5 year grace period for employer based benefits before they must comply with government "standards" and the limitations it places on competition will lead things in that direction.

Ignoring the fact that there is a possibility that the public option will drive private insurance companies out of business is irresponsible and short sighted. President Obama uses the Post Office as the shining example of competition between the private sector and a public option, but let's not forget that the post office is bankrupt and continuously raising prices; is this what we want for our health care? So maybe there is hope. If the public option in health care works as well as the post office then there won't be a problem, but on the other hand, the post office doesn't dictate to UPS and FedEx what services they have to provide or how much they can make. Nor does the post office give themselves the prevent private companies from using other carriers.

Where it not for the language in HR 3200 which limited the options for competition I would not be worried, but that language is there; and as long as it is I will see an uneven playing field designed to make one side the winner and one the loser.

Friday, August 14, 2009

Real Stimulus

The administration keeps telling us how the recession is ending and we're on the road to recovery; claiming the stimulus package is responsible even though only 10% of the money has been spent, and most of that unwisely.

New polls show that the majority of Americans believe the stimulus money should be put back in the coffers to reduce the deficit, or given to the people. Either one of these would work just fine for me, but if we really want to stimulate the economy further and we're going to use the money, then it should be in the hands of the taxpayers; 72% of Americans agree with me.

If we took the roughly $708 BILLION dollars remaining in the stimulus fund, and divided that by the roughly 92.3 million people in the country who actually pay taxes, then each person would receive $7,670 each. Think about what we could do with that money.

If you're in debt it could go to pay off that debt and boost the banks.
If you need a new car, you use it for that and boost the auto industry (buy a Ford)
If you aren't in debt and your car is fine then you could really do some shopping, increasing retail sales and boosting other companies resulting in new jobs.

Just imagine how the economy would be stimulated if 92 million people got to go on a spending spree with $7,000 of their own money. Now that's some stimulus!

Thursday, August 13, 2009

Misinformation Volume II

The idea that a new government program for health care will explode the deficit or cause an increase in taxes is "misinformation" according to the white house. President Obama (I really hate having to type that) has stated firmly and repeatedly that the program will be deficit neutral so why do we insist on applying our own brands of logic to the claims?

Obama says deficit neutral but the Congressional Budget Office says $1 trillion in set up and then an explosion of costs.

Obama says that Medicare is bankrupting us so the best solution is to expand it to everybody. (I still haven't figured out how that is logical.)

Obama says that he can pay for it with savings from cost controls. Ummmm, OK. What are those cost controls going to be exactly? Will it have anything to do with stopping doctors from whacking off your limbs willy nilly in an attempt to charge you more?

Obama says that by having everybody covered the costs will go down because people won't be going to the ER as much, but aren't the highest volume of people using the ER those already on Medicaid? I'm missing the logic again.

Obama says that he won't vote for any bill that grows the federal deficit - this claim is a little hard to swallow considering that he's already quadrupled it in 6 months. Yep, Mr President, we can see you're a real fiscal conservative.

As a cost savings initiative Obama plans to lower the re-imbursement rate to health care providers for the services they give Medicare patients. The re-imbursement rates are already pretty low so if they go much lower it's going to start costing the doctors to do the test. Forget making money, they'll be bleeding it.

Hmmmm, an interesting way to implement rationing isn't it. If the government tells a doctor they will be re-imbursed $1,000 less than their costs for a particular procedure how long do you think those procedures will continue to be performed? If it's a break even I think many doctors would still do it, but if it throws them into a negative balance I can't see them continuing. Wouldn't it be interesting to require a bailout of our medical professionals due to the new Medicare re-imbursement rates. Especially since Obama already think the doctors get $30,000 - $50,000 for taking your foot when they actually only get #350 -$750. He's only 10 times higher than the actual so we should definitely be able to trust his numbers.

There are only 2 ways to make the public option (path to single payer) deficit neutral and that is to either raise taxes or to charge premiums for the public option which will cover the medical cost payout. Considering that the people don't want or can't afford the premiums of the private sector, I doubt the public option would look much better.

How about you first do a little research, real analysis into what is driving the cost of health care up. Hire an independent team of process improvement analysts to determine exactly where the issues lie (because I frankly doubt that doctors really are cutting off people's feet just to get more money) and fixing those first and see how it goes.

One last little tidbit that I just have to share -- As much as Obama talks about the importance of routine care and how we need to expand Medicare type coverage to all, he might want to keep in mind that routine care is not covered under Medicare.

Wednesday, August 12, 2009

Misinformation Vol I

The largest piece of misinformation that Obama is perpetually poo pooing is that he supports a single payer system. So where did the pesky American people who, will believe anything, get that silly little idea. It couldn't have anything to do what he has actually said could it?

As far back as 2003 (wasn't he still in the state legislature at that point) Obama said that he was a proponent of a single payer system, but I guess he could change his mind about that; it's just not right to hold him to what he said 6 whole years ago.

More recently Obama has said that we have an "illegitimate" concern that the public option is a trojan horse for a single payer system. He's right about that. They don't have their goals hidden in anything but their own rhetoric, but I don't see the concern over moving to a single payer as illegitimate.

In May of 2007 at a health forum for the SEIU Obama said "My commitment is to ensure that we have universal health care for all Americans by the end of my first term as president.....But I don't think we're going to be able to eliminate employer coverage immediately" (so we are going to eliminate it eventually?) "There is going to be potentially some transition process. I can envision a decade out or 15 years out or 20 years out.." So eliminating employer coverage eventually is the goal? But that was still a whole 2 years ago. How could we possibly hold him to something he said that long ago. Silly, silly us.

On the campaign trail Obama told us that he was going to lower costs by taking on the insurance companies and make them lower their premiums while offering to the uninsured the option to join a government plan or policy. How exactly can they force the insurance companies to lower their premiums? Would this be the government dictating prices in the private industry? And what if the insurance companies can't cover their costs with the premiums set at the government approved amount? Wouldn't the companies then go out of business leaving only the government option -- the single payer? Sounds like that to me. But again, this was back in Octoboer of 2008, ten whole months ago. Anything can change in ten months.

Next we have Barney Frank stating that the public option is the best path to the single payer system, and numerous other congressmen touting that the public option will put the private companies out of work and achieve their ultimate goal of a single payer system. A goal which Obama himself validated with his previous statements.

So what are we supposed to believe? Is it really misinformation to question what is said now against what was said in the past, or is that just being a smart consumer? Since we'll be the ones paying for this health care plan, in essence the buyer of the product they're pitching, shouldn't we question the integrity of the marketing plan?

According to Obama now, as compared to Obama ten months ago, and according to Robert Gibbs, we should ignore all of the previous statements and believe what Obama says now. A politician would never lie to the American people in order to get what he wants.....would he?


At his town hall yesterday President Obama stated that there is a lot of misinformation floating around about health care reform and this is why support for the plan is dropping. Press Secretary Robert Gibbs reiterated this today and blamed the press for the misinformation; but what is the misinformation?

I'm going to do a series of blogs on these issues to delve into them in more detail, but here is an overview of what they are calling misinformation and I call deductive reasoning.

We will go to a single payor system - the leadership keeps telling us that there will not be a single payor system but there will be a public option. However, many of the leaders, Obama included, have previously said that the public option will be the lead to a single payor system. In March 2007 Obama stated that he would not be able to do away with employer paid health benefits immediately but believed we could accomplish a single payor system within ten years. -- Is believing the plan is to get us to a single payor system really misinformation?

The reform will explode the deficit or increase taxes - Obama says it will be deficit neutral but the Congressional Budget Office said it will cost $1 trillion just for start-up. So who is putting out the misinformation? Is it Obama or the CBO?

The Public Option will eliminate private insurance - The leadership says this will be a plan to compete with private insurance and they can work together, however private insurance will have to make a profit while the public option can operate at a loss subsidized by tax-payor dollars. If Medicare was working like private insurance now and not operatiing at a loss then it would cost the government nothing. By expanding a Medicare type benefit to all it is an acknowledgement that it will be subsidized where private insurance will not.

There will be rationing of care - Obama says there will be no rationing and yet his advisors have written papers on who should take priority in the case of a shortage. Also, a government board will be created to determine benefits and what to do when adding 40 million patients to already overloaded physicians.

Abortions will be covered under the government plan - Leadership says this will not happen while other leaders are insisting it will.

