Monday, September 21, 2009

Obama's Health Care speech, Part 1

For the past few months, I have been following the debate on Health Care reform. I am an average citizen who happens to be one of the people most affected by the current state of health Insurance. I am now and always have been an independent businessman. I have never been employed by a large corporation, nor have I ever been a member of any trade union. As a result, I have effectively been shut out of the normal employer or union purchased, third party payer, health insurance industry.

Purchasing insurance as an individual or for the small number of people I have employed over the years is impossible at competitive rates. I have been declined coverage and paid a huge premium for my independence because I didn’t have the power of a large economically desirable group behind me. I have even been told point blank by a hospital that as a self payer I would be charged 3 times more than insurance companies to offset the cost of indigent care. I look forward to a reform in the health insurance industry, but am not in favor of the proposal being offered by the house and promoted by the President.

President Obama went before a joint session of congress last week to promote his plan for his idea of reform and I listened intently to what he is promoting. I would like to offer my reaction below.

I have some friends who claim that 85% of the population "doesn't have a clue" and that this is the constituency President Obama appeals to. I disagree. I may be an idealist, as some have claimed, but I think the citizens of America are smart enough to see this "plan" for what it is -- BAD POLICY and overreaching on the part of our president.

Thomas Sowell states of President Obama's speech, "To tell us, with a straight face, that he can insure millions more people without adding to the already skyrocketing deficit, is world-class chutzpah and an insult to anyone's intelligence." I fully agree and am even more perplexed, when you add his statement that he will do so with additional “wellness benefits”.

To make this claim after an analysis by the Congressional Budget Office has already shown this to be impossible is not only disingenuous, but extremely foolish. The Congressional Budget Office, considered to be bi-partisan, says Obama’s reform plan will add $220 billion to the deficit over 10 years, but will not succeed at shrinking the overall costs of our nation's health care. To state that he "will not sign a health care bill which adds one dollar to the deficit, now or in the future" is at best arrogant and at worst an attempt to deceive. Either that or he has to fold his cards and go home without a bill.

He didn't explain how he was going to stop the "hundreds of billions of dollars in waste and fraud" in the current health care system across America. If the government knows this fraud and waste exists, what are they doing about it? Why haven't they stopped it already? And since they haven't, what makes the President think he can? He may think he very highly of himself and his Czars, but he hasn't shown up anywhere with a magic wand that I have seen. And magic is going to be necessary to pull off this feat.

“There remain some significant details to iron out.” Are the words of the President, again with a straight face, as he told legislators that he was finally delivering not lofty rhetoric, but his plan for health care reform. Of course he doesn't explain how exactly all the savings will materialize. One only needs to look at the TennCare program in Tennessee to see that this doesn’t work. Want another example, how about the state program in Massachusetts which provides for universal care? It is well on its way to bankrupting the state. So I ask, when has a Federal plan ever cut costs effectively? I would welcome anyone in the US to show me an example.

In fact, while he kept referring to "my plan" or “our plan” he never explained which plan he meant. A plan he devised in the Whitehouse no one has ever seen? One of the two House plans? HB-3200 is over 1000 pages of theory, but don’t offer and substantive detail on how the plan will be incorporated. The “plan” whichever one to which President Obama is claiming authorship is not actually a plan, but a broad brush theoretical goal, promoted with rhetoric and absent any detail on how it can be realistically implemented and achieved. If history is an indicator, this is a recipe for an incredible increase in costs, not a reduction.

More to come in a few days. Come back for the next installment.

Obama's Health Care speech, Part 2

The president claims that the ”other side” hasn’t offered any plans, but this too is an untruth. There are a number of plans which have been submitted by Republican senators and at least two I am aware of from outside the government. They may not be any better than the Presidents goals, but at least they offer more detail. These plans which offer more choice and portability to the American citizens are not acceptable in the Presidents view, so I assume he does not consider them plans, even though they offer much more detail than the Presidents unpublished theoretical framework.

The President evoked America’s “self-reliance, our rugged individualism and our fierce defense of freedom”. Does he really believe this? If so, why is he trying so hard to eliminate our ability to rely on our selves and individually buy insurance? He has made the claim that we need to fix the system because “more than 50% of the population, under the age of 65 will lose their insurance at some point during the next ten years”. This is absolutely true, because more than 50% of the population of working Americans will change jobs over the next ten years and will not be able to take their insurance with them. This is because Health Insurance, unlike life and auto insurance are not portable. In fact, in more than 36 states, employers are not legally allowed to pay for employees individually owned health insurance. There is no regulation which disallows employers from paying for employee auto insurance. In fact, many employers pay the auto insurance premiums for their employees who have to drive regularly at work. Why isn’t this allowed for health insurance? One reason is that it removes a major bargaining chip from the Union’s quiver of negotiating points. Is this president going to put anything, regardless of how much common sense it makes, in a bill if it hurts unions? Not very likely, in my estimation.

The President made the claim, loudly refuted, that illegal immigrants will not be covered under his plan. This is wrong, at least from the following perspective -- if someone shows up at a hospital emergency room with a medical issue, they are treated, whether they have insurance or not. They are not asked for proof of citizenship and turned away if they can't produce it. They are admitted and treated. Once they are released, they are able to go back to their anonymous existence, no further payment collected. Think this will change under the Presidents theoretical framework? If so, can I offer you a really good deal on a bridge to Brooklyn?President Obama said that the government option, which he continues to support, “would only be available to those who don’t have insurance, which shouldn't be more than about 5%” and "will be funded 100% from the premiums of those who enroll". This statement goes beyond the bounds of credulity. In the first place, what is the group of 5% that he is speaking of? Is he referring to 5% of the population of the country? There won't be that many people to enroll if the other programs proposed are enacted. If he is speaking of 5% of the people not now covered, the number of enrollees will amount to approximately 1.5 million nationwide. There is no way that this small number of people can be covered 100% with premiums paid.

Obama's Health Care speech, Part 3

The president stated that he would accept the principle of tort reform to reduce the costs of defensive medicine. He didn't accept it, he made mention of it. His comments weren't an endorsement of tort reform, only a bone thrown out to distract and sidestep, an area at which the president is an absolute master. Don't forget the other side of the coin. Not only are the litigators lobbying hard to leave tort reform as is, the ACORN web of organizations use malpractice to go after the medical industry with as many malpractice suits as possible. This is Alinsky's theory of overburdening the system to the point of implosion, in action. President Obama has shown and is continuing this week to show the he will fall on his sword for his Union supporters. Meaningful tort reform is not going to come out of this administration.

At the very least, Mr. Obama should listen to the will of the people he is supposed to represent; he should stop pretending that the August Townhall meetings didn’t happen, that there hasn’t been a national revolt against a government takeover of health care and start being constructive rather than continuing with the rhetoric. To paraphrase him, it’s time to stop playing games. It is time to seriously address the issues and provide some detail Mr. President.

There is certainly much which can be improved with the current state of health insurance by providing for individual ownership, portability, health savings accounts, eliminating exclusion for pre existing conditions and true tort reform. This does require personal responsibility for ones own health which doesn’t seem too realistic in today’s political environment, but it is the common sense answer to Health Insurance reform.

There is a big difference between Health Insurance and Health Care. American Health Care is indisputably, the best in the world. Health Care certainly doesn’t require a government take over and its trillion dollar price tag. Common sense, responsible Health Insurance reform can be accomplished without adding to the deficit.
It's unfortunate that the President is letting politics get in the way of common sense and responsibility.