Wednesday, August 26, 2009

Bruce: I'll end it this way.

I'll end it this way.

To all that don't agree with me, (your mothers wear combat boots, green

Just kidding. I enjoyed the discussion.

Best wishes to everyone, especially Fred.   

Sunday, August 23, 2009

Mary Kay: in Response to "the Cost Conundrum"

First, I wanted to express how thoughtful your comments are and that I agree with your comments on the discussions. I was thinking before you wrote your last piece how it would be so great if the intelligence of this family could be productive and constructive as well as entertaining and thought provoking.

I just finished reading "The Cost Conundrum" and was overwhelmed with thoughts. Visualizing my own health-care and how sometimes it's been like McAllen and some times Mayo depending on where I've gone. Also, my daughter, Kellie, is pre-med out in Colorado and the discussions we've had on medical ethics. She's found that UCC is much more focused on teaching empathy and compassion than USF or UNC. This is her third university because her husband is in the army. It has however given her great perspective. But they are finally settled for a while and bought a house. She will graduate in the Spring w/ a Masters in Biochemistry. I am going to forward this article to her as she will enjoy it also.

Teaching hospitals such as Johns Hopkins University Hospital can be much like McAllen. Same result, but different reasoning. I will not go back there with the exception of my eye doctor who is completely different from the three other specialists I've seen. But he has studied and teaches medical ethics. He has also been disgusted with my treatment from the other doctors there and doesn't recommend anyone anymore. He spends as much time as is necessary with his patients and told me years ago that I would not go blind on his watch. I only have to see him once a year now.

This article also caused a light-bulb moment for me regarding pain scales and how they ask you on a scale of 1-10 how bad is the pain? Sometimes this is evident like when I broke my arm, but most of the time pain scales are totally subjective and relative to the patient. I thought - a more appropriate question might be "On a scale of 1-10 how much does this problem affect your productivity?" And maybe that's the question they ask at places like the Mayo Centers.

However, the issue that stood out the most to me was the horrible conflicts of interest. The Renaissance Hospital reminded me of the person/company cutting your grass also being the one to fertilize it. Blatant conflict of interest. But most homeowners don't know this. All they're thinking is that they only have to call one person and my grass is green. "caviat emptor"

So the bottom line for me is that I want to support the Mayos and Grand Junctions of health-care and what's the best way to do this? I am going to take it with me to visit Congressman Bartlett next week.

Thank you!

Mary Kay

Saturday, August 22, 2009

Fred: Downplaying "Property" as a Goal of Government

Hello, everyone.

Christa, thanks for a truly wonderful (and somewhat scary, at the end) article that is, indeed, informed, informative and thought-provoking. And not partisan at all. I encourage everyone to read it. For my part, I've no objection to sharing our semi-private conversation, under the conditions you outline (identities purged, etc.).

Wikipedia offers the following summary on the "Pursuit of Happiness" question raised by Cal:

"The famous phrase is based on the writings of English writer John Locke, who expressed that "no one ought to harm another in his life, health, liberty, or possessions."[1]

The first article of the Virginia Declaration of Rights adopted unanimously by the Virginia Convention of Delegates on June 12, 1776 and written by George Mason, is:

That all men are by nature equally free and independent, and have certain inherent rights, of which, when they enter into a state of society, they cannot, by any compact, deprive or divest their posterity; namely, the enjoyment of life and liberty, with the means of acquiring and possessing property, and pursuing and obtaining happiness and safety.

Benjamin Franklin was in league with Thomas Jefferson in downplaying protecting "property" as a goal of government, replacing the idea with "happiness."[2] The United States Declaration of Independence, which was primarily written by Jefferson, was adopted by the Second Continental Congress on July 4, 1776. The text of the second section of the Declaration of Independence reads:

We hold these Truths to be self-evident, that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness."

Sorry, this is just an excerpt, for the references you'll have to go to the Wikipedia article itself. Just Google "Life, Liberty, Property" or "L, L, Pursuit of Happiness" and you should find it.

Best, -Fred

Cal: Some Truths Are, In Fact, Inviolable.

Hello Christa and all. No quarrel from me about sharing our collective ideas. But, yes, no addresses as I am certain some on our short list are finding their involuntary participation tedious.

Thanks for sending along “The Cost Conundrum”. (I notice in the first paragraph mention of “Lonesome Dove” which Marsha and I began re-viewing last night. And may I say that our Blue-Ray HD DVD player really does it justice. As some may know these players upgrade standard DVD’s to near HD quality and full picture. We just watched John Adams this way. Just gorgeous. And with HD DVD’s it’s even better.) Anyway, I’ll gladly pry myself away from the tube to read this article.

The Constitution is certainly a document born of compromise, but based on the moral absolute “that all men are created equal and endowed by their Creator with certain unalienable rights”. After all the “pursuit of Happiness” was originally the “pursuit of Property”, a turn of phrase that was problematic since slaves were considered property. I don’t know history well enough to know who insisted on this change, though no doubt it was the delegates whose sensibilities were informed by the “created equal” assertion. Some truths are, in fact, inviolable.

My most fervent wish is that those we elect to represent us truly believe this. My most profound disappointment is that many , in both parties, appear not to. And even if they do, the powerful influences of lobbyists, special interests, and their own advisors stain their every utterance with doubt. I do not suggest that they are bad or immoral people (though many obviously are). But they take an oath to “serve, protect, and defend the Constitution”. Therefore, they should serve with moral absolutes planted firmly in their hearts. That’s what I expect of our government.

A fruitful Saturday to all. Especially corn, tomatoes, and peaches. Cal.

Christa: The Cost Conundrum

Well, I'm sorry to see this devolve away from productive dialogue again in favor of partisan jabs. Most of these comments aren't really worth addressing, though if what any of you expect out of our government is one particular set of "moral absolutes" without compromise, I really do suggest you re-read the text of those documents included in the last e-mail one more time.

I was referred to an article called The Cost Conundrum recently, and wanted to share with you all as a part of this conversation. I'm still mulling it over, but found it to be thoughtful, thorough, and an interesting way to consider healthcare reform. I'd love to hear some of your thoughts if you have the chance to read it all the way through. The author touches on issues of medicare overspending that I think Fred and Cal raised, and studies several existing models that do and don't work.

I also wanted to ask a question/permission to share our conversation. Overall, I've been really interested in this discussion and I think it's made many of us consider the issue of health care much more in-depth than we would just talking about it with those who already agree with us. With all of your permission, I was thinking to informally publish this ongoing series of e-mails (without any addresses) in an informal blog, so that others (congresspeople, friends, etc.) can follow our discussion on the topic. It seems pretty rare to have such an articulate bunch of people (within the same family no less!) discussing these issues on both sides in such a thorough manner. If you don't want your words shared, I completely understand... just an idea. Let me know. If anyone strongly opposes, I won't do it.


Cal: Reading Up on the Constitution

Thank you Bob. I think perhaps the President could do more for American health by mounting a “quit smoking” campaign with himself as poster child. But, hey, it’s a free country, right?

Of course most members of congress haven’t and won’t read the bill. And I wonder how many have read the Constitution since 8th grade history class. I’d bet very few. I also do not believe they allow the document to inform their thinking much either. Most are self-described Progressives, after all, which means that they view the Constitution as arcane and largely irrelevant; an quaint document that changes with the times. In their world everything is relative and there is no right and wrong; there are no moral absolutes. Not surprising in an arena where everything is a compromise. This flawed view naturally leads to corruption. Why wouldn’t it?

Anyway, I attach, for convenience sake, the text of the Constitution and Bill of Rights If you will re-read them you will one up on you representatives and, I suspect, The President.


The Constitution of the United States

The Bill of Rights

Bob: What Possibly Could Go Wrong?

Why all the fuss?

See if I have it right:

We're going to pass a health care plan written by a committee whose head says he doesn't understand it, passed by a Congress that hasn't read it but exempts themselves from it, signed by a president that also hasn't read it, and who smokes, with funding administered by a treasury chief who didn't pay his taxes, overseen by a surgeon general who is obese, and financed by a country that's nearly broke.

Why all the fuss? What possibly could go wrong?

Friday, August 21, 2009

Cal: On Medicare Fraud

Back to you Fred. I have read that the most widespread Medicare fraud is through home care services for the elderly. They are the one's who allegedly stick their heads in and charge for several hours. The elderly are not as apt to notice, I guess. It's not so much doctors, though we have all experienced that 30 second visit. Still, they see more in those 30 seconds than I would see ever see. Sometimes less is more, I think, when you're being poked and prodded. But in my case it's not Medicare.

One possible contributing factor to the "look-in" Dr. visits might be this: Medicare pays a fee for service rate of about 50% of the going charge rate. If a surgeon operates she might be paid $700.00 for a knee replacement. That fee includes follow-up visits for several months. I've read that surgeons end up making as little as $30/hr. when all is said and done. If true it would help explain the short visits.

Anyway, we've come up with some good questions in our little tribe. It's doesn't appear that congress, in their wisdom, bothered to address any of these issues. They got the cart before the horse. Or to quote Bo--"bass ackwards".


Thursday, August 20, 2009

Fred: Two Tiers and Medicare Questions

Thanks John and Cal, this is most helpful!

