Truth, Love, and Music

[andrew]

This is about the best I've seen so far on what's going on with health care and the need for reform. Please check it out.

http://www.stumblingontruth.com/
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"The question is not, 'How far?' The question is,
'Do you possess the constitution, the depth of faith, to go as far as is needed?'"

[juanito]

Down to earth language on a hot topic - well done.
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"I'm just jazzed about being on the show, man."
- Guy

[andrew]

More straight talk, this time in two essays from the Center for Small Government:

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"6 Simple Ways to Dramatically Cut Costs of Medical Care - at Zero Expense to Taxpayers"
by Michael Cloud

Imagine that the federal and state governments imposed laws, regulations, restrictions, and mandates on medical care that drastically increased the cost - without improving medical care.

What if it were possible to cut your medical care costs by 20% or 30% or even 50% now - while keeping current levels of quality and service - by repealing and removing these government-created burdens and barriers?

If this were possible, would you want it?

Would you want the U.S. Congress to repeal and remove these laws, regulations, restrictions, and mandates?

Would you want your state legislature to do the same?

Yes? Well, these government-imposed burdens and barriers DO exist - and your federal and state legislators CAN repeal and remove them.

Would you like to see a small sample?

1. Allow price advertising. Let pharmacies, doctors, hospitals, and laboratories to publish their prices for goods and services. Eliminate all laws, regulations, and government provisions that hinder or prevent medical providers from posting their prices.

Charges for the same medical procedure can vary 30% to 300% within a 100-mile radius. But without price information, patients can't shop for the best value.

In the 1970's, U.C.L.A. Economist Sam Peltzman compared the costs of eyeglasses in states that allowed price advertising and states that outlawed it. Results? Much lower prices in states that allowed price advertising.

2. Let all Americans buy prescription drugs outside the United States. Do NOT force them to travel abroad. Allow them to have the prescription drugs shipped to their homes.

I've seen the 30% to 60% savings in prices of prescription drugs purchased in Mexico.

International competition for prescription drugs will drive down domestic prescription prices.

3. Let all people buy medical insurance across state lines. In New Jersey, a single man would pay $4,000 for medical insurance. If he lived in Pennsylvania, he'd pay $1,500. If the New Jersey man could buy medical insurance from a Pennsylvania provider, he'd save $2,500 a year.

Imagine this all across America.

This would cut medical insurance costs for millions who already have needlessly overpriced premiums.

AND, if the American Enterprise Institute study is correct, this would make medical insurance affordable for 12 million uninsured Americans.

4. Let doctors and patients negotiate discounts for paying cash. If a patient saves a doctor the time, trouble, delay and cost of dealing with insurance companies, Medicare, or Medicaid - let the doctor and patient share the savings.

5. Let patients, doctors, and hospitals enter into into legally binding, limited-liability contracts. This would reduce the cost of medical treatment by reducing the cost of malpractice insurance.

Just as Prenuptial Agreements limit marital risk, limited-liability contracts will limit medical risk.

6. End all government mandates that require businesses or individuals to buy medical insurance. End all government mandates that punish and tax those who do NOT buy medical insurance. Make insurance companies earn our business with lower prices and better quality - rather than lobby government to compel us to buy medical insurance by force of law. (See Carla Howell's excellent essay below.)

This is just a sketch of small government proposals to UN-do the government-caused high prices of medical care—a glimpse of small government proposals to come.

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"Why We Need More UNinsured Americans"
by Carla Howell

This column was originally published April 13, 2006. The cost of insurance premiums has risen steadily since then.

Socialized medicine's true believers - who dominate the ranks of mainstream news reporters and politicians - try to bludgeon us into believing that the lack of medical insurance is a crisis, a disaster, and a never-ending emergency.

Here's an example of how a news report typically casts the "uninsured":

"The number of uninsured or underinsured people in the United States is estimated to be about 46 million... they sit on the edge of catastrophe." (Journal Times, Wisconsin, February 27, 2006)

But "uninsured" Americans are usually nowhere near "catastrophe." They have plenty of access to urgent care when they need it.

Moreover, they save themselves a boatload of money by steering clear of one of America's biggest money pits: health insurance.

We don't need more insurance in America. We need much less.

The black hole of medical insurance

Americans who don't have health insurance are often neither poor nor do they lack access to medical care. They simply choose not to buy insurance because they believe it's a bad use of their money.

