How the Government Could Avoid Failing at Health Care

Many people are afraid that the Government will take over / control the Health Care system. And that with this Government control, they will lose their ability/freedom to choose their doctors and treatments. Some think that the Government will ruin the Health Care system and transform a health and medical industry that can deliver the best medicines, treatments, facilities, and research in the world, into another also-ran, bureaucratized, lowest common denominator health care system. And these fears are justified given the Government will use the tried and untrue approach to Government sponsored programs that they have advanced and failed at for generations.

The pity is that the Government could set-up a Health Care program that would operate in fashion that would not be doomed to failure and would not be degrade the health of the average American. The Government would even be able to learn from the success of a viable Health Care system to improve the effectiveness and efficiency of other Government programs in other areas completely unrelated to health care. The requirement for the Government to be able to achieve an approach to health care that does not insinuate the Government into the Health Care industry as a corrupting and destructive entity is to change from a player that dictates and controls facets of the health care marketplace. This Governmental intrusion into the industry would affect the health care system by influence or control over factors like: price of policies/premiums, coverage requirements, compensation amounts for provided treatments, and other regulatory and policy controls that can be imposed upon various elements of the industry by a governmental entity that has no responsibility or accountability for the results or consequences of their policies, decisions, processes, or oversight activities. None of these controls provides productive and effective management for Health Care. They focus energy and efforts on accounting, on procedural reporting and administrative tasks, and on pursuing methods to leverage the loop-holes and gaps within the rules to game the system for the most money that can be garnered from the system.

The new approach to Health Care that the Government should be applying would be a competitive provider reward program. The Government should establish a health care insurance taxation system that reduces the tax rates for insurance companies that provide coverage plans that deliver the health care for lower costs than their competitors, conversely; insurance companies that average higher cost plans for covering the same treatments would pay a higher tax rate on their revenues. There is not incentive in the world more effective and motivating to corporations or individuals than a tax advantage to be better at your business than your competitors. The same approach can be applied to other members of the Health Care industry. Pharmaceutical companies would be likewise rewarded for providing lower cost products for treatments and dis-incentivized for higher costs for similar treatment products. Hospitals and doctors would have the same opportunity. If you can deliver the better results for the same treatments and services than your competitors then you get to make a higher profit then they do.

Isn’t this the way the America made itself great? We let people find ways to do a better job at a lower price and they won the competitive war. I don’t buy a more expensive car when I can get a better one for less money. People can go to any doctor they want, and the doctor can charge whatever price they want; but the doctor will pay into the Government coffers more than his peers that charge less for the same service.

This fundamental free enterprise, free market, capitalistic methodology to leverage a better priced product into the Health Care system would help transform the system and the industries to become better than they are today, and certainly better than they would become under a controlled Governmental bureaucratic program. The Government’s role here should be stimulative with oversight and assessment of performance; but not guiding. The experts or political influencers that the Government would manage to put into positions of power and authority would be the same incompetent players that screw-up everything else the Government does.

Do We Know as Much about Health Care as We Do about Finances?

An article came out today in BusinessWeek about Americans’ “Financial Literacy – The Time is Now”. The article summarizes that Americans are, well for the most part, illiterate with respect to understanding much about the financial concepts and processes that infect every aspect of our lives. The article presents a view that most people are not only unaware of basic financial principles, but that they are completely unprepared to make or assess financial decisions that are essential in their own personal lives. To further bring home the point, Americans are not behaving in financial ways that critical to their own interests and needs.

So I think we can boil this down to: You are neither qualified nor capable of being trusted with your own money. I would extend this statement to a significant proportion of the very rich. Thank god they either can hire financial managers (except those who hire scam artists) or they have enough money in their inheritance to require them to make such huge and numerous missteps that they are unlike to lose it all in one generation.