Cal, I really appreciate the way your wit, always apposite, helps keep this an enjoyable exchange, thanks a lot. John's suggestions are ones many of us can support, I think. The idea of a two-tier system is not bad, it's what actually exists in some places (maybe many)--I think Austria, for example, but maybe they just have a parallel private system for those who can pay. Anyway, two-tier should be considered.

As for medicare fraud--is there some easy, foolproof way to prevent unscrupulous doctors from claiming whatever the medicare-mandated "patient visit" fee is ($80? $100? $60?) when they just stick their head in the patient's room, say "How are ya?" and sign a form in his room? So they claim to have "visited" 100 patients in a day? Or isn't that even the main problem in medicare fraud? Does anyone know?

Best, -Fred

Cal: A Lesson in Brevity

Hello John and all. You could teach us all (well some of us anyway) a
lesson in brevity. And it's just like you to offer positive suggestions
right off the bat.

Come Boomers, Gen-Xer's, and Lost Geners, "please heed the call... the
times, they are a changin'"


John: Ideas For Eliminating Waste

Fred and Other Kin/Friends

Here are a few constructive ideas for eliminating waste:
Tort Reform. Absolutely essential. I saw my doctor yesterday, and he told me that 35% of health care expenses have nothing to
do with health care, and that includes insurance premiums.

Elimination of duplicate insurance forms. Every insurance company has their own forms, so why not produce a standardized form.

I believe we eventually (but maybe not this year--the odds are getting longer) will have a two tiered system--a universal tier for everyone with limited but essential treatments--and a more expensive tier for those who can pay for it.

I've enjoyed the exchange.


Fred: Still Waiting for Constructive Alternative Proposals...

Hello, everyone.

I'm sorry, but in such comments I see mainly ideological broadsides, not practical suggestions for how to improve things. Sure, we can move to a Hobbesian world where everyone is on his/her own, the fittest survive (even thrive!), and the rest get ground out of existence. But I think that, as a society, we are all in this together and have some responsibility to prevent catastrophe (sometimes deserved, more often not) from overwhelming those whom, after all, we choose to call our "fellow citizens". The talk of "socialized medicine" and references to USSR-style commissars are scare tactics--no one is seriously proposing such things. (And, probably, notions circulated by the health insurance companies.) A comprehensive health care system is not unattainable within the context of a democratic society: Canada does it, France does it, England does it, Germany does it, Denmark does it, Finland does it, Sweden does it, Norway does it, Spain does it, Portugal does it, Austria does it, Israel does why can't we do it? Their systems are not perfect, but they're better than the mess we have today, unless you're very wealthy.

Our national health care situation will not get better by doing nothing: the number of uninsured will continue to grow, and costs of medical care will continue to increase. Yes, there are serious cost concerns that must be considered, we don't want to bankrupt the country. The question is: what can we do, in practical terms, to provide, at reasonable cost, some level of comprehensive health care/coverage for our citizenry? At least for basic medical needs? OK, you don't like Congress's current plan. But I'm still waiting for constructive alternative proposals from the more conservative side of this conversation on what we *should* do; Bruce's suggestion that medicare fraud be reduced is about the only exception--a good suggestion, too, we should explore it further. Other than that, I've heard mainly a lot of reasons to sit on our hands and let things continue to spiral downward.

Best, -Fred

Cal: Time to Start Over in Earnest

Hi George and all.
You are correct. And I think it is time to put this very bad idea to rest and begin again. The proposed health care reform was not scheduled to begin implementation until 2011, anyway. It has been a blunder by the administration to attempt to push this bill through given the economic climate. Under normal circumstances arguing that this reform is needed to keep us from going bankrupt might have worked. But not after the meltdown and especially after the insanely expensive and unpopular "cap and trade" scam. Nancy and friends were so hell-bent on pushing their agenda they ignored economic reality. The President erred badly in turning these efforts over to Rahm Emanuel and congress. Now, he's dealing with the wreckage. It must not be passed now because it has become a mess. Time to start over in earnest and with an eye on the Constitution.

Wal-Mart, eh? Yes, I can see it now. Maybe a price war with Babies-R- Us, followed by a buy-out of Toys-R-Us. I purchased my $229.95 dutch oven at Wal-Mart for $35.00. Love that competition! The stew takes great, too.


Wednesday, August 19, 2009

George: Trust is Sorely Lacking

Hi Fred and all,

I am very dubious that Mr. Obama's plan for socialized medicine is the answer; and the White House's huge marketing blitz makes one even more suspicious. When governments get involved with commerce, they impose price controls, and price controls bring shortages. Happens every time. That's why central planning didn't work in the former Soviet Union.....or, rather, it did work quite well, if the desired result was to force Russians to do without. Everybody will be covered, they say, no matter how sick, and you can see your doctor whenever you want. Sounds great, but won't costs explode? Of course they will. How could it be otherwise?

Liberals/socialists/collectivists always have these great reasons why we should turn over our money, our choices and our liberties to them, "for the common good", because they know better how to spend money than we poor ignorant slobs who earned it. This time around, the argument is that if you just let Washington run health care, everybody will have access, nobody will be refused, and the costs will be modest -- all sweetness and light and soft music. I don't believe it. The insurance employees will be replaced by more bureaucracy at the federal level - who have a far more generous benefit program and can't be fired if the program isn't working out. How is that more efficient?

Mr. Obama and his worshippers want us to trust them on this. Sorry ----- but trust is sorely lacking at this point. My fear is that unintended consequences of his program would bring us much higher taxes, fewer choices, and shortages. That's my own bias --I believe in the private sector (free people making decisions in their own best interest) much more than I trust government compulsion. I would rather see some combination of already-existing organizations - charities, volunteer health clinics, pharmacies, etc. try to put together a low-cost program to help those without insurance. Things are already evolving in that direction. I bet Wal-Mart could deliver babies for $99, if they were allowed to do it.


Cal: Stop, You're Both Right!

Bruce, you returned from your Northwest fishing trip too soon. You have stolen my thunder in responding to my honorable cousin Fred. I would not accuse Fred of assuming conservatives are of one mind. I, for one, find "corporate welfare to be repugnant. I also hold the abuses of corporations to be unethical. But most of the abuses are taken legally. At least in the technical sense. Corporate lawyers lay waiting in the shadows of the complexities and obtrusiveness of the language of regulations that are built-in by lawyers (members of congress). Lobbyists and the marriage of convenience between congress and corporations is a cancer that the people must demand be ended.

Now as to redistribution of wealth, "spreading the wealth around"* see below as the President put it, the example of risk insurance is misapplied. Purchasing risk insurance is a business contract the value of which is that the premium is shared, not the benefit. It is the high number of premium payers compared to the actuarial risk that makes it beneficial for the buyer and the seller. Both buyer and seller hope the fire never happens. But it will happen somewhere. Kind of like Health insurance.

Re-distribution, in this argument, is the mandatory taking from one person and giving it to another. This is not a popular idea. But if we can separate the rich from the not so rich, then the not so rich might not mind taking from the rich. This is what is proposed to pay for health care. *"To each according to his needs from each according to his ability". This is one of those notions that seems to have a smiley face pasted to it. The only one smiling is Karl Marx.

Death panels? Lord, why did Sarah Palin ever use this term? It is incendiary and inaccurate. But Bruce is correct about the potential intervention of bean counters between patients and care givers. It may not be operative in good times, but what happens in bad times when revenues are down or availability of care is limited. The models cited by some of the President's advisors that weigh the value of human lives as a function of their age are a recycling of the civil defense models regarding who should survive a nuclear war. It's good to be between 10 and 45 years old. Everyone else just sucks resources. I'm not saying this will be done, but it could be done.

Now, after all, it sounds as if we have settled upon some common ground. As Fred has said the time has come for us pool our ideas. We are not any of us rubes or shills. Let's exert our will on our incompetent and corrupt leadership and demand improve on the situation that we have.

It just so happens that a venue to do just this is available to us all on 9/12 Tea Parties. Everyone, regardless of political or philosophical belief, should attend. This is a ready-made opportunity to be heard, covered by all networks and newspapers, and to leave our message right on the front porch of congress. There are many sources for Tea Party information but one you can visit is There are links to other organizations, plus a list of all locations. It's a starting point.


You guys are too fast. This reminds me of the old "Certs" add. "Stop, you're both right! It's a candy mint and a breath mint." (Way too much tv as a kid.) Fred is right. We don't want folks with buboes hanging around our doors. Bruce is right. We are responsible for ourselves. But we intervene to prevent industry from dumping chemicals into our rivers. It could also make sense to prevent the health care system from doing the moral equivalent with uninsured patients. I think the operative phrase is "Common Sense".

Bruce: If You Think Quality Health Care is Expensive Now...

If you think quality health care is expensive now, wait until it's free.

While we're at it proving health care for all, let's guarantee 3 square meals a day, a roof over our heads, heat, clothing, cable tv, recreational facilities, and some type of employment that serves the common good. Wait a minute, that sounds like prison.

The CBO does not share your cost lowering assumptions. I doubt that you can find a consensus of credible financial forecasts that do either.

Bottom line, There ain't no free lunch. If the people we're not having such a large % of their incomes taken from them in taxes (much of which is needed to pay interest on the debt), there would be more $$ to pay for health care. Or would that money go to cigarettes, drugs, and gambling in our state run lotteries. It really comes down to people making good choices. Some will and some won't, and you can't legislate a change in human behavior.

