18 February 2010

Why the HealthCare system doesn't work.

I remember when I was a kid, very few people had HMO's. Most had what was called "Indemnity Insurance". Basically the way it worked was very simple. You went to the Doctor, and you paid his fee.

The End.

What? You don't get it? Think of it this way. You have Auto Insurance. Do they pay for Oil changes? No? Why Not, it's Auto Care isn't it? You're right, it's not, it's Auto Insurance. Auto Care probably wouldn't work, because then EVERYONE would start taking their cars to get oil changes 4X a year, just as the Dealers all say we should, then what would happen. There would be an Oil Change Shortage wouldn't there? Prices would go up, but what would we care, we're not paying for it, the Auto Care takes care of that.

Sound ridiculous doesn't it?

Well that's is the problem with the Whole HealthCare system. Where once they used to get involved MAYBE once every 5 to 10 years, when there was some sort of an emergency, the $250.00 to $500.00 deductibles that most policies had, insured that the vast majority of people never used their insurance, which kept the price very, very inexpensive. Now they get involved not only with every Dr. visit, but also every prescription that is filled. Health Insurance companies went from having just a few hundred employees to deal with the occasional claim, to having to hire hundreds of thousands of employees to deal with every single instance of your Medical life. Does that sound cheap to you?

Additionally, how has the health insurance industry impacted the Dr.s Office? Let's compare.

Before, your average Doctor was housed in about a 1000 Sq. Ft. office with a Nurse that doubled as a secretary. In today's dollars, he only had a payroll of maybe $200K Total. If we were to suppose that the good Doctor had a total of about 240 business days in a year doing about 16 appointments per day. Charging around $50.00 a visit would cover his payroll, and he would only need to add in another 10 to 20 bucks or so to pay the Rent and Electric bills and other expenses.

Today your average Doctor needs a couple of Billing Agents to take care of the HMO and PPO Claims, they also need collections people, plus an accountant to keep track of where the money is coming from. Keep in mind that an average Dr. might take about 3 different insurance policies. Additionally, they need a secretary to co-ordinate the calls all these people are getting, plus an office Manager to keep all the employees in line. And let's not forget there's still him and his nurse. Now take a look at Payroll. It has swelled to about $500,000.00! Let's say this doctor had the same number of days, about 240, and does about 16 Appointments per day, one every half hour. Now he needs to charge over $130.00 per visit, JUST to cover the Salaries. Additionally, since he needs a larger space, more phone lines, electricity, computers, repair expenses... you now see why the good Doctor needs to charge around $240.00 for an office visit. How did your health improve?

America has traded the freedom of the medical system for a centrally run insurance conglomerate handling your day to day Medical needs for what? So we would be free of Paperwork? Someone STILL has to do the paperwork, but the Doctor's were NEVER going to do the paperwork for free. It's precisely this system of our NOT wanting to take personal responsibility that took us down this road. Only us taking back our personal responsibility will bring us back from this nightmare.

Before my wife went back to work, I had a Catastrophic Health Policy. It had a very high deductible, I NEVER used it, but it was there to cover JUST THAT, a Catastrophe. If everyone purchased Catastrophic insurance you would not only save THOUSANDS of dollars a year in premiums, but you could demand and get discounts from your Doctors, because you don't NEED the system that he has in place. You are paying him directly, not going through a front group of insurance companies and ultimately that saves him money.

The only reason we went back to an HMO is because the company pays for it. In all honesty if we were given a choice, to have the Cash in our pockets (a Catastrophic Policy with a $5000.00 deductible can be about $10,000.00 a year LESS than an HMO), we would take the Cash and go back to having a $5000.00 a year deductible. Truth is we still have to pay a $25.00 Co-Pay, so really what do we save? $50.00 to $100.00 an office visit? (When I had the Catastrophic Policy, I would negotiate with all the Doctors to let me skate on paying between $75.00 to $125.00 Cash).

