The Front-Runner Reduction

The, or maybe a, front-runner in the Republican Party has come forth with the “solution” to Medicare and Social Security. Well, at least yet another regurgitation of a solution re-packaged and re-advertised as the path to salvation. Is it a solution? There is really only one way to tell, and let’s be serious it is not by listening to the politicians. Neither group appears to have a clue nor more pointedly neither side has demonstrated that they understand the cause-effect of the system they created, fund, manage, and (God, I hate to say this) are responsible for finding a way to secure. Our front-runner is going to use his business acumen to save us all from the folly of the past.

How does this comparatively (relative to his competition) mental giant propose to perform this miraculous feat? He is going to reduce the cost of the system of course. Is this just his easy solutions to incredibly complex problems; or just a good sounding ‘sound-bite’ for a catastrophically stupid plan? Given he is a politician the statistical bet would surely have to go to the less desirable option. Now don’t get me wrong, none of his compatriots have any better idea, and none from the Democratic party has shown any more insight or comprehension of the problems than he has. But really, the solution that we are going to be asked to vote for and then swallow is another idiotic and ill-conceived approach to addressing the problem.

The merits of the plan, more the faults actually, are: he is going to gradually raise the age of retirement. He is going to let participants choose to stay with Medicare or use a government-support voucher to purchase a plan from the market. Medicaid funding responsibility would transfer from the federal government to state governments. Federal spending would be capped at 20% of GDP, and he would cut spending by some amount. Well these certainly solve the problems, right? I mean you can judge the quality and level of intelligence represented by his and most Republicans reading from their nationally approved play-book. The Democrats are no better being equally incapable of seeing and taking the eight-lane freeway out of the disaster area and instead insisting that the steep ascent through the mountain path at the start of winter is a safe route.

Raising the age of retirement on Social Security – this eliminates more recipients so that will lower costs. The elimination is obvious right; nothing more needs to be said on that. This is similar to paying more if you retire later, which we do today. We could stop COLA that would work also. These are the same old methods that have been used over and over. Takes a real brainy type to think of these now doesn’t it. “Same old, same old.”

Now using Government supported vouchers (or any marketing researched advertising terms that polls well with the public) will certainly reduce the costs of the Medicare. Because instead of running a big government bureaucracy, the plan that solves the problem will be to have the government run just a large bureaucracy and also pay insurance companies to make up the difference. Once again, let’s not see the obvious solution that Americans have been taught over each generation will solve the problem; let’s go with a politician’s approach to diddling the public.

And think how much less it will cost when we transfer the cost of and responsibility for Medicaid from the federal government to state governments. The states will have two basic choices, the same ones the federal government has, pay the bills for what is covered or cut what is covered/delivered. It’s not likely the states will see the efficient approach that reduces costs, improves coverage, and help the economy.

And capping federal expenditures to 20% of GDP is just another way to say, I don’t know how to solve the real problem but surely if we reduce the value delivered and the benefits provided and cut more and more the problem will be solved. The consequences of the approach are not reflected in this approach, but yes it is true that if you spend less money you will in fact spend less money. I think I learned that in some elementary school math class, probably around third or fourth grade or even earlier. Why cap it as the method, why not have it reduce itself as the consequence of a smart plan? I guess he/they haven’t thought of that.

If you want to solve the health-care and safety-net problems in America, you should look to someone who can present a plan that doesn’t just do less, shift costs, pretend to provide a difference, and more importantly addresses the underlying dynamics of the cost causing principles that the currently flawed policies and plans are based upon.

Have you seen any politician who has shown even the slightest indication that are even modestly intelligent, let alone smart enough to trust with setting the direction for the nation on any of these issues?  Perhaps what we need here is another ‘stupor’ committee to produce a bipartisan plan.

A Treatment Plan for Healthcare

Both Republicans and Democrats want to fix America’s healthcare system. Both want to reduce the rapidly rising cost of health care, particularly Medicare and Medicaid. And both want to use their view of how healthcare should be provided to defeat their opponents in their election campaigns. But neither has shown any ability to actually provide a plan that actually provides a plan for accomplishing it that would serve the public. How is this possible, if healthcare is an important issue to the public?

The easy answer is that politicians are as woefully ill-equipped to grapple with the healthcare system as they are with pretty much anything else. Yes, our politicians are an incapable lot. But while it’s an easy answer, and it is true that the politicians are in no position to develop or craft a viable healthcare plan; they are unfortunately in the position of having to agree to whatever plan would ultimately be adopted. So they are a player at the table, we just need to find a way to put them at the kiddy-table and remind them that they should be quiet while the adults are discussing serious matters. Once the adults are done, they will be allowed to go play in the family room (Congress), but will have to do what they’re told.