If most people are so bad at understanding finances, what would make us think that Congress is going to come up with a financing plan for the Health Care Reform system that they are moving forward toward passage into law. Now it may be that I missed the explanation Congress gave about how the cost of the new system will be provided. Let me see if I can remember the basic principles of their plan:

• Everyone must purchase health insurance or be fined (taxed)
• Employers (with more than 100 employees) must offer health care insurance programs to their employees or be fined (taxed)
• For anyone who cannot afford a health care insurance program there will be a public option sponsored by the Government which they will be able to enroll in

Looking at these requirements, the new Health Care system appears to be in line with the financial astuteness of the American public. The new system will be able to cover more people than it does today because they will be compelled to purchase it. Employers not offering plans today will be required to offer a plan and so they are all but required to pass these costs on to their customers. So the cost of services and produces will rise. This won’t be any problem at all, because people will have less money in their bank accounts given they have spent more of that on buying the mandatory health insurance plans that they were not purchasing before. So those individuals who could not afford a health care plan before will now have less personal funds available to afford the new health care plan that they are required to have.

But not to worry, if you have a good plan today then the Government will tax you for the extra value that you are provided with and this will make it more affordable to you.

The logic of a “more affordable“ plan is of course a Government concept. The financial expertise and acumen that is required here is nothing more than an extension of the financial knowledge and skills that the American public reportedly possesses. The Congressional approach of making people pay for their mandated policies will clearly result in lower health care costs for the nation. I don’t know why this is true; but apparently the wise and intelligent servants of the people in Congress have it all figured out.

An American Intelligence Test: How Do You Think You Would Do?

A lot of fuss and fluster about the Health Care Reform bill today. Protesters rallying to decry the Government takeover of the health care system.

Now surely you regard yourself as an intelligent person. After all on average half of us are smarter than the other half. But do you think your intelligence is being applied to the Health Care debate and the issue? Well then how about a test? It will be a strange test, but one that many of you might have probably had a version of before. This test will have to be self-graded. So you can decide that you passed regardless of the validity of your judgment. Of course, isn’t willfully deluding yourself a significant measure of your actual intelligence? It’s not a long test, I only had a few minutes to put it together; but I hope it is an illuminating one. Oh, and if you wonder whether I think I would rate myself in the intelligence arena, I have to rate myself as only average. Therefore I would conclude that well more than half of you should be more intelligent than me. The unusual aspect of the test; the question is simple but there is a context that goes along with it. Your answer is to be considered in the context of (and I do like it when I can do this) the context. So pencils up, it’s test time!

Question 1: Do you trust politicians?
Here’s the help on this one, consider what this questions is actually asking you. You have to consider the politicians to be a member of your own preferred party (if you have one). So if you’re a die-hard Democrat/Republican then your answer is about do you trust Democratic/Republican politicians. If you’re not affiliated then pick the politicians of the party you last voted for; and if you voted for more than one party’s candidates then answer about how those individuals would pan out in your mind. The trust question should really boil down to this: Do you truly, absolutely, swear-to-god believe that they would not lie to you; and will always put your interest ahead of their own?

Question 2: Do you believe that the politicians that you have voted for are smarter than you?
This one really is simple, do you really think they are smarter than you? Now you do have to remember and consider all of the things that we all see on television or the internet, hear on radio, read in newspapers and magazines, and discussed with our friends and associates about innumerable politicians. If you need some help, go look up on the internet all the politicians that have been charged with a wide range of intelligent decisions that they have made.

Question 3: Do you believe the Government regulates and influences the insurance and medical industries?
The Government here would include the Federal, State and local governmental groups. It includes the regulatory agencies that well regulate insurance companies and medical companies, and requirements on both that must abide by to operate as businesses. It even includes agencies that you probably don’t think about being connected to insurance companies like the IRS and the FDA. Oh, and don’t forget the politicians themselves. You know those folks who take very large pots of money from insurance and medical companies.