I would like to see government fix the fraud and abuse in the current Medicare system before they venture further into a new arena.

Fred: Everyone in the Pool

The feeling is mutual, Bruce, I enjoy it too!

To pick up only on the insurance analogy: as a civilized society, we should simply consider everyone in the country as our insurance "pool" for health care. Unlike with home ownership, we mostly don't have a choice in whether we have good health or injuries or not. As we all know, the poor health of some can be positively dangerous to the rest of us, too, and can be a drag on the productivity of the economy as a whole. We don't want the grievously/dangerously ill roaming our streets and dying there. So make everyone in the country one health insurance pool and provide at least good basic care for everyone. Yes, it will be some redistribution of assets, but worth it in my view. And it would lower overall health care costs by eliminating the 30% or so that now goes to the "insurance overhead"--the amount insurance companies spend trying to avoid paying the claims you file. More anon!

Best, -Fred

Bruce: Rebuttals and Comments

I think you are making some assumptions and generalizations that may not be

I do agree with you on the corporate welfare argument. I doubt that you will
find a true conservative that supports corporate welfare.

I'll make some rebuttals and comments:

a) Redistribution: Using your example, I think what people are referring to
is in addition to the 100 people that have the insurance pay for their
houses that burn, we pay for an additional 100 homes that burned for people
that never paid any insurance premium. Insurance is a voluntary pooling of
risk. Your example and subsequent suggestion that I would cancel my
insurance is a false argument made on an incorrect premise.

b) Social Security: This is nothing more than an elaborate Ponzi scheme gone
bad (courtesy of politicians). Yes, you can make anything appear to work by
changing the terms. SS is not actuarially sound. When you increase the
retirement age, you are lowering costs. If your employer pays you $1,000
every two weeks then changes it to $1,000 twice a month, you have lost
money. It's the same argument. Keep the amount the same and change the
terms. Google Galveston/Social Security. This was the last municipality that
opted out of SS before the law changed. See how they did after 25 years.

c) 50 million uninsured: I have heard a more realistic number is 12 million.
I guess it depends on who is spinning the plates.

d) Death Panels: This sounds pretty ominous, but what do you call it when a
bureaucrat decides that the treatment is not worth the cost given your age?
Oregon has this now. Is Pres. Bush or Ted Kennedy going to be subject to
this? How about our members of congress? They are all way to arrogant. I'll
quote Marie Antoinette when the peasants were starving, her response - "Let
them eat cake" Then the French revolution ensued. Want a public option, make
every member of congress the first subjects. Lead by example.

Fred, I really enjoy sparring with you.

Have a good day, all the best.

Fred: Things are Never so Simple

Hello again, everyone. Sorry to have been offline a while, I have had to attend to my "day job". Thanks to Mary Kay for sharing some of Bo's and her dad's wisdom and optimism! I know I tend to get long-winded so I'll try to keep this short. No promises, though, it's 3 AM and I can't sleep so you're all in for it.

(1) Our mutual discussion, which has been endlessly enlightening and enjoyable, seems to have moved from the health care reform issue to much broader philosophical/political issues that people have been debating for centuries with no resolution. This isn't really helpful in helping us to decide what we should do about health care here and now, and I think we should try to move discussion back to the specific problem of health care reform. Regardless of your political persuasion, what do you think can be done to make health insurance more affordable and avaialble to everyone? So we don't have 50 million uninsured, amother 50 million underinsured? To keep medical costs from rising so fast that companies can't afford to provide insurance, and to ensure that people aren't bankrupted by medical costs even though they had insurance? The fact is, like it or not, the system we have in place is what we have to start with, so how do we make things work better (which, to me, means more predictably, affordably, and equitably)?

(2) Some of the more general political issues raised take the form of canards that are not really true, and shouldn't be allowed to pass unchallenged: introducing them into the discussion only muddies the waters. Just a few that I have noticed saiing by in past postings--and I bring them up NOT to provide a "definitive" rebuttal or to open the broader issues for debate yet again, but simply because I want it on the record in our mutual discussion that these things are NEVER so simple as the sound bites/canards would have it:
  • (a) "Redistribution" is a bad thing...Obama wants "redistribution", etc.: Well, let's see, if 100,000 people pay for fire insurance on their homes but only 100 people in that group have their homes burn down...they get to collect the insurance for their casaulty, while the other 99,900 merely pay their premiums, that's (horrors!) redistribution. So I assume that Bruce and others who rail about this sin have long ago cancelled their fire insurance and now self-insure? Or maybe redistribution isn't always such a bad thing? In which case, let's drop this canard. Do I hear conservatives complaining about what is usually called "corporate welfare," or huge government subsidies or tax breaks to various industries (sugar, dairy, cotton, motorcycles), which also amounts to "redistribution", from the lower part of the income pyramid to the upper parts? Not usually, so it seems that redistribution is only a problem in their mind when the money is going from the rich to the poor, not the other way around.
  • (b) Government can't manage anything as well as private business: social security (broke), medicare (broke), etc. as examples: well, again, not so simple. First of all, I seem to recall lots of companies that have gone broke/bankrupt over the years--remember Enron? TWA? American Motors? Pan Am? --at least some of which also pillaged their workers' pension funds on the way down, or defaulted on pensions of workers who had been loyal to them for decades, leaving them without the retirement pension they had earned. So mismanagement is just as much a private as a public quality. Second, the problems with Social Security and maybe Medicare are fixable. For SS at least, if we raise by a few years the age at which one can begin to collect benefits (and thus extend the time in which workers have to pay into the system), we can I think put it on an OK footing. The problem with SS is not really mismanagement but demographic change: people are living in 2009 much longer than they were expected to in the 1930s when the system was created, and population growth has slowed, so the system has gotten increasingly out of kilter: too few workers supporting too many retirees, for too long. Congress can solve it by changing the payout age; you can say it's mismanagement that they haven't made these changes, but then as I said many private firms similarly failed to make changes and were bankrupted by their original assumptions. Medicare faces different something similar, perhaps, augmented there by the fact that the cost of health care (PRIVATE!) is skyrocketing--so how is that the government's fault? Anyway, I think it's just too simple, and misleading, to say that "government = mismanagement." So let's drop that canard too.
  • (c) Government regulation makes business inefficient, etc.: but one can just as easily argue the opposite, that our problem is not too much government regulation of business, but too much business interference in government. As Christa pointed out, if you visit Europe today you find that many systems there (public transportation, health care, etc.) are superior to ours in terms of providing a good basic product fairly to everyone at reasonable cost. This enhances the quality of life of everyone there. We lack the same level of quality in these arenas (transit, health care) because the private industries affected by them have warped the political process. The pretty good light rail systems that most large and many smaller American cities had until the 1950s, for example, were axed in the '50s and '60s because the oil, auto, and tire industries jointly hired high-powered lobbyists to suborn the city councils of those cities so they would scrap their light rail and buy, instead, buses. This is a well-documented fact. So now, instead of a cleaner light rail network in our cities, we have a polluting system (perennially underfunded, too, because everyone was encouraged to buy a car, so no one wanted to use public transit any more). The same thing is happening now in the health care debate: the insurance companies, hospital corporations, and pharmaceutical concerns are pouring billions into lobyying to thwart change to a system that is making them rich and bankrupting everyone else. And many of their talking points/scare tactics are showing up in our own discussions: "socialized medicine"; "redistribution"; "death panels"; "health care rationing"; etc. C'mon, everyone, let's get beyond these empty phrases (many of them patently untrue), get back on track, and put our heads together to see if we can figure out what will make the system we have--which is where we must start today-- into a system that helps more people (ideally everyone) at a cost we can afford!
Best, -Fred

Sunday, August 16, 2009

Mary Kay: Faith and Hope

I don't know if anyone remembers some of Bo's sayings? "Every day above ground is a good day." His favorite color was "Sky-Blue-Pink". I am so grateful for these thoughts he shared. They show faith and hope. Two feelings that are priceless to me. Fortunately, they cost nothing, but bring me much wealth. Because of Bo, and my Dad I have faith and hope. But, faith and hope need not be blind but are choices and I chose to have them because I need them everyday. For me, if I didn't have them I would need anti-depression meds. It sounds like some don't have hope. That's all.

When I think about it, it was amazing that my Dad had so much hope for us since he worked for the federal government for thirty years and his favorite joke was that military intelligence is an oxymoron.

Mary Kay

Cal: What is Congress Afraid Of?

Hello again Fred, Christa, and all.

We have heard many anecdotes regarding the hardships, the horror stories, and the unfairness of the availability and application of American health care. It would be too easy to simply suggest that life is unfair, though it is. That might apply my coming down with cancer while my neighbor does not, but not, I think, to access to medical care. The central question, it seems to me, is how one goes about making access more available at reasonable cost, and without punishing restrictions. I have seen no evidence here or in watching the town hall protests, or from any opponents of the current proposals that anyone believes access should be denied (with the notable exception of illegal aliens). That begs a different discussion, though it is easy to include them in the abstract if we insist.

