Thursday, December 24, 2009

If you have your health, you have everything!

Leadership Center 
Health Care Reform
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“If you have your health, you have everything!” This is a common saying that I have heard in our senior community in the US. The Senate health care reform bill will take 1/7 of our economy, and seniors will be the largest beneficiaries. I believe that the expansion of Medicaid will solve the Medicare bankruptcy problem. Ben Nelson is seen as a pro-life senator that was the remaining hold-out on health care reform. I believe that the golden thread and common ground of health care reform was not anyone’s stance on abortion or even the deficit. I believe that the underlying pressure that is forging this bill is a political problem of how to honor the senior community. The public option failed because it did not serve seniors. The Senate bill succeeded because it met the needs of seniors. I couldn’t help noticing Harry Reid, Max Baucus, Chris Dodd, Richard Durbin, and Charles Schumer’s hair color and outward appearance as they announced their victory after the Senate vote. They were all noticeably elder statesman. The ultimate winner of the 2009 Health Care reform bill could be the US Senior community.

Last year I had the privilege of traveling to China. When I was there, I was able to capture an outsider’s perspective of attitudes toward the senior community in China. We passed by some seniors that were dancing in the park. I pointed at them and asked my driving companion who those people were. She said that they were retired. “They have nothing to do with their time.” Her off-chance comment resonated in my mind, and I have not been able to forget it. I wonder if what is happening in China today could be a premonition of something that we must avoid. From an outsider’s perspective, the tradition of honoring elders is commonly assigned to the Chinese people. In my opinion, the Chinese government honors this tradition, but does not tap the resource of this elder population.

Our senior community is also desirous of a life style of indolence. I would ask that they be careful what they ask for on this Christmas Eve of 2009. They may get it. What we desire is not always what will best serve us. I have just celebrated my 54th birthday. I am knocking at the door at becoming a senior myself. I believe that the senior community and the gang of five with the legacy of Ted Kennedy mentioned above should be empowered and not retired. They are an important asset that we must find a way to utilize. Ultimately, seniors will not be happy if they are not useful. If health care reform paves the way for an indolent life style, our desire for care will be confounded by irrelevance. My Christmas wish for 2009 is that 1/7 of our economic output be used to keep seniors in the mix of solving our problems and contributing to solutions to move our country forward as we compete on the world stage.

Many of the problems we face as a society are common to our shared desires for safety, comfort, and efficiency. A merging of cultures and values will create a greater need for collaborative skills to find solutions to new problems. Unfortunately, many of these problems will be irregular problems in the years ahead. The smartest, sharpest, and fastest individuals can solve some of these difficult problems by trying new alternatives. Many of these problems have been endured by our senior community over their lifetime. The senior community can provide a safety valve of life skill moderation for the younger population who will be forced to try new alternatives to solve problems.

I found it ironic to this post that the Senate provided a moderating influence over the House of Representatives health care reform bill. Senators are typically older than members of the House of Representatives. They hold a place of honor and usefulness in our government process. They should not be retired to “dance in the park.” They should be forced to interact and collaborate with the younger generation to forge compromises filled with the moderation of brilliant ideas. Jefferson would have said the values to preserve would be life, liberty and the pursuit of happiness. I would say that these values are currently in a state of reconfiguration to reflect the values of the world stage. The United Nations Declaration of Human Rights would say these values are life, liberty, and security of person. I believe that the shift from the pursuit of happiness to a security of person will be facilitated by embracing the assets of our senior community. In this way, our senior assets are moving our country forward as much as the younger generation as we compete and cooperate with the world community.

Tuesday, December 22, 2009

Winners and losers of in the senate compromise for Health Care Reform


Employees with rich benefit programs, will receive a 40 percent tax on any plan exceeding $8,500 for an individual and $23,000 for a family.

Employers: There is a $750 penalty per worker on employers of 50 or more who are not covered by the federally approved package of health benefits.

U.S. pharmaceutical companies, which have set up overseas subsidiaries in developing markets (like India), will have to pay tax on their earnings earned abroad.

Alternative medicine, could be expanded to provide comfort for symptoms and choice for treatment when traditional medicine fails to give relief.

Health care facilities, will be forced to provide more services for less money.


Trial Attorneys, could be taxed when they make huge profits while the cost of health care continues to escalate from defensive medical practices.