Question 4: Do you believe the insurance and medical industries influence and manipulate the Government?
Read the last two sentences in the context from Question 3.
Also consider, do you believe that the insurance and medical industries place helping you above their profits?

Question 5: Do you believe that any and all Government controlled, provided and paid medical programs should be prohibited, and that the Government should have absolutely no involvement in directing and making any insurance and medical decisions?
In this area you think that the free-market, public sector, corporate sponsored medical and insurance businesses are going to be the safest way for you to protect your health care.

Test Over. You can put your mental pencils down.

Well how did you do?

If it’s of any interest, here’s how I did.

Question 1: No Question 2: No Question 3: Yes Question 4: Yes Question 5: No

Of course, I don’t think I am as smart as most of you; so my answers are only indicative of my own intelligence.

What Congress Hasn’t Gotten Yet: It’s The Economy Stupid!

The results are in. The electorate has spoken. And apparently the public is unhappy about the economy. How anyone could have discerned that before this election, I cannot imagine. Thank God the Republicans are going to save us and return the economy to a robust and dynamic state. Because we know that Republicans would never be fiscally irresponsible, they would never spend money that we don’t have, or allow the financial industry to engage in risky and irresponsible investment and monetary policies, and they would never allow international trade policies and agreements to threaten the long term interests of the country.

Wait! I forget; didn’t the Republicans actually do all these things? These stalwarts of conservative philosophy and America First posturing, aren’t they as or even more responsible for the atrocious financial situation that we find ourselves in then the Democrats? Who else could have funding a war on “off-the-books” budgeting? Or, who could have deregulated banking and blindly assumed that the banks and financial institutions would be focused on the national interests before their own? And has anyone done a better job in supporting the ever growing trade deficit with the rest of the world, and devaluing the dollar against other currencies?

I don’t mean to say that the Democrats haven’t demonstrated the same levels of incompetency in their skills and expertise. They have been the prime movers on any number of Governmental programs that have managed to completely hose up Government budgets, taxes, regulation, trade, and all the other elements of our national economy.

All that aside; we can all look forward to the Republicans arriving as the saviors of the economy. And because Republicans are the defenders of citizens who seek individual freedoms, small government, the efficiency of the free market system, and a strong defense; we can expect them to step up and force America to face the hard facts. The Republicans will bring a strict monetary accountability upon not only the Government, but upon corporations and upon the populace. The new leadership (it must be a new leadership, because the old leadership couldn’t do it) will expect Americans to live within their means, and will require companies to be prudent with and tie bonuses to long-term delivered performance and not short-term promised future value.

The way that we know that Republicans are up to this task is that they have never demonstrated any indication of being aware of such responsibilities, and they are only interested in protecting campaign funding sources to keep them in office. In other words, they are just like the Democrats. Promise with is easy, and what people want but don’t want to have to pay for. Blame anyone else for the problems, and accept none of the responsibility. Yes, be a politician.

So whichever party you are expecting to return America to its strong economically dominate position in the world order, what do you expect them to do? Do you expect them to strengthen the dollar, to stop borrowing money from the rest of the world (reverse the trade deficit), and prevent corporate and business leaders from funneling the value of companies into their own pockets? Do you think they are going to make executive be accountable for and paid according to their mis-management, high risk bets that are unprofitable, and for self-interest directed fiduciary irresponsibility?

Do you really think either party even knows how to do this?

Election Night – Vox Populi or Voters InAction

Another, albeit small, election night is upon us. And we have the usual context of “don’t vote for the other guy because he’s/she’s [______] (fill in the blank with whatever horrible statement you think will evoke anger or fear with the regional voters related to the particular contest).

The electorate will have the usual two parties’ candidates to choose between. While in some cases there may be some other listed candidates, the two parties have to have done a particularly bad job of selecting their respective candidates. I don’t want you to be disheartened about the ineptitude of our two major political parties; Yes, they have managed to lose various elections to outsider candidates because they are still unable to provide a motivating reason why anyone should actually intentionally vote for them, as opposed to against the other guy.

