Universal Health Care

Throw out the garbage being spewed by the White House and congress. There are some fairly simple and inexpensive solutions which would vastly improve our health care delivery system and dramatically reduce costs. Lets remember, world leaders and the wealthy elite come from all over the world for treatment in America. Health care in America is second to none. It is the delivery system that is broken, not the quality of our health care.

1. Tort reform. Place a limit on tort claim awards and corresponding attorney's fees. Cap awards at $250,000 and limit attorney's fee awards to 10 - 12%. People like John Edwards milk the system and become fabulously wealthy, but each of us pays that cost in higher insurance premiums, higher medical costs and the ordering of unnecessary or superfluous testing for even the most common of medical problems. Doctors feel like if they don't order every possible medical test, no matter how obscure, even though the likelihood of finding any negative results are perhaps miniscule, some trial lawyer will ruin them in that unlikely event. Doctors are human and miss things too. Medical malpractice exists and those tort claims should be prosecuted like any other tort. But for a neurosurgeon to have to pay $200,000/year in malpractice insurance coverage is absurd. The standard for testing and evaluation of various conditions should be medical reasonableness, not the remotest possibility of missing something. We would have more doctors willing and able to practice, and more free competition among doctors. Loosen medical school standards somewhat, so that we have more homegrown doctors, rather than those who complete less demanding programs in other countries.

2. Government provision of catastrophic coverage for everyone. This is what people fear most, that they won't be covered in such an event, but which event seldom occurs. This would eliminate the need for enormous malpractice awards, as the government provides necessary lifetime care. Government has the deep pockets to provide this coverage for all Americans, which when spread out over the entire population, would result in considerably less cost per person than the obscene numbers being provided to us as costs of Obamacare, as provided by the non-partisan Congressional Budget Office. Set a threshold level of future lifetime medical care and treatment, and anyone whose expenses exceed that amount becomes eligible for government assistance. The experts can flesh out the numbers, but it should not be a large actuarial challenge.

3. Convert emergency rooms to real emergency rooms. If you don't have a true medical emergency, head down the street to the urgent care. People have been gaming the emergency medical system in this country for decades, as they know that generally they cannot be turned away from an emergency room simply because they cannot pay, and they will go there for even the most minor of afflictions. Set up a triage system in every emergency room. In questionable cases, have a real doctor spend a few minutes with each patient right away to be able to quickly determine whether a true emergency exists. A sore throat is not an emergency. This will also greatly curtail cases of people dying in the waiting room as they await being seen. Those without emergencies should be denied treatment. They will have to find help and pay for it themselves, or through their own insurance or other resources. Gaming the emergency room system will no longer be possible. Initiate an E-verify system, so that medical providers can instantly check the immigration status of anyone seeking emergency care. True emergency cases can postpone the E-verify check pending true emergency treatment, but thereafter immigration status would have to be verified, if not, customs notification, and indemnification demand made to home country of immigrant.

4. Set federal standards for insurance coverage, eliminate State standards (most of which differ) through federal preemption. All insurance companies would offer similar coverages within federal guidelines, all would cover preexisting conditions, and all could compete nationwide. Additional coverage could be made available at additional cost to those desiring it - free market competition. This would include prescription coverage. All coverage would be freely transferable and portable. Employers can select standard or enhanced coverage for employees. If employee leaves that employment, he can select standard or enhanced at the same cost his employer paid. 

5. Amend current system such that ALL Americans, including federal employees, congressmen, senators, unions, etc., all have the exact same coverage options and access to medical care. That is fundamental fairness. You can be sure lawmakers will sing a different tune when their own family health care is at stake. They cannot approve any program they don't feel is appropriate for their own families. 

6. Initiate means testing for Medicare. There is no reason for the federal government to be responsible for the health care costs of all elderly, regardless of circumstances. As to Medicaid, set federal standards, preempting State regulation. Welfare and/or unemployment status would enable government subsidized health care in addition to existing benefits, on a par equal with minimum coverages offered privately to general citizenry. No more, no less. Those eligible and able to work would have to be seeking gainful employment, etc. 

Lets put the federal government in charge of things that make sense: Setting nationwide standards of coverage and care, handling catastrophic care, tort reform. Lets not get the government involved in health care decision making for individuals, or in maintaining electronic databases of our citizens' medical and financial records. Who in the bureaucracy has the right to determine if a senior or drastically ill person has a "duty to die."? This is America after all. 

