Last week, a group of religious leaders released the Manhattan Declaration - a statement reaffirming the essential justice and goodness of upholding and protecting the sanctity of life, traditional marriage between a man and a woman, and of the rights of religious conscience and liberty. Although written from a Christian perspective, the ethos of the declaration conforms to the foundational Judeo-Christian heritage of our traditional American values and morality. The document urges believers and non-believers alike to recognize the evident detrimental societal ramifications caused by the steady erosion of these 3 principles. It is not written simply from a perspective of fidelity to the Christian faith, but from that of the well being of society and of love for all individuals. The declaration also calls on people of conscience to actively promote these doctrines in our American society and further to civilly resist attacks on and abandonment of these doctrines.
This point of view undoubtedly will be assailed from the left as bigotry, intolerance, and imposing church on the state. They incorrectly argue that the principle of separation of church and state that prohibits a state sponsored religion also requires a person to exclude their religious perspective from their politics. This position not only is a misunderstanding of that principle but also fails to grasp that a person’s belief system is their religion. It is their framework for understanding this world, this life, and their purpose or vocation in this life. Further, a person’s belief system intrinsically has an associated code of morality or ethics. This moral code provides an ethical standard by which a person measures the conduct of their lives. For many, this cosmologic and ethical framework arises from their belief in an eternal, omnipotent, and loving God. For others, their belief system arises from their secular understanding of the world. In either case, what they believe is their “religion.” One’s politics can not possibly be separated from one’s “religion”. It is facetious for a “non-religious” person to say that a Christian’s political position which is based in their religious beliefs should not be expressed in the political process and yet insist that their political position that is based in their secular beliefs are legitimately expressed in the political process.
Ironically while many on the progressive left claim to espouse broad tolerance of individual beliefs, they do so only as long as those beliefs conform to their beliefs. As Americans, we rightly pride ourselves in freedom of beliefs and in that sense we certainly live in a tolerant society. However, living in a free, democratic, and tolerant society does not mean that all beliefs should have equal expression in that society. Our American freedom confers the right to any citizen to utilize the political process to incorporate into our society those beliefs they consider beneficial and to exclude those they believe to be detrimental.
The principles and objectives of the Manhattan Declaration will also meet resistance from the right. Some conservatives argue that these issues of sanctity of life, traditional marriage, and religious liberty are peripheral social issues that divide and thereby weaken the conservative movement. They feel debate of these issues only distracts from the more important conservative effort to promote traditional American individual freedoms and the traditional American economic principles of free markets. This stance however, does not recognize that the same liberal ideology underlying the systematic attack on traditional American morality also underlies the attack on traditional American individual freedoms and economic principles. Progressive ideology comprehensively rejects the intrinsic, absolute, and personal nature of individual freedoms, talents, and responsibilities as understood in our Judeo-Christian heritage. Rather than primacy of the individual person and of the individual family, the progressive movement emphasizes the ascendancy of the non-personal collective society. Rather than the absolute and unchanging morality of our Judeo-Christian heritage, the progressive movement champions a changing and relative morality that “fits” with our societal and scientific “progress”. We must understand that the attack on traditional American individual freedoms and economic principles is part of the broader systemic ideological assault on all of traditional American society and must be resisted on all fronts.
We have reached a defining crossroads in our nation’s history. We can sit back and watch the “enlightened” progressive economic and moral principles insidiously supplant our traditional American principles and values; or we can each step up, and actively participate in an unprecedented grass roots political movement that embraces and promotes traditional American free market principles, individual freedoms, and morality. Please read the Manhattan declaration. It is a compelling and lucid statements. Aand, if it conforms to your beliefs, add your signature (http://manhattandeclaration.org/images/content/ManhattanDeclaration.pdf). Forward the document to those who care for traditional America. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm). Join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com//, and other traditional American values based grass roots organizations.
Monday, November 30, 2009
Sunday, November 1, 2009
Reclaiming the American Vision of Freedom and Prosperity
Regardless of our political affiliation, Republican, Democrat, or Independent, most of us would agree America faces serious issues with regard to the economy, healthcare, poverty, morality, education, and the aging population. Further, many of us, Republicans, Democrats, and Independents, share a similar vision for our country. It is a vision of America with a strong and sustainable economy in which individuals and families can be secure in their ability to provide for themselves. It is a vision of America based on economic and personal freedoms, allowing individuals to decide what sacrifices they will make, education they will pursue, opportunities and talents they will use, and risks they will assume to succeed. It is a vision of America with the ability and commitment to make us secure from those within and outside our country who would do us great harm. It is a vision of America as a shining model of individual freedom, economic and societal success for the rest of the world. It is a vision of a compassionate America that provides a safety net of basic housing, education, and healthcare. It is a vision of America of our generation passing on not only a better society, economy, and environment to the next generation but also the opportunity for our children and grandchildren to be able to choose how to live out their American dream. Most importantly, it is a vision of American government that fosters, rather than impedes this vision.
There is another vision, that of President Obama and the far left. Theirs is a vision of government taking over more of our economy and lives to provide a “fairer” society. Theirs is a vision of government limiting individual decisions and opportunities and instead providing “equality” of economic outcome, of healthcare, of education, of standard of living. Theirs is a vision of America being just another country, renouncing and even apologizing for the principles of individual and economic freedoms that have made our country great. Theirs is a vision of government abandoning the traditional American virtues and morality and instead espousing broad societal moral tolerance based, not on an absolute standard, but rather on the “enlightened” morality agreed upon by contemporary “intelligent” society. Most importantly it is a vision of American government (tyranny) that imposes this vision on us.
We must recognize the current political upheaval is not simply a debate between the Republican perspective and Democrat perspective within the traditional American economic and political society but rather a well-veiled effort to overthrow our traditional American society. In actuality, it is a struggle between those of us (Republican, Democrat, or Independent) who believe in the goodness and efficacy of traditional American economic principles, individual freedoms, and moral values, and those who would renounce those principles, freedoms, and values and remake America into a European-style social democracy.
Without a doubt, at this time in our country’s history, we find ourselves with significant economic break down and social difficulties. Yet these troubles are not a result of the failure of traditional American free market principles and personal freedoms in a more complex modern world, but instead the result of the erosion and corruption of those principles. Our economic and societal troubles can only be successfully addressed by again embracing the traditional American free market principles, traditional American individual freedoms, and traditional American morality that made our country the greatest of the modern world, the shining light on the hill of liberty, freedom, and prosperity.
Our country has come to a defining moment. We (Republican, Democrat, or Independent), who love freedom and liberty, must recognize the stakes. We must pick sides. We must join the fight. Our children’s and their children’s futures depend on what we do now. Though it may initially strike you as hyperbole, the “Great Generation” fought and died to protect the very liberties and freedom that we risk losing because of a well-organized “progressive” minority and a corrupted political process.
Every individual can make a difference. We must fight those who would denounce and remake traditional America. We must take back the corrupted political system through historic grass roots pressure to force transparency and accountability on the politicians and bureaucrats. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and other free market based grass roots organizations.
There is another vision, that of President Obama and the far left. Theirs is a vision of government taking over more of our economy and lives to provide a “fairer” society. Theirs is a vision of government limiting individual decisions and opportunities and instead providing “equality” of economic outcome, of healthcare, of education, of standard of living. Theirs is a vision of America being just another country, renouncing and even apologizing for the principles of individual and economic freedoms that have made our country great. Theirs is a vision of government abandoning the traditional American virtues and morality and instead espousing broad societal moral tolerance based, not on an absolute standard, but rather on the “enlightened” morality agreed upon by contemporary “intelligent” society. Most importantly it is a vision of American government (tyranny) that imposes this vision on us.
We must recognize the current political upheaval is not simply a debate between the Republican perspective and Democrat perspective within the traditional American economic and political society but rather a well-veiled effort to overthrow our traditional American society. In actuality, it is a struggle between those of us (Republican, Democrat, or Independent) who believe in the goodness and efficacy of traditional American economic principles, individual freedoms, and moral values, and those who would renounce those principles, freedoms, and values and remake America into a European-style social democracy.
Without a doubt, at this time in our country’s history, we find ourselves with significant economic break down and social difficulties. Yet these troubles are not a result of the failure of traditional American free market principles and personal freedoms in a more complex modern world, but instead the result of the erosion and corruption of those principles. Our economic and societal troubles can only be successfully addressed by again embracing the traditional American free market principles, traditional American individual freedoms, and traditional American morality that made our country the greatest of the modern world, the shining light on the hill of liberty, freedom, and prosperity.
Our country has come to a defining moment. We (Republican, Democrat, or Independent), who love freedom and liberty, must recognize the stakes. We must pick sides. We must join the fight. Our children’s and their children’s futures depend on what we do now. Though it may initially strike you as hyperbole, the “Great Generation” fought and died to protect the very liberties and freedom that we risk losing because of a well-organized “progressive” minority and a corrupted political process.
Every individual can make a difference. We must fight those who would denounce and remake traditional America. We must take back the corrupted political system through historic grass roots pressure to force transparency and accountability on the politicians and bureaucrats. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and other free market based grass roots organizations.
Sunday, October 11, 2009
Where is the Republican Health-Care Reform Proposal?
The Baucus Bill, now on the verge of passing, fails to indentify and fails to address the root causes of the unsustainable escalating cost of the failing health-care system. Further, disingenuous and unrealistic budgetary scoring has falsely determined the bill to be fiscally responsible. As reasonably argued by many across the political spectrum, the 3rd party payer system that disconnects the consumer of health-care from the cost of those services primarily drives the unsustainable growth of our health-care costs. The 3rd party system creates nearly unlimited demand that in turn results in increasingly unaffordable premiums. Inappropriate government mandates and insurance regulation impose additional costs and discourage competitive forces, further aggravating the cost growth. The Baucus bill can only exacerbate escalating costs by placing more persons into this failed 3rd party system and by legislating greater mandates that directly increase costs and indirectly suppress competition.
