Would it be malpractice if a doctor examined a patient, discovered cancer and a head cold and only treated the head cold? What if the doctor didn’t tell the patient about the cancer or told the patient that he’d take care of the cancer later? What if the doctor told the patient that curing the head cold would fix the cancer?
What if the doctor did this because treating a cold is easy and dealing with cancer is less pleasant? With cancer there is the cost, the time consuming nature of treatment, the emotion, and less chance for a permanent cure.
I’m guessing your answer to the question - “Would it be malpractice?” - would be yes and I’ll further speculate that you’d volunteer to be on the jury, just so you could be sure that justice is done? Am I right?
Here’s the reality of the Health Care and Health Care Financing Reform initiative being addressed in Washington. Our elected leaders - the President and Congress, the lobbyists that fund them, the special interests that elect them, and the Political Parties that exist to support them are - IN MY OPINION - guilty of malpractice.
They are telling us - the American people - that we’ve got a problem. They have correctly diagnosed the problem to be the cost, quality, and accessibility of Health Care. Unfortunately after that, their priorities, diagnosis, and prognosis are at best misunderstood, their efforts misdirected, and intentions self serving - they are being negligent or worse. At worst they are ignoring what they know needs to be done.
Here are the facts - our current health care system is great for some, limited in effectiveness for others, and not available too many. Its current cost is over $7,500 for every man, woman, and child and trending at a level that will double this cost in 6 - 8 years. Our current system is not sustainable. Our system is “infected” with two diseases of cost - one is the financing (insurance / Medicare /etc.) and the other is the delivery of care. Financing is our “cold” - the cost of delivery is the “cancer.”
Our elected officials are all focusing on the “financing” because (in their words) “insurance companies are evil (dishonest)” - the insurance industry is an easy “dog to kick.” The reality is that the cost of delivering care dictates the cost of insurance. For every premium dollar you spend 15 - 25% goes to the insurance company, while 75 - 85% goes to doctors, hospital companies, pharmaceuticals, etc.
If we cure the cold by eliminating insurance companies - we wouldn’t even save the quarter since some other payment mechanism would have to be developed. As a practical matter if we discontinued those evil insurance companies - our costs for Medicaid and Medicare would instantly go up because right now the federal government in the Medicare system and the state and federal government in the Medicaid program intentionally under fund the providers (doctors, hospitals, etc.) knowing that these costs will be paid by / shifted to the insurance companies.
What if we first chose to treat the cancer - the cost of care in our country? What if we not only acknowledged that the quality of our care could be better but that even the best care can’t make us well if WE CHOOSE TO BE SICK? What if we acted on what we know? Diet and exercise will fix obesity quicker, cheaper and longer than will gastric bypass surgery and pills that are temporary solutions at best.
What if we recognized that all of us are individuals made up of mind, body, and spirit and our ideal condition is “wellness” not sickness yet our Health Care System is built upon a “body” focus and a treatment of “sickness?” Add wellness and fitness diagnoses / protocols to the ICD 9 Codes. Pay doctors for these outcomes.
What if we acknowledged that the simple aspirin is the most effective medicine in Health Care today? What if we acknowledged that there are better answers than a prescription drug for every disease - every time - all the time?
What if we recognized that the most inefficient, costly, limited tool in our medical bag is the ink pen? Its usage has caused malpractice claims, creates massive problems with HIPAA, storage of documents, copies, etc. Left unchecked it encourages redundancy and waste. In the hands of the wrong player it can lead to fraud. What if we did in HC what every other segment of the economy has done - leverage technology to reduce paper, enhance efficiency, and improve effectiveness?
What if we chose to leverage technology not just for better care but for enhanced administration of care? What if we embraced a system that captures all information about our diagnoses, protocols established, and outcomes achieved? What if we used this to determine best practices and best of class procedures?
What if we used this technology to take us paperless, make regulation less onerous (eliminating over a hundred thousand pages of regulation that exist today)? What if we made lawyers the least utilized “specialist” in our system? What if we only allowed lawsuits for gross negligence or criminal acts and created a “no fault” (workers comp type) system to compensate patients for other bad results.
What if we acknowledged that there is and will be well into the future a significant shortage of physicians and other health care providers and leveraged technology (telemedicine) to create integrated care delivery teams that can deliver quality care that is readily available and affordable? What if we used licensing laws to assure all practitioners were qualified inside the context of their profession not to protect turf?
What if we redefined hospitals to the needs of their communities and recognized centers of excellence can do work better and less expensively and we used these centers for the most costly, high risk procedures? What if added incentives and disincentives to encourage individuals to eat better, exercise more, seek most appropriate care? What if we focused first on the cancer then on the cold?
What if Congress “treated” the cost of care first and financing second? What if?
Copyright - Michael G. Manes (November 6, 2009)
All rights reserved
Friday, November 6, 2009
Friday, October 23, 2009
The Delcambre Canal - A Health Care Reform Model
What follows is a brief factual recap of a disaster and an “assumption” that might be the model needed for Health Care Reform. The Delcambre Canal is 1.2 miles south of Lake Peigneur. The Delcambre Canal forever had “flowed” water from the Lake to Vermillion Bay. The Delcambre Canal was an outlet for Lake Peigneur.
The facts are - (Wikipedia) November 20, 1980 a 14 inch drill bit from a Texaco oil rig penetrated the roof of the Diamond Crystal Salt Mine at Jefferson Island Louisiana. “This turned an almost 10-foot deep freshwater lake into a saltwater lake with a deep hole… So much water drained into those caverns that flow of the Delcambre Canal that usually empties the lake into Vermillion Bay was reversed, making the canal a temporary inlet.” These are facts… Now the assumption:
Somewhere along the Delcambre Canal there was a Cajun who has spent his entire life in a suspended animation - created by consumption of vast amounts of alcohol. On that November day when the Canal reversed itself, our Cajun friend had taken Old Crow from his pocket for his next drink. I’m assuming he looked down saw the change in water flow, poured out the remaining liquor, asked forgiveness from the good Lord, and changed is life forever - now he’s dry, prayerful, and better.
The Miracle of the Delcambre Canal was not that it reversed its flow - the Miracle is that our Cajun Friend changed his life - he became a new, better person - dry, thoughtful, prayerful, and productive. This is our hope for Health Care Reform.
Most agree that the “birth” of today’s health insurance system was in 1929 at Baylor University when teachers were guaranteed 21 days of hospital care for $6 a year. The insurance system created began the flow of dollars to providers as reimbursement for the care they provided and simultaneously began the intoxication of the patient / consumer to spend other peoples’ money (OPM). Now 80 years later - we none know or understand the cost of the care we demand, or utilize. We’ve gone from premiums of $6 a year per individual to over $3,000.
Like our Cajun Friend we, as the users of and payers for health care, need a life changing experience. We need to realize the problem is not just the dollars flowing into the system but the health of the population, the care provided, and waste, fraud, and inefficiency that overwhelm the system. All of us - consumers that use care, those that pay for it, those that provide it, and those that impact the system in any way - must become more responsible, thoughtful, accountable, and practical.
We must eat less and better, exercise more, seek care only when needed and demand quality for the care provided. Payment systems must “incent” better results for less cost. Regulation, paperwork, lawsuits, and defensive medicine must be reduced. Wellness, research, preventive care, etc. must be enhanced. We must spend less on facilities and more on results - less on advertising designer drugs and more to reduce use of prescriptions. We must all be responsible. We must all change…
Copyright - Michael G. Manes (October 2009)
All rights reserved
The facts are - (Wikipedia) November 20, 1980 a 14 inch drill bit from a Texaco oil rig penetrated the roof of the Diamond Crystal Salt Mine at Jefferson Island Louisiana. “This turned an almost 10-foot deep freshwater lake into a saltwater lake with a deep hole… So much water drained into those caverns that flow of the Delcambre Canal that usually empties the lake into Vermillion Bay was reversed, making the canal a temporary inlet.” These are facts… Now the assumption:
Somewhere along the Delcambre Canal there was a Cajun who has spent his entire life in a suspended animation - created by consumption of vast amounts of alcohol. On that November day when the Canal reversed itself, our Cajun friend had taken Old Crow from his pocket for his next drink. I’m assuming he looked down saw the change in water flow, poured out the remaining liquor, asked forgiveness from the good Lord, and changed is life forever - now he’s dry, prayerful, and better.
The Miracle of the Delcambre Canal was not that it reversed its flow - the Miracle is that our Cajun Friend changed his life - he became a new, better person - dry, thoughtful, prayerful, and productive. This is our hope for Health Care Reform.
Most agree that the “birth” of today’s health insurance system was in 1929 at Baylor University when teachers were guaranteed 21 days of hospital care for $6 a year. The insurance system created began the flow of dollars to providers as reimbursement for the care they provided and simultaneously began the intoxication of the patient / consumer to spend other peoples’ money (OPM). Now 80 years later - we none know or understand the cost of the care we demand, or utilize. We’ve gone from premiums of $6 a year per individual to over $3,000.
Like our Cajun Friend we, as the users of and payers for health care, need a life changing experience. We need to realize the problem is not just the dollars flowing into the system but the health of the population, the care provided, and waste, fraud, and inefficiency that overwhelm the system. All of us - consumers that use care, those that pay for it, those that provide it, and those that impact the system in any way - must become more responsible, thoughtful, accountable, and practical.
We must eat less and better, exercise more, seek care only when needed and demand quality for the care provided. Payment systems must “incent” better results for less cost. Regulation, paperwork, lawsuits, and defensive medicine must be reduced. Wellness, research, preventive care, etc. must be enhanced. We must spend less on facilities and more on results - less on advertising designer drugs and more to reduce use of prescriptions. We must all be responsible. We must all change…
Copyright - Michael G. Manes (October 2009)
All rights reserved
Sunday, October 18, 2009
Health Care Financing is like a pipeline
Health Care Financing is like a pipeline. On one side of the line - dollars flow in. On the other side of the line dollars flow out. Looking a little closer we learn that the dollars flowing in are premium dollars, tax dollars, and out of pocket expenses provided by individual consumers. On the opposite end of the line dollars flow out to pay the cost of health care, the administrative cost of delivering care, the cost of the legal / defensive medicine systems, and the cost of funding the care.
The ownership of this pipeline is shared. For profit insurance companies, not for profit companies, and the government are all invested in the line. For profits want extra dollars out to reward their stockholders, not-for-profit companies need extra dollars as reserves, and governments must have equal dollars in and out to avoid a deficit. If dollars in and dollars out don’t match up - the pipeline could collapse.
The problems we face today are not in the design, construction, or operation of the pipeline. The problem is simple - we the people want to use the legislative, regulatory, and consumer advocacy process to tighten the “valve” on the “dollars in” end of the line. We also want to use this same political, regulatory, and advocacy process to open the “valve” on the “dollars out” - payment end of the line.
All of us want to put in as few (premium, tax, and out of pocket) dollars as possible and simultaneously pay out maximum dollars for the “sick” folks. To make matters worse - the government (federal [Medicare] / state and federal [Medicaid]) chooses not to put in adequate dollars to cover the care they provide to their constituents so the private payers (insurance companies) must put in more than they really owe.
As an example - in 2007 in Louisiana insurance companies paid 133% more for the actual care utilized by their policyholders. This was necessary because the state’s Medicaid program was under funded by 12% and the Medicare program shorted the providers by 9%. (Adapted from the AHA and Avalere Health TrendWatch Chartbook 2007: Trends Affecting Hospitals and Health Systems)
Today - all agree that the pipeline is broken. The vast majority of our population that pays the premiums and taxes to fund this line has said, “ENOUGH!” Magnifying this problem is that most of the folks funding this adventure are not big users of the care they are funding. Most of the population is chronically well.
The average family that is insured is paying over $13,000.00 a year in premiums and other dollars in taxes and only recovering a small percentage of their contribution in claims. Now “reformers” are promising to add more users to the line.
The line is broken. To fix it we can’t focus only on the end of the line that flows dollars in - we must address the end that flows dollars out. We each must accept some responsibility for our individual health, exercise, diet, and utilization of care. We the people are part of the problem and must become part of the solution.
Copyright - Michael G. Manes (October 2009)
All rights reserved
The ownership of this pipeline is shared. For profit insurance companies, not for profit companies, and the government are all invested in the line. For profits want extra dollars out to reward their stockholders, not-for-profit companies need extra dollars as reserves, and governments must have equal dollars in and out to avoid a deficit. If dollars in and dollars out don’t match up - the pipeline could collapse.
The problems we face today are not in the design, construction, or operation of the pipeline. The problem is simple - we the people want to use the legislative, regulatory, and consumer advocacy process to tighten the “valve” on the “dollars in” end of the line. We also want to use this same political, regulatory, and advocacy process to open the “valve” on the “dollars out” - payment end of the line.
All of us want to put in as few (premium, tax, and out of pocket) dollars as possible and simultaneously pay out maximum dollars for the “sick” folks. To make matters worse - the government (federal [Medicare] / state and federal [Medicaid]) chooses not to put in adequate dollars to cover the care they provide to their constituents so the private payers (insurance companies) must put in more than they really owe.
As an example - in 2007 in Louisiana insurance companies paid 133% more for the actual care utilized by their policyholders. This was necessary because the state’s Medicaid program was under funded by 12% and the Medicare program shorted the providers by 9%. (Adapted from the AHA and Avalere Health TrendWatch Chartbook 2007: Trends Affecting Hospitals and Health Systems)
Today - all agree that the pipeline is broken. The vast majority of our population that pays the premiums and taxes to fund this line has said, “ENOUGH!” Magnifying this problem is that most of the folks funding this adventure are not big users of the care they are funding. Most of the population is chronically well.
The average family that is insured is paying over $13,000.00 a year in premiums and other dollars in taxes and only recovering a small percentage of their contribution in claims. Now “reformers” are promising to add more users to the line.
The line is broken. To fix it we can’t focus only on the end of the line that flows dollars in - we must address the end that flows dollars out. We each must accept some responsibility for our individual health, exercise, diet, and utilization of care. We the people are part of the problem and must become part of the solution.
Copyright - Michael G. Manes (October 2009)
All rights reserved
Sunday, October 4, 2009
Racism - Lemons and Lemonade
If the seven deadly sins (lust, gluttony, greed, sloth, wrath, envy, and pride) were being updated today, it is possible that Racism might be added or maybe hate would be added and racism would be included as an example in the definition. If a committee was formed to update this Top 7 List of Sins, I am certain there would be special interest groups to lobby for the inclusion of racism.
Racism is. It’s a bitter lemon in life - so is hate. Some might consider the 7 deadly sins life’s lemons as well. My observation is that the 7 sins as written are lemons we consume or that consume us. Racism and hate (most don’t see themselves as Racists or haters) are lemons that others consume and that we let make us sick. We can control 7 sins. We can’t control Racism (since we’re not racists / haters).
Jimmy Carter blamed significant numbers of Racists for the challenges that President Obama faces as he moves his agenda forward. Since Carter’s comments the media is consumed by discussions of the topic. Racism is the new Swine Flu.
In the name of full disclosure - I’m a “pink” American from the South. I’ve been a Democrat and Republican twice each. Nixon made me a Democrat and Carter made me a Republican. My history includes Native American blood, Cajuns exiled from Nova Scotia, mental illness, leprosy (Hansen’s Disease), and poverty. We all have problems and history. We never owned slaves. The “N” word was not allowed in our home. Two of the women that most influenced my childhood were black.
I believe some white people hate other folks because they are “colored” and I believe some black and brown people hate white folks because they aren’t. I believe there are “nuts” on the two ends of the Bell Curve we call America. In the middle you have the group that makes this country work. I believe most of us just want independence, jobs, opportunity, and progress - a better life for us and our kids.