In a town hall meeting on July 1st 2009, Dear Leader ZerO met Exhibit 'A' of how the government controls health-care costs. Debbie Smith is suffering from Renal failure and is allegedly unable to work. But the government no longer considers Renal failure a disability (cost cutting) and she can not get Medicaid assistance to pay for her medical needs. This is the result of government efforts to cut medical costs. Today the government denies disability and medical assistance to a woman with Renal failure, tomorrow they delay tests and biopsies for suspected tumors, and the day after tomorrow they deny procedures and drugs for people deemed non productive for society. This is what government health-care cost cutting means. A bureaucrat decides what is and isn't a medical disability, prudent preliminary test, or a necessary procedure.

Debbie Smith said: (from http://www.whitehouse.gov/the_press_office/Remarks-of-the-President-in-an-Online-Town-Hall-on-Health-Care-Reform/ )

"Good afternoon, Mr. President. I'll try not to cry. I'm trying to figure out what I can do currently. My situation is I had renal cell carcinoma in '98 that was radiated, because my dad was dying of colon cancer at the time, and I was his health care server on his living will, so I could not be tied up having my kidney removed. So they did radiation procedures to kill the tumor then. And I had insurance and everything was taken out.

But basically because of the damage that the radiation did in things, I'm no longer able to work and I have no health insurance. Now I have a new tumor. I have no way to pay for it. Doctors will not see you without paying $100 or $150 to come into their office. I can get checked into a hospital -- under their program, they will run tests and release me, but that costs a lot of money.

So currently I basically -- Social Security will not give me disability because renal failure is no longer a qualifying factor under Social Security currently. I cannot get Medicaid from the state of Virginia because you have to be considered disabled through Social Security to qualify for Medicaid in the state of Virginia because I have no dependent children at home -- it's just me. I get food stamps, but that's it. And I'm just trying to figure out how I'm going to make it in nine years until I'm qualified to get my regular Social Security -- now that I have a new tumor and I have nowhere to turn."

As Dear Leader ZerO has stated in the past. We need to control costs, why should we pay for extra tests when they aren't really needed. Tests and treatments that your doctor may need to eliminate a possible ailment origin as well as to determine the cause. Or a test that can lead to early discovery of a disease not even contemplated. They aren't really needed.

On June 15 2009: (http://www.whitehouse.gov/the_press_office/Remarks-by-the-President-to-the-Annual-Conference-of-the-American-Medical-Association/ )

Dear Leader Zero: "treatments that, in some cases, they don't really need"

Of course, government control of costs is all about finding what works.

Dear Leader ZerO: "identifying what works is not about dictating what kind of care should be provided."

Of course it isn't about 'control' or 'dictating' what is and is not allowed due to costs. It is about what 'works'. According to some bureaucrat.

Dear Leader ZerO does advocate better medical information sharing and computerization of medical records to help modernize the medical profession and cut costs through better efficiency. A program proposed by President Bush during his State of the Union address in February 2005, and signed into law by President Bush with full implementation by 2014. President Bush was following up on an idea begun by his father President George H. W. Bush which hit a lot of snags due to concerns about privacy of the electronic records. Although Dear Leader ZerO yearns to take credit for it. (from http://www.whitehouse.gov/the_press_office/Remarks-by-the-President-to-the-Annual-Conference-of-the-American-Medical-Association/ )

Dear Leader Zero: "First, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping."

But his top priority is control. By government top down central control of the Medical delivery system. The operative phrase here is 'government control'.

On June 23 2009: (from http://www.whitehouse.gov/the_press_office/Press-Conference-by-the-President-6-23-09/ )

Dear Leader Zero: "What I've said is, our top priority has to be to control costs. And that means not just tinkering around the edges. It doesn't mean just lopping off reimbursements for doctors in any given year because we're trying to fix our budget."

It means control by eliminating options that the government does not have control over. Like private enterprise. Like freedom of choice. It means giving Americans an offer they can not refuse like the Public Health Program.

The Public Health Program option is a rigged game. Like Fannie Mae and Freddie Mac, this Government agency will look on the surface to be an independent entity, but in fact will be a toy of the members of Congress that are on the oversight committee. They will appoint cronies to oversee it and manage it. Giving them bonuses and incentives to cut costs to look good on one hand, and subsidizing their revenue shortfalls from the cost cutting with tax money on the other. No private Insurance program of any kind will be able to compete with a company that can print it's own money to be profitable. In short order, the only option will be the Public Health Program option, and the controlled costs of any medical care you may need.