HMO's and PPO's place the burden of the Paperwork on the Doctor. The Doctor then has to hire people not only to deal with the Paperwork, but also to collect money from the Companies, for something that the VAST Majority of Americans can afford to pay. He then has to raise his rates accordingly to pay for the expanded payroll. To top it off, we haven't' even talked about the number of people that Insurance Companies have had to hire to go from only occasionally dealing with someone filing a claim going over their deductible to dealing with EVERY SINGLE medical situation. All of these people are additional salaries that have to be paid for, when you pay your insurance premiums and the truth is that it is NOT sustainable. Considering the fact that Government tends to over-regulate things, I don't see them reducing the burden placed on Doctor's that would allow them to reduce staff. We should as a country reconsider the role of HMO's and PPO's in the Health Care debate as a way of curtailing the boom in health care expenditures. While it's clear that the bottom 10% can't afford paying $75.00 for an office visit, we shouldn't design a system with the bottom 10% in mind, that should be a supplemental system put in place AFTER the main system has been fixed.

We need to figure out a system that works for the top 90% of Americans, that lowers costs, keeps Medical inflation in check and gives us the freedom to choose who we want to take care of us. As I've said before, once we've fixed that problem, then we should design a supplemental system to take care of the poor.

14 February 2010

The Not So Great Depression of 1920

I remember when I was in Middle School and my history teacher was going over the Great Depression. Of course when talking about the Great Depression, they were speaking about what happened between 1929 and 1944. They spoke about how we should not have increased interest rates and Import duties, since all of these things made things worse. I remember how all the books and teachers talked glowingly about FDR and how he fought so hard for the regular Joe to try to make things better for us. Lesson plans like these are what shaped America's belief that FDR was a great President and was the right guy for the right time. I sometimes wonder however, if our opinion of him would have been very different if they had showed more of who he really was, along with sort of a "Compare and Contrast". Especially a Compare and Contrast to Warren G. Harding, the 29th President of the USA. Robert Murry has written a compelling book that seeks to dispel the myth's surrounding his administration, but for now, let's do some Comparing and Contrasting of our own.

FDR Increased spending by the Federal Government.
-- The result? The Government was in the business of picking winners and losers, and usually the winners were the Big Businesses who had the "Right" connections. Crony Capitalism.

Harding Reduced spending by the Federal Government.
-- The result? Federal Debt was paid off, increasing the amount of private capital available for the Private Sector. Banks now needed to look for opportunities to lend, with the Government not giving them any more "Free" business.

FDR Increased Government regulations on business to force them to be more "fair".
-- The result? Since it's always easier for big business to deal with regulations, smaller businesses suffered the most and were driven out of business, thereby increasing the levels of unemployment.

Harding Reduced Government regulations on business to go back to a state of "Normalcy" from the Wartime regulations.
-- The result? With Government "off their backs" all businesses, especially smaller businesses were able to exercise the kind of freedom that allows businesses to prosper and expand without government intervention, thereby increasing the levels of employment.

On Taxation:

Harding reduced the top marginal rate from 75% to 25%, the resultant boom in the economy brought in a 25% increase in Tax revenue with more people working. By the end of his administration, unemployment had dropped to just 1%, the lowest level EVER recorded.

When Hoover took over, his response to the crash of 1929 was to increase taxes from 25% to 63%. FDR was elected in part with campaign promises to reduce taxes, but instead he increased taxes to 100%! on anything over 50K!

-- The result?
With the incentive to make more money removed, the number of people earning over 50K a year plummeted, thereby DECREASING revenue going to the government in the form of Income taxes. Additionally, with the government confiscating an ever expanding amount of capital from the private sector, there was less capital available to start new businesses. New business creation stagnated.
I could go on and on with this "Compare and Contrast", but I think you get the point. The real hero here was Harding, not FDR. Let's not forget that Harding's Recession (which he inherited from Wilson) while initially much worse, only lasted 18 months, while FDR's inherited mess and meddling ended up lasting for about a decade.

Just as we learned in "48 Liberal Lies of American History", our history is being distorted by people with an Agenda. They want us to believe that Big Government is the only solution to our problems, they want us to believe that higher taxation and regulation will bring us prosperity, when in fact history shows us that the reverse is actually true. Harding and Reagan should have proven beyond all reasonable doubt that the only way back to prosperity is by getting government off our backs, reducing legislation, reducing taxes and reducing the size and scope of the government. If we revisited The New Deal, I think we will find that it was more like "The Raw Deal".

In the wise words of Abraham Lincoln,
You can fool all the people some of the time, and some of the people all the time, but you cannot fool all the people all the time.
Americans won't stay in the dark much longer, they are starting to get educated and they are finally starting to realize what the real truth is.

