Archive for August, 2009

Put me on the Death Panel

August 28, 2009

When it comes to a big, long term, government run health programs, the ultimate question is: would you trust YOUR health to President Obama? He would be the ultimate guy in charge, at least according our Constitution. Lots of people say yes.  Then I ask: would you trust your health to George Bush or Sarah Palin?  I just get laughs… “That will never happen. Why would I?” Well, I explain, you don’t know who is coming after Obama, it might even be Sarah Palin herself.

The problem with the current health bill is that everyone who is pushing it really wants a single payer system. Single payer won’t sell now, so they came up with a 1200 page bill that nobody understands and claim it is nothing like a single payer system. Would you believe them? These proponents are being disingenuous, and most people understand that Obama will implement the bill as though it is a single payer system, eventually. In a single payer system all of your health decisions are controlled by a single payer, and guess what, YOU are not that payer.

Whether Congress passes a health bill with death panels or rationed care or free care for illegals or value based decision making really makes no difference. Whatever bill is passed now is just a another step down the path of thinking that the our government knows better than we do. The national health insurance system currently assumes that our employer makes better decisions than we do. Our employer decides our benefits, our deductibles, our drug plans, our co-pay our medical groups, and in many cases our employer even has to approve specific medical procedures. For most people it is not a stretch to change employer to government, in both cases someone else is making our most basic decisions for us.

To say that there is no choice in medical insurance plans is just wrong. There are lots of choices, it is just you aren’t allowed to make them. When my company wanted to offer medical insurance we asked a broker to come up with a list of possible plans. I expected a handful of plans and got literally hundreds, more than we wanted to read or understand. I’m an engineer, not a insurance specialist. We ended up offering our 5 employees a choice of just two plans, one HMO one PPO. Four years later we have more than 40 employess and have added a third choice: Kaiser. This is the way medical insurance is decided for 80% or more of Americans. By the way, employers make the same decisions for 401K retirement plans. I had to pick one of those too.

The health bill I would propose would be very short and contain just two key and simple elements: employers or other groups are not allowed to offer insurance, only individuals and families can purchase insurance; insurance rates or availability may not depend on individual or family genetics or health history but may depend on the number of years they are uninsured (this would have to be phased in) and other general characteristics. This would provided a basis for universal coverage in that all people could be covered if they could pay an average rate. If someone decided not to have insurance, that is OK, but if they get sick they would have to pay up, maybe 2 times, maybe 100 times the going rate before they get coverage. The value of having insurance would be amplified, and the cost would be controlled by the individual. People wanting only catastrophic insurance to reduce their health insurance costs could. If you want complete coverage it is your choice, not your employer’s and not your President’s.

If Congress wants to pass a law to pay for the insurance of people who do not want to, or cannot pay for insurance Congress can, but that would be a different bill with its own issues. Any such law would have to define a minimum acceptable insurance plan (MAP) which would be a source of great debate. It is the same question that each of us would have to answer ourselves, which plan is best, only this time it would have to be a plan that would fit everyone. Let’s face it, there is no such plan. I’m sure they can write another 1000 page bill that describes a minimum plan. 1000 pages may be too few though, I mean the tax code is a lot bigger and that.

While we are at it, we should eliminate the 401K retirement program and replace it with personal retirement accounts too. I like giving people their own choices in life, but I guess that is a perverted idea in Democracy today. I learned in high school that Democracy was about letting people vote for the things that make a difference in their lives. I didn’t realize that meant that my neighbors could vote if I qualify to live. Seventy years ago my father left a country that voted on whether he would live or die. They picked die. Each of us deserves to make our own health insurance decisions, to be the one and only member of our own personal death panel.


U.S. Health Plan: Stay Healthy

August 14, 2009

I would like to write a post about the truth of the Obama/Reid/Pelosi/Democratic health bill but that is really difficult because I don’t want to read the thousand page bill, and apparently nobody else does either. Even Congressman John Conyers, who heads the committee in charge of the bill, points out that he can’t be expected to read the bill because even if he were to read it aided by two lawyers he wouldn’t understand it. We are supposed to be a country of laws, but this is ridiculous. Perhaps we should be a country of laws that the average person can read and understand. I think that was in the Napoleonic code.

So instead of discussing the facts, let me discuss the claims.

First, Obama says that the bill will allow one to keep their own doctor. What does that mean? Right now my insurance, as is almost everybody’s, is decided by my employer, not by me. My employer today might decide to get insurance that has one set of doctors, but tomorrow (actually they can only change annually), they might decide to choose a different plan that only supports other doctors. Is Obama saying that they cannot make this decision? He has said that employer’s are still going to provide insurance so I am confused. I think he means that your employer will continue to decide your health insurance, not the government. Obama is trying to personalize healthcare today without understanding the basic reality, heath insurance is decided by employers, not by individuals.

The second statement from Obama is that private insurance will be more competitive if there is a “public” insurance plan. