Barack Tells Congress To Get Off Their Pork-Filled Butts

Barack Obama is apparently not happy with the progress, or lack thereof, that his Legislative Glee Club is making on putting together a health care reform proposal. So, in true “Yes, we can!” form, he has decided to roll up his sleeves and write the thing himself. Well, when he gets back from France anyway.

According to the Associated Press: “The White House, backing away from President Barack Obama’s ‘it’s-all-on-the-table’ approach initially advocated, prepared to get louder and more involved in the details of a health care overhaul that officials once were content to leave to Congress, administration officials said Saturday.”

This certainly explains why Obama has backed off on his campaign promise not to tax health care benefits. Remember when he blasted John McCain for even suggesting that taxing employer paid health coverage payments was a viable option? I think his comment was something to the effect that the last thing the American worker needed was increased taxes.  In the interest of getting some form of reform through before what’s left of his political capital washes away in a sea of spending, he’s leaving all the options open.

So, for those who haven’t been keeping up, let’s see where the health care debate is right now. It’s important to understand the plan options that are being thrown around, especially since the President is bound and determined to have a plan finalized and approved by the end of the year. This means he will need to get something rolling on Capitol Hill before Congress goes off to Summer camp.

To review the issues:

Health care costs: Wayyy too high
Health care quality: Wayyy too low
Americans without health care: 46,000,000
Estimated cost to expand health care coverage to include them: $1.2 trillion greenbacks (over a ten year period)

Do we need reform?  Definitely.  I think most people on both sides of the political fence would agree that our health care system is bloated and broken.  The debate rages around the measures that need to be taken to fix it.

The two primary points of contention?

One, should health care coverage be mandatory for all Americans? Why make insurance coverage mandatory?  Why should I care if you have insurance coverage or not?  Because if you don’t have coverage and get hospitalized, you may not be able to pay your medical costs.  You will default on them and they will be passed on to me in the form of taxes and/or an increase in my medical coverage premiums.  So coverage for all reduces costs for all.

Obama was against this during the campaign.  It was a Hillary rallying cry that Barack opposed in favor of a more incremental approach where coverage would first be mandatory for children only.  I believe his opposition was more of a pragmatic “there’s no way we could make this happen immediately” than a disagreement over an ultimate goal.

Well, now he appears to be open to this requirement, which is being promoted by Democratics and some Republicans in both sides of the house, being made a part of the initial bill.  Again remember, goal number one for Obama is to get a health care reform bill passed this year.  Therefore, compromise where necessary.  He does mandate that a “hardship” exclusion be a part of the bill which would exempt certain people unable to afford the cost of coverage.  What constitutes a “hardship” is an open question.

The trick is that to make health care coverage mandatory, alot of work will have to be done to clean up the existing medical system to reduce the waste and inefficencies that have resulted in the upward spiral in treatment costs.  Reduce treatment costs and presumably you reduce the cost of providing coverage for them.

There also would need to be a clear understanding of what mandatory coverage includes?  Presumably some baseline for the minimum accepted coverage levels would be defined.  But again, until there is reform in the medical treatment system that reduces waste and costs, trying to enforce mandatory coverage is putting the cart before the horse.

The other main point of contention in the battle to put a health care reform bill together is whether the bill should include the formation of a government-run public insurer agency.  This agency would serve to, theoretically, provide a low-cost alternative to the private insurance that is typically subsidized by employers.  This would not be a totally new role for the government, as it already does such a *great* job running Medicare and Medicaid.

There are obvious reasons why most Republicans and many of the moderate Democrats are against this.  It’s anti-business.  A government managed health insurer would have the leverage to force doctors, hospitals, big pharma, and other players in the game of medicine, to cut costs.  A good thing, right?  Usually.

But what has happened with Medicare, is that all the government cost cutting has led to a significant reduction in the quality of medical care for those who are covered.

The health insurance industry, with the backing of the pharm companies, is lobbying really hard against the formation of a government-run public insurer agency.  This is purely in their best interest.  They don’t want to be in competition with the government.  From a cost standpoint, it’s a war they will not win.  Not when the government can strong arm the medical field into cutting costs and even subsidize coverage costs with taxes.  Definitely an unlevel playing field.