The more important part of the answer is that the public is once again caught in their wishful thinking mode about healthcare. Most people are satisfied with their medical care. This satisfaction is of course disconnected from an appreciation of what they are paying for. Either they are covered by a medical play that covers all or most of the costs, or their deductable is not outrageously bad and the co-pays are relatively small. What they are not accounting for is that they are paying for other medical costs that are not part of what they think of as their expense. Local, state and federal taxes that go to support medical systems like hospitals; the Medicare and Medicaid programs that are not adequately funded and which are increasingly consuming more and more in public funding. The public doesn’t see the increasing medical costs that are outstripping any salary increases or inflation rates anywhere else in the economy as part of their medical expense problem. The public thinks that an unsustainable healthcare system doesn’t mean they will be affected in the future. I am not saying that they’re stupid, but Forrest Gump had a philosophy about intelligence that comes to mind.

What the public needs to do is not delude themselves into thinking that things are generally ok with healthcare, they are not. The public must reject the notion that the political parties or factions within a party are even more clueless then they are about how to fix healthcare. The first step as with most problems is to admit that you have a problem and then to find someone who can help you find your way. The problem is that as the healthcare system collapses under the weight of unaffordable costs, your personal healthcare will suffer through either increased costs, reduced available providers, or altogether unavailable healthcare services.

The solution is for the politicians to remove themselves from being the agents that design the healthcare system, they must be restricted to only agree that whatever is funded under a government budget is paid for with non-borrowed revenues. If the public cannot pay for it, then they cannot get it.

Now while neither the Democrats nor Republicans can design a governmental healthcare system that will provide more care at lower costs then the mess we have today, it can be done by people who know how to solve problems that are constrained by the requirements that define what is to be delivered as the end product.

Why Politicians Fail (like on Medicare)

Obama and GOP leaders were squabbling today at the White House. Wow! Is this some wacky completely outlandish Hollywood movie idea that is just so removed from reality that it ruins the movie? No, it’s the same old political posturing that the Democrats and Republicans engage in because it is their most sophisticated strategy. “It’s your fault because you didn’t tell me how to do it.” “Your idea won’t work because it’s just stupid.” Imagine the mental power that must be behind the planning that goes into this elementary school playground ploy. Is this any way to run a country? No, it isn’t.

The reason that the Republicans and Democrats cannot find a mutually acceptable solution is that they are ignorant of at least four factors.

First: neither has any idea of how to actually solve the problem.

Second: each side believes that it’s either they win and the other loses, or they lose and the other wins.

Third: both are incapable of looking beyond their own view-points to find options and alternatives that would be superior to their own feeble efforts.

Fourth: you don’t solve financial problems in a political arena; you solve the political problem of demonstrating how the solution aligns with your political perspective.

Considering these failings on the part of politicians of either stripe, is it any wonder that they flail and stumble around desperately trying not to get caught in the light of day where it would be clear that they don’t know how to demonstrate the soundness of their position. Instead of developing a viable strategy to deal with issues like the sustainability of the Medicare objective, they seek to garner enough of a voting majority to just push through their version of a catastrophic approach. Yes, one side may want to provide what you can’t afford and the other to prevent you from getting what you need; but either way you wind up in the same sorry state.

Do you really think it’s as hard to fix Medicare as they are showing it is for them to do it? Maybe they should just put out their own explicit plan for how they are going to deal with Medicare, and let the voters decide. If you can’t elect representatives that can solve the problem once put into office, then maybe the voters can pick the plan they want to live with/under. Put the plan on the ballot, structure it so that it is not alterable by the politicians once the plan is chosen, and let it rip. I wouldn’t recommend this myself, because there is a much better way to fix Medicare. But the politicians haven’t got a clue and you don’t want them tinkering with the plan after you vote for them. You want it in writing before you do.

A Medicare Prescription: Sleight of Hand, Slight of Mind

2011 may well be a pivotal year marking the end of the world as we know it. So the Mayan’s may have been wrong about their 2012 prediction. What with Congress haranguing and flailing over the 2012 federal budget, the run up to the gladiatorial 2012 Presidential and other elections, and just for kicks the US economy will be suffering from high oil and gas prices and anemic job growth. All in all, the stars are aligning to portend the inevitable apocalyptic outcome from the confluence of ideological political policies, rabid special interest groups smelling pork, and an economic environment enfeebled by lackluster political leadership. Add to this the dullards’ debates on and pathetic proposed plans for how either the Democrats or the Republicans will ‘save’ Medicare and you have the spark to ignite the powder keg that blows us all to hell.

The Republicans are going to require future Medicare seniors to choose from the for-profit market place, and that choice will somehow magically save money. It may save the government money and thus the Republicans will be able to prevent Medicare’s astronomically increasing costs from busting the budget. But it only stops medical costs from devouring the federal budget, leaving the unquenchable beast free to feed upon the vast resources that the seniors will surely have in their treasure vaults. I am not trying to demean the Republican proposal because that would imply that it has any worth, value or merit whatsoever.