Now there are a sizeable number of people that are committed members of either the Democrat or the Republican parties. These are folks who will vote for their party’s candidate no matter how heinous, odious or useless the candidate is. These candidates don’t have to have any value that they will bring to government, or any intention of helping strengthen America, or any fortitude to stand up for and serve the electorate.

You would think that as low as American’s hold politicians in regard to trust, honesty or integrity that there would be a massive landslide to choose any other candidate except a Democratic or Republican.

Why is this, because the American people have turned elections into sporting events. They treat the parties as competing teams, and are fanatic about supporting that team and winning regardless of the caliber of the players on the field. Even if they reluctantly admire a player from another team, they still support their team because they have always support their team. And winning the election is the prize. They are successful and proud if they win the election, and it doesn’t matter how badly, irresponsibly or stupidly the winning politicians act afterwards. They cannot connect the problems in their lives, the burdens placed upon them and their children and their children’s children, and they cannot see the blind arrogance and greed in their ‘champions’.

If the candidates and parties provide someone or something to fear, hate or condemn and blame the country’s problems on then the people can be at ease that they have voted for their team and all will be well in the world if they just win the election.
Insanity is doing the same thing over and over, and expecting different results.

Vaccinations: Being Held Responsible for Irresponsibility – A Case for No Legal Immunity

Ok, you’re free to choose to not get an H1N1 vaccination. At least as long as the Swine flu does not evolve into a highly fatal plague that would actually threaten the continuity and existence of our very nation. You know, that point when everyone who doesn’t want it would be willing to kill everyone else if they got in the way of them getting the vaccine. But that is the most extreme case. Under that circumstance, no one would be looking to figure out how to protect the rights of everyone else from the folks who decided to not get the vaccine. After all, most of them would be dead; or those few who are not would be lucky Darwinian survivors, who might possess useful genetic traits that can be harnessed to protect the public in the future.

But what about a mid-way scenario, a circumstance in which everyone who would want to be vaccinated is not able to because there is just not enough supply. This could be a transient condition, where eventually the supply will come to meet the needs of anyone who wants it; and where those in need haven’t yet succumb to the disease. In this case, there are individuals who will contract the flu from others, and as likely or not and most probably from the very group of individuals who choose not to be vaccinated. If you are one of these flu-stricken individuals who is sickened and even killed because of the inaction of others; don’t you or your survivors have a legitimate claim against the people who contributed to the spread of the infection? After all, if I knowingly spread the AIDS virus to other, isn’t there case law that says that I am guilty of attempted murder? How is contributing to the spread of the H1N1 flu not an analogous action? Why aren’t non-vaccinated by choice individuals culpable of their decisions.

If you don’t get vaccinated and through that decision you effectively allow yourself to become another carrier of the H1N1 flu when you become infected, then why don’t you have a responsibility to the consequences of that decision?

You can claim that there is no way to show a direct link between their decision and my contracting the flu. And let’s face it, there isn’t. But it is also true that the H1N1 flu cannot spread without hosts that carry and disseminate the virus. By not vaccinating, these individuals become the very vectors that propagate the disease to others. Thus the very fact that the disease is spreading is proof that individuals who are not protected are spreading it to others, and they are doing so at a multiplicative rate. One of them spreads to flu to two, three or even dozens of others in the population. And were it not for those who are getting vaccinated, the virus would be spreading even more rapidly throughout the populace. Your guilt is because you actively supported the spread of the flu; and you are therefore responsible for the impact that the disease has upon people who were placed at risk because of those actions.

In a free society where you have the right to decide to be vaccinated or to not be, you should also have the responsibility to account for your choice and to be held liable for it. The important question is what are the consequences to you for having placed others at risk? Today, there are no consequences imposed by our social system.