Health insurers are fighting back.  They state that “a public plan won’t be needed if reformers successfully expand coverage to the uninsured through mandated insurance and guaranteed issuance of policies, find ways to control medical costs, prohibit exclusions for pre-existing conditions, and provide subsidies to help people afford coverage.”

So, it would appear that due to Obama’s pushing, health care reform is coming.   At this point it really seems to boil down to a race between the existing insurer industry and the government to create a proposal that is palatable to the populace.

I really have little faith that the insurers can band together and create a package that will force them to clean up their own act by reducing costs, expand coverage to the uninsured, and upgrade the quality of care provided.  Especially when they’re up against a current administration and Congress that has shown a willingness, and even an enthusiasm, for throwing buckets and buckets of money at a problem.

We’ll get a public health insurance agency of some type.  And we’ll be paying through the nose for it.

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Barack Obama Says Grow Old and Die

Barack Obama’s newly passed stimulus package is supposed to provide a jump start to the economy. Providing tax cuts to stimulate spending and infrastructure projects to stimulate jobs, the 1200+ page bill is being represented as a much needed shot in the arm for the economy.

Well, it’s a shot to the heart for many people. They just don’t know it yet.

Among the hundreds of pages of the bill are a couple of health care provisions that radically change the way the medical field will be allowed to treat patients. Authored by Tom Daschle, the latest in a long line of problematic cabinet nominees, the provisions cover a couple of key areas.

The first is the establishment of a federal system to electronically track and store medical records for “every individual in the United States”. This will allow for the centralization of your health records and, in theory, will eliminate the need for the manual transfer of your records every time you see a new doctor. In addition, duplication of records and erroneous treatment histories should be minimized under this new central tracking system. Again, in theory.

Okay, aside from the potential privacy issues, the creation of a centralized records system is probably a good idea. Nice to know all your records are consistent and accessible to the doctors that need to see them.

But the bill doesn’t stop there.

The bill also provides for the creation of a new federal bureaucracy called the National Coordinator of Health Information Technology. This agency will monitor your medical treatments to ensure that your physician is only providing what the federal government deems appropriate and cost effective. The underlying intent is to cut health care costs by “guiding” your doctor’s decisions around treatment.

I am all for doctors being kept informed of the latest medical developments and treatment options, but not for the federal enforcement of treatment uniformity across the medical profession. Doctors are being told not to think, but to follow what will be regimented step by step treatment options for most any disease or illness.

Who gets hit hardest by this? The elderly.

According to Daschle, reform of the health care system will “not be pain free”. He alludes to the fact that senior citizens should accept the onset of age related conditions instead of seeking treatment for them. Currently, Medicare pays for treatment deemed effective and safe. The stimulus bill provision will change that and implement a cost-effectiveness factor into the treatment options to be offered. In other words, Medicare will no longer cover many of the treatments currently being prescribed to our parents and grandparents.

And who determines these cost-effectiveness standards? Another new federal agency called the Federal Council.

The Federal Council is modeled after a U.K. government agency that establishes treatment standards based on calculations related to condition severity, cost of treatment, and the patient’s expected years left to live.

As an example of how the new U.S. system would work, in 2006 this U.K. agency decreed that elderly patients suffering from macular degeneration would not receive treatment utilizing a costly but effective drug until they actually went blind in one eye. It took three years before public protest forced the agency to reverse that decree.

This is the health care system we are moving to. This is the first of many changes that certain politicians have been trying to push through since the Clinton administration. And the only reason you haven’t heard more about it is because this time they were smart enough to hide the provisions in a massive “we need it now or disaster will befall us” stimulus bill.

Prior to the bill being passed, President Barack Obama said it was “inexcusable and irresponsible” for senators to delay passage. Using guilt and misplaced public sentiment, Barack Obama has set the wheels in motion to nationalize health care in the United States.

The U.S. Constitution states “Bring us your sick, huddled masses”. I guess we’ll now need to add “Just don’t expect to get any better”.

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