The fact is that when federal mandate is brought to bear we can never be sure of the unintended consequences, no matter how many pages comprise a bill. I have noted earlier how it can be foreseen that the proposed plan(s) will force me to cease providing access to health insurance to my employees. It is all but written in the plan. They will be on their own and will have no choice, being of modest means, but to join one of the "co-ops". They will be stuck with whatever they are offered, and, what ever the co-op becomes over time. That may not be pretty.

Consider that the housing mortgage and economic meltdown (and the loss of our retirement money) was caused by the passage of a well meaning congressional act called The Community Re-Investment Act of 1977. For anyone who does not know about this the act forced lenders to lend money in the neighborhoods where their branches were. It abolished the unfair practice of "red-lining", the lenders' policy of not lending in certain low-income areas, even to qualified borrowers. Clearly this was wrong. The Act sought to correct the injustice. But over time the mandate was changed, mostly for political gain-but that's another story.

By the mid 1990's lenders were encouraged to make mortgage loans to people who had no down payment money, not enough income, and poor credit records. Lenders, of course were reluctant, but were given assurances that they would be backed with mortgage default insurance which was provided by AIG, among others. Why would AIG do this crazy thing? Because the house banking committee headed by Barney Frank and Christopher Dodd provided pledges that the federal government would back them. Besides, what could go wrong? Well here's what did go wrong. The housing bubble burst (the bubble having been caused by the subsidized demand for housing), home values fell, people who had borrowed 125% of the original value and who were stuck with balloon loans could no longer afford the payments. Many had taken second mortgages and bought stuff. They walked away. Now the lenders looked to AIG to make good on the mortgage default insurance claims. AIG said, Who us? We don't have that kind of money. The rest is history. Hence, the market collapse. Hence, the loss of 40% of personal wealth. I don't think congress meant to do it. They're not that smart. But they are that incompetent. Can you name a single government program that came in on budget? Medicare Part D (prescription drug coverage) has already run up an unfunded liability of $17 trillion!

That's a long winded way of illustrating how the governments' intentions often morph into something unanticipated and ugly. The New Deal, which many say extended the Great Depression; Welfare, which trapped the poor in their poverty; the ban of chloro-flourocarbon (sp?) propellants, the replacement for which is many times worse for the ozone layer; the complete banning of the production of DDT, the result of which is the needless deaths of tens of millions of Africans to malaria.

Access to health care needs to be improved. It can be done through means much less draconian than federal programs. The needed changes are relatively simple. Make insurance portable, make it available to everyone, pre-existing conditions included, make it available to part-time workers, make it available to anyone who will pay for it (or who might need help with paying for it).

In America we do not have a guaranteed right to be born. We do not have a guaranteed right to a funeral. We do not have a guaranteed right to happiness. And we do not have a guaranteed right to health care. The governments role is to "promote the general welfare". The right that we have is the right to pursue it.

The Constitution of the United States of America is consists of about 1,100 words. The federal health care plan about 1,100 pages. What is congress afraid of?


Mary Kay: A Chance to Add Your Voice to the Solution

Hello to all,
The link below gives the opportunity to voice your opinion. Not part of the solution? Then part of the problem. So far there are 54 people signed up for my location and time.

After studying Mr. Burke's words, what I found were excuses to do nothing. We've been doing nothing. Nothing has changed in Maryland since the late nineties. President Obama's primary plan is to level the playing field of all states, (The United States of America). This is the first step. This costs little or nothing for the government. It will however cost the insurance companies to change the infrastructure of their computer software. The insurance companies have been left to their own devices. That's what we have right now.

What we don't seem to get and hasn't been addressed are the millions-billions of dollars that are already being absorbed by health care providers for services that are not being paid for because of personal debt. This will only get worse. Have your credit card interest rates gone up? Has anyone paid down their balances only to have their credit limits reduced? All of my rates went up in May 2008, and there was nothing wrong with my credit, but now there is. Banks are charging good customers higher interest rates to pay for the defaults of others. That's exactly what health insurance companies have been doing all along. Taking advantage of younger, healthier individuals, and not covering pre-existing conditions.

Making health care more comprehensive will make a healthier society and that does not remove ones individual rights to make their own peaceful agreements with one another. I believe that ones health is not ordinary but rather extraordinary. Health is necessary to be happy, ones emotional and physical health is necessary to make a living, go to school, be a productive human being. Do you know why there are so many support groups for individuals who suffer from long term illnesses? Because they cause depression. The trickle-down effects of poor health are poor people. This is why I agree with Fred and Christa. We have a duty as a society to take care of our own and provide health care for the underprivileged. It will ultimately pay off by giving people hope who had little or none before. Taking care of our own is what sets us apart from third world countries. Third world countries also don't educate their people. "Mushrooms" keep them in the dark and feed them shit. Did you know that Mexico does not pay for their children to go to school past 6th grade. You must have a scholarship given by the pueblos. Any wonder they come to America?

Anyway, I've chosen to be part of the solution. For the first time in my life, other than election day, I feel like I can make a difference

Mary Kay

Fred: We Must Do Better.

Hello, all. And thanks, Christa, for your illuminating observations. Having seen the health-care systems of several European countries myself, and spoken to people there about them, I'd say most of them do provide a level of security in matters of health care that we manifestly do not enjoy in the US. No one there has to worry whether they will be financially ruined by illness or injury, or hesitates to visit a clinic to check on a "minor" complaint, to make sure it isn't the beginning of something more serious and, if necessary, begin appropriate treatment in a timely fashion. It provides them with a tremendous amount of peace of mind.

As for Mr. Burke's comments on "coercion", let me add this to Christa's completely justified objection: My wife's younger daughter has diabetes. She also has a job as a social worker--good, steady job, important work, modest pay. If she leaves her job in order to have a child, she loses her health insurance. She also wouldn't be able to get new health insurance because of her "pre-existing condition," and she wouldn't be able to afford the medications that keep her alive. She is forced, in short, to choose between the dream of having a child and her own financial and physical health. THIS, it seems to me, is real coercion, imposed by our profit-driven health care "system."

America's founding documents begin by emphasizing the importance of "Life, Liberty, and the Pursuit of Happiness" as the highest goals of government. We repudiated the British crown because it wasn't providing these things. We hear a lot about the importance of Liberty. But, note that the first item is LIFE. It seems to me that our present health care "system," which rations health care according to ability to pay (and according to the whims of insurance company bureaucrats), is a repudiation of those founding principles. It endangers the very lives of millions of fellow citizens, arbitrarily and through no fault of their own, because they have less money or higher health care needs. Thousands (maybe even millions) of Americans die, or are first bankrupted by medical bills and then die, because they can't afford the health care they really need. (Or they don't die, but become homeless: one of the biggest factors contributing to homelessness is medical costs.) These may be admirable people in every way, otherwise young and vibrant and hard-working, but they have a low-paying job and get seriously ill and simply can't afford treatment. "Your money or your life." If this isn't an immoral "system,"I don't know what is! We must do better.

The current health care reform does not, as I understand it, coerce anyone. If you like your present health insurance plan, you can keep it. No one is being coerced to join anything; all that is being done is to create an alternative plan that is available for people who are left out by our profit-based health insurers. It's high time we provided something like this, so we no longer have 50 million citizens without health insurance--a national disgrace.

Best, -Fred

Christa: A Response for Mr. Burke

In regards to Mr. Burke's argument, I have to say that it's astounding to me that this language about "force and coersion" is being used to discuss NOT our country's complicated history of military force (which *is* funded by the government / us) but instead to attack a kind of health care support that millions of Americans have in fact called out for.

Mr. Burke objects to making everyone "poorer" as the frightening penalty for taking care of the country's poor. It may indeed even the playing field a bit more than some would like, but to confuse this with national "impoverishment" surprises me coming from someone of his professional stature. Has anyone ever been to Finland? Denmark? France? Any other "developed" country? These are not impoverished or unhappy places, though the average person may not pull in the kind of income that our top paying executives (and basketball stars) somehow manage to.

In 2006 - before the economic collapse forced us to take the cost of health care more seriously - psychologists at the University of Leicester in the UK released a study mapping 'subjective well being,' or happiness, worldwide, interviewing over 80,000 people across the globe in their research. Interestingly, Denmark, Switzerland, and Austria came out at the top of this list. The US ranked 23d. According to the responses they received, a nation's average level of happiness "was most closely associated with health levels. Prosperity and education were the next strongest determinants. " and "People in countries with good health care... were much more likely to report being happy." Well being may be a sort of wealth that many Americans have yet to experience on such a level, as most of us have always had to be so preoccupied with the other kind.

You can read the BBC's abbreviated report of this study:
or this more in-depth one from an American perspective through ABC News:
The latter is an interesting read beyond any discussion of health care.

There is clearly a lot of anxiety about who might suffer as a result of national health care, which has led to a lot of rash and inaccurate hypotheticals. For instance, an ill-informed assertion in Investor's Business Daily claimed that disabled people like physicist Stephen Hawking wouldn't have survived under a national health care system (Hawking is in fact British, and responded that he is alive today because of national healthcare). In response to such misunderstandings, the London Telegraph published a concise clarification of several recently mis-cited US concerns about NHS coverage in the United Kingdom: Telegraph Article

Anyway, more resources to add to the discussion.


Bob: Thomas Patrick Burke Commentary

I hope you will consider this commentary from a friend of mine.

