Health Care Debate Resources

I implore Americans not to formulate ultimate opinions based on the rhetoric of cable news personalities or extremist (on either side) politicians. There are no proposed death panels...this is not a government plot to kill off the eldery...these kinds of statements and viral e-mails are ridiculous and irresponsible. We are better than this. We are braver than this. We are smarter than this.

I have begun compiling information resources that I believe might be helpful. I acknowledge the reality that most Americans (myself included) do not have time and cannot be expected to read thousands upon thousands of pages of proposed legislation. However, we all MUST MAKE the time to do our due diligence. We must make the time to write our representatives and the White House. Our individual health and the health of our family, friends and children depend on an intelligent debate.

The following are sources of information on this issue that are serious...not based on personalities show boating for ratings. I may not agree with all of the views contained within these resources, but they are none the less resources/idea worthy, in my opinion, of consideration. I will add resources to this post as I find them, so please check back. If you are familiar with helpful resources, please post them as comments. I will edit the post so that they can be added to the resouce library.

Transcript of 9/9/2009 Obama Address to Joint Session of Congress

Video, Part 1 9/9/2009 Obama Address to Joint Session of Congress

Video, Part 2 9/9/2009 Obama Address to Joint Session of Congress

Republicans in Congress Plan

Obama Plan

Five Myths About Healthcare Around the World

Senate Committee on Finance

AARP is updating a landing page that links to the various proposed bills. These bills are lengthy, but please remember that a pdf file can be quickly searched to fact check things that sound "fishy." If something sounds nonsensical, there is a decent chance that it is fabricated spin.

American Medical Association's (AMA) Positions

Politifact.com--a great fact checking website

FactCheck.org--another great fact checking website

Find Your Representatives

Contact the White House

Healthcare Debate...Thoughts, Opinions, Ideas

I am more than tired. I am in fact weary of the divisive and destructive politics our system has nurtured for the last 30 years or so. I am frustrated with Washington; I am highly annoyed by the entertainers masquerading as political commentators who have built very nice businesses out of the division. But, I am sickened by myself and my fellow citizens. We are the ones who allow all of it to take place.

Hateful division is not helping our nation and is not helping us as individuals. It is, literally, killing us. Our problems, the healthcare debate being no exception, require and deserve more thought than self righteously repeating the rants of television and radio personalities. We owe it to ourselves and to our country to participate productively in the current healthcare debate.

The right to voice differing opinions is a coveted and cherished right in the United States of America. Intelligent debate is the true engine of an effective democracy. Hateful, unproductive comments are simply not American--or it is not the America I want to be part of. Our country, our people deserve better.

In this spirit, all opinions are welcome within this blog. Hateful, meaningless words and accusations will be removed in order to foster an environment within which ideas might be exchanged. Hopefully, our country has what it takes to fix or improve the healthcare situation. To allow politicians and commentators to, again, shut down progress on this issue would be criminal.

The central question of this post, of the entire healthcare issue is:

Do you believe that every American citizen or legal resident has the right to affordable healthcare of reasonable quality?

In other words, should every American have access either—via health insurance through the private sector, a government plan or a combination— to competent and appropriate healthcare?

Please Note: I did not say free, I said affordable.

If you do not believe that every American has the right to access to the healthcare system, if you are not concerned about your own ability to pay if serious illness strikes you or one of your family members, you might want to spend your time doing something other than reading this post. However, if you are interested in exploring ideas to this challenge, please read on. I would love to hear your ideas.

Why are healthcare cost rising so rapidly? In my opinion, several reasons including:

1. Our litigious society—we all know that the “legal machine” is an “industry” to be reckoned with in the United States. Everyone has a right to competent and safe products and services and has the right to claim damages when they have been truly wronged. I think most of us have reasonable common sense when it comes to these issues. If your spouse’s surgeon performs surgery drunk and kills your spouse, you are entitled to reasonable damages. If your doctor uses his/her best judgment and knowledge and your situation does not end as hoped, the situation probably should be chalked up to the complexities of the human organism and to the mysteries of life.

2. Longer life expectancies—longer life spans mean more medical costs over the course of ones lifetime.

3. Advancing medical technologies—medical technologies have given us wonderful life saving advancements, but these technologies cost a great deal of money. In addition, these technologies contribute to longer life spans and often extend disease state life expectancies. These advancements are fantastic, but also present there own challenges. It is wonderful that we have in some cases greatly extended the amount of time people can live with a terminal disease. And, we have in many cases greatly improved the quality of that time. The challenge is that it is expensive. Who is going to pay for this?

4. Preventable diseases—obesity, poor nutrition, smoking, excessive drinking all add to society’s overall cost of healthcare. The percentage of obese Americans— men, woman and children is alarming.