You can’t blame the Republicans though. Their proposal adheres to a couple of their core tenets of ideological faith and so must be right. The problem is that the Republicans are no better at translating their ideology into practical and well conceived policies and programs than say, the Democrats are to theirs. But that won’t matter, if they are wrong then 20 years from now it won’t be a problem that they care about because they will either be retired, dead or most likely be the first to blame someone else.

Now don’t think that you can turn to the Democrat’s to save you either. Their proposal is, well not actually a proposal, is to trim some here and there; to reduce some payments on this and that; and to encourage and reward providers that improve their quality and avoid unnecessary tests. Doesn’t sound like the kind of inspired reinvention of a Medicare approach that fulfills our promise to insure medical care for seniors over 65. They don’t really know what to do either.

The secret pill that they are looking for is to leverage competition, yes the market place, but not to trust the medical industry or insurance companies; rather to watch and verify, to reward for achievement and to penalize for failure [unlike Congress], and to limit the program to it specific objective. Even if Congress understood this, they are not the people to implement it; and therein is the biggest problem: Congress cannot be the agent of change, they can only be the authorizers of a solution.

Congress Can't Empty A Boot With Instructions On The Heel

The Republicans have passed a federal budget proposal that demonstrates once again that whether the ideas in Congress come from Republicans or Democrats that the American people can depend upon Congress and its denizens to get it wrong. It's not that they're stupid, well it's not just that anyway. Congress' problem is that they fashion their policies, programs and plans from the ideological puffery that endears them to their core constituencies. Their attempts to beat their accursed foes consistently takes the fore in their efforts, leaving the matter of serving the public either in the background or completely out of the picture. It is in this context that Paul Ryan has set out his plan for 'The Path to Prosperity'.

The plan is not very long and does repeat itself a lot; much like a political speech at a fund-raising rally. In it he explains that if you take a lot of money out of government spending, that the government will spend a lot less. This may be math beyond the understanding of most Americans, but I am not sure that it would dazzle any 8th graders. He also refers to other areas where he would save money by cutting many of the items that have been noted by others here and there, including the bi-partisan committee that issued a set of recommendations for how America should deal with the national debit.

Ryan included in his plan a proposal for saving Medicare. He is sure of his plan working because he has some principles, some beliefs, that will resolve the problems that the current program is unable to deal with. And this one aspect of his plan illustrates the very reason that you cannot rely upon any one in Congress, Republican or Democrat, to solve America's problems. Ryan, our case study object of scrutiny, has put his faith in his “beliefs”, his “principles”. It's the free market, competition, and the ability of individuals and their own doctors in making the best decisions concerning their health care that Ryan knows in his heart will reduce the cost of Medicare.

My first issue with Ryan's claims is that his feelings and beliefs are the stuff of mom, home and apple-pie. I don't dislike his feelings and beliefs; but they don't constitute a plan, they don't assure anyone (except perhaps Ryan) that this will work better then the current abysmally run system, and they don't do anything like coming close to reducing the cost of Medicare. So once again we have a Congressional “Prince Vagueness” charging to the rescue with his plan to kill the evil dragon of government Medicare. He is going to replace it with the kind, generous and benevolent corporate behemoths that always do everything in their power to serve the public. And the government will be there to insure that the health care industry is fulfilling its role through the control of the government subsidies to public health care that they will manage on our behalf.

Say! Haven’t we seen this movie before?

I don't care what Paul Ryan believes. I want his plan to stand on something more firm and practical then a Congressman's intellect, particularly one warped and distorted by political ideologies that haven't worked before.

What will the free market guarantee under Ryan's plan. It will guarantee what a free market always guarantees. It will insure that the price will be what the market will bear. It may or may not be cheaper than one that is constricted by governmental involvement. Let's hope that it will be as efficiently and effectively run as say the financial institutions were over the last decade, or that the CEO's of the health care industries won't suffer too much with salaries and bonuses that will probably only be 200 to 500 times what the average American makes. Surely the public will not find the premiums to high to accommodate such sacrifices made by the officers and board of directors of these companies. Besides the public will receive a government provided subsidy to help off-set the higher costs of delivering services via for-profit institutions. Of course, the subsidy comes from our taxes, so we are getting subsidized with our own money again. Unless you are too well-off, then your money will be used to help support those who earn less. Well! At least the government won't be redistributing wealth like other plans would.