Legitimate reform must transform the current failed 3rd party payer model to a consumer centered system that also promotes salutary free market forces. Such reform would include: 1. promotion of Health Savings Accounts; 2. tax treatment equalization of individual purchased policies with that of employer provided policies so that individual purchased policy costs and the employer provided insurance costs are both either taxed or not taxed; 3. insurance reform including fewer mandated policy benefits, ability for individuals and businesses to purchase insurance across state lines, and allowance of insurance providers to fairly assess an individual policy holder’s risk in the price of the policy. Further reform reflecting traditional American economic principles, values, and individual freedoms would address the inability for some to afford insurance (many fewer than currently if above measures were legislated) by the Government providing subsidies to qualifying individuals and families to purchase their own insurance as opposed to creating a massive new entitlement program with more bureaucracy and irresponsible increased deficit spending.
Although various Republicans have individually made proposals that would provide components of sustainable and successful health-care, the Republican caucus has made no effort to offer a unified alternative vision for reform. Why have they not outlined a broad proposal incorporating the principles of individual responsibility, free market economy, and fiscal responsibility that they claim to espouse? It would seem the Republicans mostly are more concerned with thwarting the Obama and Democrat health-care reform rather than with offering a viable and responsible proposal to successfully address the health-care crisis. Sadly, both major political parties primarily function to obtain and maintain majority political control and the concomitant power and political spoils rather than to solve problems facing our country.
Liberal ideology promulgating the abandonment of the traditional American economic principles, personal freedoms, and values progressively erodes our singular national greatness; yet our liberty and prosperity has been threatened and damaged to a greater extent by the corruption of our political process and parties that now preferentially serves self-interest and special interests over the public good.
The many pressing problems facing our nation including the unsustainable health-care system, formulation of rational environment and energy policy, failing economy, etc., will only be addressed by thoughtful policy grounded in traditional American free market principles. But, before we can even hope for such legislation, the citizens of this country must take back the corrupted political system through historic grass roots pressure to force transparency and accountability on the politicians and bureaucrats.
Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and other free market based grass roots organizations.
Legitimate reform must transform the current failed 3rd party payer model to a consumer centered system that also promotes salutary free market forces. Such reform would include: 1. promotion of Health Savings Accounts; 2. tax treatment equalization of individual purchased policies with that of employer provided policies so that individual purchased policy costs and the employer provided insurance costs are both either taxed or not taxed; 3. insurance reform including fewer mandated policy benefits, ability for individuals and businesses to purchase insurance across state lines, and allowance of insurance providers to fairly assess an individual policy holder’s risk in the price of the policy. Further reform reflecting traditional American economic principles, values, and individual freedoms would address the inability for some to afford insurance (many fewer than currently if above measures were legislated) by the Government providing subsidies to qualifying individuals and families to purchase their own insurance as opposed to creating a massive new entitlement program with more bureaucracy and irresponsible increased deficit spending.
Although various Republicans have individually made proposals that would provide components of sustainable and successful health-care, the Republican caucus has made no effort to offer a unified alternative vision for reform. Why have they not outlined a broad proposal incorporating the principles of individual responsibility, free market economy, and fiscal responsibility that they claim to espouse? It would seem the Republicans mostly are more concerned with thwarting the Obama and Democrat health-care reform rather than with offering a viable and responsible proposal to successfully address the health-care crisis. Sadly, both major political parties primarily function to obtain and maintain majority political control and the concomitant power and political spoils rather than to solve problems facing our country.
Liberal ideology promulgating the abandonment of the traditional American economic principles, personal freedoms, and values progressively erodes our singular national greatness; yet our liberty and prosperity has been threatened and damaged to a greater extent by the corruption of our political process and parties that now preferentially serves self-interest and special interests over the public good.
The many pressing problems facing our nation including the unsustainable health-care system, formulation of rational environment and energy policy, failing economy, etc., will only be addressed by thoughtful policy grounded in traditional American free market principles. But, before we can even hope for such legislation, the citizens of this country must take back the corrupted political system through historic grass roots pressure to force transparency and accountability on the politicians and bureaucrats.
Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and other free market based grass roots organizations.
Tuesday, October 6, 2009
Wrong (Bad) Diagnosis=Wrong (Bad) Treatment Part II
As previously discussed, without intelligent and logical evaluation of a sickness, ill-conceived and hastily implemented “therapy” can only exacerbate the illness and is worse than no treatment. The current proposals for health-care reform not only fail to address our defective health-care insurance model that disconnects the consumer of health-care services from the costs of those services (the primary cause of unsustainable escalating health-care costs) but instead increases the costs by effectively placing more persons (the uninsured) into the same defective system. Similarly, these proposals do not deal with but rather add to the other key contributor to our national health-care “illness”, the over-regulation and lack of competition in the health-care insurance industry.
Obstructive regulation and lack of competition are evident on multiple fronts. Firstly, the inability to sell insurance across state lines limits the number of insurers, which in turn limits the competition, thereby increasing insurance costs. Further, individual state mandates, i.e. required covered health-care services, vary significantly from state to state compounding this problem. Only the largest insurers have the resources to comply with all the various individual state mandates and thus there are only a handful of national health-care insurance companies, again limiting competition.