5. Tremendous inefficiencies in the healthcare system. Our healthcare system has not responded like a true market-driven market because, it isn’t a pure market-driven market. The healthcare market is subsidized by different sources namely corporate American (i.e. employer provided health insurance) and local, state and federal governments. Players at every corner of our healthcare system have not addressed inefficiencies because they do not need to—why would these entities look for cost savings when they are very, very profitable without having to change their operations.

A great deal of the medical system still operates using paper record keeping and the horrendous inefficiencies that exist within the pharmaceutical manufacturing and development are just two examples. On top of the fact that many sectors of the healthcare industry have not needed to maintain operational efficiencies, sometimes regulatory bodies create conditions in which making operational improvements is unaffordable given the revalidation of processes and procedures that are necessary if changes are made.

6. Lack of taking “ownership” for personal healthcare issues. Due to the litigious nature of our society, many unnecessary tests and medical procedures are done. Patients need to take greater ownership and responsibility for their own care including the risks and rewards and the costs of those decisions.

Patients need to partner with doctors in order that joint decision making may transpire. Frank and difficult conversations need to happen more frequently. Is it worth $200,000 to extend a terminal cancer patient’s life one more month? When the patient is yourself or a loved one, these costs seem to be worth every penny. But, as a society we are all paying for these decisions in the form of unaffordable health insurance costs and sky rocketing healthcare costs.

My Thoughts/Solutions Ideas:

1. Caps on malpractice settlements.

2. Due to longer life expectancies, individuals and governments need to budget for these new realities—this will mean, for most individuals, working more years.

3. A Health Savings Account approach should be adopted as the norm—preventative care would be covered fully, encouraged and perhaps demanded. A high deductible insurance program is coupled with a savings account that accumulates over time. Care above and beyond preventative care is paid for from the savings account until the deductible is met. After the deductible is met, care is paid for 100%.

If this move is coupled with caps on malpractice suits, billions of dollars of unnecessary spending (CYA spending) will be removed from the system which will lower costs. This approach also shifts some of the decision making back to the patient so that more of a doctor/patient partnership might be reached. For more information on a Health Savings Account approach, please click here.

4. “Sin” taxes should continue to exist for tobacco and alcohol products. And, in my view, a “sin” tax should be applied to “luxury” unhealthy foods (ice cream, fast food, high calorie/low nutrition foods). HOWEVER, the revenue from all sin taxes need to go into the healthcare system and not be used as they are currently to support the lack of financial discipline amongst local, state and federal governments.

I do not support, for example, using tobacco sin taxes to fund road construction. If sin taxes were continued on tobacco and alcohol and applied to unhealthy foods, this would be an extremely fair way to fund healthcare for all. People who statistically are causing the most strain on the system via preventable diseases, pay more into the system through the sin taxes. A “Fair Tax” for healthcare.

Private insurance policies held by high-risk patients could be subsidized in some way by the sin tax revenue. Government provided healthcare for the elderly, the disabled and other identified groups would be funded via sin taxes and the current system of payroll deductions.

5. Every corner of the healthcare system MUST be dedicated to and rewarded for operational efficiencies. Regulatory bodies must not impede this progress and competitive pressures must be realized across the system. The current situation of private/public subsidizing of the system must stop immediately.

6. As individuals we must take ownership of tough decisions. Not playing an active role in our own healthcare decision making is driving costs through the roof and contributes to the frequency of malpractice suits. Americans don’t seem to like to be open and realistic about the realities of life. We seem to like to think of ourselves and our society as invincible and tend to sweep the unpleasantries of life under the rug.

As a society we must be willing to have uncomfortable conversations like—at 90 years old, is it fair to ask the system to spend $50,000 to extend my life a few more weeks? Would we be better off as a society and as a nation if we could come peacefully to terms with the inevitable ending of life?

Maybe a more harsh way to pose this question—at a certain point (whether this point be caused by a disease state or age), is it more fair for us to come to peace with our mortality, to gracefully bow out of the game so that someone else might live?

Let’s get really crass—is society better off paying $50,000 to extend the life of a deteriorating 90-year-old by a few weeks or a few months or spending those dollars to assure quality healthcare for children?

Money does not fall from the sky. When as a society we make decision that life should be extended at all costs, the price of health insurance becomes unaffordable and/or tremendous financial pressures are experienced by governments. Currently, we have both situations—unaffordable private health insurance and government budgets under extreme pressure.


Final Comments

For those crying “communism” and denouncing out of hand a revamp of our healthcare system, it must be acknowledged that we have a form of universal healthcare today—a pretty unpleasant form. Half of all bankruptcies are cause in full or in part by medial costs. These bankruptcies cost our system (eventually individual taxpayers) a great deal of money each and every year.

