Friday, February 26, 2010

I give in!

I give in!

Let's pass it, but let's also continue to work on making health care something that we can pay for as well as benefit from. Let's continue to work on developing technology with an eye toward cost savings as well as health care.

I think regulation on alternative medicine should be loosened to emphasize comfort over cure.

I think that insuring 30 million Americans is worth the risk of a few bad apples if there are incentives put in place to stop abuse.

The respect the economists in the NY Times article. There is no reason why medicare can be fixed and defensive medicine corrected after this bill is passed.

Our President has done a masterful job of bring the stake holders together. Although I think the summit could have taken place with a caucus process.  (See my previous post) I believe that he make the changes necessary to the health care bill after it is passed.

Monday, February 22, 2010

The Blind Spot of Obama Health Care #HC

Let’s simplify things about the health care debate. Republicans are for states rights. They generally would agree with a health care proposal that has the most limitations on the federal government. Democrats are for federal initiatives. They disagree with the republicans that states should solve national problems and wish to maximize national solutions. The libertarian camp has recently entered the debate in the form of Ron Paul. They go a step beyond Republicans to maximize individual rights over the rights of individual states. I would recommend that there is a forth point on the political compass that is being ignored. That point could be called the “Statist” solution. A statist solution would delegate our democratic freedoms to a panel of experts for a time to solve a problem. This solution would be the way that countries like Germany have traditionally solved problems. Countries like Germany hire a commission of experts to solve these problems, and then take the governing of this solution out of political hands so that the commission can stay the course and solve the problem. Recently, our president set up a bipartisan commission of two former deficit hawks in both parties to remove this blind spot from our eyes. I believe that our president is on the right track here. Why shouldn’t this same strategy work on health care?

I appreciate technological tools like twitter that open up this debate to small voices like mine to enter the fray. Many of the news commentators and journalist have a vested interest in selling advertising. They choose to interview people who are controversial so they can increase their ratings. I do not believe that the German solution has much controversy or democratic input to drive public policy debate. That is why it is currently a blind spot in the health care debate. America is a country made up of salespeople. We love to give our best pitch and hear about ideas we believe in. I think it is time to give the Americans with more or an engineering perspective a turn to govern. The health care system is broke and it needs to be fixed. Should we consider all possible solutions? Problems that do not appear in the blind spot of our rear view mirror may be better solved by us looking directly to the experts for a time until the problems are more easily seen.

Wednesday, February 10, 2010

The Third Rail of Politics meets Twitter Health Care Reform #HCR

There are three problems facing our president as he prepares for his upcoming televised health care summit. I am a progressive Republican who is rooting for his success. I am going to suggest something that a politician should never do. I would suggest Mr. President that you boldly touch the third rail of American Politics.

1.    He should fix the funding of Medicare and social security.
2.    He should tie the future costs of health care to our standard of living.
3.    He should form an alliance with the Republican Party as well as secure populist support with all stakeholders.

My proposal would be to pre-pay Medicare and Social Security with a 13.5% payroll tax for the employee and employer. A 13.5% payroll tax would enable to begin pre-paying social security and then slowly reduce the tax over 10 years. This could also be accomplished by keeping payroll taxes as they are now and taxing employee benefits. Then contain costs by tying future expense to GDP growth. If our country is not growing, then we must make decisions about comfort instead of cures for those of us in need of health care. Another funding proposal to pre-pay Medicare and Social Security is to empower the IRS and the Social Security Administration to debit $3500 from every retirement account in US. These funds would be used to pre-pay medicare for those designated social security numbers in those households. If a household does not have a retirement account then they would have the option of a 13.5% payroll tax to meet the prepayment option. The magic of compounding interest multiplies the usefulness of these pre-paid funds. Within five years payroll taxes can be lowered to more reasonable levels. The investment options for these funds will be determined by an independent commission  of economists elected by the National Association for Business Economics. (NABE) It could be set up similar to the federal reserve board.

Health care must make sense…

•    Pre-existing conditions must be included in the insurance pool
•    Health Insurance should be able to be purchased across state lines.
•    Those with out health insurance should pre-pay medical expenses at a discount for preventative health care.
•    The uninsured should continue to receive acute critical care through the established practice of cost shifting.
•    Universal health coverage can still be explored at the state level.

Health care cost must be contained

•    Pharmaceutical companies should pay a portion of health care based on their profits.
•    Disincentives must be built into the health care delivery system for patients to sue. 
•    Alternative medicine practices should be encouraged to provide comfort when cures are beyond our ability to pay for them.
•    Electronic reporting procedures must become standard in the delivery of health care by medical professionals.

We are currently being slammed by a snow storm in the Mid-Atlantic States. I am history teacher stuck in my house spinning solutions to problems that I have no business attempting to solve. Perhaps this snow storm can generate more ideas right now. A snow storm can slow things down enough to include the average Joe’s opinion on issues that matter to us all. I want you to solve these difficult problems that are facing our nation. I believe that your judgment is probably better than the intellectual community as you enter into negotiations with the stake holders of this dilemma. I am at the bottom of the list of these stakeholders. The beauty of democracy is that when a snow storm happens I have the time to think through these issues as both the least significant and most numerous of your constituents as I twitter my thoughts to you.

I see the stakeholders as …

•    The Democratic Party
•    The Republican Party
•    Organized Labor
•    Small business
•    Pharmaceutical companies
•    Defensive medical practices
•    Medical community
•    And me Pat Citizen