Health Care Law

I hope I can be civil on this topic. I am more sad and disappointed than angry over the liberal congress members voting this into law this week. I am aligned with 51% of this nation that thinks what happened this week is either completely wrong (40%) or they aren't sure (11%). In my opinion this nation is too deep in the whole for the financial outcome to be good, and adding this extravagant and ill designed plan will be the final large blow that brings the country to its knees.

I want to cover several subtopics - again just so I can vent. If anybody ever finds a reason to read this they should know exactly why I have issues with what just happened in Washington. Too bad I live in California. This is such a liberal state my vote has meant very little over the past 40+ years living here. Barbara Boxer and Dianne Feinstein are worthy to their party - they are just wrong. Every time my wife and I have tried to communicate our desires for yes or no votes on some critical bill we are sent a form letter politely indicating they are going to do what is best for the people of the state; in other words they ignore us.

1) The need for health care reform.
2) Where I think the health care problems lie.
3) Comparing this vote to the "success" of Social Security and Medicare
4) How this will impact the health industry and our health care.
5) The real cost.
6) Why an alternate plan makes so much more sense.

1) The need for health care reform.
I don't question the need for change in America's health care system. Certainly when such a huge percentage of the population can't afford health care something has to be done. Those that can afford it, like me, are pumping huge amounts of money to purchase a family plan, crippling our retirement budget. Health care costs have the potential to independently drag the economy down. Most people choose to drop insurance and take their chances on their own health.

2) Where I think the health care problems lie.
It is broken on so many levels it is hard to know where to start.

I'm sure the vast majority of the health care professionals who tread the ill and maimed love what they do and are dedicated people. This is not where the problem lies.

The real problem lies in the dissemination of components of health care, separation between those in need and how payments are distributed by health insurance companies, out of control lawsuits for malpractice, and the belief by many that they should be afforded nothing but the best care in spite of their age because they have no involvement in the cost of procedures.

The way money is managed throughout the entire system is a mess. Doctors who work at hospitals are often free agents who are paid outside the hospital money flow. The hospitals are forced to take patients who have no health insurance and pass that cost on to the insurance companies pushing up premiums for the rest of us. Health care for the individual normally involves multiple doctors who don't share our medical history, we are forced to use lab services often independent of our doctors or hospitals, and through all of this we normally don't know the actual costs charged to the insurance company.

3) Comparing this vote to the "success" of Social Security and Medicare
I've recently heard the likes of Nancy Pelosi and the president use Social Security and Medicare of examples of successful government laws that have not only helped the population but saved us from the depths of the depression. Nothing could be further from the truth and here lies the biggest problem with the federal health care law.

By the way the original 10 year estimate on the overall cost of Medicare was off by a factor of EIGHT! Don't trust the government estimates. Heck I am an anal budget-er for our family with 20 years of our spending habits detailed to the penny using Quicken and we go over budget just about every year. How can we expect the government to project something as complex as our health care system and get it anywhere near right.

Anyone who is on the receiving end of a handout will appreciate the money or service. So it is easy to find positive comments about Social Security and Medicare. Why not; it appears as free to the individual. Heck our house gets checks every month and we couldn't survive without them. If you think you paid for it and deserve the benefits you didn't. In no case has anyone put sufficient money into the system to pay for what it will cost the federal government over your retired lifetime - unless you die early.

The problem of course is Social Security represents 21% of the budget, Medicare, Medicade, and CHIP represent another 20%. That is 41% of the total federal budget as of December 2009. All of this is funded each year by deductions from the paychecks of the shrinking working population. As the baby boomers retire these costs will go up as the working population has to foot the bill. Both of these programs are rapidly running into a brick wall. They will run out of money. The government has not stockpiled money to pay for these programs, they spent any extra that has come in over the past decades on other things. There is no pool of money sitting and waiting for the baby boomers. Its all been spent.

When Social Security was enacted there was a definite need. Older people were simply going to die without the help. They either didn't put away money for their retirement, or they couldn't due to the long lasting recession. The biggest problem with this whole plan was the government did little to educate the population about the need to save for themselves. Indeed the average citizen counted on Social Security to support themselves in retirement, even though in most cases it never would fully accomplish that goal. So what did people do with their future seemingly secure? They spent all their earnings, or even more than their earnings by using credit. They live month to month. The U.S. savings rate is currently 4% which is huge compared to past years and decades where it even fell below 2% many times (http://www.bea.gov/BRIEFRM/SAVING.HTM). As of October 2009 China is said to have a savings rate of 39%. Not only does savings put away money for our future, potentially reducing burdens on federal budgets, but that money isn't sitting in vaults, it is being used to fund manufacturing and it helps keep interest rates down.

Consumer spending persisted for the past few decades as we enjoyed ever larger houses, RVs, every electronic toy on the market, vacations, home improvements, cars, boats and other wants. We were taught to do so. Even now as the Great Recession is underway the government highly encourages us to spend; they have even sent us money to spend. While this principle may be what is required to yank the economy off the ground it is once again pushing us down the road of consumption without any focus on savings. Fortunately a portion of the population is turning the corner and starting to save for their future. Sadly many can't or don't follow this new pattern.

