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A right-leaning disgruntled Republican comments on the news of the day and any other thing he damn-well pleases.
Comment: Probably every one of us has an automobile dealer friend or someone who works for an auto dealer affected by the U.S. government high-jacking of General Motors. I have not seen confirmation of it yet in the press, but I have been told that Jim Reed Chevrolet had been ordered closed. Jim Reed has been a Chevy dealer for almost a hundred years here in Nashville. I never thought I would see the day when this could happen in America. No one is secure. Your company or the company you work for could be next. We are watching our freedom slip away.
Wrong Way on Health 'Reform'
By Robert J. Samuelson Monday, June 15, 2009 , Washington Post
It's hard to know whether President Obama's health-care "reform" is naive, hypocritical or simply dishonest. Probably all three. The president keeps saying it's imperative to control runaway health spending. He's right. The trouble is that what's being promoted as health-care "reform" almost certainly won't suppress spending and, quite probably, will do the opposite.
A new report from Obama's own Council of Economic Advisers shows why controlling health costs is so important. Since 1975, annual health spending per person, adjusted for inflation, has grown 2.1 percentage points faster than overall economic growth per person. If this trend continues, the CEA projects that:
-- Health spending, which was 5 percent of the economy (gross domestic product) in 1960 and is reckoned at almost 18 percent today, would grow to 34 percent of GDP by 2040 -- a third of the economy. (link)
Comment: This article from America's premier economics journalist sheds light on the enormity of the problem of runaway health care cost and explains why President Obama's health care reform will actually make the problem worse.
By INVESTOR'S BUSINESS DAILY Posted Friday, June 19, 2009 4:20 PM PT
Media Bias: As much of the U.S. private sector, including health care providers, resists government takeovers, what a sorry sight to see ABC News leap forward to make itself a propaganda arm of the government.
But that's the story as ABC crosses the line from journalism to advocacy in turning its coverage of health care over to the White House. (link)
by Ken Dychtwald Ph.D
While most of the current healthcare debate has focused on how to cover the tens of millions of uninsured Americans and who should pay (granted, these are critically important issues), after thirty-five years working at the intersection of gerontology and healthcare, I'm convinced that we have the WRONG healthcare system for our aging nation.
If your train is headed in the wrong direction, it doesn't help to give everyone a seat. And, since the U.S. currently spends nearly twice as much per capita on healthcare as all the other modernized nations, while our national life expectancy ranks a humiliating 42nd worldwide, it's not that we throw too little money at the problem, but that we may not be spending it in the wisest ways. (link)
Comment
This is a thought-provoking article. The arthor argues that we are not prepared for the health care needs of the future and that Americans do not take enough responsbility for their own health.
He points out that Medicare spends approximately 28 percent of its total budget on patients in their last year of life and argues that prolonging the dying process may not be the best use of health care dollars. I do not want the government deciding when to pull the plug, however I agree that simply prolonging life with high-tech and expensive care may not be the best use of health care dollars. If we do not get Medicare spending under control, it can bankrupt our nation. How much to spend on Medicare is a public policy issue and there is a limit to how much the public can spend on prolonging life of those who are dying.
Many people end their life in poverty and impoverish their spouse and family due to extremely expensive care which extends the life of the patient by only months. Nursing home care can run to thousands of dollars a month. One does not get public-funded nursing home care until all of their own wealth is exhausted. Once the patient and his or her spouse have exhausted all of their wealth, the tax payers pick up the tab. Often the patient may have no hope of recovery and be in an almost vegetative state for months prior to dying. I know it is difficult to let a parent or spouse die, but I do not think simply prolonging life when their is no hope of recovery and the patient has no quality of life is preferable to letting the patient die with dignity. As health care advances, the ability to prolong the dying process continues to expand.
As a baby-boomer myself and someone who has a loved one afflicted with Alzheimer's, I think about these issues, as unpleasant as they are to contemplate.
You often hear critics of health care reform say that we have the best health care in the world and that the reformers are trying to destroy it. Is the true? Do we have the best health care in the world?
I guess it depends on what you mean by “best.” Certainly, many Canadian and others come to the US for medical procedures that they cannot get at home or for which they would have to wait a very long time. The royalty, celebrities and rich of the world often come to America to get treatment. The U.S. has more of the best medical centers, best-equipped hospitals and most highly specialized physicians in the world. Many of the world’s advances in curing and treating decease originate in America. In that sense we may fairly say we have the best health care in the world. We have the best health care that money can buy, if you have the money.
The best quality health care that can be purchased is only one measure of “best.” Most of us will never be treated by a world-renowned physician or have miracle surgery. “Best” has many measures. So while we may have the absolute “best” health care that is available, do we have the best health care for the average person?