If Ronald Reagan was black, would liberals and academics be demonstrating in Washington D.C.? If Thomas Sowell or Colin Powell was President today and was pursuing a right of center agenda, would there be as many people upset? Is today’s issue RACE or POLITICS? If Carter is right - Racists elected the President.
Henry Ford said, “If you think you can or you think you can’t, you are right.” I agree. I believe for some folks of color - Racism is motivation to work harder to succeed. For others it’s an excuse why they can’t. If liberals, democrats, and the Als and Jesses of the world dropped the “R” word for one year and focused all their efforts on teaching that personal growth can come through adversity - where would we be in 2011? What if every parent started showing their children how they can succeed versus saying why they can’t, what would happen? If the Great Society had “incented” personal responsibility versus “entitlement,” where would we be today?
Is it time to turn our lemons into lemonade? I think it is. Want some lemonade?
Copyright - Michael G. Manes
All rights reserved
Racism is. It’s a bitter lemon in life - so is hate. Some might consider the 7 deadly sins life’s lemons as well. My observation is that the 7 sins as written are lemons we consume or that consume us. Racism and hate (most don’t see themselves as Racists or haters) are lemons that others consume and that we let make us sick. We can control 7 sins. We can’t control Racism (since we’re not racists / haters).
Jimmy Carter blamed significant numbers of Racists for the challenges that President Obama faces as he moves his agenda forward. Since Carter’s comments the media is consumed by discussions of the topic. Racism is the new Swine Flu.
In the name of full disclosure - I’m a “pink” American from the South. I’ve been a Democrat and Republican twice each. Nixon made me a Democrat and Carter made me a Republican. My history includes Native American blood, Cajuns exiled from Nova Scotia, mental illness, leprosy (Hansen’s Disease), and poverty. We all have problems and history. We never owned slaves. The “N” word was not allowed in our home. Two of the women that most influenced my childhood were black.
I believe some white people hate other folks because they are “colored” and I believe some black and brown people hate white folks because they aren’t. I believe there are “nuts” on the two ends of the Bell Curve we call America. In the middle you have the group that makes this country work. I believe most of us just want independence, jobs, opportunity, and progress - a better life for us and our kids.
If Ronald Reagan was black, would liberals and academics be demonstrating in Washington D.C.? If Thomas Sowell or Colin Powell was President today and was pursuing a right of center agenda, would there be as many people upset? Is today’s issue RACE or POLITICS? If Carter is right - Racists elected the President.
Henry Ford said, “If you think you can or you think you can’t, you are right.” I agree. I believe for some folks of color - Racism is motivation to work harder to succeed. For others it’s an excuse why they can’t. If liberals, democrats, and the Als and Jesses of the world dropped the “R” word for one year and focused all their efforts on teaching that personal growth can come through adversity - where would we be in 2011? What if every parent started showing their children how they can succeed versus saying why they can’t, what would happen? If the Great Society had “incented” personal responsibility versus “entitlement,” where would we be today?
Is it time to turn our lemons into lemonade? I think it is. Want some lemonade?
Copyright - Michael G. Manes
All rights reserved
Tuesday, September 29, 2009
What would Maslow say?
Ambraham Maslow (1908 - 1970) was a psychologist and theorist and a leader in the humanistic school of psychology. He is noted for his “hierarch of needs” - a theory presenting human needs (survival, security, social, self-esteem, and self-actualization) as rungs on a ladder. The belief was that unmet needs motivate.
Theorists “think” more than they “do” so it might be interesting to hear Maslow's thoughts today. He now has the background of decades of history and can compare his theory to actual behavior. Here’s what I believe he might say.
“Ladies and Gentlemen, thanks for inviting me here today. I’ll be brief. With the benefit of an eternal prospective and a background of current civilization (I use the term lightly) I’ll offer the following retrospective on my theory.
I developed my “ladder” in the “hope of tomorrow.” I believed that was the secret to mental health and human potential. I focused on the self-actualization of individuals - those who had found professional and personal success and fulfillment. The rungs on the ladder to me represented working through unmet needs and the achievement of the pinnacle by accomplishment of this process.