Insurance companies, insurance companies also be taxed for out sourcing their employees? When insurance companies are making profits they should share in the cost.

Working families at 150 % the poverty level without insurance: The most important number in 2011 could be Medicaid’s expansion to include wage earning families making $33,000 a year and individuals making $29,327 per year.

Health care practitioners, helped to write the compromise. When health care practitioners are making bonuses they should share in the cost.

Saturday, December 19, 2009

The weakest link of health care reform

The weakest link

The medical professionals are paying for Nelson-Reid health reform compromise currently being debated in the Senate. They will receive a 21% pay cut starting in 2010.

What kind of cuts are insurance companies taking?
What kind of profits will Pharmaceutical companies continue to make?
What kind of fee will lawyers benefit from defensive medical practices?

Unfortunately, the truth is the medical professionals are the weakest link. They have less political clout because they are less in numbers. The truth is that most doctors would not mind taking a 25 % cut if insurance companies, Pharmaceutical companies and trial attorneys also took the same cut. True health care reform can not happen without cost containment.

Cost containment can happen in two ways. The groups profiting from health care delivery can take a cut. This is the crux of the Nelson-Reid health care compromise. Unfortunately only the weakest link is taking a cut? Another way to contain costs is to introduce competitive forces. Patients should question the cost of health care treatment and be motivated to seek out more efficient choices. New alternate medical practices that promote comfort as much as cure should be allowed to compete on the open market with traditional forms of health care. Patients and medical professionals should be motivated to deliver and receive health care in the most efficient manner possible.

Tuesday, December 15, 2009

The balance of health care costs and health care delivery

Now that the Senate looks like it has given up on its single payer sweeping health care bill it is time to consider incremental health care reform. The principal of reciprocity is a critical to linking health care delivery with cost control. I believe that twitter followers understand this argument and can help our legislators make sense of it.

When you look at health care reform you should take “deep throat’s” advice from the movie,
'All the President’s Men", “follow the money”. The vast majority of the money spent on health care is coming from expensive medicines. If prescription drug companies are willing to lower their prices to other countries to enlarge their market share, then drugs should be re-imported to pass these savings on to United States patients. This measure will introduce the kind of competition into the market place that will control costs.

Pre-existing conditions are not spread across the population. They need to be. The concept of insurance is to spread risk out across a healthy population. Health care delivery should be portable and available to those of us with catastrophic illness. Crossing the boarder of New Jersey when I live in South Eastern Pennsylvania should not require a health care visa. This practice is awkward and makes health care more costly. The health care payer (insurance) and provider should establish a practice that works in the interest of the patient.

Health care must be opened up to less costly alternative medicine practices. This medicine and therapy may not cure a patient, but it can give them hope and comfort. The growth of disease and illness is outpacing our current research and development of it. If we can not keep up with the development of disease, then we can at least make it more comfortable for the patient in the last days of life. In this day and age of a growing hospice movement health care is becoming as much about comfort as it is about cure. Therapy caps can be eliminated in the current health reform measure if alternative medicine is able to compete in the open market. These reciprocal measures represent some of the incremental change to bring cost into balance with treatment protocol.

Monday, December 7, 2009

Twitter’s 3 Rs of # Health Care


Doctors and patients should be given the responsibility to make health care decisions. Patients should think about how much the care costs. Doctors should consider the value in the medicine or procedure. Between the two of them they should make a decision that will be the best solution keeping in mind the cost, the benefit and the quality of life.


Pharmaceutical companies are benefiting from the advertisement of drugs. Advertising could be banned. You will not see many commercials in Canada where health care is nationalized. Pharmaceutical drugs that alleviate symptoms of medical conditions could be taxed if we do not ban them.

Defensive medicine must stop. Lawyers are benefiting from out of court settlements from malpractice suits. Legal advertising could be banned. You will not see lawyers advertising in Canada where health care is nationalized. Lawyers who choose to pursue practices of medical malpractice could take a separate set of bar exams to qualify. They could also pay a surtax to offset the increased cost of medical procedures because of the award.


Technology must be capped at what we can afford. One recommendation would be to create a delay of adopting new health care drugs and procedures. Affordable alternative medicine procedures and medicines could be expanded to help people be more comfortable in tolerating symptoms.

The three Twitter Rs will distribute the cost of health care across the people who are most likely to benefit.