What we should have is less stifling of the Health Insurance industry in inter state commerce so that people in each state are not limited to only the local insurance companies where there may only be a few or even just one offering. The extra competition will lower costs of insurance and expand the diversity of products offered.

What we need is the addition of a tax exemption for Insurance costs on an individual level equal to the tax exemption businesses enjoy. That would allow individuals to purchase the insurance of their choosing while not eliminating the advantages business have in offering a health insurance benefit to attract employees.

Individuals should be allowed to partner with their employer to allow the business the tax advantage if they pay all or part of the insurance premium. At the same time allowing the individual mobility to carry the insurance to a new job when needed that may not offer any health insurance benefits.

Vouchers for insurance premiums for low income families to purchase a policy could be designed similar to the food stamp program model. Approved Insurance plans would be offered to anyone using the voucher system to prevent fraud and abuse. Some states already use a system of approved Insurance plans with premiums paid for by the Medicaid program instead of being a direct payer.

Everyone will have the freedom to choose their benefits they want, the doctor they like, and have the ability to switch plans if they are not being served adequately.

The best way to control medical costs would be if everyone paid out of pocket for medical care and by necessity had to shop for the best medical care for the purchase amount. Insurance and Government programs do not provide for consumer oversight of medical costs like individual direct payment would, but with medical costs as high as they are for even minor ailments, it would be beyond the means of most family budgets to be direct payers of medical costs. We have to rely on a common pool of funds. The proposition is if we rely on one government controlled fund, or on a choice of many Insurance funds.

Our future will be one Government controlled program when Dear Leader Zero implements his medical cost controls and Public Health Program 'option'. More and more people will be like Debbie Smith. When more ailments are added to the list of inadequate diseases to qualify for treatment, like renal failure no longer qualifies for disability, all to cut costs. We will all be unable to qualify for medical disability. Or we will be waiting for tests. Or we will be in line for approval for a review of a preliminary exam for the necessity of an operation for a life threatening ailment.

First, a big shout out to my buds @ The New York Times. While the "Paper of Record" chose not to use my name or the name of RedState's Moe Lane we were both quoted verbatim as the authoriative voice on what ought to be done about the "Cap & Tr8-ors"

Thanks for giving this a wider audience

 "I don't think one can minimize why this was a truly hideous vote for those eight folks," a commentator on the conservative blog the "Next Right" wrote. "Here we had a chance to derail the Obama socialism train and restore the Republican party to policy relevance, and these guys bailed out so they could get a nice mention in the NY Times."

Guess it still feels like John Mellencamp sang in "Small Town" "hey, look at who's in the big town"

I digress

Here's the choice for the Cap &Tr8-ors

former Democratic Vice Presidential nominee Joe Lieberman has come out against Obama's "public option" health care scheme.

“If we create a public option, the public is going to end up paying for it,” Lieberman said following an hour-long confab with public-health experts at the Ashmun Street community center of the Monterey Homes public housing complex. “That’s a cost we can’t take on"

I've disagreed with Joe frequently, but on this one he is clearly part of the "reality-based community".  Evidently "Countrywide Kent" Conrad is also not sipping the public option kool aid either.

So, here's the deal for Rep. Bono Mack, Castle, Kirk, Lance, LoBiondo, Reichert and Smith (I omitted McHugh on purpose; he's already been bought).

 You can go with Joe Lieberman and publicly break with the central element of Obamacare.  

Or you can get sent to the ice floe.

Choose Wisely. (if you you choose poorly, this will do you more good than Pac $$ and endorsements)

It will be a few weeks yet before we see the final details, but the broad outlines of the democratic proposals to take over the American health care system are becoming apparent. And from what we can see so far, it looks like bad news for American taxpayers, health-care providers, and, most important, patients. The plan would not initially create a government-run, single-payer system such as those in Canada and Britain. Private insurance would still exist, at least for a time. But it would be reduced to little more than a public utility, operating much like the electric company, with the government regulating every aspect of its operation.

• At a time of rising unemployment, the government would raise the cost of hiring workers by requiring employers to provide health insurance to their workers or pay a fee (tax) to subsidize government coverage.

• Every American would be required to buy an insurance policy that meets certain government requirements. Even individuals who are currently insured — and happy with their insurance — will have to switch to insurance that meets the government's definition of "acceptable insurance."

• A government-run plan similar to Medicare would be set up in competition with private insurance, with people able to choose either private insurance or the taxpayer-subsidized public plan. Subsidies and cost-shifting would encourage Americans to shift to the government plan.