Let us look at some measures of health care quality. Consider life expectancy at birth. We rank 50th, a little ahead of Cuba and Albania but way behind Japan, Singapore, France, Sweden, Norway and Spain. Many factors may enter into life expectancy other than the quality of health care. Homicide rates, suicide rates, and highway death tolls may work against us. In Highway Death Tolls, we lead the world at 15.5 per 100,000. That stat is obviously not a function of the quality of our health care. We have more cars and drive more miles than most nations. Lifestyle choices such as smoking, drug use, diet and sedentary lifestyle may also have more impact on longevity than medical intervention.
Let us look at another measure: infant mortality. In the United States infant mortality is 6.26 per 1000 live births, which barely beats Croatia at 6.37 but trails Cuba at 5.82 and Canada at 5.04. Our infant mortality rate is almost twice as high as that of Japan and Norway. Maybe again, there are social factors to blame. Maybe we have more crack addicted mothers giving birth and more young unwed mothers, but the statistics are, I think, a valid indication that we do not have the “best” health care in the world.
On some other measures of health, the United States also scores not quite so well. It you look at the “probability of not reaching sixty,” Americans have a 12.8% probability which beats Poland at 17.5% and Portugal at 13.1% but trails Denmark at 12%, France at 11.4%, Germany at 10.6%, Spain at 10.3%, and Canada at 9.5%.
On some measures of health, we score quite well. On the survival rate for cancer, we lead the world at 62.9% for women and 66.3% for men, followed by everyone else with Spain at 59% (women), England at only 52.7 (women) and 44.8% (men).
In 2000, The World Health Organization ranked the nations of the world as to the quality of health care for the first and only time. The U.S. ranked 37th out of 191 countries, trailing France, Italy, Spain, Greece, The UK, Canada and Costa Rico. We were immediately followed by Slovenia and Cuba. The methodology and weight given to various factors proved controversial, but nevertheless the poor showing by the United States should cast doubt on the claim of the best health care in the world.
Do we have the best health care in the world? I don’t think so.
(This essay on health care reform is a work in progress but these are my thoughts at this time. More documentation and more thoughts to follow.)
I don’t want more government; I want less. I wish government nowhere built sports stadiums or convention centers. I would even support privatization of some current government services such as our Interstate Highway System, TVA, and mail delivery, so I certainly do not advocate nationalizing health care. I don’t want socialized medicine. I don’t support “single payer.” However, I think we must do something about health care in America.
In a recent CNN poll, 80% of Americans said they were satisfied with their health care. That may be seen as an excuse to say, “Leave well enough alone.” We can’t. There is a crisis. We cannot continue along the current trajectory. What we have is not working very well. We have a problem. Just saying “no” and supporting the status quo is not a solution. We need to get all the smart people in a room and figure out what needs to be done. I hope there really is a debate about health care. I am not sure what reform, I can support at this time but as I think about the issue here are some “givens” on my part in this debate.
We need health care reform. I accept that what we currently have is flawed and needs improvement. It is not sustainable.
Health care costs are rising. Health care costs are rising considerable faster than increases in the general price index.
Rising health care cost will wreck the economy and bankrupt the government. (More to follow.)
We do not have the best health care in the world. “Best” is a subjective term, but by many measures we do not have the healthiest people on the planet. What we have may be the best that money can buy but unless you are extremely wealthy you can’t afford the best.
The you-want-be-able-to-choose-your-own-doctor argument is exaggerated. Until we see the particulars of a specific plan this argument is nothing more than an attempt to manipulate people into opposing any change. Most people do not now go through a methodical process to choose a doctor. How many doctors did you interview before you ending up with your current doctor? I belong to an HMO and can choose from quite a long list of doctors but they have to be on the list. Unless we end up with a very draconian, almost boot camp military-style health care system, you will probably have about as much choice in choosing a doctor as the choice you exercised in choosing your current doctor. In many cases your current ability to choose a doctor depends on what kind of insurance your employer provides you.
Employers should not provide health insurance. There is nothing natural or inherently rational about your employer providing you with health insurance. The practice of our employer providing our insurance really took off in World War II when the nation had wage and price controls. Employers could not offer higher wages to attract labor but they could offer better benefits. Unions also had a roll in pressuring employers to provide insurance. Your employer should no more provide your health insurance than they should your home insurance or auto insurance. How many people are working at a job they dislike, just for the health insurance benefits? We are like serfs on the manor. We are often tied to our desk by our insurance. Breaking this tie would be liberating. Divorcing insurance from employment would free labor to me more mobile. I suspect that if people were freed from a dependency on their employer for health care, we would see a growth in small business and more overall economic growth.
Taxing of health care benefits should not be taken off the table. I do not want the taxing of health care benefits to be used as simply a tactic for destroying consumer choice and forcing most people into a government insurance program, but the concept that health care benefits should be taxes seems rational. If you are receiving your health insurance from your employer that is the equivalent of additional income on which you are not paying taxes. If all other factors are equal and you earn $30,000 and get $3000 worth of insurance benefits and your neighbor earns $33,000 and no insurance, should he have to pay more in taxes than you do? I don’t think so. It is usually the lowest income earners without employer provided heath care benefits. I am generally opposed to increasing taxes, but part of health care reform should consider taxation of employer provided benefits.