The state legislated mandates in themselves significantly add to the cost of health-care insurance. The mandates are of 2 general forms. The first type requires insurers to provide coverage for particular services that may include drug/alcohol rehabilitation, smoking cessation, infertility, autism care, hair restoration, etc.; may further require coverage for provider services such as chiropractic, massage, acupuncture, etc.; and finally could require family coverage to include grandchildren, dependent family members, domestic partners, etc. The number of these types of mandates differs from state to state from as few as 20 to as many as 60. The estimated increased cost of insurance varies from 20 to 50% depending on the state and number of mandates.
http://www.cahi.org/cahi_contents/resources/pdf/HealthInsuranceMandates2008.pdf
While not intrinsically inappropriate, mandates do increase the cost of health insurance. Many individuals or families who presently can not afford health-care insurance could afford simpler and more limited coverage insurance. They could choose policies that do not include coverage for services they personally would never need to use e.g. drug or alcohol rehabilitation or perhaps infertility services, etc. while still getting essential medical care coverage. Further, more insurance companies would likely enter the market to sell simpler policies resulting in more competition and lower premiums.
One further disturbing aspect of individual state mandates: Many, in fact, are political payoffs to special interests rather than for the public well being. Not infrequently, mandates for coverage of some less traditional service are more likely a result of that service’s special interest group making a campaign contribution to a state legislator rather than as a result of an argument made to that legislator that such service benefits the insured.
“Guaranteed issue” and/or “community rating” requirements comprise the 2nd form of mandates. Guaranteed issue requires insurers to issue policies regardless of a person’s health status while community rating requires insurers to blend the utilization of services risk of a particular person with the risks of a broad group of persons. In both cases, such regulations inhibit the insurance company from pricing the policy to reflect the risk a particular individual contributes to the overall pool of risk. As a result, a healthy young person would be unable to get a health-care insurance policy premium that accurately reflects their much lower likelihood of utilizing services than that of an older or less healthy person. Further, because of that “mandated” increased premium, many younger healthier people opt out of buying health-care insurance, in turn, further driving up the cost of insurance for those persons, persons more likely to utilize services, left in the “community rating” pool.
For the healthy and young, true risk assessment would directly lower premiums. “Fair” pricing would afford many more young families and individuals with the ability to obtain health-care insurance. Those with higher risk could be part of large national pools of higher risk conditions. Some would argue that without “guaranteed issue” or “community rating”, insurance would be prohibitively expensive for those with pre-existing medical conditions or conditions e.g. older age, etc., likely to require medical services. Still, allowing premiums to be fairly priced for all risk pools would encourage more insurance providers to enter that market, encourage competition, and result in the best pricing for premiums in all risk pools. None-the-less for some in the higher risk pools, insurance may be prohibitively expensive, but allowing pricing to reflect actual risk brings more transparency to that problem. Rather than burying those costs in a “community rating” pool, effectively discouraging more healthy persons from obtaining coverage, government could instead subsidize those fewer individuals that could not afford their premiums. Clearly, such focused government assistance is much preferable to massive takeover and bureaucratic expansion of our health-care system.
Returning to wrong (bad) diagnosis can only result in wrong (bad treatment): the Democratic congressional majority intends, despite public objection, to pass some version of the Baucus bill. “Forcefully impose” more accurately describes the action than “pass” given they intend to utilize, if necessary, “reconciliation” and thereby circumvent the ability to filibuster, a mechanism that acts as a safeguard against bad legislation. Whatever the final form of the Baucus bill, it will include significant mandates including extensive required covered services, “guaranteed issue”, and the most egregious of all mandates, mandating the states to expand their Medicaid rolls to include all persons up to the 133% of the federal poverty level. This expansion of Medicaid imposes a huge unfunded liability on states already in the throes of a historic state government financial crisis. http://online.wsj.com/article/SB10001424052970203917304574414831869954664.html?mod=googlenews_wsj
Although boasting of historic healthcare reform, the Democrat-controlled Congress readies to pass a bill that will place more persons in a failed health-care insurance model; readies to pass a bill that includes more mandates and decreased competitive forces; readies to pass a bill that will impose more government intrusion and bureaucracy into our lives; readies to pass a bill that can only exacerbate our national health-care “illness”.
Indisputably, we need health care reform, but successful reform requires thoughtful and rational policy formulation, utilizing traditional American economic free market values; not hastily crafted, misconceived and intrusive government policies.
There is no problem so bad that it can’t be made worse by doing the wrong thing.
We must all fight to prevent the wrong kind of healthcare reform and the dangerous expansion of government control and debt. Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and other free market based grass roots organizations.
Obstructive regulation and lack of competition are evident on multiple fronts. Firstly, the inability to sell insurance across state lines limits the number of insurers, which in turn limits the competition, thereby increasing insurance costs. Further, individual state mandates, i.e. required covered health-care services, vary significantly from state to state compounding this problem. Only the largest insurers have the resources to comply with all the various individual state mandates and thus there are only a handful of national health-care insurance companies, again limiting competition.
The state legislated mandates in themselves significantly add to the cost of health-care insurance. The mandates are of 2 general forms. The first type requires insurers to provide coverage for particular services that may include drug/alcohol rehabilitation, smoking cessation, infertility, autism care, hair restoration, etc.; may further require coverage for provider services such as chiropractic, massage, acupuncture, etc.; and finally could require family coverage to include grandchildren, dependent family members, domestic partners, etc. The number of these types of mandates differs from state to state from as few as 20 to as many as 60. The estimated increased cost of insurance varies from 20 to 50% depending on the state and number of mandates.
http://www.cahi.org/cahi_contents/resources/pdf/HealthInsuranceMandates2008.pdf
While not intrinsically inappropriate, mandates do increase the cost of health insurance. Many individuals or families who presently can not afford health-care insurance could afford simpler and more limited coverage insurance. They could choose policies that do not include coverage for services they personally would never need to use e.g. drug or alcohol rehabilitation or perhaps infertility services, etc. while still getting essential medical care coverage. Further, more insurance companies would likely enter the market to sell simpler policies resulting in more competition and lower premiums.