Unfortunately at some point in time the practice of “entitlement” distracted us into believing that the government, our parents, or others could deliver achievement to us without our working for it. Self-actualization is being happy in your own skin but it assumed obtaining scar tissue on that skin. So much for assuming…
Self-esteem is earned success. Again I failed to realize that parents (and sometimes government and others as surrogate parents) with good intentions would protect children from falling physically, emotionally, financially, etc. and in so doing would create a “right or guarantee” to happiness versus a “right” to opportunity and the pursuit of happiness. You can’t give success - it must be earned.
With my past including the great depression and two world wars, I could not have foreseen modern society that has so much and its citizens being so disadvantaged by it. Maybe I was distracted by the Ozzie and Harriet world of the 1950s but I didn’t or couldn’t predict the family dysfunction that has occurred and the crack created in our melting pot society. We are no longer being assimilated into one culture but have hyphenated ourselves into a world of diversity - a house divided - by entitlements and opinions but not bound by shared values. We’re not one society.
If I was creating my ladder today - the survival rung would include love and respect as necessities to our development. I never thought the family structure would have disintegrated as it has. I anticipated killings over food and water but never because someone “dissed me.” As night follows day - this disintegration of family makes necessary a new meaning for security - we need to take back our streets / our neighborhoods. Climbing the ladder builds strength that doesn’t come for free.”
Copyright - Michael G. Manes
All rights reserved
Theorists “think” more than they “do” so it might be interesting to hear Maslow's thoughts today. He now has the background of decades of history and can compare his theory to actual behavior. Here’s what I believe he might say.
“Ladies and Gentlemen, thanks for inviting me here today. I’ll be brief. With the benefit of an eternal prospective and a background of current civilization (I use the term lightly) I’ll offer the following retrospective on my theory.
I developed my “ladder” in the “hope of tomorrow.” I believed that was the secret to mental health and human potential. I focused on the self-actualization of individuals - those who had found professional and personal success and fulfillment. The rungs on the ladder to me represented working through unmet needs and the achievement of the pinnacle by accomplishment of this process.
Unfortunately at some point in time the practice of “entitlement” distracted us into believing that the government, our parents, or others could deliver achievement to us without our working for it. Self-actualization is being happy in your own skin but it assumed obtaining scar tissue on that skin. So much for assuming…
Self-esteem is earned success. Again I failed to realize that parents (and sometimes government and others as surrogate parents) with good intentions would protect children from falling physically, emotionally, financially, etc. and in so doing would create a “right or guarantee” to happiness versus a “right” to opportunity and the pursuit of happiness. You can’t give success - it must be earned.
With my past including the great depression and two world wars, I could not have foreseen modern society that has so much and its citizens being so disadvantaged by it. Maybe I was distracted by the Ozzie and Harriet world of the 1950s but I didn’t or couldn’t predict the family dysfunction that has occurred and the crack created in our melting pot society. We are no longer being assimilated into one culture but have hyphenated ourselves into a world of diversity - a house divided - by entitlements and opinions but not bound by shared values. We’re not one society.
If I was creating my ladder today - the survival rung would include love and respect as necessities to our development. I never thought the family structure would have disintegrated as it has. I anticipated killings over food and water but never because someone “dissed me.” As night follows day - this disintegration of family makes necessary a new meaning for security - we need to take back our streets / our neighborhoods. Climbing the ladder builds strength that doesn’t come for free.”
Copyright - Michael G. Manes
All rights reserved
Wednesday, September 16, 2009
Truth or Lies in Politics and Health Care Reform - Who knows?
Lying in politics is generally accepted in our country today. Calling down a politician as a liar is awkward. Calling the President a liar is more uncomfortable. Calling the President a liar while he’s speaking to the Congress is a break with tradition, rude, and by some folks’ belief outrageous.
I’d like to know… was Joe Wilson rude or wrong? More importantly was President Obama lying, telling the truth, making assumptions that he hoped were true or performing a miracle before our very eyes. I don’t know. Time will tell. I’ll offer the following and each of us can draw his / her own conclusions.
