The Big Pill of Health Care - Pharmaceutical companies

By now you are probably getting depressed and bummed out about the cost of health care. Don’t worry, we have a pill for that. And thank goodness, it’s very affordable and may even be covered by your health insurance plan; if you have one of course. The cost of prescription medicine has gotten so bad, that Congress passed a bill a couple of years back that helped the elderly cover the (wait for it) ever increasing costs of medication. Course, Congress did such a good job that they put a doughnut hole in the middle of the plan.

Now why would drugs keep getting more expensive? Well, they are produced by companies that want to make a profit; and when they create a drug they file for a patent and get exclusive rights to manufacture it. And exclusive rights means that they don’t have any competition, so if they can find a good size market then ka-ching! So yes, they get to charge more than the market will bear, because the market can choose between things like buy the medicine or death, pain, debilitating problems, or other unpleasant consequences. As they are operating in a free and capitalistic society, this is legal and they are well within their rights. The public has no reasonable claim to expect pharmaceutical companies to do otherwise.

It’s not like the public gives these companies anything. The money we pay for their pills does not support any corporate activities that benefit the drug companies and adds to the cost of the medicine. Activities like:

• Advertising to promote public awareness of their drugs, and why the public should tell their doctors that they need these drugs
• Political contributions to legislators, particularly those leading health care initiatives
• Doctor and hospital promotions to encourage doctors to prescribe their drug to patients

And the public doesn’t fund any scientific or medical research into drugs which when something promising turns up, turns into a new product for a drug company.
And of course the cost of bring a drug to market requires federal approval processing and reviews. These are conducted by very efficient and money conscious government bureaucrats and/or government paid consulting groups. Without the FDA’s approval, a company cannot sell a drug in the US, which further cements the drug companies monopoly on their drug.

How could these practices possibly case increased costs for drug? Not possible. So we can move on to some other source of irrational increases in health care.

In Health Care, It’s Location, Location, Location

Hospitals, that’s where a lot of the bills come from. And we are not talking about your everyday bill either; we are talking BILLS on steroids. These are bills that have $100 dollar aspirins, $500 dollar gauze bandages, and really expensive night-gowns that don’t even cover your butt. Given such excessive charges, there can be no doubt that this is where major responsibilities for health care costs lies. Except, if this is correct; why are hospitals not among the highest profit industries in the nation. I mean if you make that kind of profit on things like aspirins, you have got to be raking it in.
And if the hospitals were making those profits on every patients’ bills; they would be awash in gold stethoscopes and diamond studded tongue-depressors. So what’s going on here? They are charging people high prices, but they aren’t making tons of money! This sounds like creative accounting; and in fact, that is what it is. We have lots of number crunchers moving money around in order to do exactly what should not be done, distorting the true cost of our health care system. They are not doing this to make those huge profits which they are not achieving; they are doing it to literally balance their books. You know that stuff that accountants go to school to learn how to do.

Now why are they doing this. Well, it appears that the Health Care programs that the Government has created: Medicare, Medicaid, … are paying hospitals and doctors set rates for various items which do not actually cover the actual costs of those items. Add to this that states also require hospitals to provide emergency care to any and all who come in to the emergency rooms with treatment; and whether they can pay for that care is not a requirement. So add a cost here and a cost there; and as William Proxmire said: “Pretty soon your talking real money.”

And this is where the accountants come in. They tell the hospitals how much money they are short, and that they will have to make up from the “paying” customers. So if you are someone who has health care insurance, or worse someone who has to pay out-of-pocket, they you get to play the golden goose. You can pay for your care, and for the care of everyone else that cannot. Now if you are the unfortunate who pays for their self, well you are really going to hurt from your sickness or injury. If your insured then I am sure you think, hey at least I don’t have to pay for this; or your one of those individuals who think, hey let’s get as much care as I possibly can: I’m not paying. Well you are paying, and it does drive the cost up.

This behavior is driven by a system that is fundamentally broken. Bureaucrats set rates for various services that have to be provided, they make the rates lower than the real costs and then they promote a payment method that encourages the rendering of as many services as possible to jack up the total charges that can be reimbursed by the program. It fosters an atmosphere of playing the system, rather than focusing on helping the patient.