One further disturbing aspect of individual state mandates: Many, in fact, are political payoffs to special interests rather than for the public well being. Not infrequently, mandates for coverage of some less traditional service are more likely a result of that service’s special interest group making a campaign contribution to a state legislator rather than as a result of an argument made to that legislator that such service benefits the insured.
“Guaranteed issue” and/or “community rating” requirements comprise the 2nd form of mandates. Guaranteed issue requires insurers to issue policies regardless of a person’s health status while community rating requires insurers to blend the utilization of services risk of a particular person with the risks of a broad group of persons. In both cases, such regulations inhibit the insurance company from pricing the policy to reflect the risk a particular individual contributes to the overall pool of risk. As a result, a healthy young person would be unable to get a health-care insurance policy premium that accurately reflects their much lower likelihood of utilizing services than that of an older or less healthy person. Further, because of that “mandated” increased premium, many younger healthier people opt out of buying health-care insurance, in turn, further driving up the cost of insurance for those persons, persons more likely to utilize services, left in the “community rating” pool.
For the healthy and young, true risk assessment would directly lower premiums. “Fair” pricing would afford many more young families and individuals with the ability to obtain health-care insurance. Those with higher risk could be part of large national pools of higher risk conditions. Some would argue that without “guaranteed issue” or “community rating”, insurance would be prohibitively expensive for those with pre-existing medical conditions or conditions e.g. older age, etc., likely to require medical services. Still, allowing premiums to be fairly priced for all risk pools would encourage more insurance providers to enter that market, encourage competition, and result in the best pricing for premiums in all risk pools. None-the-less for some in the higher risk pools, insurance may be prohibitively expensive, but allowing pricing to reflect actual risk brings more transparency to that problem. Rather than burying those costs in a “community rating” pool, effectively discouraging more healthy persons from obtaining coverage, government could instead subsidize those fewer individuals that could not afford their premiums. Clearly, such focused government assistance is much preferable to massive takeover and bureaucratic expansion of our health-care system.
Returning to wrong (bad) diagnosis can only result in wrong (bad treatment): the Democratic congressional majority intends, despite public objection, to pass some version of the Baucus bill. “Forcefully impose” more accurately describes the action than “pass” given they intend to utilize, if necessary, “reconciliation” and thereby circumvent the ability to filibuster, a mechanism that acts as a safeguard against bad legislation. Whatever the final form of the Baucus bill, it will include significant mandates including extensive required covered services, “guaranteed issue”, and the most egregious of all mandates, mandating the states to expand their Medicaid rolls to include all persons up to the 133% of the federal poverty level. This expansion of Medicaid imposes a huge unfunded liability on states already in the throes of a historic state government financial crisis. http://online.wsj.com/article/SB10001424052970203917304574414831869954664.html?mod=googlenews_wsj
Although boasting of historic healthcare reform, the Democrat-controlled Congress readies to pass a bill that will place more persons in a failed health-care insurance model; readies to pass a bill that includes more mandates and decreased competitive forces; readies to pass a bill that will impose more government intrusion and bureaucracy into our lives; readies to pass a bill that can only exacerbate our national health-care “illness”.
Indisputably, we need health care reform, but successful reform requires thoughtful and rational policy formulation, utilizing traditional American economic free market values; not hastily crafted, misconceived and intrusive government policies.
There is no problem so bad that it can’t be made worse by doing the wrong thing.
We must all fight to prevent the wrong kind of healthcare reform and the dangerous expansion of government control and debt. Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and other free market based grass roots organizations.
Sunday, September 27, 2009
European Social Democracy Doesn't Work
The great danger of the current distressed economic situation is not the downturn itself but rather the subsequent political reaction that has brought us to the verge of abandoning the very principles that have made our country the greatest national success story of the modern world. Our nation has been the global economic engine and the global shining light of freedom because of traditional American free market principles and traditional American personal freedoms. American innovation, ingenuity , and our free market system has spawned the lion’s share of the modern world’s innovations in health technology, pharmaceuticals, aerospace, computer technology, communications, etc. from which the entire planet has benefitted. Undeniably, our country faces serious problems including the ailing economy, unsustainable expense of healthcare, inadequate primary and secondary education, incoherent energy policy, environmental deterioration, etc. But our troubles are not a result of the failure of those economic principles and values but rather a result of corruption of those principles and values by self-interests, special interests, and misconceived government policies.