In Massachusetts - the Overpriced Health Care Capital of the World - young, healthy families can spend over $9,400 a year for the cheapest HMO policy they can find, and over $19,800 for a broader coverage plan. Families with middle-aged parents can spend over $30,000 - every year - to be insured. The older you are, the more unaffordable it gets.

What's worse, these exorbitant prices don't even guarantee that you'll be covered. A policy's fine print gives insurance companies the option to terminate your coverage if your care drags on too long. The insured who suffer from a serious disease or medical trauma have to turn to the same government welfare programs they would if they had no insurance at all. What's the point of buying an insurance policy that doesn't insure you in your times of greatest need?

"Uninsured": Down & out? Or smart investors?

The "uninsured" are portrayed as poor, desolate souls on the brink of "catastrophe." But contrary to media propaganda, they have access to the health care they need.

The wealthy don't need health insurance. Their money is better spent on investments that provide a return. They can easily cover the cost of treating a serious medical condition.

Many above-average wage earners don't need insurance either. They're better off investing their money in their retirement and withdrawing funds for health care only if there's a need.

Even people with no cash savings to fall back on - average and below-average income families - are often able to insure themselves. They may have an IRA or equity in a home or business they can borrow against in the event of an emergency. Although a serious illness could wipe out their assets, they at least have a chance of building wealth - and not depleting what assets they have by forking over huge sums for an overpriced medical insurance policy.

Individuals and families that invest the money they would otherwise spend on medical insurance can build a nest egg worth over $100,000 in just 5 years. In 10 years it could grow to over $250,000 - enough to cover a major health care catastrophe. Or buy a house. If they continue to enjoy good health, they can retire as millionaires.

Hazards of medical insurance

There are other good reasons to avoid medical insurance.

Whenever an insurance company pays for health services, it drives up everyone's cost - yours included - and renders health care services clumsy, inefficient, and even dangerous.

Neither patients nor providers have incentive to keep costs down. This encourages doctors to prescribe procedures you don't need - raising costs for insurance companies. They respond in turn by raising the price of your premiums, raising the amount you must pay for co-pays and deductibles, and reducing the services they cover.

In addition, excess treatment can put your health at risk. Patients who undergo unnecessary tests, operations, and drug regimens sometimes end up with worse medical problems than they started with.

At the same time, insurance rules forbid practitioners from giving you services you actually need. Again, your health suffers.

When you pay directly for services, you or someone you trust is in the driver's seat. You and your health care providers have direct incentive to give you high quality care at a reasonable price.

Medical insurance co-pays, deductibles, and coverage denials make medical bills confusing and hard to read. Billing errors are common - and difficult to correct. You're forced to either pay what your bill instructs you to pay or to try to avoid overpayment by submerging yourself in paperwork that can be as complicated and infuriating as filing taxes.

The best way to minimize billing hassles is to forgo medical insurance and pay your providers directly for medical services.

If insurance is such a bad investment, why do so many people have it?

Many Americans have insurance because Big Government mandates it, subsidizes it, and provides tax incentives for it.

Seniors are forced to sign up for Medicare or they forfeit their Social Security checks. Taxpayers are forced to fund high-priced health plans for government employees.

Employers are forced to provide their employees insurance. If employers were free to use the tax-free money they now spend on medical insurance to pay tax-free wages instead, many employees would far prefer the higher wages. It's a much better deal.

Others buy insurance, or seek a job that provides insurance, because of the horror stories they've heard about how expensive medical bills can be. A catastrophic care episode can cost tens, even hundreds, of thousands of dollars and leave a family in dire financial straights.

Big Government is directly responsible for these high costs. Thousands of state and federal laws, regulations, mandates, and subsidies drive up the cost of health care. What should be a minimal part of the family budget is a backbreaking expense. If we end Big Government Health Care, prices will drop dramatically. Far fewer people will need or want insurance.

Rather than end these disastrous Big Government Health Care Programs and allow prices to drop, Big Government Politicians seek to expand them. They keep the demand for insurance artificially high.

People also seek insurance because Big Government outlaws health care charity, leaving poor people with medical problems nowhere else to turn but to Big Government welfare programs.

Years ago, medical special interests convinced politicians to shut down free clinics for the poor, once common in the United States. Rather than allow them to reopen, socialized medicine advocates claim that the high cost of health care is the fault of people who refuse to buy insurance and who run to a hospital emergency room instead every time they have a problem. What they never admit is that Big Government Politicians cut off poor people from life-saving zero cost, tax-free alternatives.