So hospitals are contributing to rising costs; but I would maintain more in a reactionary manner than in a motivator manner. These institutions would transition to a more favorable and beneficial mode of operation if they were driven by productive processes and by systems and programs that directed their activities to serving public health interests.

What’s Up? Is it the Doc? – Health Care Costs

If we’re spending trillions on medical care, then doctors must be all getting very rich. Well, not as rich as you probably think. Doctors do make good livings, but the national average is just that a good living; not an extraordinary living. Not like CEOs, who make millions in salary and multi-millions in bonuses. So in terms of salaries, doctors are paid on average around $200K per year. I can’t find this an excessive amount considering I do want to have these folks around to help keep me alive, patch me up when bad things happen, and to heal me should I get real sick. But even if there were 1 million physicians all sharing $1 trillion dollars they would all get $1 million a year. So doctors are not directly getting excessive amounts of our health care dollar. And while some doctors get much more, others get less; but regardless of how much some may bilk their patients; it is not the driver of the huge cost increases that we have to “reign in”.

Ok, so if it’s not their salaries; perhaps they are stashing it all away in some other manner. Now, I don’t know that they are; but let’s be pragmatic here, there are some doctors that are running businesses and groups and are likely establishing other operations that are sucking up more at the health care tit. And yes, this portion of the physicians are gaming the system and leveraging every rule, process and procedure that enables them to grab more than is necessary or beneficial to anyone (particularly the patients) except themselves.

But even this abuse is not ‘the factor’ that is behind the rapidly increasing cost of health care.
If we exempt the doctors’ from simply being overpaid, and cannot legitimately blame their excessive wages from being the root of all evils; we still should look at another factor that they are involved with which may be at the core of the costs explosion. The doctors are responsible for selecting and recommending the procedures that the patients need ‘in the best interests of their health’. Now here we probably have some meat to feast upon. Doctors’ apparently are ordering more procedures, tests, routines, … then they have in the past. So yes, they are contributing to rising costs; but if and only if, these activities are not truly in the best interests of patients’ health.

Most likely, all the additional work is not necessary, not in the patients’ interest or needs, and not done for any rational reason that we or most of the doctors would consider worth the expense or effort (or the additional risks that some are likely exposing some patients to).
So something is wrong with the system that the doctors’ are participating in. They may be willing or unwilling participants; but they do own some of the responsibility for the health care cost problem. It would seem therefore that in any ‘fix’ from Health Care Reform would incorporate some methods to encourage doctors to engage in responsible diagnostic and treatment procedures which serve the patients’ health care needs and not extraneous parties’ interests involved in the health care industry (including their own).

Unfortunately, we have several more parties to consider and I suspect we will find that they rightly (or would it be wrongly) share in the responsibility for the rising and unnecessary increase in health care costs.

Next in queue, hospitals; let’s bring them into the assessment. Please take the following forms, fill them out, and bring them back when you are done. And let me have your insurance information and card.

If You Slow Growth Who Gets Stunted? - Health Care

Health Care costs are rising too fast. OK, so why? What is driving up the cost and why is it increasing too fast?

Where can the cost come from? I think the list of cost-causers is generally short. How may cost-causers, let me count the ways:
A. Insurance companies
B. Doctors
C. Hospitals
D. Pharmaceutical companies
E. Patients
F. Administrators
G. US Government
H. Retirement communities / Elder Care facilities
I. Medical Device manufacturers

Might as well start at the top - Insurance Companies. Doesn’t seem logical that they would be the actual cost causers. While they come in two basic flavors: for-profit and not-for-profit. We won’t include or focus on the predatory for-ripping-you-off companies; I don’t think they are a significant portion of the market. Besides the rip-offs don’t need to raise prices, they just want to take the money and run; and they pretty much keep costs low because they deny everything.

Well then, the for-profits and not-for-profits; are they increasing the costs in any direct way? They don’t really have to. They can target a profitability level, or a covers the expenses and provides the management with really good salaries, and sit back and let the rest of the system raise the cost/rates. If you are a for-profit then if the costs that you have to cover and use to set your rates increase at any rate (high or low, fast or slow) then your profits go up accordingly. Afterall, 10% will return more money if the costs are $1 trillion dollars, then it does for $1 billion dollars. So if the executives get half the profits in bonuses and there are 10 of them; they get $5 billion dollars each if the costs go to $1 trillion dollars instead of the $5 million they get if the costs are only $1 billion dollars. Plus, if they want to nudge up their profits (or fair-market based salaries) then they can tighten the approval guidelines and decrease they costs. So no, I don’t think the Insurance companies are in the running for even third place in the cost causer category.