Proposed policies creating a more centrally controlled economy so government can provide broad social programs such as health care for all, higher education for all, housing for all, etc., are inherently economically flawed. Funding for these programs inevitably requires increased taxation for nearly all individuals and businesses but disproportionately the successful ones. Eventually however, the increasing tax burden discourages and suppresses innovation, risk taking, and personal and business success, resulting in fewer and fewer successful persons and businesses. The resultant suppressed economy generates less private revenue (wealth) and in turn, progressively lower tax revenues. As tax revenues decrease, unsustainable deficit spending to pay for the social programs further restricts the economy. Ultimately with a decreasing ability to pay for those social programs, the government "benefits" inevitably are provided (rationed) at a minimal level. At the same time, because the government has promised to provide expansive public social programs and by policy discouraged individual achievement, fewer and fewer people try to provide for themselves. The end result of this system is an increasingly dependent and dispirited citizenry and, at best, a tepid economy. This is not theory but has proven to be the case throughout Europe and every where else such policies have been implemented.
We have reached a defining crossroads in our nation’s history. We can sit back and watch our country and our children’s’ futures slide down the slippery slope to European style socialism, which can only result in economic insecurity and individual dependency and unhappiness; or we can enact policy that both utilizes the self-energizing and auto-correcting forces of traditional American free market principles and addresses the corrupting influences of self-interests and special interests by increasing transparency in the public and private sectors. Our current economic and social problem can only be successfully reversed by utilizing those traditional American free market principles and personal liberties that made our great land the global economic powerhouse and bastion of freedom.
Proposed policies creating a more centrally controlled economy so government can provide broad social programs such as health care for all, higher education for all, housing for all, etc., are inherently economically flawed. Funding for these programs inevitably requires increased taxation for nearly all individuals and businesses but disproportionately the successful ones. Eventually however, the increasing tax burden discourages and suppresses innovation, risk taking, and personal and business success, resulting in fewer and fewer successful persons and businesses. The resultant suppressed economy generates less private revenue (wealth) and in turn, progressively lower tax revenues. As tax revenues decrease, unsustainable deficit spending to pay for the social programs further restricts the economy. Ultimately with a decreasing ability to pay for those social programs, the government "benefits" inevitably are provided (rationed) at a minimal level. At the same time, because the government has promised to provide expansive public social programs and by policy discouraged individual achievement, fewer and fewer people try to provide for themselves. The end result of this system is an increasingly dependent and dispirited citizenry and, at best, a tepid economy. This is not theory but has proven to be the case throughout Europe and every where else such policies have been implemented.
We have reached a defining crossroads in our nation’s history. We can sit back and watch our country and our children’s’ futures slide down the slippery slope to European style socialism, which can only result in economic insecurity and individual dependency and unhappiness; or we can enact policy that both utilizes the self-energizing and auto-correcting forces of traditional American free market principles and addresses the corrupting influences of self-interests and special interests by increasing transparency in the public and private sectors. Our current economic and social problem can only be successfully reversed by utilizing those traditional American free market principles and personal liberties that made our great land the global economic powerhouse and bastion of freedom.
Sunday, September 20, 2009
Wrong Diagnosis = Wrong (ineffective) Treatment
In medical practice, successful treatment of a patient’s illness requires establishing a proper diagnosis. Without intelligent and logical evaluation of a sickness, ill-conceived and hastily implemented “therapy” would only exacerbate the illness and would be worse than no treatment. It would be utter folly to declare a patient critically ill and hurriedly implement treatment because “something must be done” without first properly understanding the cause of the illness. Yet, this is the very attitude and approach underlying the current proposals in Congress for health-care reform.
Health-care costs currently account for 18% of our GDP and that percentage is projected to nearly double in the next 20 years. Escalating health-care costs place ever increasing financial burdens on families and businesses, threatening the long-term viability of our economy, the long-term solvency of our state and Federal governments, and, in the end, our opportunity and our children’s opportunity to live the American Dream. As needed for treating medical illness, successful treatment of this national health-care “illness, first requires thoughtful analysis to determine and identify the underlying causes of this “illness”.
While multiple factors contribute to ever increasing health-care costs, our health-care insurance system, which effectively disconnects the consumer of health-care services from the immediate cost of that care, is the essential driver of those costs. Certainly, the insurance premium cost is felt directly by the consumer who may pay for part or the entire premium, and/or felt indirectly through reduced wage dollars that are instead paid as health-care insurance employee benefit. However, once that premium is paid, there is little incentive not to use health-care services as much as one desires. Health-care insurance in our country is unlike any other type of insurance. Imagine the cost of auto insurance, if having paid the insurance premium one could have as much automobile as they desired or the cost of home owner’s insurance, if having paid the premium, one could have as much home as they desired. Once inside the health-care insurance system, the demand for services becomes almost unlimited. As a result, the cost to get into this system, i.e. the insurance premium, continually increases. In turn, the premium becomes unaffordable for more and more Americans or places increasing financial stress on families and businesses that continue to purchase health-care insurance.
The same mechanism drives the continually increasing Medicare and Medicaid expenses and propels those programs further into insolvency. As with the private health-care insurance, once inside the government (taxpayer) health-care programs, there is little incentive or restraining forces to limit demand for care. Not recognizing or not addressing this essential underlying cause of the health-care expense “illness”, the current health-care “reform” proposals effectively would place more people into the same unsustainable insurance system, and would only make the “illness” worse.