Notes from Wynnewood August 11, 2009
America's Health Care

One of the chief marks of a civilized society is that its members are reluctant to use force or coercion to solve the problems of human interaction and prefer voluntary means such as reasoning, persuasion, entreaty and agreement. If we see that someone possesses something we would like to have, we might possibly take it by force, if we have the force, but the civilized way is to make a voluntary exchange, to buy it. Every adult human being has the power of free will, the ability to make his own decisions about his own actions, the other person as much as I. To use force on him is to place my will above his, to override his freedom and subject it to my freedom. But this is the essence of injustice. Justice consists above all in respecting other people's freedom of will. For they have as much right to their freedom of will as I do to mine. This is why it is universally felt that force can legitimately be used to remedy injustice, because injustice is always coercive, and it takes coercion to prevent or overcome coercion.

Primitive and savage societies do not respect the inherent freedom of will of individuals, but impose their desires on them by force. We now have the privilege of witnessing this daily in graphic detail on our television screens as suicide bombers around the globe inflict their destruction on others who do not conform to their will. It is no accident that these societies are economically underdeveloped. The chief reason why the third world (as it used to be called) is third is that the rule of unnecessary force prevails there, through the common use of violence and corruption in place of the peaceful means of the market.

But every action of government in our own country is an act of force or the threat of force. To ask the government to take action in any case is always to summon the use of force. This is why we have police and courts of law and prisons. Government has no other way of acting. In a civilized society the role of government is therefore very severely restricted. There are occasions when it must necessarily be used, as in the prevention or punishment of crime. But beyond narrow limits, the more government, the more brutal the society and the less civilization.

Those who have the passion for redistribution do not care about civilization. Rousseau, their ideological father, considered civilization was precisely the cause of humanity's problems, for nature, he claimed, was the realm of equality, but civilization introduced inequality. Those who favor redistribution will often not even speak of "civilization," for it is their opponent. Some believe the world would be better off without human beings at all. But if we respect human dignity and wish the human race to prosper, we will cherish civilization and its freedoms.

Now Mr. Obama wishes to redistribute health care. This is not to be done by voluntary and civilized means, through the peaceful agreement of the market, but by coercion. Whatever the details of the final plan, it will be imposed by force. This is an offense against human dignity. Each of us is a center of free will and initiative of equal human worth to Mr. Obama. We have the ability to take measures for our own well-being just as he does, and to take the chance of succeeding or failing just as he does. The real redistribution will not be so much from those with health insurance to those without, but a redistribution of power from America's citizens to the government and its clumsy bureaucracy. He should withdraw his plan and turn his attention to the realm where the physical force of government has its legitimate employment, such as the defense of our nation against its armed enemies.

But perhaps someone will object that redistribution can contribute to civilization: a society that takes care of its poor is more humane than one that callously leaves them to fend for themselves. Certainly, if to make everyone poorer is humane, this will be true. But true humanity is a quality of the heart, and so of individuals in their dealings with other individuals, it is not a quality possessed by the large, impersonal bureaucracies of the state.

If society is not to be impoverished, the essential thing is that the price mechanism of the unfettered market must be allowed to function, otherwise no one knows what the true value is of anything. That means that government must keep its thumb entirely off the scale. If the health care market, including the health insurance market, is left free to organize itself, probably most Americans will not protest if a small, perhaps means-tested program of assistance is provided. But there is more to having a healthy society than having medical care. A truly healthy society is only one where people rely on themselves and their peaceful agreements with one another, rather than on the coercive actions of government, to take care of their ordinary needs.

-Thomas Patrick Burke

Bob: Good Luck

The one thing I am sure of is that whatever plan is passed ; The quality of your health care will diminish.

Good luck all,

Saturday, August 15, 2009

Cal: Movie Metaphors

Hello Family, friends and others (you know who you are). It's time for another installment of Cal's Crazy Movie Metaphors. In this episode we ask the reader to power up "Mr. Peobody's way-back" memory recollection machine. We travel back in time to the 1950's, yes those thrilling commie-baiting days of yesteryear. You are getting very sleepy (and I haven't even finished the first paragraph). You are remembering the terrific 1956 Don Siegle black and white sci-fi cult classic "Invasion of the Body Snatchers" starring the great Kevin McCarthy, the comely Dana Wynter, and that guy from The Bob Cummings Show who always called him "Bubby-boy". "Smile--I think you're gonna like this picture!"

Remember the premise? Regular caucasoid Americans are abducted as they fall asleep and are placed by previously snatched folks into large incubators which appear to be fabricated from spider webs, Venus Fly-Traps, and the world's most gigantic okra pods, complete with goo? Anyhoo...the sad sacks cook in there for a while and eventually morph into--well, themselves on Valium. Okay, I see a comparison coming on. I am Kevin McCarthy, the misunderstood, but nevertheless insane voice of truth, banging on car windows trying to warn people that "They're Here!! Don’t' you understand?!! They're here!!!" Then the movie ends and everyone presumably becomes and "okrapod" because they didn't listen to me, dammit! I mean Kevin.

Now, if you've read this far you must be aching for more or you really need to get a life. I shall assume the former to be true.

Most of us belong a generation that was "incubated" (am I stretching?) in a climate of government intervention and do-gooderism. Social security (broke), Medicare (broke), Medicaid, Food Stamps, Welfare, a progressive income tax system, and all manner of economic safety net provisions and benefits. According to my handy 2007 Federal Income Tax Booklet these expenditures account for 57% of the Federal budget, not including Federal Housing Assistance and credits such as subsidized home mortgage loans). National Defense, Veterans, and Foreign Affairs comprise 23% combined. That's 2007--before the mortgage and economic meltdown. From Social Security and Medicare alone America has an unfunded liability of $99,000,000,000,000. That's trillions! That's$133,000 for every person now living in this country! This doesn't even count the interest on the national debt. Tick, Tick, Tick.

Now back to the "way back" machine, but only for a second--back to September 2008. Americans have just lost $4.5 trillion in personal wealth from their home values and their retirement plans. Most of us felt that pain. We didn't riot. We took it one the chin. But we made a mental note to find out who and what caused this to happen. Didn't we? What did congress do to make amends? Spent $687,000,000,000 on TARP bailout funds and they bought GM and Chrysler.

Now, I ask the following given all that happened prior to President Obama's inauguration. Are these good ideas?

-spend another $1.2 trillion tax dollars to stimulate the economy
-pass a "Cap and Trade" plan that will cause massive increases in energy costs costing more trillions of bleed-out from the economy
-try to force feed the nation a $1.7 trillion government mandated health care plan that will forsake the 253,000,000 Americans with insurance coverage for 47,000,000 of whom only 12,000,000 are legal and want to pay for coverage, but can't afford it or qualify.
-totally ignore medical malpractice law and tort reform which results in huge awards and settlements, and that causes the massive overuse of testing by doctors in order to protect themselves from such lawsuits.

Friends, we are the pod people. We have drunk the cool-aid for 50 years. "We have met the enemy and they are us". Thanks Pogo. We pulled our heads out of the sand on September 12, 2001 for about 3 months and then we buried them again. We believed "Duck and Cover" would save our lives. We believed we would get 40,000 miles on a set of tires. We believed "We're from the government and we're here to help you."

We are saddling our children, grandchildren, and great grandchildren with perhaps hundreds of trillions of dollars of debt. That is just plain wrong. That is criminal.
We are preparing the pods for our descendants and if we allow this to happen then our generation will have squandered it's one chance to achieve greatness. Sleep calls--your Pod awaits.

Please plan to attend your local Tea Party. Your great-great grandchildren can't.

PS: It wasn't Yogi Berra who said " You could look it up". My mistake. It was Casey Stengel. Yogi said "When you come to a fork in the road, take it". Words to live by.

Friday, August 14, 2009

Fred: Crafting a Better System

Thanks, Mary Kay-- We need another family reunion, I haven't seen you in eons!

Back to some of Bruce's points: markets are surely more "efficient" (by which we mean what? I suppose, delivering a quality product at the lowest reasonable cost?) than ossified monopolies. But, pace the acolytes of my erstwhile colleague Milton Friedman, not every arena of life is really appropriate for market systems, and I think health care is one of them. Maybe others don't think so, but I feel that as a community--in this case, a national community, but the point would be the same if we limited it to our own local community--as a community we have an obligation to ensure that *everyone* can be as healthy as possible. It's partly idealism, a commitment to equality of opportunity (b/c if one is ill, one can't really compete), but it's also profoundly realistic, because as I pointed out many emails ago, if one's neighbor is ill his disease might spread to you, too, and more generally, widespread illness undercuts the productivity of the whole economy.

It's one thing to say that those who work harder should be rewarded, and those who are lazy or inept should lose out. In that case, we can rationalize the resulting differences in wealth as the reward to the "virtuous" for hard work, insight, etc. I don't have a problem with that. But when it comes to health issues--it's a different matter. Some people, through no fault of their own, face serious health challenges that others just don't. Look at my cousin Mary Kay: is she to blame for her diabetes? Hardly! But when you make health care something that must be paid for, then the unlucky in matters of health simply have to pay more than those blessed with good genes (or good luck in avoiding injuries). I doubt anyone in our discussion group would be in favor of eugenics, but by making health care something people have to pay for (and hence have insurance for) we adopt a policy that is almost like eugenics, in that we inevitably discriminate against those who get sick or injured or have chronic health problems. This is because the market-based, profit-oriented health insurers will inevitably try to reduce their costs by insuring only those who are healthy, and avoiding ("like the plague," to use a phrase curiously appropriate to this discussion) anyone who can be predicted to have higher health care costs. Either they won't insure such people, or they will charge them astronomical rates, which means many people of modest means can't afford the health insurance/care they need.