And we can consider the Doctors next.

Health Care Cost - How Slow Can You Go?

Finally, we must have reached the, or one of the, objectives for Health Care Reform that the Government will excel at delivering. Everyone who pays into an insurance plan/program, either directly or indirectly, would prefer to be able to obtain their current benefits without constant increases in what they have to pay. Do you know of anyone who wants to pay more than they are paying today?

Companies offering plans to their employees actually spend money trying to find ways to both eliminate cost increases and to reduce their current expenditures. Labor Unions would jump at the chance to not have to defend against the constant onslaught of medical expense containment in their contract negotiations. Unions have to fight to preserve not only their member’s wage levels, they also have to keep companies from eroding their members’ real income by requiring the members to “share” in the increasing costs of medical costs. And individuals who must find their own insurance programs, are surely the most aware of the ever increasing costs and decreasing value of the plans that they must select among.

So, if all these entities cannot effectively contain or constrain health care costs, the Government must be the one who can. Now, I can certainly understand how we would look to the same group that has managed to keep the Medicare and Medicaid programs at tightly budgeted and as limited growth operations as they have with these programs. The fact that neither program is financially sound or even sustainable in its own right, should not distract us or cause us to waiver in our confidence that the practice that the Government has gained in the mismanagement of funding these societal programs will be proof of their ability to get it right with yet another medical insurance policy.

Now that I ponder on their demonstrated abilities, I must pause and reconsider if the Government or its programs will be likely to slow health care costs increases.
Alright, maybe the Government won’t be any good at slowing the costs of health care in general. But if they extend those costs to the broader consumer base that their plan will bring into the system, well then the average cost to those of us paying today will be lower. And therefore, the cost increases will also be spread over a larger number of people and thus the average increase will be lower for each of us also. So the Government can actually do it. Wow, who would have thought?

Opps! I am trying to remember, who pays for all the care given to the uninsured today? Oh, yeah! All the existing health care plans and programs that the insured consumers have are paying for it. And where is the money going to come from that will cover the universal coverage plan(s). Still gotta come from the citizenry, because that is the only place it comes from. If you cannot avoid the monetary equivalent of the three laws of thermodynamics; then you are not going to get more out than you put in; and we are either going to be putting in the same amount (or more), and we will not get more out.

The rate of cost growth must be being limited from some other factor. Got to look around for it.

I Will Not Be Denied

OK, if Universal coverage is not an issue upon which Health Care Reform should turn then what is? Oh, and as we seek insight into issues that are worthy of our efforts, we should let those who get their jollies wasting their time fight over dead horses and demonstrating the quality of intellect that such feats require.

Perhaps the issue is its guarantee of continuity, or that no one can be denied.
Well, I cannot find much in this goal to contend with. Who can argue with letting people who have a health care system that they want and like, keep it? I am sure that someone will come up with numerous reasons for why its not fair that they have health care coverage and that others don’t; but let’s go back to basics. That is not the issue. Keep focused. You must not be distracted by a sleight-of-hand effort, the goal does not require that you take from someone else what they have. The goal is to make sure that you can obtain a system of health care that provides what would be fair under a democratic system which was created to preserve our freedom, liberty and life.

Wait, maybe it’s the requirement that no one can be denied. Yes, that must be it. After all, how is it possible that in a system where all men are created equal and endowed by their creator with certain unalienable Rights, that we would expect that no one could be denied access to a health care system?

I think I will leave the rest of this analysis to the reader. If you cannot deduce the answer, please apply for a hint, I will graciously provide it.Looks like we will need to move on to another facet of this debate.

The Plan, What Is Their Health Care Plan? Universal?

The Health Care Reform plan(s) has/have some basic goals:
A. insure everyone has or can get coverage (that’s what universal means)
B. guarantee you keep coverage, you cannot be denied coverage
C. slow the growth of health care costs
D. improve the quality of care provided
E. hold insurance and health care companies responsible to deliver service

Might as well examine each goal then, so here goes Universal.
If you have an ethical philosophy that would advocate that we individually have a social responsibility to all the members of our society, or to humanity at a more general level; you would most likely take the position that something like health care should be a societal responsibility. If your ethical/moral philosophy is rooted in a religious belief structure, it is even easier to expect that you would hold everyone individually to being responsible to aid and assist those in need, like the sick or injured, of such basic benefits from society. Among these is health care.