To achieve meaningful health-care cost control, any reform must include shifting the primary payment responsibility of routine medical care expenses and a higher percentage of initial extraordinary health-care expenses to the consumer of those services. Third party health-care payers would then be responsible for extraordinary medical expense above this higher consumer payment threshold. Much like high deductable auto or property insurance, health-care premiums for such policies would be significantly lower than for low deductible policies. The individual consumer could then apply the premium savings to payment of routine health-care and/or to payment of their portion of extraordinary medical expenses. Such a system would decrease demand for health-care services and therefore expenditures for health-care services. Further, the system would incentivize the individual consumer to demand more accountability and transparency with regard to quality and cost of those services from the providers of health-care services e.g. physicians and hospitals. This accountability and transparency would also indirectly promote lower implant and medication costs.
Such reform in fact has been proposed in Congress but has not received any serious discussion or even consideration by the Democrat majority. The critical component of these proposals is expansion of Health Savings Account insurance. These policies include high deductibles, low premiums, and individual owned and controlled tax-favored health-care savings accounts. HSAs are not the entire solution to our health-care problems but would logically and effectively address a key cause of our health-care “illness”.
Two years ago facing yet another significant annual increase of our health-care premiums, Orthopaedic and Spine Specialists discarded traditional health-care insurance and implemented an HSA policy. OSS pays a significant portion of the premium and annually funds the health savings accounts with roughly 70% of the annual (high) deductable amount for our employees. Although the change did involve some effort to educate ourselves and our employees about the mechanics of the program, last year was the first that our premium did not increase and it appears the premium will remain stable again this year.
Indisputably, we need health-care reform but successful reform requires thoughtful and rational policy formulation, utilizing traditional American economic free market values; not hastily crafted, misconceived and intrusive government policies.
There is no problem so bad that it can’t be made worse by doing the wrong thing.
We must all fight to prevent the wrong kind of health-care reform and the dangerous expansion of government control and debt. Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and/or other free market based grass roots organizations.
Health-care costs currently account for 18% of our GDP and that percentage is projected to nearly double in the next 20 years. Escalating health-care costs place ever increasing financial burdens on families and businesses, threatening the long-term viability of our economy, the long-term solvency of our state and Federal governments, and, in the end, our opportunity and our children’s opportunity to live the American Dream. As needed for treating medical illness, successful treatment of this national health-care “illness, first requires thoughtful analysis to determine and identify the underlying causes of this “illness”.
While multiple factors contribute to ever increasing health-care costs, our health-care insurance system, which effectively disconnects the consumer of health-care services from the immediate cost of that care, is the essential driver of those costs. Certainly, the insurance premium cost is felt directly by the consumer who may pay for part or the entire premium, and/or felt indirectly through reduced wage dollars that are instead paid as health-care insurance employee benefit. However, once that premium is paid, there is little incentive not to use health-care services as much as one desires. Health-care insurance in our country is unlike any other type of insurance. Imagine the cost of auto insurance, if having paid the insurance premium one could have as much automobile as they desired or the cost of home owner’s insurance, if having paid the premium, one could have as much home as they desired. Once inside the health-care insurance system, the demand for services becomes almost unlimited. As a result, the cost to get into this system, i.e. the insurance premium, continually increases. In turn, the premium becomes unaffordable for more and more Americans or places increasing financial stress on families and businesses that continue to purchase health-care insurance.
The same mechanism drives the continually increasing Medicare and Medicaid expenses and propels those programs further into insolvency. As with the private health-care insurance, once inside the government (taxpayer) health-care programs, there is little incentive or restraining forces to limit demand for care. Not recognizing or not addressing this essential underlying cause of the health-care expense “illness”, the current health-care “reform” proposals effectively would place more people into the same unsustainable insurance system, and would only make the “illness” worse.
To achieve meaningful health-care cost control, any reform must include shifting the primary payment responsibility of routine medical care expenses and a higher percentage of initial extraordinary health-care expenses to the consumer of those services. Third party health-care payers would then be responsible for extraordinary medical expense above this higher consumer payment threshold. Much like high deductable auto or property insurance, health-care premiums for such policies would be significantly lower than for low deductible policies. The individual consumer could then apply the premium savings to payment of routine health-care and/or to payment of their portion of extraordinary medical expenses. Such a system would decrease demand for health-care services and therefore expenditures for health-care services. Further, the system would incentivize the individual consumer to demand more accountability and transparency with regard to quality and cost of those services from the providers of health-care services e.g. physicians and hospitals. This accountability and transparency would also indirectly promote lower implant and medication costs.
Such reform in fact has been proposed in Congress but has not received any serious discussion or even consideration by the Democrat majority. The critical component of these proposals is expansion of Health Savings Account insurance. These policies include high deductibles, low premiums, and individual owned and controlled tax-favored health-care savings accounts. HSAs are not the entire solution to our health-care problems but would logically and effectively address a key cause of our health-care “illness”.
Two years ago facing yet another significant annual increase of our health-care premiums, Orthopaedic and Spine Specialists discarded traditional health-care insurance and implemented an HSA policy. OSS pays a significant portion of the premium and annually funds the health savings accounts with roughly 70% of the annual (high) deductable amount for our employees. Although the change did involve some effort to educate ourselves and our employees about the mechanics of the program, last year was the first that our premium did not increase and it appears the premium will remain stable again this year.