There is not a functioning “market” in health care/the market does not work. There is really not a price for health care cost. For some services, such as an office visit there may be a set price, but it is very difficult to actually determine the cost of a medical procedure and a hospital stay. The price is a function of who is paying the bill. Different insurance companies have different reimbursement rates. Many times those without insurance are charged a much higher rate than those with insurance, yet in many cases they default on the bill and do not end up paying it. Those without insurance who are charged the ticket price often bankrupt on medical bills. The roll of price as a reflection of supply and demand for a service is simply not functioning in heath care.
When a third party pays for a service, demand and cost will rise. It really does not matter whether it is the insurance company or the government paying the bill, when a third party pays the bill, people do not consider what something cost. Also, when the patient is not the one paying the bill, service providers are not as mindful of the cost. Imagine you paid a set fee for groceries and then someone else paid your grocery bill, would you eat more steak and lobster? Would you care what something cost if someone else was picking up the tab? If someone else is paying the tab, that someone has to have a roll in restricting supply. Whether it is your insurance company or government; someone has to control cost when the consumer is not the one paying the bill.
The government is already involved in health care. Many opponents of health care reform argue they do not want the government involved in health care. The government is already involved. Medicare, Medicaid, SCHIP (State Children’s Health Insurance Program), and Veterans hospitals already account for over 50% of American health care spending. On top of that, each of the fifty states has massive bureaucracies to regulate health insurance and often dictate what insurance must cover and what they can and cannot do. Also, many cities support charity hospitals and public health clinics. Most cities and states have a Department of Public Health. A lot of medical research is paid for by government grants.
Too much is spent on health care administration. With a variety of complicated health care plans and a different set of government rules in each of the fifty states, we have too much of our health care dollars spent on paperwork, bureaucracy, and administration. Surely there is a way to reduce the overhead.
Too many people are without health care. 46 million Americans do not have health insurance and the number without health care is rising. A third of the companies in America do not offer their employees insurance. Many individuals are uninsurable. This of course does not mean all of these people are totally without health care. Hospital emergency rooms are required to serve anyone with an emergency. So, without regular health care, many people depend on the emergency room for all of their health care. Who pays? We do. Free services given away by hospitals are covered by increasing the cost to the paying customers. When this happens, your health insurance cost increases. Also depending on the emergency room care for health care means many people do not get preventive care or get diagnosed for an illness until it is advanced.
Not all of those without health care are unable to get it. There are some people (we don’t know how many but maybe up to half of those without insurance) who are now now covered by insurance who could now get insurance if they wanted it. Some of those without insurance are young adults who think they are invincible and prefer fancy cell phones and electronic gadgets, eating out and going to concerts over having health care. They are people who could afford insurance; it is simply not a priority. There are other people who qualify for Medicaid or some other existing program but are too ignorant or trifling to enroll.
Mandatory Health Insurance should not be taken off the table. I don’t like the concept of mandating that one purchase health insurance, but we should not out right dismiss making people at least carry catastrophic health insurance. Most states require people who own a car to have auto liability insurance. I am not so sure that mandating health insurance is any more odious than mandating that one pay taxes or be subject to a military draft. Another person’s failure to have insurance does impact my financial standing, because we all pay higher prices for our insurance to care for those without insurance. There should perhaps be creative opt-out provisions for those who will bear the full cost of their own care, but the idea of requiring one to have some sort of responsibility for their own health care, even if it means mandatory health insurance coverage should not be summarily dismissed.
Posted on Jun 11, 2009 by Staff, Baptist Press
SACRAMENTO, Calif. (BP)--One month after being allowed to keep her crown, Carrie Prejean was fired Wednesday by the Miss California USA pageant, with both sides in the dispute disagreeing over the reasons.[full article]
The mayor wants us to get serious about saving the planet. This was in the newspaper today:
Dean calls for pledge to conserve
Mayor Karl Dean is asking Nashville residents to take a five-step pledge to help the environment by saving electricity and water and cutting back on greenhouse gas emissions.
The mayor is asking people to use at least four compact fluorescent light bulbs; turn off the water while brushing their teeth; take the bus, walk, ride a bike or carpool at least once a week instead of driving; plant a tree; and use reusable shopping bags. [Full Article]
This photo was taken at a ceremony to mark the 65th anniversary of the D-Day landings in Normandy at Colleville-sur-Mer cemetery, June 6, 2009. I don't have a clue what is going on here, but our First Lady does not look very pleased with France's First Lady. I lifted this from Bluegrass Pundit.
Please suggest a caption.