But let’s suppose you are not religious, but more of a person who is committed to the principles of a democratic and capitalist system like that in America. Well, despite the fact that most founding Fathers were also persons of various religious orientations; they tried to insure that our Government did not interfere with our religious freedom; and equally, if not perhaps more importantly, to preserve our freedoms and Government from an advocated religious view. Makes for an interesting contention of ideals, principles and values that are based in or consistent with religious beliefs with insuring that our democratic system and freedom is not compromised by these same moral values. An odd thought: to be compromised by one’s moral values.

But I contend that the “right to life, liberty and the pursuit of happiness” would encompass the right to reasonable and quality health care. Further, that to be a democratic society; we would accept that there are rights that we are responsible for which can only be effectively provided by a collaborative endeavor. A recognition that we will individually benefit the most only from an approach to health care that is based on the principles of universality. This is why the capitalistic system developed the insurance business. An understanding that the best way to provide the greatest value at the most competitive price would be to form a collaborative endeavor that shared the cost of health care services by getting a sufficiently large pool of individuals to share in the risk that they may need those services. When we talk about socialized medicine and health care as if it were some socialistic, communistic, repressive, totalitarian, evil, corrupt, and perverted approach to health care; we are deceiving ourselves. Americans created the best health care system in the world by understanding that it was at it heart a capitalistic and a societal approach. If you don’t join together in participating in the system, you cannot achieve the benefits that a free society can deliver to itself.

So the debates and arguments on Health Care Reform, are off-topic. The politicians have either mis-understood the issues themselves, do not or cannot recognize their responsibilities to guide the public discussion toward what is important, or are too busy focusing on political priorities and campaign funding opportunities that are available from special interest groups and lobbyists. It would appear that we cannot depend on the politicians, of either stripe, to lead us to a Health Care Reform approach that will help realize the benefits from using the principles of the American vision that have created the wealth and power of a free and democratic people. They are not likely to achieve “promoting the general welfare”.

While the responsibility to provide universal health care may be an appropriate and reasonable obligation of a free democratic society, it does not explain how it is to be paid for. I don’t think there is any significant portion of the American populace that would not support a universal Health Care system, if they were not afraid that either their own health care might be placed at risk, or that they would be unduly made to bear the cost of such a system. If it were less expensive than our current system and no one would have to spend more for their specific coverage than they do now; who would stand up and shout down moving to such a system. Perhaps, fools and warped individuals who just don’t want anyone else to receive any benefit would protest; but not rational and informed individuals. You know the fools and cynics, the folks who want their piece of the pie; but they cannot see why someone else should even expect to be treated equally.

So unless you don’t think it’s in your own interest to have affordable, available and quality health care; the question of universal is not a salient aspect of the debate. We need to move on to something that is.

Doctors Prescribe Health Care Reform

Your friendly neighborhood physician, well many of them anyway, endorse the need for health care reform. While this same group was on the other side last time, having opposed health care reform efforts, today they back the proposal. Like any astute politician, they have seen the light and if they have to change “parties” that is just the price you gotta pay. Doctor groups are now realizing that something has to change, because the current momentum is carrying the health care system towards the precipice of doom. Cost are rising faster than probably any other economic indicator; except the cost of saving the Financial markets and institutions, and the Stimulus package for the rest of us.

Makes you wonder what symptoms the good doctors detected that lead them to the diagnosis that the patient was terminal. Do you think their concern was the patient was slowly bleeding funds and could not survive if this rate continued, or worse if the rate the funds flowed keep increasing. Or despite their ethical concerns and dedication to their patients’ welfare, might there have been the recognition that they were facing their own lethal cardiac attack – the sudden and rapid cessation of clients that can actually pay their medical bills. Well, it probably doesn’t matter why they have reached to right decision. After all, when doctors know what to treat you for, your survival rate improves considerably. Of course having the right diagnosis doesn’t always mean that they have a treatment or the right treatment. None of us would be happy if the treatment was successful, too bad the patient died.