Medicare, while appreciated by many, contains similar pitfalls. Since we retired bunch (not me yet as I'm just 63) just depend on Medicare we aren't really involved with the cost of our medical care. It is mostly paid for us and all we have to do is cough up a small premium each month and perhaps a copay. So there is no individual accountability. Again we are being taught not to save for these things at an early age because it has been promised to be there for us. Our children will pay but we will too.

This simply can't continue. Major adjustments will have to be made. Services will be cut in Medicare; witness the new law just passed this week that contains articles to cut Medicare. In other words the federal government is already in the position of deciding what medical care you can and can not have. It isn't a future worry. It is here today.

Social Security and Medicare seem good on the surface but they are the two biggest reasons the country is sliding down a slippery economic slope and there is no way out without major cost to each of us.

When you stack the new health care law on top of this failing pyramid it is sure to colapse.

4) How this will impact the health industry and our health care.
The new law does exactly what it shouldn't do for we individuals. It puts enormous burdens on the health care insurance companies. Oh I'm sure there are some excess profits involved in the industry, but forcing government limits on medical care and not paying an amount to keep the insurance companies afloat will cause slow but sure failure. The end result will be that the government will step in and finally take over the entire health care system. We are then doomed. This is not a dictatorship, but it is rapidly becoming one if you allow the definition of a dictator to be broadened to include the congress and senate. Isn't that what just happened?

The liberal Democrats forced a vote using sneaky rules to put a law in place, one that can't be repealed, against the wishes of the majority of the population including the entire Republican base.

I won't even try to argue if we will have good or bad health care in the long run. What I can promise is if it is good or very good it will simply sink the budget even faster. The only hope to balance the budget will be either to reduce our benefits or heavily tax everyone...oh that seems to be what is already happening isn't it.

This is a disaster and it is like a snowball rolling down hill.

I am of the opinion that the larger the social program put in place the longer it will take to fail. Social Security is a perfect example. It is a Ponzi scheme in the world, and like Madoff's kingdom the bubble will eventually burst. The bursting of the Social Security Ponzi bubble is now upon us.

5) The real cost.
The real cost eventually shows up as such a large amount of our workers paycheck goes to service these three huge failing programs, and the majority of the population works for the government rather than designing, manufacturing and selling products, will cause catastrophic failure of the American government. I will be long dead as I expect this to take two or more decades. My children will experience this collapse. You think the Depression and this Great Recession are bad. They will pale by comparison.

6) Why an alternate plan makes so much more sense.
The plan signed into law this week by President Obama is possibly the worst of all choices. I firmly believe that doing nothing would have been better than this new law. So what would I recommend? A whole new structure to the Health Care system. And there are working examples. Fortunately we are insured and serviced by one such great example. We have Kaiser Permenante.

Kaiser is one very good example of how the government should have begun to massage this country into a working health care system, perhaps without spending one dollar of federal money. It is a highly efficient operation, and good health care, with lower costs than most of the rest of the country. By switching to Kaiser from Blue Cross this year we reduced our medical costs by 22-46% (we won't know until the end of the year). If the whole health care system could cut 22-46% out of health care costs our problems might be solved. Furthermore the way Kaiser works is so pleasant compared to other health care situations.

To the best of my knowledge Kaiser is both a health care insurance company and a health care provider. They use no outside services unless it is the only recourse. It is in their best interest to provide good health care (or else they would lose participants) and to keep costs down. They are in the business of balancing these two sides of the equation. It isn't a case of get what you can from the other side of the operation. There is a strong emphasis on keeping people healthy to save money, and at the same time the care is very good. The entire operation is computerized so every facility I visit has my entire record on their computer terminal. This speeds office visits because I don't have to answer redundant questions. It also means my entire record is visible which reduces the possibility of prescribing conflicting medications. When I leave the doctors office I'm given a printout of all data entry during the visit. All of the doctors, nurses, and aids are at the computer during visits to both keep up with my medications and to enter their diagnosis and any changes to my medical care. Further I can log in from home and view all this data any time I want.

Here is a new thing for me. I can email my doctor. While my previous internist served me well for 20+ years he was old school. No email, no texting, just phone calls and personal visits should I be in the hospital. I can even ask my Kaiser doctor to extend my prescription by phone or email - no office visit in most cases. Kaiser has it's own pharmacy and the doctors electronic prescription is sent immediately. When I show up at the pharmacy there is an overhead digital scroll with my name telling me if my prescription is ready or not, normally it is ready before I arrive. This is a smooth operation.

I have my share of medical issues. I'm a cancer survivor. I have a 10 year history of a heart condition called Atrial Fibrulation so I'm on Coumadin which requires constant monitoring of my blood every couple of weeks. Before joining Kaiser my representative blood tests involved a prescription from my doctor which I would take to an independent lab. The lab had to then contact the doctor by phone to give him the results of the test. The doctor would then call me with an update and perhaps an adjustment to my prescription. Now with Kaiser the lab is part of the local Kaiser office. I just drop in, sign in, they swipe my card. I've given up sitting down in the waiting room because they call me in so quickly there is no time to sit. I'm in the office for perhaps 3-5 minutes total to have my blood drawn. The Kaiser group that oversees my blood thinner then emails me with the results and tells me when to repeat the process. Neat

Why, oh why, did the congress go down the path of implementing rules about health care that isn't their area of expertise when something like a Kaiser example is sitting right here?

Our government is out of control.