So the challenge, it seems to me, is to craft a aystem that provides acceptably good health care to *everyone* in our society: rich or poor, young or old, healthy or chronically ill. We are, comparatively, a rich society: it's little short of obscene that we, alone among developed nations, adhere to this "your money or your life" approach to health care. It's often said that the US has the "best doctors and health care in the world." This is true--if you are rich. This is why a lot of very rich people from other countries come to the US for medical treatments--they can afford to pay handsomely for it out of pocket, and do. Hospitals now compete for their business.

But I always thought the ideals of America were "land of opportunity" and the "level playing field." It seems to me that our current health care system, rather than leveling the playing field in health matters as much as possible, and thereby allowing all citizens are healthy enough to pursue whatever opportunities life affords them, is a cruel betrayal of those ideals--cruel especially to the poor and those of modest means. It's a system that exploits everyone's need for health care so as to maximize profit for the insurers (and some others), and treats those who need serious help but can't afford it as expendable. Uninsurable. "Your money or your life." As a society, we can do better! The question is, how?

There are some other points Bruce made that I'd love to comment on--you're a great interlocutor, Bruce!--but I need to get back to my "day job"...

Best, -Fred

Wednesday, August 12, 2009

Mary Kay: Fair and Consistent Competition

This has been a great debate thus far.
I love you Fred!

O.K. So when Clinton got into office, Hillary tried to spearhead health insurance reform. Whoever was the one who said that it is on a state by state basis is correct. Back in the late 90's because of Hillary, Maryland adopted 2 is a group with no pre-existing condition clause. This is the only reason I've had health insurance that covered my pre-existing conditions. However, I first had choices of insurance companies. I went with John Alden Insurance Company because provider's took it, it was the least costly, and was comprehensive. John Alden was a member of the Alliance network. After 1 year John Alden pulled out of the state of Maryland. So I then went with the Alliance network itself. After 2 more years the entire Alliance network pulled out of the state of Maryland. Which left BCBS of MD, and 2 other very obscure companies which none of my providers would take, (HMO's). So I went with BCBS of MD cause "DUHHHH" Maryland. So like I thought, they wouldn't pull out of MD. Why would they? Can you say Monopoly? But, the problem is there is still no real, viable competition in Maryland. This is why Cal's premiums are so high. Also, the average age of employees makes it go up and down. This should not be because it makes it more expensive to keep one's experienced and trained employees.
It has been this way for approx. 14 years.

I am not for de-regulation. PERIOD! Even though I have many Federal regulations I must follow between USDOT Safety Regs, and EPA Regs. These affect me every day and I complain about them often. But lets be honest, Regulations are not put into place for the ethical, and the fair. Without standardized regulations there are no repercussions for those who are ignorant or negligent. State regulations give us a place to hide in ignorance. They also make it hard to be law abiding in other states. I could go on about reciprocity between states regarding traffic laws and the points system, but I won't, but suffice it to say that Maryland and Colorado are so far off it's a brain twang-er. For those of us living in Maryland be grateful.

I had a pseudo appointment at Rep. Roscoe Bartlett's office today. I expected to be given 5 minutes if I was lucky. Instead they spent 1-1/2 hours with me and asked me to come back to speak to Rep. Bartlett himself in a week.

I proposed today, that if health care regulations were federally enforced rather state by state this would simplify the system and bring down the cost. Fair and consistent competition.

I have hope.

Mary Kay

Bruce: More vs. Less Regulation


I disagree with the premise of your argument that we need more regulation and not less. As for the tort bar, I agree that we need a means to take our grievances to a court, but is the tort law practiced by John Edwards and this crowd done anything to benefit anyone other than the plaintiff bar? The answer is no and their lobbyist have Democratic legislators in their back pocket.

Think about the banking crisis and the TARP bailouts last year. Has any government official explained what went wrong and what has been done to fix the problem? Government forced and encouraged lending institutions to make bad loans, and guaranteed them through Fannie and Freddie. It seems like only a few hedge funds managed to figure this scheme out.

The very reason you don't have a competitive health insurance market in Maryland is because of government regulation. It's as simple as "if you can't charge what you want and insure who you want, the price goes up". It works that way in any market with any commodity or service.

I'm not saying that insurance shouldn't be available to all people, only that it will cost more to do this. Judging for past and current programs, government involvement will only make it cost more and work less efficiently.

Show me some examples of government programs that work well, have balanced budgets, and deliver the product or service better than the private sector?

The underlying reason for our problems today is that we are taxed excessively, with much of the $$ going to pay interest on the debt. This is a never ending spiral downward. You just can't create new programs, keep promising more, and paying for it with $$ that doesn't exist. In the past year, we have added 1 trillion to the deficit and increased the money supply by 25%. The result will be a short term party followed by a long and painful hangover. My answer, wait until the party is rolling along again and buy gold, oil, managed futures and hedge funds. The next fall will be worse.

Fred: A Call for Proactive Proposals

Hello again, all.
In response to Bruce's comments, it seems we might ask him to clarify just how a new system might work. Can he make some positive, specific proposals for change that would, in his view, help the situation? "Lowering taxes" and "Reducing government regulation" sound great in principle, but the first will make our health care cost crisis much worse (how would we pay for Medicare?), and the latter would enable more corporations to do what the bankers did as a result of the banking deregulation of the 1990s--run off with a lot of our money. The main lesson of the current financial crisis, it seems to me, is that we need more regulation, at least in some arenas.

A lot of people who oppose changes currently being proposed are afraid they'll LOSE their Medicare coverage (although the proposals won't do that), but lowering taxes would make Medicare go belly up that much faster. Do we want to "starve the beast" and let Medicare be the first casualty? Who, then, would pay the medical costs of our elderly? Do we just want to let them bankrupt themselves (and/or their children) and then be out on the streets, ill? This sounds as bad as Cal's original nightmare of "Solyent Red".

Can we find a way to keep plaintiff attorneys from running up such huge legal bills that tax the system? Maybe, but it would mean more government regulations--laws to cap damages, for example. If the cap is too high, it won't help reduce costs; if it's too low, some health care providers will take shortcuts with our health care, knowing that if they got sued they wouldn't have to pay that much. It's a bit ironic that conservatives who always argue that market forces are the most efficient solution to everything don't want market regulation of torts--i.e., the free exercise of lawsuits by the aggrieved--presumably, because in that case the lawsuits cost the big corporations lots of money. But such lawsuits act as an effective check on corporate (and individual) misbehavior, through a market-like system. The damages awarded are sometimes huge because the corporations that are the defendants are hugely rich, so (a) they can afford to pay, and (b) they need to be penalized sufficiently that they will notice it; a piddling judgment against them won't deter them from misbehaving in the same way again. This, it seems to me, is the market at work. I'm surprised that anyone who claims to be a conservative/free marketeer would be in favor of limiting lawsuit damages. (And, by the way, I'm NOT an attorney!)

Best, -Fred

Cal: Dream On!

Bruce, you are just so sensible! And, like the Ravens will beat the 'skins. Dream on!


Bruce: I Don't Know of a Better System than Open Competition.

There is just one problem with this conclusion. Insurance companies operate in a competitive environment, within the constraints put upon them by state government. Still, it is competitive within this framework and I don't know of a better system than open competition.

What is not being addressed, and won't be addressed are the following:

1> The cost of defensive medicine which is dictated by plaintiff attorneys. This is the largest lobbying group of the Democrat party.

2> Restrictions imposed by the FDA to prevent the usage of new drugs. You'll have to go to a foreign country to get these.

Medicare, Medicaid, Social Security (all government programs that are upside down). Given this track record, I doubt they will do any better with health care (they can't even run cash for clunkers)!

Maybe if government got out of over regulating business and over taxing the people, insurance premiums would be lower and there would be more $$ to pay for it.

Dream on!

Tuesday, August 11, 2009

Cal: There is Too Much Subterfuge in This Process.

Fred, you are correct. Longer than 20 years. Pregnancy was not covered in Maryland when our son Rylan was born in 1980. It was all out of pocket, though worth every penny, if I may say. Point being that it is the states (influenced by lobbyists, that make the rules on health insurance. Not the Feds. Thus, the plight of Mary Kay and Christa, though in her case she is punished for working two or more part-time jobs, neither of which provides health insurance or premium assistance. States could easily change that. Doing away with pre-existing condition exclusions and making insurance portable and available across state lines will go a long way toward fixing their problem. And who among us doesn't have a pre-existing condition, anyway?