Stepping back, the doctors’ support does provide an important data point. Whether they are advocating the Hippocratically appropriate position or the self-interest “Gordon Gekko”-ish capitalist view; they are telling us that the current system is harmful to us, to our society, and to our country. The system is sick, it needs to be treated, and hopefully restored to a healthy state.
Now while I appreciate the doctors’ support, I don’t look to them to necessarily know what the cure is. I know that they will work with the politicians, particularly via their lobbyist groups; but I think that they have not demonstrated the skills, knowledge nor vision to believe that they know how to remedy the problems that I believe they have in some cases helped create.

Therefore, we need to consider and understand the role and needs of the physicians in the Health Care Reform effort; but what is most essential is that we create a system that will:
· drive the costs of service to competitive low-cost and profitable levels
· insure that medical services provided are of the highest quality that is consistent with affordable practices
· prevent abuse and inefficiencies for the patients, the doctors, and the industry in general
· stimulate advances in treatments and policies
· avoid the creation of a bureaucracy that is more focused on its own continuity than in the stated goals for with it was created.

In closing, I would say that I don’t think we can expect to have Health Care Reform achieved by depending upon the proscription: “Physician, heal thyself.”

The Government Way – Health Care, just like your Founding Fathers’

Let’s consider how the Government will bring about Health Care Reform and deliver unto us the holy grail of universal coverage. The Government (our representatives) and their administrative might (the various agencies and bureaucracies) will bring about Health Care Reform by using the classic tools of their trade. They will construct and pass a bill, authorize one or more of their agents to administer and oversee the execution of the bill, commit public funds to cover the payments they have arranged to delivery to their advisors and supporters, and step back and watch the fun begin.

The first step, writing the bill: The House and Senate will each independently prepare one or more draft bill proposals. If you have ventured to look at and read (even a part) of any of these drafts then you will experience the wonder of governmental jargon-ism and obfuscated description. The politicians will announce that they crafted a plan that runs to hundreds or thousands of pages. The bill I have been reading is 615 pages long. If this seems overwhelming, don’t be fooled. The size is very misleading and represents no challenge whatsoever. The format of the bill is double spaced, printed in large font, and both left and right margins are, well let’s just say: W__I__D__E. The net effect is that there are only 25 lines on average to each page. Now add to this that there is a line numbers for each line, every section has sub-sections with sub-sub-sections, ….; and there are numerous section headers and references. They also have a great penchant for lists. Everywhere you turn there is another list of terms. This lists do chew up more space with fewer words, so the Government is at least saving on ink in order to achieve their mammoth bill. When you are done, you have say: 150 or to be generous 200 pages of content. I don’t mean to say, useful content; just content.

Before you will actually notice that the bill is fluffed-up to seem more imposing than it has any need to be, you will notice that it is general very difficult to read. It’s not that they have used particularly difficult or large words; but rather that they have apparently crafted a “See Spot Run” novel. They repeat the same words and phrases over and over again; it seems that there must be some need to remind the Representatives and Senators what the bill is about.

So the first step in crafting the vitally important Health Care Reform legislation is to use lots of words to say very little, and what little is said has been rendered cryptically convoluted and confusing. You would almost think that the most important objective that they had was to insure that no one would be able to determine that they apparently don’t know what they are doing. This of course is part of their method, because buried in the bill there actually are requirements that they will be imposing on how health care will operate in the country.

Health Care Reform - the religious leadership?

Given that it’s Sunday, and that I noticed a news item on the clergy’s views/positions on the Health Care Reform initiatives; it seems appropriate that I postpone my discussion of Congress’ and the Government’s own actions and capabilities with regard to Health Care Reform. In general, much of the religious community and leadership supports the goals and principles of the Health Care Reform agenda.

This can hardly be unexpected. The goal of available, low-cost and quality health care for everyone is consistent with the principles and teachings of most religions. Of course, just because religious leaders support the goal of universal health care, there is no universal agreement even among them as to what exactly that means or what is included under “universal” health care. And of course lacking any general agreement, they also either have not or cannot come to a common statement of what they would advise their flocks or their flocks’ representatives about the content and specifics regarding the Health Care Reform bill.