Maybe, it's the competitive factor that will insure Ryan's plan is cheaper and better than the current Medicare program. Now why is this? Because the insurance companies have boards that review and oversee what costs are covered or not under their plans. They seek to pay as little as possible for what they do pay for, and that must be how the insure that the price will go down. Well, I am glad that I won't be facing a government death-panel and can instead rely upon these corporate review boards to determine if the drug, procedure or cost of treatment is acceptable versus deciding on letting me die. And in medicine, we also always see that the price a medicine goes down with competition. Except in those cases where there is no competition like a patented drug, or a procedure performed by a capable surgeon, or the profit made by everyone if the patients have the greatest number of everything: drugs, treatments, tests, …

The reliance on the patient and doctor making the best decision thus leading to the lowest cost. You have got to be joking. If you don't see the falsifies in this logic then the drugs are not going to help you.

And now the really sad part. Ryan got close to an approach to revamp Medicare. He almost saw the way through the fog. But I think his 'feelings' got in the way. His 'beliefs' blinded him.

Ryan will be just another politician who stumbled down the road and took the wrong 'Path'. He isn't headed to Prosperity; he's on his way to Perpetuity, a place where Congress just keeps trying to get it right but lack the knowledge, skills, tools and understanding to have a chance. A pied-piper so to speak.

Ryan The Republican – Another Comic? You Wish.

We can all relax now. The 7th term Paul Ryan (R-Rep. from Wisconsin) has seen the way to fix the health care system. Well, not really fix the system, but to get rid of the unsustainable Medicare program. Ryan proposes that the Government limit Medicare to people who are now 55 and older, and to create a new system that will provide subsidizes to future retirees who will select from private companies’ insurance plans. Not government vouchers, which Ryan the Republican knows is an unacceptable concept/term; but government subsidizes for insurance premiums. Because we all know that a voucher is a designated amount of money collected from our taxes, whereas a subsidy is a designated amount of money from our …? Well, anyway a subsidy which will solve our Medicare problem.

Ryan’s plan solves the Medicare problem because after about 40 or 50 years, the Medicare problem will be uhh! ... dead. And because Medicare is over, there is no government funding problem and no Medicare entitlement program. I am not sure Ryan has thought about it in detail yet, but there will be a new Government program and bureaucracy for administering the Ryan Economic Administration and Management Entitlement Department (REAMED) to collect the taxes required for the vouchers (sorry, subsidies), to maintain records of payments by individual, determine eligibility and allocation of payment amounts to individual retirees, and to engage in all the other governmental, legislative, bureaucratic, and budgetary activities that are necessary to have a government program, particularly an entitlement program. So that is one way the Ryan’s plan is different than Medicare.

But surely when we examine his plan in greater detail, we will see that there are many ways that it will reduce health care costs for the American public. For example, instead of using the leverage that the Government has under Medicare with health care providers, it will rely upon the insurance companies to not really care about the cost of services rendered. Fortunately, the additional cost that private insurers will impose on the health care industry segment, the providers will spontaneously and wit a self-sacrificing spirit reduce their costs. This is not to even mention the additional costs for insurance and health care that will be funneled into political contributions to support even more legislative efforts to reduce any leverage that a tax payer would have against the health care industry.

I also suspect that unlike Medicare, which collects taxes from current wage earners and spends these funds immediately for those retirees needing payouts to cover their incurred health care expenditures. The new Ryan plan would collect taxes for a number of years and then after you retire return those funds back to you. Oops! Who pays for the Medicare costs incurred during this transition period? Oh, yes. You do. Those funds collected will I suspect be spent and then Ryan’s plan will be spending it’s incoming taxes on the out-going subsidies (vouchers) just like Medicare.

Al least we won’t have the same issues with the current system. Ryan’s plan doesn’t involve creating the dreaded ‘death panels’ the Republicans’ terrorize those ill-equipped to relate to reality. His plan employs two paths simultaneously. First, those who can’t afford a private plan can just expire, the self-directed death panel so to speak. Second, the pre-existing private health insurance companies’ claims review/approval boards, the corporate death panels who are eager to kill grandma to insure a good bottom line, will execute their profit-motivated approaches as they do today.

There are going to be many similar superior differences just like those mentioned above that will make the Ryan Plan clearly different from the Medicare system. I am overjoyed with the prospects of such a wondrous plan. Fortunately or unfortunately, I am already too old to have such governmental largess granted to me.

What does annoy me is that Rep. Ryan, just as ineptly as any Democrat, does not understand the problem. He has the answer though, a feat that cannot be matched by the best minds in any other field or area of life. What a remarkable individual he must be to be able to solve a problem without a clue as to what the problem itself actually is. It never amazes me to see politicians take an important issue and turn it into a political platform without any notion of what they are doing or what its consequences are. The short-view of the small minded to address the complexity of a problem that has eluded his peers for generations, and which cannot seek a solution that would be more profitable for the private sector, more effective for the medically in need, and far cheaper for the American people.