At one extreme, we have the benchmark for honesty provided by the legend of George Washington. This is the simple and unambiguous statement, “I cannot tell a lie - I cut down the Cherry tree.” At the other extreme we have (choose your Party) - Richard Nixon (R) proclaiming, “I am not a crook” and Bill Clinton (D) declaring, “I did not have sex with that woman, Miss Lewinsky.”
The most outrageous statement I’ve personally ever heard was made by Senator Chris Dodd, “Lobbyists’ dollars do not influence Congress.” I’ll say it - “Senator Dodd, you’re a liar, crazy, or too innocent to represent the American People.” The good news is that Mr. Clinton later provided us the legal framework to allow for review of ambiguity and lies with, “It depends upon what your definition of is, is.”
If I heard President Obama correctly he said that his plan would not add one cent to the federal deficit and would not increase our costs. He further indicated that he would veto a bill that increased costs or raised the deficit. Unfortunately I believe the laws of economics will dictate that costs go up or benefits are reduced.
The President said that pre-existing conditions will be outlawed as an underwriting tool. Therefore people who are “sick” can now buy coverage. When “sick” people enter the insurance pool, more claims are paid. This will raise costs. He said there will no longer be limits on the amount of coverage available (either annually or in a lifetime) in a health insurance policy. Coverage without limits will cost more than coverage with limits.
He promised that coverage will now be provided for health screenings and more preventive medicine (mammograms, colonoscopies, etc.). These procedures cost money - lots of money. Some studies indicate that catching diseases / conditions earlier raises the total cost for the population - it does not lower it.
President Obama pledged out of pocket costs will be capped. Deductibles, co-payments, and co-insurance lower premiums. Limiting the use of these tools will raise premiums and / or the cost of claims.
President Obama can sell - my question is, “What are we buying, a fix or fantasy?”
Copyright - Michael G. Manes (September 2009)
All rights reserved
I’d like to know… was Joe Wilson rude or wrong? More importantly was President Obama lying, telling the truth, making assumptions that he hoped were true or performing a miracle before our very eyes. I don’t know. Time will tell. I’ll offer the following and each of us can draw his / her own conclusions.
At one extreme, we have the benchmark for honesty provided by the legend of George Washington. This is the simple and unambiguous statement, “I cannot tell a lie - I cut down the Cherry tree.” At the other extreme we have (choose your Party) - Richard Nixon (R) proclaiming, “I am not a crook” and Bill Clinton (D) declaring, “I did not have sex with that woman, Miss Lewinsky.”
The most outrageous statement I’ve personally ever heard was made by Senator Chris Dodd, “Lobbyists’ dollars do not influence Congress.” I’ll say it - “Senator Dodd, you’re a liar, crazy, or too innocent to represent the American People.” The good news is that Mr. Clinton later provided us the legal framework to allow for review of ambiguity and lies with, “It depends upon what your definition of is, is.”
If I heard President Obama correctly he said that his plan would not add one cent to the federal deficit and would not increase our costs. He further indicated that he would veto a bill that increased costs or raised the deficit. Unfortunately I believe the laws of economics will dictate that costs go up or benefits are reduced.
The President said that pre-existing conditions will be outlawed as an underwriting tool. Therefore people who are “sick” can now buy coverage. When “sick” people enter the insurance pool, more claims are paid. This will raise costs. He said there will no longer be limits on the amount of coverage available (either annually or in a lifetime) in a health insurance policy. Coverage without limits will cost more than coverage with limits.
He promised that coverage will now be provided for health screenings and more preventive medicine (mammograms, colonoscopies, etc.). These procedures cost money - lots of money. Some studies indicate that catching diseases / conditions earlier raises the total cost for the population - it does not lower it.
President Obama pledged out of pocket costs will be capped. Deductibles, co-payments, and co-insurance lower premiums. Limiting the use of these tools will raise premiums and / or the cost of claims.