Indisputably, we need health-care reform but successful reform requires thoughtful and rational policy formulation, utilizing traditional American economic free market values; not hastily crafted, misconceived and intrusive government policies.
There is no problem so bad that it can’t be made worse by doing the wrong thing.
We must all fight to prevent the wrong kind of health-care reform and the dangerous expansion of government control and debt. Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and/or other free market based grass roots organizations.
Monday, September 7, 2009
My Experience in Government Medicine
When I was in orthopaedic training, I joined the Army Reserve. The Army supplemented my limited resident income and I assumed a 6 year reserve obligation to serve in the Reserve. Upon completion of my 5 year residency at Penn State University Hershey Medical Center and a subsequent 6 month fellowship in spine surgery at the University of Rochester, the Army posted me to a local hospital reserve unit intending for me to drill with the unit 1 weekend a month. Knowing that the Army could better utilize my training and skills for which they helped pay, I sent such a letter inquiring where they might better use the services of a board eligible newly trained orthopaedic and spine surgeon. Subsequently, I was assigned to the Dunham Medical Clinic at the Army War College in Carlisle, PA.
Once a month, I would leave my private practice in York and run an orthopaedic clinic at Dunham primarily seeing military retirees. Very quickly, I became aware of significant differences between my 2 practices. At Carlisle, I was taken aback by my patient schedule, being assigned 3 patients an hour for 3 hours, then an hour for comp time, an hour for lunch and then 2 more hours of patient visits in the afternoon. I quickly revised my schedule so I could see 50% more patients and still evaluate and implement an appropriate diagnostic and treatment plan.
Further, in York, I provided care to individuals from the York community; while at Dunham, I was seeing patients from a 150 or more mile radius. When I inquired of my patients why they travelled so far, I learned that otherwise they would likely be traveling just as far to Walter Reed Army Hospital in Washington for orthopaedic consultation where there was a many week wait for a non-urgent consult. My patients in York typically were seen within a week or so.
Finally, ordering advanced diagnostics or planning surgery within the military system proved to be difficult and untimely. In York, if I saw a patient who needed an MRI, that MRI could be obtained within a day or two. If surgery, were recommended that could occur within a week or two. In the military system, obtaining an MRI involved a couple month wait and surgery a several month wait for non-emergent problems.
At the time, I had 2 distinct thoughts about the practice differences. First, I felt that there would never be nationalization of our health system because people would not tolerate such slow delivery of care (now I recognize that nationalization could take place against the will of the majority). Even more, it struck me to be manifestly unfair that military retirees, men and woman who had served their country should have second rate care. In practice, uninsured patients in York enjoy more responsive care than those military retirees.
Again, there is no doubt that our healthcare system, which draws people from all over the world because of its premier status, would benefit from reform to decrease expenses and improve access; however there is no problem so bad that it can’t be made worse by doing the wrong thing. More government involvement in healthcare is the wrong thing.
We must all fight to prevent the wrong kind of healthcare reform and the dangerous expansion of government control and debt. Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and/or other free market based grass roots organizations.
Once a month, I would leave my private practice in York and run an orthopaedic clinic at Dunham primarily seeing military retirees. Very quickly, I became aware of significant differences between my 2 practices. At Carlisle, I was taken aback by my patient schedule, being assigned 3 patients an hour for 3 hours, then an hour for comp time, an hour for lunch and then 2 more hours of patient visits in the afternoon. I quickly revised my schedule so I could see 50% more patients and still evaluate and implement an appropriate diagnostic and treatment plan.
Further, in York, I provided care to individuals from the York community; while at Dunham, I was seeing patients from a 150 or more mile radius. When I inquired of my patients why they travelled so far, I learned that otherwise they would likely be traveling just as far to Walter Reed Army Hospital in Washington for orthopaedic consultation where there was a many week wait for a non-urgent consult. My patients in York typically were seen within a week or so.
Finally, ordering advanced diagnostics or planning surgery within the military system proved to be difficult and untimely. In York, if I saw a patient who needed an MRI, that MRI could be obtained within a day or two. If surgery, were recommended that could occur within a week or two. In the military system, obtaining an MRI involved a couple month wait and surgery a several month wait for non-emergent problems.
At the time, I had 2 distinct thoughts about the practice differences. First, I felt that there would never be nationalization of our health system because people would not tolerate such slow delivery of care (now I recognize that nationalization could take place against the will of the majority). Even more, it struck me to be manifestly unfair that military retirees, men and woman who had served their country should have second rate care. In practice, uninsured patients in York enjoy more responsive care than those military retirees.
Again, there is no doubt that our healthcare system, which draws people from all over the world because of its premier status, would benefit from reform to decrease expenses and improve access; however there is no problem so bad that it can’t be made worse by doing the wrong thing. More government involvement in healthcare is the wrong thing.
We must all fight to prevent the wrong kind of healthcare reform and the dangerous expansion of government control and debt. Every individual can make a difference. Write your congressman and senators (contact info found at http://www.conservativeusa.org/mega-cong.htm); and join and contribute your time, energy, and money as you are able to grass root organizations such as the American’s for Prosperity http://americansforprosperity.org/national-site, American Liberty Alliance http://americanlibertyalliance.com/, and/or other free market based grass roots organizations.
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