Instead, the clergy places their trust in the politicians to know what is best to do and how to do it. Somewhat strange for a community that has received the inspirations and teachings/instructions of their respective deities: to “beware of false prophets”, or of placing their faith in men. It seems even more irresponsible when you consider how often the religious communities have had no faith in such politicians. Further, in many cases these same religious communities have a great deal of difficulty in accepting and resolving the inherent conflicts between their religious principles from those of a free and democratic secular governmental system. I suspect some of this is due to the fact that solving the riddle of universal health care is not easily penetrated even when you have a firm belief in “God’s Plan” for us all.

We can hope that at least the clergy will advise and council the politicians to remember the tenets of their own respective faiths and seek to do what is both “right” and compassionate. To implore our elected representatives to do their duty, to “establish Justice” and to “promote the General Welfare”; consistent with the tenets of our Democracy.

So, if the spiritual leaders choose to turn to the politicians then it is even more imperative that we consider the knowledge, wisdom and sage understanding that our political leaders posses.
Perhaps this detour to the religious perspective on Health Care Reform was not a minor diversion from the main topic. The more reliance we put upon the legislative effort to get it right; the more the citizenry should be assessing whether they are qualified to do so.

Today for your consideration, let’s discuss what would actually motivate the medical and insurance industries to seek ways to provide better and lower cost products and services.
We can start with what the Health Care Reform proposals proponents claim will bring this about: competition and the opportunity to increase their customer base to expand their business. Oh yes, and the government is going to make them do better. The opposition is no better; they maintian that the marketplace is the proper way to bring lower costs to health care. And as we all know, the Health Care system has already achieved that because it operates as a competitive capitalistic business already. Of course this wouldn’t explain the fact that we have an over-priced and under-performing health care environment that isn’t actually working to provide good health care to the majority of people.

So what are these industries and the government doing wrong today?

Ah, so many thing!

Starting with the easiest groups: the insurance and medical businesses. They are operating according the to exact principles and motivations that any free-market, capitalistic enterprise would and should follow. They are in it to make money for their owners. Even the not-for-profit outfits are often motivated to turn out excellent incomes for their management teams and principle owners. This is what we expect and encourage businesses to do. It is the American way. You are not motivated to provide your products and services for the lowest possible costs because you have to if you want to stay in business. You only have to do that, if there is a competitor who can actually offer your services/products to your customers at a lower price and those customers choose to purchase from those competitors.

Now there are competing insurance companies, pharmaceutical companies, hospitals, doctors, and other health care entities; but not necessarily competing to get you the lowest cost. Sometimes they are looking to find groups of customers who are the most profitable, and exclude those who are not. Or they control the drug that is needed under their patents and strive to insure that they keep the profits has high as possible. Hospital and doctors are encouraged to perform tests, procedures and treatments because their compensation is driven by what they sell and do; not by what they achieve for their patients.

It’s not that these companies or people do this because they are bad, wrong or evil. They are Americans working in a system that rewards these business methods. Some companies may on occasion, work with our legislators and governmental agencies to distort the competitive process and the free-market place. We can expect this from general human nature. There are those among us, probably most; who will put their benefiting before that of everyone else. This is in-line with the principle of working for your own self-interest; a very American – capitalistic idea. The motivation isn’t bad; but if it is allowed to distort the free-marketplace and to prevent true competition, then it is destructive to the public interest that we all have in the free democratic society that all Americans claim as their birth-right.

As to the government, Health Care is a touchstone issue that brings out all the worst in the American political process. Our representative Congress-men and -women and our Senators are attempting to craft various versions of a Health Care Reform bill to accommodate the needs and interests of their constituents (and more importantly the lobbyist and special-interest groups that stoke the engines that run their re-election campaigns). The medical and insurance industries (and their well-financed lobbyists and public-relations arms) are raising the alarm on how the ‘best medical system’ in the world could be imperiled, if the politicians are allowed to establish government oversight or controls on our current system. Political parties, strategist, and assorted public groups are seizing the day to grab their share of the 15-minute time-slot. Confusion, ire, vitriol, and stupidity are running rampant throughout the land. So we all need to turn to our elected political leaders for their inspired enlightenment on how to reform Health Care.

Whoa! Wait a minute. Hold on there. Look to our leaders for the answers?