Bemoaning the "uninsured" is a ruse. Big Government Politicians drive up the cost of health care. They drive affordable free-market alternatives out of business. Then they blame the taxpayer for not buying health insurance - made unaffordable by Big Government. It's a scam.

Get Big Government out of health care

We must reject calls for more insurance. Rather, we should celebrate every time Americans free themselves from unnecessary and oppressively overpriced government-mandated health insurance.

What we need is to bring down the high cost of health care by removing Big Government health care prohibitions, mandates, regulations, and subsidies. We must vote against every politician who refuses to tear them down. Who deny us our health freedom.

We must vote out of office politicians who blackmail voters by threatening to cut needed subsidies - while leaving in place the legions of health care laws and regulations that drive up cost and reduce access to medical care.

We must replace them with candidates who will remove all Big Government laws and regulations that escalate medical care costs or that block free care FIRST and who will cut back subsidies that people depend on LAST - after free market alternatives, including free clinics, are in place.

When we separate health care from government, we'll dissolve the government-created, artificial demand for needless, high-priced medical insurance. Those who need insurance will be able to buy affordable policies that protect them in their times of greatest need. Those who can't afford care at all will have access to lovingly-donated free care services. We will enjoy higher quality, cost-conscious health care. We'll take $1 trillion every year from overpriced medical spending - and put it back in the pockets of working Americans.

Note: Since original publication of this column on April 13, 2006, it was learned that Tennessee is relatively lax about permitting the operation of free medical care clinics. However, free clinics appear to remain effectively prohibited throughout most of the United States. If you find a clinic that is neither sanctioned by government nor free of government subsidies, i.e., an unencumbered health care clinic charity, please let us know by contacting the Center For Small Government.

It is worth noting that while free clinics unaffiliated with government are largely prohibited, many individual medical professionals generously donate their services and/or give price breaks to those in need who lack financial means.
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"The question is not, 'How far?' The question is,
'Do you possess the constitution, the depth of faith, to go as far as is needed?'"

[missourah_rebel]

I knew a family in Oregon years ago from the UK. They were forced to come here to get dialysis for their over-55 mother. It seems that if you are not productively employed in an above average career (whatever that might be!) you don't get dialysis after 55 there.

This whole health care non-sense scares me because Nicole, my wife of 12-1/2 years is going on dialysis in the next 6 months. She is trying now to get everything lined up for that and a transplant list. What will they do to her? Will they deny her the every other day dialysis treatments if her paperwork isn't in order?

There's a saying: "The bureaucracy is expanding to meet the needs of the expanding bureaucracy." If Prezident Zero-bama screws up our health care, where will the Canadians go?
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Matt McCune
The Dixie Diarist
http://maxpages.com/dixiediarist
or, here:
http://stores.lulu.com/Confederate
Stories of the Old South by Those Who Were There

[juanito]

Call me suspicious, but when the government reports (its own) numbers to support a program that is fast becoming unpopular, and a business group that usually opposes that sort of program suddenly comes out with big bucks to back it....

LINK

[andrew]

GuaranTEED they are not spending the big bucks unless they think they will get all that back and THEN some. Simple math.
_________________
"The question is not, 'How far?' The question is,
'Do you possess the constitution, the depth of faith, to go as far as is needed?'"

[juanito]

Despite my outspoken criticism of all things political, I'm a life-long Democrat. So, I'm naturally on the distribution list for everything out of the DNC. The latest is an invitation to an organization meeting this Thursday where we can ask question of Pres Obama regarding the whole health care thing. We're even allowed to offer questions (for consideration). Aside from the budgetary and personal freedom questions that are automatically ignored, I thought I'd offer one of my own, which is probably automatically on the ignore list as well, but I figure it's worth a shot:

[juanito]

Well, I'll be a shocked deer in the headlights....

No doubt folks have heard about the guy shouting "you lie" at Pres-O during a speech. Well, HERE'S a clip of that event. While heckling the president may surprise some, they should listen to a session of the UK parliament. They'll find such short outbursts are common, regardless of the issue. Perhaps it's a culture thing, like the quiet Episcopalian congregation listening to their priest give a homily, versus the Amen and Hallelujah shouting Pentecostal congregation. All the hubbub over it seems at best overblown, certainly disingenuous, and probably hypocritical - at least the guy had the guts to say "you lie" publicly to the president's face, rather than the usual smirky post-speech jabs tossed out to sympathetic constituents.