• The government would undertake comparative-effectiveness research and cost-effectiveness research, and use the results of that research to impose practice guidelines on providers.

• Private insurance would face a host of new regulations, including a requirement to insure all applicants and a prohibition on pricing premiums on the basis of risk.

• Subsidies would be available to help middle-income people purchase insurance, while government programs such as Medicare and Medicaid would be expanded.

• Finally, the government would subsidize and manage the development of a national system of electronic medical records.

Taken individually, each of these proposals would be a bad idea. Taken collectively, they would dramatically transform the American health care system in a way that would harm taxpayers, health care providers, and — most importantly — the quality and range of care given to patients.

In the face of this assault on one sixth of the US economy and some of the most important, personal, and private areas of our lives, one would think that the Republican response would be a resounding “No!”  One would be wrong.

Instead, the Republican response has been a plan of their own to increase regulation, mandates, and government control over the health care system. 

Sens. Tom Coburn (R-OK) and Richard Burr (R-NC) and Reps. Paul Ryan (R-WI) and Devin Nunez (R-CA) have proposed a plan based on the failed Romneycare experiment in Massachusetts.  

It is not all bad. 

In fact, it contains some very good proposals, such as changing the tax treatment of health insurance and expanding HSAs. However, it would also preempt many state insurance regulations, establishing new federal insurance rules, including a requirement that insurers accept all applicants regardless of their health or age.   There would also be a federal “risk adjustment” board that would tax some insurers and subsidize others based on whether the people they insure are healthy or sick. These policies will mean higher insurance premiums for the young and healthy.

The plan falls just short of an individual mandate, setting up automatic enrollment in exchange plans at “places of employment, emergency rooms, the DMV, etc.” — essentially, trying to achieve universal coverage by nagging Americans to death.

Notably, Coburn-Burr-Ryan-Nunez abandons one of the best recent Republican ideas for health reform, Rep. John Shadegg’s proposal to allow Americans to buy insurance across state lines, in favor of a requirement that states establish Massachusetts-style connectors. But the Massachusetts Connector has been one of the worst aspects of that state’s reform, acting as a super-regulatory body, adding new mandated benefits, restricting consumer’s choice of plans, and adding both regulatory and administrative costs to insurance. (In fact, the Connector adds its own administrative costs, estimated at 4 percent of premium costs, for plans that are sold through it.) What the Connector has not done is live up to its promise of breaking the link between employment and insurance, giving workers personal, portable insurance that they could take with them from job to job, and which they would not lose when they lost their jobs. Unfortunately, the Connector has not lived up to its promise in the latter regard. In fact, as of May 2008, only 18,122 people had purchased insurance through the Connector. That’s very little gain for so much pain.

Since there is virtually no chance that the Coburn-Burr-Ryan-Nunez will actually be enacted, perhaps one shouldn’t get too excised about its failings. It is clearly far superior to Obamacare. But one can’t escape the feeling that the best way to show the American voters that Republicans have regained their commitment to limited government—and to defeat Obamacare—is not with Obamacare Lite.

Chris Dodd's effort to change the subject for the 2010 election to health care made a pit stop yesterday at Derby's Griffin Hospital.

Since the Senator got it from both sides, maybe he should have skipped the event and checked himself in.

Before he got there, he was greeted by a picket line of protesters from Dump Dodd. This is a sight he was unaccustomed to seeing in his travels around Connecticut.

Then it got worse, Dodd may have thought he was going to run a pep rally for Obama-style "health care reform", but was confronted with a cadre of militants demanding the immediate adoption of single payer health insurance.

Needless to say, it looks like it was ugly.

DERBY — A “town hall discussion” on health care reform held at Griffin Hospital Saturday became contentious when advocates of a single-payer health insurance system shouted at U.S. Sen. Christopher Dodd to put the plan back “on the table.”.......The two people evicted from the meeting in Derby Saturday were members of the group Single Payer Action. Russell Mokhiber of West Virginia, formerly of Simsbury, was the first to stand and shout at Dodd. He asked him several times, “Why did you take single pay off the table?” Then he added, “Tell us about your corporate connections.”Jerry Kann of New York was the second person to stand and ask Dodd why he had taken the single-payer proposal “off the table.” He, too, was escorted from the building. 

The Democrats in general have a rather large problem on their hands which us poor Republicans can;t solve.  There are millions of lefties out there who actually believed their party's diatribes and think the Democrats are going to hand the Gitmo detainees a plane ticket home and an ACLU lawyer; and implement every social policy pipe dream that got a favorable mention in Mother Jones or the Nation.  