The government’s proposals are going to fix the current problems by expanding the systems and approaches that we fundamentally have now. They are going to require all or more people to have insurance; and that will lower the cost because we will be paying even more money into the insurance companies. They are going to get the insurance, drug and medical businesses to find ways to operate more efficiently avoid waste and eliminate fraud. You know the things they have been doing for years.

I think we may have to consider the government methods further. But for now, I am going to go have a good nights’ rest; dreaming of the wonderland that awaits us after we nibble on the government’s mushrooms (which grow very well in the halls of Congress) and take a hit off that hookah that they burn our tax money in.

Health Care Reform brought to you by ?

In For Your Consideration, the consistent principle that will guide postings is that we are rarely given an assessment of the monologues, dialogues, or multi-logues that are clamoring for our attention every day. At least not an assessment that is unconcerned with a partisan view. The blog will attempt to step-back from the “messages”, sound-bites, and posturing that are flooding every form of media whether they are offering re-plays, reporting and/or commentary on topical issues. The postings are intended to present an independent perspective on any given issue, a view that you do not get from our leaders or representatives; be they political, cultural, religious, or social. I seek to offer an assessment of what is overlooked or unexamined, and bring something to the discussion that might illuminate what has been relegated to the dark corners because it takes effort to ask, seek and know.

By examining “issues of the day”, an outsider’s view is put forth to contrast with the experts and professionals who know what is important, what you should understand and how to inform you about it. It is unlikely that these views will be those of your friends, colleagues, and neighbors; those of groups or organizations to which you belong, and just as unlikely to be your own. But in presenting these perspectives, the blog will expect you to decide if the views are perhaps the ingredient that you have been missing; or the key that unlocks the riddle that the issues have become. Perhaps a strange view is just what you wanted delivered for your consideration.
As Benjamin Franklin said, “Any fool can criticize, condemn and complain; and most fools do”. While some criticism will be difficult for me to avoid, I would consider myself as having failed only if I do not offer an alternative meaning to or proposal for addressing the same issue.
So it would seem a good time to begin.

Health Care Reform, this appears to be a current and popular issue of the day. There is and has certainly been plenty of furor over the Health Care Reform debate in the news, political point-of-view and late-night comedy shows; and last night in the Presidential address to a joint-session of Congress. Not surprisingly, the vast majority of reporting and debate seems to be on what it is or isn’t; what it will cost or where the funding will come from; who will be in control of medical decisions: the government or your doctor & you; and whether it is an attempt at socialism or a responsive protection/guarantee of individual rights. These and other points are framing the public discussion; but not only do these issues consume the discussion, they also constrain the space in which the debate is taking place. As important as any of the above issues may be, they overlook more important and relevant ideas and decisions that are truly central to Health Care Reform and essential to creating a solution that will deliver the world-class health care system that Americans should demand of and for our country. And I won’t comment upon the vast amount of distracting idiocy that is treated as if it were meaningful comment.

If we assume that the government might actually find a way to get something done, then we can expect to see yet another program or set of programs that will establish rules and guidelines, processes and procedures, and committees and boards that will oversee the implementation of the plan. You know, just like the government has done for all those other highly efficient and cost effective programs. And therein lies the ‘blind-spot’ that the reform effort suffers from. Congress and the administration are approaching the solution with the same mind-set, methods, and means that they know and understand.

Isn’t there an old joke that crazy is doing the same thing over and over again and expecting a different outcome? Well, looking to the folks who brought us Social Security, Medicare, Medicaid, the Drug Proscription Program and the “un-funded mandate” is absolutely the place I would go for a solution to Heath Care. That is, if you’re crazy and you expect a different result.

How then do we get Health Care Reform? Because, do not doubt that we do indeed need it.
The answer is that we need the government to realize that their role is to create a reform effort that uses the very engine that created the greatest economy in the world: Capitalism. America has demonstrated time and again that if people are motivated to find better ways to do things, to more profitable products and services that the market-place demands then you can deliver the type of low-cost and responsive services/products that we need created in the Health Care environment.

If you wonder why I think our political leaders are unlikely to develop a good Health Care Reform plan, I would turn to Mark Twain who expresses my general assessment of our governmental leaders: “Suppose you were an idiot. And suppose you were a member of Congress. But I repeat myself.”

For the next post, let’s consider the following: What would make the medical and insurance industries seek better ways to provide better and lower cost products and services?