For those who are railing against the idea of the government having a role in making healthcare decisions for individuals—is the current system of health insurance companies making healthcare decisions for individuals a good system? I argue not. The reality is I want to be in a system where I have more control over my own care—neither the government nor insurance companies controlling the care I receive or the decisions I make.

Misc. Healthcare Facts/Stats

-Best estimates suggest that healthcare costs the typical American family between $12,700 - $20,000 per year.

http://economix.blogs.nytimes.com/2009/07/21/how-much-does-health-care-cost-you/

http://www.nchc.org/facts/cost.shtml

-Healthcare costs are outpacing inflation by a factor of 2 – 3.

-Although in 2008, healthcare spending accounted for 17% of GDP—a greater percentage than any other industrialized nation— 45 million Americans remain uninsured.

-A recent study by Harvard University researchers found that the average out-of-pocket medical debt for those who filed for bankruptcy was $12,000. The study noted that 68 percent of those who filed for bankruptcy had health insurance. In addition, the study found that 50 percent of all bankruptcy filings were partly the result of medical expenses.9 Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.

-According to a recent report, the United States has $480 billion in excess spending each year in comparison to Western European nations that have universal health insurance coverage. The costs are mainly associated with excess administrative costs and poorer quality of care.14

-The United States spends six times more per capita on the administration of the health care system than its peer Western European nations.

The Common Sense Party Platform

Political philosophy versus “perversion” of the philosophy via the actual act of governing is fascinating.

From a philosophical perspective, I love both the ideas of Marxism (core belief that one’s labor should not exceed that which is necessary to produce the goods he/she consumes) and Libertarianism (emphasis on indiv. liberty generally with the goal of minimizing or abolishing government).

Of course these philosophies are more complex and involved than this, and many over the years have presented their views within the framework of these two core idea resulting in many philosophical branches.

Both Marxism and Libertarianism are nice ideas, but neither work in reality once the historic evidence of human nature is truly considered. So, the question becomes….how do peoples and nations effectively implement political ideas in practice?

There are also, of course, many branches of “liberal” philosophy and once society-based contextual considerations along with mud slinging from the other side come into play, lord only knows what we are actually talking about.

So, I think that I am going to start my own political party called The Common Sense Party (unfortunately for me, my definition of common sense does not jive with everyone else). The following would be the party’s core platform positions (of course, like any politician, the details of these positions will only be revealed once I am elected):

• “Fair” capitalism is the ideal practical market structure. People have to have incentive to better themselves and advance or many/most of use would revert to our naturally lazy selves. However, laissez-faire capitalism results in wealth and power being concentrated into the hands of very few. The “lower rungs” of society at that point do not have a fair opportunity for advancement as the rules of the game are decidedly stacked against them.

Rules of the “market” have to be created and adjusted as the market and society adjusts to preserve as much fairness and opportunity for all as possible. Markets are not natural entities, like oxygen, as some “free-market” advocates seem to imply. Markets are man-made structures (big games really) and the rules of the game need to be created, adjusted and tweaked as makes sense given market/game conditions and as new ways of beating the game are innovated by various individuals and organizations. Capitalism does encourage innovation both good and bad. New technologies, products, services and advancements are often, although not always, good. Capitalism also inspires other forms of innovation—besting/rigging

the system and other expressions of creativity.

Governments, comprised of elected and appointed officials are the only organizations that can logically be held responsible for enacting/changing rules (laws) to control the markets. Governments, as they are comprised of human beings, often go too far one way or the other resulting in the fundamental necessity for a changing of the guards—elections.


• A healthcare system in which people go broke trying to take care of themselves and their families (especially within a country as rich at the United States) is absurd. A healthcare system that has become so expensive that more and more people are unable to access the system is equally absurd. A healthcare system that stifles innovation is not best for long term progress. The magic question—where is the balance? France’s healthcare system offers some interesting ideas that should be considered. The British and Canadian systems have very real problems and we need to work to not repeat their mistakes.

• Access to quality education (pre-K thru advanced degrees) is vital to a successful society. Our public school systems, on whole, are broken. Public universities have gotten so expensive that we are excluding more of our citizens from participation. Both public school systems and public universities need to be both better funded and better managed. Throwing more and more money as inefficiently run organizations (which both public schools and public universities are often very inefficiently run) is not the answer. More money and better management has to be achieved simultaneously.

• Taxation policies need to be fair. To improve overall services to our society (healthcare and education to name two big ones) taxes will likely have to increase. However, taxation policies cannot be so stifling that they snuff out innovation and willingness for people to “give it a shot.” If taxes are too high, there is no/limited incentive for people to work hard to advance themselves and society.