The Obama  Adminstration and folks like Dodd now have to cater to Rachel Maddow's whims as well as trying to run a government. Reap what you sow, folks.

Chris Dodd is a lot of things, but if you think he's going to crush the private insurance industry in CT, which only accounts for 65,000 jobs and is the highest concentration of such jobs in the nation, might I suggest you move on to marijuana legalization.

The internal contradictions of "health care reform" are rather immense; it appears to be the theory that somehow better management will lower costs to consumers; lower costs to the government. cover everybody, and maintain the expected standard of care.  I'm not bright enough to figure out how this is going to work, but then again maybe Peter Orslag has invented a perpetual motion machine in his spare time.  It doesn't seem NY Governor Paterson has had much luck reducing the excess cost of his state's health care system  and closing hospitals and laying off insurance workers is not going to be an easy sell in what is likely to be a jobless economic recovery.

So, the Obama team has decided that rather than engage in the merits of the issue, it will merely accuse skeptics of "swiftboating". To wit.

We knew healthcare reform would face fierce opposition -- and it's begun. As we speak, the same people behind the notorious "swiftboat" ads of 2004 are already pumping millions of dollars into deceptive television ads. Their plan is simple: torpedo healthcare reform before it sees the light of day by scaring the public and distorting the President's approach

 Dunno guys, looks like the more dangerous squadron is coming at you from your exposed left flank, arguing you guys aren;t socialist enough.  Gonna explain why healthcare costs money to the likes of them?

Looks like this prescription isn't going to restore the ailing Dodd back to political health.  Then again, every day he spends on this is a day he isn't socializing the financial services industry.

* Full disclosure: My wife works in the CTICU at a local CT acute care hospital (Not Griffin).

The rhetoric about "stimulus" gets more head-spinning every day. As I note in my Galen Institute post today, folks like Heritage's Robert Book have picked up on the insanity of spending more (taxpayer) money where we're supposed to be reducing costs in health care.

Interestingly, we're not the only nation trying to spend our way out of an economic downturn in this area. China has announced it will provide universal health care for all 1.3 billion of its people.

A Chinese study showed "that in government-sponsored health insurance areas, people are spending more" -- and they see this as a good thing!

So, more government financing should strengthen the economy... and raise health care costs, too?

Those who are commenting on the stimulus should call attention to this disconnect in logic.

While you're at it, spread word far and wide about this scary language from the House on comparative effectiveness -- two long words that mean government could decide which drugs and treatments are acceptable. Here you go:

"By knowing what works best and presenting this information more broadly to patients and health care professionals, those items, procedures, and interventions that are most effective to prevent, control, and treat health conditions will be utilized, while those that are found to be less effective and, in some cases, more expensive, will no longer be prescribed."

This is part of the "stimulus."

Read more.

Paul Hsieh - proprietor of the first blog I read every day, Geekpress - writes about the dangers of universal health care in the Christian Science Monitor, hitting on a crucial point: the loss of economic freedom invariably leads to loss of social and political freedom....

Imagine a country where the government regularly checks the waistlines of citizens over age 40. Anyone deemed too fat would be required to undergo diet counseling. Those who fail to lose sufficient weight could face further "reeducation" and their communities subject to stiff fines.

Is this some nightmarish dystopia?

No, this is contemporary Japan.

The Japanese government argues that it must regulate citizens' lifestyles because it is paying their health costs. This highlights one of the greatly underappreciated dangers of "universal healthcare." Any government that attempts to guarantee healthcare must also control its costs. The inevitable next step will be to seek to control citizens' health and their behavior. Hence, Americans should beware that if we adopt universal healthcare, we also risk creating a "nanny state on steroids" antithetical to core American principles.

For instance, note the recent decision by the LA City Council to "prevent fast-food chains from opening new restaurants in a 32-square-mile area..." in order to improve public health and help out the stores favored by the city council.  Open Left thought this was basically a good first step.

In their eagerness to Do Good, the Left will ultimately invite and impose civil rights violations far, far worse than those of the Bush administration.  As Judge Brandeis said, "The greatest dangers to liberty lurk in insidious encroachment by men of zeal, well-meaning but without understanding."

The Right is almost certainly going to lose the battle over health care.  Indeed, with our current government managed, cartelized health care system in which almost 50% of expenses are already paid by government, we've basically lost it already.  Practically speaking, we probably need to focus our attention on the social engineering that will be sure to follow.