There is too much subterfuge in this process. Too many behind the scenes players, like lobbyists and social engineers. That is why the Clinton plan failed. It was written in secret and then sprung on congress for approval. Well that won't work; and besides nobody liked Hilary very much. Now, I for one, remember nothing about specifics of that proposal. Maybe I wasn't paying much attention in 1993. And now, the President has erred in delegating the health care reform process to the most distrusted body in the government led by Nancy Pelosi who most people don't like very much. That won't work either. There is a huge pool of citizens who know they pay too much for insurance coverage, and they are beginning to understand why. But just. That is why the issues must be aired and discussed thoroughly before any vote comes to the floor. If you believe that the system must be deep sixed, that is one position. (The President and Congress didn't think so in the cases of Wall Street or the automobile industry, though). But have we had that discussion? I don't think so. There has been little discussion as far as I know about how to repair the existing system. We need to do that. If it can't be fixed, so be it. But I think it can, and must be. Profit is not a dirty word. Hell, I'd love to make a profit. Profit(and that can be merely enjoying the fruits of one's labors) is a motivation. Fraud and inefficiency must be curtailed.

And from a business person's perspective here are some things I know. My employees are all as happy as can be expected with their CareFirst/BlueCross/Blue Shield with prescription coverage. The company pays 30% of the premiums which run about $14,000/month. It's a burden but we have managed so far (we used to pay a much larger percentage). But the proposed plan will require us to pay for a much larger percentage for both about 75% employee and 65% dependant coverage. That will be too expensive for us and we will be "forced" by circumstances to drop the coverage and join the government plan. So, while we are "allowed" to keep our coverage we won't be "able" to. It amounts to the same thing. Or, if we don't join the government plan we will have to pay an $80,000 penalty not to participate. We will all be on our own, like Mary Kay and Christa. I don't see the improvement. And my employees won't have any help with their premiums!


Mary Kay: Inaction is Not an Option Anymore.

I understand that many viewpoints are based upon life's experiences. That said, I believe in the saying that in striving for perfection we may attain excellence, but in-action is not an option anymore.

How long should we study this before we decide to change the status quo? I've been living with this pre-existing condition clause since I was 21, pregnant with my daughter. I'm 49 now and still this issue keeps coming back around. God bless those of you who do not have a systemic disease which can be blamed for everything, and every symptom I have on any given day. Diabetes is extremely, and widely prevalent. It's not just me. Millions of americans have this disease. Some because of poor diets, lack of exercise, and genetics. Mine is genetics only. If I could change that I would. Sign me up!

BCBS will pay for 80% of my insulin pump, (retail cost $6,500.00), but not the 24hr blood glucose monitor so that I can keep my glucose levels in a healthy balance. This device is $1,000.00 + supplies. This is a financial burden for me, but not for the insurance companies. The financial burden of the long term affects of Diabetes is much more costly. One trip to the E.R. and 4 days in the hospital would cost the insurance company 6x the one-time cost of the monitor. Tell me how this makes sense. "Well Care" is much less expensive in the short and long term.

I have two choices: Hope that change takes place, so that I can remain self employed, or declare bankruptcy, so that I can afford to work for the Park Service and have their health insurance. It's a great job, but won't pay for my small business loans.

By the way, on a lighter note - It makes me smile that I have family out there!
Really late for work! Gotta go.

Mary Kay

Fred: Reform is Long Overdue

Hello, everyone.

Hmmm...seems to me this issue has been on the table for at least twenty years. We've all been aware of it, and it has been discussed repeatedly during that time. So I don't see much hurry, actually. The opposite, in fact. Some kind of reform is long overdue, and we've all known for along time that something has to be done.

I think Obama has tried hard to include representatives of all the key groups (doctors, hospitals, AARP, insurance companies, patient advocates, etc.) in the discussions of how to formulate a plan, so it seems like it's just the kind of thoughtful, considered approach that George says he'd like to see. We--the citzenry at large, not just our elected representatives--even we are now getting the chance to weigh in with our opinions (whether we know anything about the issues or not). Congress will vote on their plan(s) after they have heard from us during this recess. Given the complexities of governing 300 million people, this seems like a pretty inclusive process to me, not something being rammed down our throats.

What has been rammed down our throats is the present system, in which insurance company profits largely determine whether one can get, and afford, meaningful health coverage or not. (No wonder that it's one of the most profitable of all industry sectors.) That gagging sound you hear is our population choking on insurance rates that are ruinous for more and more of the people who can get coverage, or living with their hearts in their mouths because they have no coverage at all. This is a system that needs to be changed!

Best, -Fred

George: White House Propoganda vs. Study and Debate

This sounds like pure White House propaganda, which I have already received from them directly, thank you.

My concern is that the Obama plan, in trying to fix aspects of U.S. healthcare that don't work, will louse up the parts that do work, leaving us all worse off and with big financial problems too.

Like most full-time working people, I have medical coverage through my employer which uses a private insurer, and am fairly happy with it, though it is expensive. My fear is that a government plan can always put private insurers out of business eventually, not because it is truly more efficient but because a government program can operate indefinitely at a loss, and a private company can't do that. The result will be LESS CHOICE.

Are the President and the senators and representatives and their families, and all federal workers, going to depend on the Obama proposal for their health insurance? No. They have no intention of giving up the very nice plan they already have. It contains lots of choices, and it is subsidized by the other taxpayers ---- us. They cannot extend this to all Americans because then the funding would be insufficient. As Margaret Thatcher observed, "The trouble with socialism is that eventually you run out of other people's money."

I firmly believe that this complicated problem needs to be studied and debated. We all understand that there is a need for a way to help deserving and hard working citizens like Christa or Mary Kay, who for various reasons cannot get health insurance coverage. In this great country there surely can be found a sensible solution to this situation. But medical care is very expensive and there is no use pretending that it's free. Somebody has to pay for it.

The reason people are disturbed is that a bunch of privileged politicians are attempting to shove this massive and expensive program down our throats in a big hurry, without debate, and whether we want it or not. Their arrogance deserves to be repudiated.


Fred: Addressing Misinformation

Hello, everyone.

Here's some information about misinformation (aka "lies") that is being spread about the health care reform plans now being discussed. I hope it helps clear the air in discussing these issues--real information, rather than misrepresentations, can do that. If you're interested in following any of these things up, you'll find sources at the end of the piece I've pasted in.

Best, -Fred

Lie #1: President Obama wants to euthanize your grandma!!!

The truth: These accusations—of "death panels" and forced euthanasia—are, of course, flatly untrue. As an article from the Associated Press puts it: "No 'death panel' in health care bill."4 What's the real deal? Reform legislation includes a provision, supported by the AARP, to offer senior citizens access to a professional medical counselor who will provide them with information on preparing a living will and other issues facing older Americans.5

Lie #2: Democrats are going to outlaw private insurance and force you into a government plan!!!

The truth: With reform, choices will increase, not decrease. Obama's reform plans will create a health insurance exchange, a one-stop shopping marketplace for affordable, high-quality insurance options.6 Included in the exchange is the public health insurance option—a nationwide plan with a broad network of providers—that will operate alongside private insurance companies, injecting competition into the market to drive quality up and costs down.7

If you're happy with your coverage and doctors, you can keep them.8 But the new public plan will expand choices to millions of businesses or individuals who choose to opt into it, including many who simply can't afford health care now.

Lie #3: President Obama wants to implement Soviet-style rationing!!!

The truth: Health care reform will expand access to high-quality health insurance, and give individuals, families, and businesses more choices for coverage. Right now, big corporations decide whether to give you coverage, what doctors you get to see, and whether a particular procedure or medicine is covered—that is rationed care. And a big part of reform is to stop that.

Health care reform will do away with some of the most nefarious aspects of this rationing: discrimination for pre-existing conditions, insurers that cancel coverage when you get sick, gender discrimination, and lifetime and yearly limits on coverage.9 And outside of that, as noted above, reform will increase insurance options, not force anyone into a rationed situation.

Lie #4: Obama is secretly plotting to cut senior citizens' Medicare benefits!!!

The truth: Health care reform plans will not reduce Medicare benefits.10 Reform includes savings from Medicare that are unrelated to patient care—in fact, the savings comes from cutting billions of dollars in overpayments to insurance companies and eliminating waste, fraud, and abuse.11

Lie #5: Obama's health care plan will bankrupt America!!!

The truth: We need health care reform now in order to prevent bankruptcy—to control spiraling costs that affect individuals, families, small businesses, and the American economy.

Right now, we spend more than $2 trillion dollars a year on health care.12

The average family premium is projected to rise to over $22,000 in the next decade13—and each year, nearly a million people face bankruptcy because of medical expenses.14 Reform, with an affordable, high-quality public option that can spur competition, is necessary to bring down skyrocketing costs. Also, President Obama's reform plans would be fully paid for over 10 years and not add a penny to the deficit.15


Check out the new White House "Reality Check" website: or this excellent
piece from Health Care for America Now on some of the most
outrageous lies:


1. "More 'Town Halls Gone Wild': Angry Far Right Protesters Disrupt Events With 'Incomprehensible' Yelling," Think Progress, August 4, 2009.

2. "Fight the smears," Health Care for America NOW, accessed August 10, 2009.

3. "Palin Paints Picture of 'Obama Death Panel' Giving Thumbs Down to Trig," ABC News, August 7, 2009.

4. "No 'death panel' in health care bill," The Associated Press, August 10, 2009.

5. "Stop Distorting the Truth about End of Life Care," The Huffington Post, July 24, 2009.

6. "Reality Check FAQs,", accessed August 11, 2009.

7. "Why We Need a Public Health-Care Plan," The Wall Street Journal, June 24, 2009.