But if your son or daughter, your husband or wife, your brother or sister, or your friends and neighbors were harmed or killed by such actions; would you find people who promote and advise others to not be vaccinated completely free of responsibility? Would you think it was their right to contribute to this result?

I am sure of my position which is: if you demand the protection of your rights and freedoms from our society that you are also responsible and required to protect that system, and that you will be held accountable for failure to do so.

Voting on Vaccinations: Thumbs Up, Thumbs Down. It’s Your Life

CBS’s 60 Minutes did a segment on H1N1 flu and the vaccine. The segment extended the coverage they had done previously, and was one of their traditional follow-up stories providing an update on the Arkansas boy (Luke Duvall) who had come down with the flu. In their story, CBS brings up the issue that about 40% of the population has indicated that they won’t get the vaccine even if it is available to them. Public Health officials, of course, express their concerns that these people are placing themselves at risk by not availing themselves of the protection the H1N1 vaccine will offer them.

What is being overlooked here is a great scientific and medical research opportunity; and I would suggest an intelligence test as well. Consider the following: we are at a point where the Government could institute a program to enable each citizen to opt-in or opt-out of the vaccine program. It would be similar to programs that many school systems have begun to employ with regard to vaccination efforts. Children are being required to obtain their parents’ consent before the school allows them to be vaccinated at school. Some local school efforts have been mentioned on the news in my area and the news reporters seem a little surprised that a large proportion of the parents have refused to give their permission.

I am not going to spend a lot of time pointing out that the reporters have not looked into a very interesting possibility with respect to these schools’ approach to their vaccination programs. After all, how many of the children, who did not return a signed parent’s permission slip did so because the child did not ask the parent to even decide. Not that any child might not have wanted to get a shot or that they just forgot.

But the schools’ have illuminated a process that any of the various Government agencies could leverage as a means to create a grand experiment. We could set up an Opt-In or Opt-Out H1N1 vaccination program. Given the current limitations with supplies this would even help in focusing the need for the vaccine into areas that are seeking it and to avoid distributing the vaccine to locations where the need is not as great. The program would be very simple; if you want the Vaccine for H1N1 you can register for eligibility – Opting-In. A web-site could be set up to make this registration easy and readily accessible. And for anyone who doesn’t have access to a computer, registration at doctor’s offices, pharmacies, public health office and other public centers could be offered. Not only could individuals register to be eligible to be vaccinated, they could register to not be eligible – Opting-Out. Parents could obviously register their children according to their preferences.

Now come the tricky part. If you register to Opt-Out and then later change you mind, you have to wait until the people who Opted-In to receive their vaccines before you would be able to get vaccinated when supplies are no longer limited. It is not clear that the Government would be able to not allow you to not change your mind and prevent you from getting vaccinated. This would be ideal from an experimental perspective, but it would be difficult to keep the lawyers from trying to sue everyone they could think of when an Opting-Out individual dies or is seriously impaired from the flu. Some family member will then insist that it was the Government’s responsibility to give them access to the vaccine.

With such a self-directed Vaccination choice program, the Government would be able to collect an enormous amount of data about the consequences to the different groups from their decisions. This experiment would help the Government assess the efficacy of their H1N1 flu information dissemination efforts. It would provide an insight to different social groups with regard to their decision making on matters from health care to other social issues. It would even allow the public to determine the impact their personal choices can have and in the significance that the religious, political, and social leaders that they are placing their trust in.

It could be a grand experiment. How many more people from what groups lived or died because of their choices. It would even provide proof for how efficiently diseases are spread in populations that are composed of mixed vaccinated and un-vaccinated groups. It would be a great waste of data and understanding to be gained from a situation that is going to be taking place anyway. Why not use this opportunity to learn and help our society in the future. It will also be a more definitive teaching lesson if we have the data to show people that there are real consequences to such decisions. And isn’t it the obligation of the Government, the health care system and the public itself to help insure that we are provided with the best information possible in matters of life and death?