27 January 2010

Obama quietly continues to defend Bush's terror policies | McClatchy

Obama quietly continues to defend Bush's terror policies | McClatchy
WASHINGTON — Although the FBI has acknowledged it improperly obtained thousands of Americans' phone records for years, the Obama administration continues to assert that the bureau can obtain them without any formal legal process or court oversight.

The FBI revealed this stance in a newly released report, troubling critics who'd hoped the bureau had been chastened enough by its own abuses to drop such a position.

In further support of the legal authority, however, the Justice Department's Office of Legal Counsel backed the FBI in a written opinion issued this month.

The opinion by the OLC — the section that wrote the memos that justified enhanced interrogation techniques during the last administration — appears to be yet another sign that the Obama administration can be just as assertive as Bush's in claiming sweeping and controversial anti-terrorism powers.

The Justice Department's watchdog, the inspector general, said the OLC opinion has "significant policy implications that need to be considered by the FBI, the Department, and the Congress."

"The FBI says that this kind of activity is in the past," said Michael German, a former FBI agent who's now the American Civil Liberties Union's policy counsel. "But if they're saying that they have a continuing legal authority that means it's not in the past."

In another similarity to Bush era-legal decisions to keep legal theories under wraps, Obama's Justice Department refused to release to McClatchy the OLC opinion, despite the administration's vow to be more open than its predecessors.

The little-noticed revelation about the OLC opinion and the FBI's legal position appears in a heavily redacted section of an inspector general's report released Wednesday.

In the report, Inspector General Glenn Fine concluded the FBI committed egregious violations of the law when it obtained thousands of telephone records without court oversight or through any formal legal process.

The report described a "casual" environment in which FBI agents and employees of telecom companies treated Americans' telephone records so cavalierly that one senior FBI counter-terrorism official said getting access to them was as easy as "having an ATM in your living room."

Yet it also stated that "the OLC agreed with the FBI that under certain circumstances (word or words redacted) allows the FBI to ask for and obtain these records on a voluntary basis from the providers, without legal process or a qualifying emergency."

FBI and Justice Department officials refused to comment on that assertion.

In a letter sent Friday, Sens. Russ Feingold, D-Wis., Richard Durbin, D-Ill., and Ron Wyden, D-Oregon, demanded that Attorney General Eric Holder release a copy of the memo.

"Although much of the information about the OLC opinion is redacted in the public version of the (inspector general) report, the opinion appears to have important implications for the rights of Americans," the senators wrote.

FBI Director Robert Mueller has said that the informal practice of requesting telephone records as described in the report was stopped in 2006 when he found out about it from the inspector general.

Since then, it appears the bureau now refrains from using the authority it continues to assert, according to another heavily redacted section of the inspector general's report.

"However, that could change, and we believe appropriate controls on such authority should be considered now, in light of the FBI's past practices and the OLC opinion," Fine warned.

Privacy and open government advocates called on the Justice Department to release the opinion outright.

"There's a tremendous mystery as to what this legal basis is," said Kurt Opsahl, senior staff attorney for the Electronic Frontier Foundation, a nonprofit that advocates privacy protections for technology. "It does not seem like a legal justification should be a national security secret."

Last March, Attorney General Eric Holder released Bush administration OLC memos justifying interrogation methods that Bush's Justice Department had refused to release.

"It is my goal to make OLC opinions available when possible while still protecting national security information and ensuring robust internal executive branch debate and decision-making," he said at the time.

Such rhetoric hasn't necessarily translated into action, however, according to the Citizens for Responsibility and Ethics in Washington, an open-government group. CREW released a report this week that criticized the Obama administration for recent decisions to withhold information.

"Judging by CREW's interactions with various federal agencies over the past year, the promise of transparency and openness has not translated into new government-wide . . . policies," the group said.

The American Civil Liberties Union, meanwhile, filed a lawsuit Friday to try to compel the Justice Department to make public a report from Justice's Office of Professional Responsibility that examines possible ethics violations by lawyers who wrote the interrogation memos.

Holder had said in late November the report was finished and would be released soon.

Friday was also the deadline for executive branch agencies to release certain "high-value" data as part of President Obama's open government directive. Open government experts, however, said it remains to be seen how useful the information will be since the agencies themselves are determining what to divulge.

As of Friday afternoon, for example, the IRS had released its files tracking citizens' changes of addresses and the Department of Housing and Urban Development posted federal housing inspection data.

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