8. "Obama: 'If You Like Your Doctor, You Can Keep Your Doctor,'" The Wall Street Journal, 15, 2009.

9. "Reality Check FAQs,", accessed August 10, 2009.

10. "Obama: No reduced Medicare benefits in health care reform," CNN, July 28, 2009.

11. "Reality Check FAQs,", accessed August 10, 2009.

12. "Reality Check FAQs,", accessed August 10, 2009.

13. "Premiums Run Amok," Center for American Progress, July 24, 2009.

14. "Medical bills prompt more than 60 percent of U.S. bankruptcies," CNN, June 5, 2009.

15. "Reality Check FAQs,", accessed August 10, 2009.

Sources for the Five Lies:

#1: "A euthanasia mandate," The Washington Times, July 29, 2009.

#2: "It's Not An Option," Investor's Business Daily, July 15, 2009.

#3: "Rationing Health Care," The Washington Times, April 21, 2009.

#4: "60 Plus Ad Is Chock Full Of Misinformation," Media Matters for America, August 8, 2009.

#5: "Obama's 'Public' Health Plan Will Bankrupt the Nation,"The National Review, May 13, 2009.

Monday, August 10, 2009

Mary Kay: Write to your Representatives.


Thanks for your input. I am volunteering to visit Roscoe Bartletts' office this Thursday to voice my support for the proposed bill. I've attached a letter I wrote for whoever wants to read. I've also emailed it to the White House. Don't know if it will help, but can't hurt. I'll send the link for the bill and office visit guide under separate email.

I hope all is well with family and friends.

Mary Kay

The Reality of Health Insurance

I am self-employed. Two is a group. Since I've had to cut my work force and their hours I’ve lost my group coverage and they’ve lost theirs. I have Type 1 Diabetes and other health issues which means I have pre-existing conditions. Unless I'm a part of a group, Health Insurance will not cover anything that has to do with my Diabetes of 28 years, Asthma, my lower back, serious allergies, or serious IBS. My insulin alone cost me $279.00/month after the Medicare discount card. I had no other prescription drug coverage between 10/1/08 and 4/1/09. My health insurance coverage of more than 10 years was cancelled and I had to go onto a conversion policy on 10/1/08, with no dental or prescription drug coverage.

Also, because I’ve had to cut my employees’ hours, they are not eligible for health insurance, nor can I afford it now because of the economy.

So on 4/1/09, I had to beg to go on my husbands’ health insurance. I had no other choice. Which wouldn’t seem bad but we are separated and will be divorcing in 2010. When he divorced his first wife, he changed the deductible to $1,200.00. He gives his employees a check for the $1,200.00 to cover it. His ex-wife gets alimony. I get neither. So I was forced to buy my insulin from Nova Scotia because it was $125.00 instead of paying almost $400.00 for the insulin and running it through my husbands’ health insurance against the deductible. I didn’t have the $400.00 to pay for something so basic. I would be dead without it. The insulin didn’t come in the 10 – 12 days like it was supposed to. So I ran out and had to call the doctor late at night on the weekend to get another prescription for one vial. I thought I could buy it without a prescription. Some kinds can be. Mine, Novolog, cannot. My pharmacy in Boonsboro was closed. I was alone, afraid and in tears. In addition to not having control over my deductible, my husband has threatened to cancel me if I don’t do what he wants with other issues that have nothing to do with health insurance, even though he promised it would be good for 1 year. The second time he threatened to cancel my health insurance was the day after I left him a message that I’d broken my arm.

What it comes down to is that I need to be able to make my own choices for coverage, doctors, prescription coverage and the premiums I can afford to pay. If I could get coverage on my own without having two as a group, and the insurance would cover my pre-existing conditions, I would feel so much more secure.

Lastly, the deduction we receive for paying for health insurance is only 50% of what we actually pay for ourselves and our employees and it’s not on the Schedule C. The credit is taken on the 1040 which reduces our AGI only, so we’re still paying social security taxes on the health insurance premiums we pay, in addition to Federal and State taxes on half.

Every day that I have health insurance coverage, I thank God, even though my husband continues to threaten canceling my coverage. I’ve been without before and not only are there the many, many medicals bills, there is also the issue of feeling like a second class citizen when the emergency room sends you out the door after giving you so many drugs that you can’t put on your own sweat pants. The first question out of any medical providers’ mouth is: “What insurance do you have?” If an individual doesn’t have insurance they either won’t take you as a patient or you have to pay up front. In addition, without coverage, individuals don’t receive the benefit of the discounted, contract price the insurance companies get. An individual pays the full price. The Conversion policy I was on only provided 75/25 coverage and a hospital stay in CCU in February 09 left me with thousands of dollars in medical bills I can’t afford to pay.

As far as I can tell, these issues would be resolved with the bill currently proposed.

Mary Kay

Sunday, August 9, 2009

Cal: The Government Does Not Have the Answers.

Hello Again Friends and Family.

Boy, what a crazy few weeks. It appears that providence has prevented Congress from rushing through a health care reform, the details of which we were apparently not meant to know and which the supportive representatives themselves would not have read had they voted on it when they wanted. That is the first victory and great opportunity in this skirmish.

The representatives have gone home for August and actually believed they would be allowed to offer their usual non-answer platitudes to their constituents questions. Is anyone besides them surprised at the passionate responses they received? That’s how out of touch they are. We had the fragile and hapless Arlen Specter stunned by the anger, literally rolling his eyes back in his head, and Kathleen Sibelius defending him by saying he shouldn’t be blamed for not reading the bill because it hadn’t been written yet. BUT THEY WERE SUPPOSED TO HAVE VOTED ON IT ALREADY! Can these people even think?

Now, I don’t know if the protestors were plants, but they certainly didn’t look like plants. They looked like me. And I am no THUG. I am, and I personally know every recipient of this message is, reserved and gentle by nature. I’m sure all of us are uncomfortable with all the yelling. Yet, it seems to me this is a result of the fact that we have had no previous input (except for voting these people into office) and that there has little actual open discussion of the provisions of the bill, and that it has been the obvious intention of bill’s proponents to shove this thing through without due process. I am every bit as angry as the vocal protestors about that.

The rhetoric seems to be subsiding a little now, with more moderate statements on both sides. Even my local liberal Washington Post has published much more reasonable editorials and columns lately. My local conservative Washington Times has done the same. And therein lies what I believe is the golden opportunity offered by the September 12 Tea Parties.

I doubt that any of us opposes health care reform. Costs are way out of control, pre-existing condition exclusions are obscene and need to be eliminated, insurance should be portable and available across state lines, people who want health insurance (and are willing to pay for it, at least in part) should be able to get it.. Each of us should be able to purchase insurance in the same way we buy car insurance, in my opinion. All reasonable goals, I think. And I think most of the perhaps hundreds of thousands (or more) participants in the 9/12 gatherings would agree to a great extent. The extremists on the right and left are drunk on their obsessions and aren’t even listening. They blather on.

So my hope and belief is that the Tea Parties will be a meeting of reasonable people with reasonable ideas from all walks of life, politics, and ideology; that the events will serve as an expression of the justified disgust and contempt for the corrupt and cynical politicians, and that they will expose the ideological socialist radicals in congress such as Nancy Pelosi, Barbara Boxer, Barney Frank and the others who believe the government should handle everything. Does Pelosi actually think the protestors are Nazis? Last I looked fascists were the politicians who stifled free expression and promoted government control of business and programs. (Most fascist movements and tendencies in the 20th century grew out of the LEFT not the right, after all. Eugenics-progressives, whose list of proponents included T. Roosevelt, W. Wilson, W. Churchhill, O. W. Holmes, L. Brandeis, H. G. Wells, G.B Shaw, and M. Sanger-Planned Parenthood—and whose research was conducted at Harvard, Princeton, Yale, Stanford, and Johns Hopkins; Hitler/Mussolini-progressive socialists killed 6,000,000; Stalin-communist killed 25,000,000.) Sorry for that little side trip digression down memory lane. But as Yogi Berra said: “ You could look it up.”

So I urge everyone to take part in their local Tea Party, to meet the multitudes of reasonable Americans merely exercising their God-given (not government given) constitutional rights, and to hear their reasonable ideas. Join them in demanding that the politicians re-establish and maintain transparency in government. Stop bankrupting the nation. Cut taxes, do no not raise them Congress and the White House need to hear the passionate, intelligent and measured voices of regular Americans demanding that their motivation needs to be the good of the people and not what will get them elected or strengthen their power base. This goes for both parties. The lunatic far left and the crazy far right will be conspicuous by their exile to the shadows under the elm trees lining Constitution and Independence Avenues. The real events will be held front and center, in the open, on the broad green, in front of the Capitol and the State Houses across the country. We must awaken from the slumber we have settled back into since 9/11. The nation is in peril from within and from without. Please join this watershed beginning of the taking back of our Country. We cannot allow the special interests, the lobbyists, and their stooges in the government to fool and distract us into squandering the nation’s collective outrage. We don’t get this mad very often. 9/11 was the last time and President Bush’s greatest blunder, I believe, was in letting that opportunity get away. This time we must do it ourselves! THE GOVERNMENT DOES NOT HAVE THE ANSWERS! What say you?

Your friend and/or cousin+-