Robert Gibbs said this is all a case of he said / she said and this is how the misinformation is getting out there, but considering there is no final bill to work from isn't all we have to go on what people are saying?

What I think I object to most is applying deductive reasoning to the situation and coming to a conclusion and then being told that I'm wrong - that I'm spreading misinformation - and given no facts to back it up.

Tuesday, August 11, 2009

Productivity Rises - Labor Costs Drop

The labor department is reporting that productivity rose in the second quarter while labor costs drop, and this is touted as a sign the recession is slowing. I have the opposite view. I think this is an indication of how deep the recession really was.

Productivy rose because people are scared shitless of losing their jobs and pushing themselves to not only keep their job, but to make up for the work of the people who were not so lucky. We now have one person doing the work of at least two, but consider that a good sign.

Labor costs went down because people were either laid off, not given a raise, or asked to take a pay cut. Most of the people I know did not get a raise this year as the company was forced to make the decision between layoffs or no raises and chose to keep their staff, yet we see the reduction in labor costs as a good sign.

Seeing this particular statistic as a good sign and not that we are working are people harder for less because we can't afford anything else, is proof for me that the labor department is seeing only the numbers and not the people behind them.

There is more than this information that a few percentages, there are people behind every number.

Term Limits - But That's Unconstitutional

At the townhall Senator Specter was asked to vote for term limits. He sluffed it off saying that the people can subject him to term limits by voting him out, but the usual response to this is that they are unconstitutional. Government takeover of industry is good but term limits are bad. Here are a few things that were unconstitutional until we amended the Constitution to include them.

Amendment XVI - Federal income tax
Amendement XXII - Term limits for the President

I find it interesting that they can amend the constitution to take a third of my paycheck, and they can amend the consititution to limit the term of the president, but limiting their own terms is so sacred that no constitutional amendment could even be considered.

We also have issues that are covered under the Constitution that are ignored. We've been acting as if the 10th amendment was repealed without ever voting to do so. The Legislative and Judicial branches just pretend it doesn't exist. The 10th amendment has very simple wording, perfectly clear and uncomplicated, but we can't seem to understand it.

Amendment X - The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

If we are going to follow the Constitution, as I absolutely believe we should, then we must follow it all and not pick and choose what we will follow and what we will ignore. By picking and choosing we compromise the document as a whole and that is something we cannot afford to happen.

Monday, August 10, 2009

The Tone of Debate

I have been away from the blog for a while writing a novel, but the draft is done, the document sent out for a critique and a literary agent obtained. So now my mind and my time are free to return to the blogosphere which I enjoy so much, and what do I find when I turn my mind back to current events, that people who oppose the Congressional plan for universal health care are unamerican.

The town halls on the subect of health care have become a bit heated; people seeking to be heard screaming down or talking over the hosts and speakers, but is this really unamerican as Nancy Pelosi suggests?

The right to peacably assemble and request a redress of our differences is a protected right under the first amemndment so how can that be unamerican? As long as the protests remain peaceful, they are as American as applie pie and baseball. I believe that people should be polite and respectful during these discussions, but that only works if the other side will listen. When you have been polite, when you have been speaking respectfully and when you have been totally ignored, the need to raise your voice may become your last option so it appears the opposition has two choices before them.

1)speak softly and respectfully and be completely ignored.
2)shout loud and long and be labeled a nut, a nazi or unamerican.

Not much of a choice there is it?

There's something else that really bothers about this whole situation and that is why it is wrong for people of like minded opposition to band together. Why is it a great thing for one side to be organized but wrong for the opposing side to do the same? Why is one side praised for their organization but the other side reviled for theirs? Why does the organization of one side validate their information while the orgnaization of the opposing side discredit theirs?

Discrediting anyone who does not agree appears to be a major theme within the current leadership of both the white house and congress. Both the executive and legislative branches of our government appear to forget that they represent ALL American citizens and that the voices of all of us count.

What purpose is possibly served by claiming that anybody who disagrees is unreasonable and unamerican? What does that do to smooth the ruffled feathers of the descenters? And what is actually being done to address the concerns of the dissenters? Oh, right, what's being done is to disregard their concerns and call them names. Good plan.