• Helping hand up—not long term hand outs. I fully support government subsidized daycare for those who need it, government funded adult education/career repurposing programs, quality affordable education (as mentioned above), etc. However, if citizens are not willing to work and take advantage of these programs/opportunities…if they are not willing to remove their rear ends from the couch and turn off American Idol…they can rot for all I care. There are too many Americans with out of date skill sets and education—something has to be done about this.

• Protecting worker rights is critical. No one should be treated unfairly or work in excessively dangerous conditions. However, many of the labor unions are out of control. They have gotten as greedy and as self-interested as any poorly managed company. American workers are/will continue to pay a very steep price for this. Labor unions should have an important place in today’s world, but they need to make a 180 degree adjustment to their approaches in order to productively help/protect American workers.

• As a reasonable and compassionate society, social safety nets are important—unemployment insurance, social security, welfare programs of various sorts, etc. However, these programs can get out of control. No one in a country as rich as ours should starve or be denied core necessities and core services. Some citizens are just not able to support themselves—handicapped people, disabled people, etc. These people need to be taken care of. However, able-bodied people need to earn their own supper. Incentives for able-bodied people to tap into welfare and other social safety nets long-term cannot exist. Education and job skill training may be necessary in many cases (see above). In addition, many of us fall onto temporary hard times. There needs to be social safety nets for these situations via some of the above mentioned programs.

• We must take better care of our environment/planet. Cap and trade systems and other forced mechanisms are necessary because we are certainly not taking care of our planet under the current systems. Real recycling programs should be mandated. Currently, the higher oil/crude prices are the more incentive the market has to recycle. When oil/crude prices fall, there is disincentive. These practices are killing our planet. Our planet cannot count on us doing what is right as the result of our own free will—clearly we are not doing the right things and we have had plenty of opportunity to make the right choices.

• People owning unnecessary Hummers should be shot at dawn. Few, if any people I know in mainstream American society, need to own a Hummer.

• Social legislation (abortion, gay marriage, etc.) should, for the most part, follow a Sandra Day O’Connor populist model. When the fringes of society (either ultra conservative or ultra liberal) jam their views through the system, a society has very real problems on its hands. You can’t push a society too hard, too fast. You can’t try to hold it back either.

• Our Constitution is a brilliant document and needs to be respected. However, our Constitution, I believe, was designed to be a living document. Constitutional literalists, on whole, are using their “literal” arguments to jam ultra conservative views down the throats of the American people.

• We must respect the views, desires and cultures of other nations. American as a global bully will only continue to exasperate problems.

• We need a strong military, but not a military that mushrooms for no reason. Our military might is a last resort tool—must be used in full force at times (WWII), must not be used for needless and inhumane slaughter (Iraq).

• The religious and moral views of all people need to be respected. The separation of church and state is not an issue than can be compromised—for the good of both the state and the church.

• The Common Sense Party respects the vital and necessary role of government. However, our governments need to focus on doing for the people what they cannot do for themselves. The government should focus on activities that the private sector is not very good at doing. For instance, the private sector is profit driven. Potential profit that is too far down the road or is too small compared to the risk is not a path that the private sector will or should take. The government should have been aggressively funding alternative energy research for decades now—we could have avoided a lot of death and destruction. The private sector, with low oil prices, had no/little incentive until recently. Rapid oil consumption is killing our planet and is a very real national security risk. The role of government should be to step into situations like this—no/little profit in sight for the private sector, but the good of the people is at stake.

• The Common Sense Party embraces fair and productive globalization. However, raping less developed countries for their cheap labor is bad for the people of the world and is bad for Americans.

• Fiscal responsibility is necessary. At times, the government needs to deficit spend (to do for people what they cannot do for themselves). Times of economic crisis, times of necessary war are two cases in point. However, we cannot in good times and in bad spend money like mad and continue to lower taxes. Already, five full months of tax collection (Jan-May) goes to service our national debts. I am sure that the latest (necessary) stimulus spending will tack a couple of months onto this. We are approaching the debt practices of third-world nations. Eventually social services have to be cut sharply because tax dollars go largely to servicing the nation’s debt. Granted, we are fairly far from the numerous Latin American and other countries that essentially starve(d) their people to service their debts—but it could happen if we are not more responsible.

Government's Role: Protect the People From Themselves
The Peoples Role: Protect the People the Government--especially a government gone mad (e.g. the last eight years)

So, given The Common Sense Party platform—do you think we have a shot in 2012? On second thought, the last thing I want it to be elected for anything. I am perfectly happy to let President Obama continue to take a run at fixing the mess we are in.