Anyway - what shocked me are the words of the speech that followed the incident. Obama very plainly says, "No Federal dollars will be spent on abortion. And Federal Conscience Laws will remain in place." This sounds like a pretty direct answer to my query.

If he's not lying about it, that is.

Or hiding "the rest of the story" behind a vague "truth". A story where Federal dollars aren't spent on abortion, but funding to the States is earmarked in such a way that States will be able to free up their own money to spend on abortion. Or the Federal dollars will cover all the "non-abortion" expenses surrounding an abortion, from transportation to the clinic, to building costs, to nurse costs, to utility bills, etc; ie, everything other than, say, a five buck fee that covers the "actual abortion".... (Not to mention 'education' promoting abortion.)

And "the rest of the story", where doctors and nurses are still allowed to refuse to do abortions, and pharmacists are allowed to avoid participation in chemical abortion via contraceptives, but will face some undermined penalty or harassment.

OK, color me New York cynical, but at least he's on the record with something.
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"I'm just jazzed about being on the show, man."
- Guy

[andrew]

Yeah, the reaction to that was typical for these days: a lot of overblown posturing for political effect. Yawn.

I still can't figure O out, but I'm pretty sure he's not the Savior or the Anti-Christ that some seem to think he is. I've narrowed it down that much....
_________________
"The question is not, 'How far?' The question is,
'Do you possess the constitution, the depth of faith, to go as far as is needed?'"

[juanito]

<sigh>

I just got an email forwarded to me. It's looking for folks to sign a petition protesting a proposed federal mandate that all health insurance plans MUST cover abortions as part of "family planning" "health" care.
_________________
"I'm just jazzed about being on the show, man."
- Guy

[andrew]

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"The question is not, 'How far?' The question is,
'Do you possess the constitution, the depth of faith, to go as far as is needed?'"

[juanito]

LINK

Wall Street Journal editorial on ObamaCare:

REVIEW & OUTLOOK DECEMBER 14, 2009 The 'Cost Control' Bill of Goods
How Peter Orszag and the White House sold a health-care illusion.


ObamaCare's core promise—better quality care for everyone at lower costs—is being exposed as an illusion as it degenerates into the raw exercise of political power. Naturally, the White House and its media booster club are working furiously to prop up this fiasco, especially on cost control.

As Obama budget director Peter Orszag put it at a revealing media breakfast earlier this month, the Senate bill does everything the experts recommend to "get at the underlying drivers of health-care costs." While he admitted that "we don't know enough" to produce results right away, the key is to encourage "continuous improvement" through pilot programs and demonstration projects. Cost containment will actually take "years to decades," Mr. Orszag conceded.

The torch was then passed to Ron Brownstein of the Atlantic Monthly, David Leonhardt of the New York Times and editorial writers for the New England Journal of Medicine, among others. Last week the New Yorker ran a 5,000-word apologia from Atul Gawande, who likewise owned up to the fact that there is "no master plan for dealing with the problem of soaring medical costs," only "a battery of small scale experiments." Keep in mind, this is an argument in favor of ObamaCare.

They might have piped up earlier: What they're finally admitting is that all the grandiose talk about "bending the curve" used for months to sell ObamaCare really comes down to their hope that bureaucratic improvisation will make a difference over the long term. Yet the liabilities of the greatest social spending program in American history will be added to the budget almost immediately, and what happens if Mr. Orszag's technocratic revolution doesn't work as promised? Or rather, when it doesn't?

Forgotten in ObamaCare's march-to-the-sea campaign is that during the transition and early on, the White House was divided on whether to pursue health reform at all. Opponents included Larry Summers, worried about the economy and deficits, and David Axelrod, worried about the politics. Another faction led by Tom Daschle preached from the conventional social-equity church of liberalism.

Mr. Orszag proposed another option, citing academic research observing that as much as 30% of health spending is "waste" that doesn't affect outcomes. He argued the country could save $700 billion a year without harming quality—more than enough to pay for universal coverage.

Thus cost control migrated from Orszag theory to free political lunch. Mr. Gawande wrote an influential New Yorker essay on the topic in June, and the theme shaped both the case for a new entitlement and especially the appeal to potential opponents in business.

But then Congressional Budget Office director Douglas Elmendorf testified in July that "the curve is being raised," given that ObamaCare lacks "the sort of fundamental changes" necessary to tamp down costs. Meanwhile, it became clear that Mr. Orszag's favored research was always more nuanced and qualified than his pose of papal infallibility. One of his main gurus, Jonathan Skinner, mused recently that "the key lesson" from a new study challenging some of his findings "is how little we know about the science of health-care delivery."