President Obama can sell - my question is, “What are we buying, a fix or fantasy?”
Copyright - Michael G. Manes (September 2009)
All rights reserved
Saturday, September 12, 2009
The End - Are we there yet?
As a little boy, Claire and I often rode with our parents to Baton Rouge. At ages 5 and 7 our patience was limited and we’d begin the interrogation of Momma and Daddy with the refrain “Are we there yet?” When we were within half an hour of the city, Momma would encourage us to watch for the State Capitol Building. When it was in sight she’d explain, “We aren’t there yet, but you can see it from here!”
The thirty four story Capitol Building was the vision of Governor Huey P. Long (nicknamed Kingfish). It was completed in 1934 and it was the site of Mr. Long’s assassination in 1935. Long was a radical populist who rode the program of “Share our Wealth” and the mantra “Every man a King” to the Governor’s mansion, the
U. S. Senate, and some believed it would ultimately carry him to the White House.
Long advocated “wealth redistribution” and encouraged federal spending on public works, public education, old age pensions, and other social programs. His popularity among his cronies and most poor and working folks was unparalleled. His opponents were concerned about his dictatorial tendencies and near total control of state government. Some here believe he was assassinated by supporters of FDR that were threatened by Long’s popularity. As a young boy going into rural grocery stores I remember often seeing over a door a crucifix and a picture of Long.
Huey may have given the “title” to entitlements. Looking at the debt of the U.S. and government’s overreach into our lives I’m reminded of the following quote:
A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves from the Public Treasury. From that moment on the majority always votes for the candidates promising the most benefits from the Public Treasury with a result that a democracy always collapses over loose fiscal policy always followed by dictatorship. The average age of the world’s greatest civilizations has been 200 years. These nations have progressed through the following sequence:
From bondage to spiritual faith;
From spiritual faith to great courage;
From courage to liberty;
From liberty to abundance;
From abundance to selfishness;
From selfishness to complacency;
From complacency to apathy;
From apathy to dependency;
From dependency back into bondage.
Alexander Fraser Tytler
Now I must ask myself, could this be the end of the greatest country, economy, and super power that has ever existed in the history of the world? Considering the aforementioned quote - it‘s not the end but I believe “we can see it from here!” Pray for U.S.
Copyright - Michael G. Manes (August 2009)
All rights reserved
The thirty four story Capitol Building was the vision of Governor Huey P. Long (nicknamed Kingfish). It was completed in 1934 and it was the site of Mr. Long’s assassination in 1935. Long was a radical populist who rode the program of “Share our Wealth” and the mantra “Every man a King” to the Governor’s mansion, the
U. S. Senate, and some believed it would ultimately carry him to the White House.
Long advocated “wealth redistribution” and encouraged federal spending on public works, public education, old age pensions, and other social programs. His popularity among his cronies and most poor and working folks was unparalleled. His opponents were concerned about his dictatorial tendencies and near total control of state government. Some here believe he was assassinated by supporters of FDR that were threatened by Long’s popularity. As a young boy going into rural grocery stores I remember often seeing over a door a crucifix and a picture of Long.
Huey may have given the “title” to entitlements. Looking at the debt of the U.S. and government’s overreach into our lives I’m reminded of the following quote:
A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves from the Public Treasury. From that moment on the majority always votes for the candidates promising the most benefits from the Public Treasury with a result that a democracy always collapses over loose fiscal policy always followed by dictatorship. The average age of the world’s greatest civilizations has been 200 years. These nations have progressed through the following sequence:
From bondage to spiritual faith;
From spiritual faith to great courage;
From courage to liberty;
From liberty to abundance;
From abundance to selfishness;
From selfishness to complacency;
From complacency to apathy;
From apathy to dependency;
From dependency back into bondage.
Alexander Fraser Tytler
Now I must ask myself, could this be the end of the greatest country, economy, and super power that has ever existed in the history of the world? Considering the aforementioned quote - it‘s not the end but I believe “we can see it from here!” Pray for U.S.
Copyright - Michael G. Manes (August 2009)
All rights reserved
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