Well, sure. A field as dynamic and innovative as U.S. medicine, in which costs are largely driven by new technologies and better ways of caring for patients, is rife with complexities and uncertainties. But no one bothered to strike that note of caution when Washington was hopped up on a cost-control gambit that was too painless to be true.

The new cost-control apologists concede that there isn't any actual plan for controlling costs: Throw enough speculative policies against the wall, they say, and some breakthrough will stick. Yet Mr. Orszag's no-less-confident predecessors spent decades trying to pull down Medicare spending with little to no success. Technocracy rarely if ever works as intended. Mr. Gawande points to the case study of U.S. farm policy, and if politically sacrosanct agriculture subsidies and rural price-supports are the best to hope for, then what's the worst?

More relevant examples include Medicare's "relative value" payment scale, which was designed in 1985 by the Harvard economist William Hsiao to encourage more primary care. That's this year's rallying cry too. "Diagnosis-related groups" were introduced into Medicare in 1983 to alleviate hospital cost growth, and what a monumental success that turned out to be. With only brief periods of relatively slower growth, nominal Medicare spending has risen on average at an annual rate of 9.6% since 1980. Over the same period total Medicare spending has grown 13-fold, climbing from 1.2% of the economy to 3.2% today.

Congress lacks the stomach for serious cost control in any case. One policy Mr. Orszag favors—Medicare penalties for hospitals that re-admit certain patients—is limited to only three conditions in the Senate bill, and the penalties are trivial.

Another—a putatively independent commission that is supposed to enforce cost cutting—is barred from going after costs incurred by doctors and hospitals, which leaves out more than half of Medicare spending. Earlier this year Mr. Orszag got into a heated debate with Henry Waxman over such a commission at a dinner party hosted by Connecticut Rep. Rosa DeLauro, precisely because the House baron enjoys the political power that flows from controlling health spending.

Even if Mr. Orszag's Princeton and Yale Ph.D.s really do cook up some hope-and-a-prayer savings plan, it will invariably offend one constituency or another and Congress will block it. Thereupon the political class will do what it always does when costs run over: Tighten price controls across the board, before moving on to denying patient access to costly treatments that will be defined as "wasteful." That is, ration care.

"Basically everything that has been put forward in health policy discussions for a decade is in this bill," Mr. Orszag said on a conference call shortly before Thanksgiving. He then asked critics pointedly: "What specifically else would you do?"

Hmmm. One liberal sage noted in a 2007 paper that "four decades of empirical research" have shown that insulating people through third-party insurance coverage "from the full cost of health care has been responsible for anywhere from 10% to 50% of the large increase in health expenditures." Ultimately, he concluded, increasing cost-sharing would give individuals a direct stake in more prudent purchasing, as opposed to today's invisible health dollars that vanish as more expensive premiums, foregone wages and higher taxes.

Those are the words of Jason Furman, now the White House deputy economic director who seems to have been put into witness protection. Every serious health economist in the country recommends reforming the tax exclusion for employer-sponsored insurance, perhaps by converting it to a deduction or credit. Cost control will never stick unless it is extricated from politics and transferred to individuals to make their own trade-offs.

Such reforms were ruled out by union opposition, so the Senate gestures at them with a 40% excise tax on high-cost insurance plans, on the theory that two wrongs will make a right. But this untargeted tax will simply raise the cost of coverage for all workers in a given pool—it's too clever by 40%—while doing nothing to stem the distortions from first-dollar, third-party insurance.

No doubt there are efficiencies to be had in health care, and maybe Mr. Orszag has even identified some of them. But all of his bright ideas could be taken for a whirl without adding trillions of new liabilities to the federal balance sheet. And the bad faith of the White House and its acolytes is breathtaking.

The White House hawked a permanent entitlement expansion on flimsy and speculative theories that its own partisans now admit—albeit when it is nearly too late—aren't more substantive than the triumph of hope over experience, while simultaneously writing off the one policy that has been effective in the real world. The cost control mantra of ObamaCare was always a political bill of goods, and its result will be the opposite of its claims: poorer quality care at higher costs.
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"I'm just jazzed about being on the show, man."
- Guy

[andrew]

The government screws up every program it touches. No reason this one should be different.
_________________
"The question is not, 'How far?' The question is,
'Do you possess the constitution, the depth of faith, to go as far as is needed?'"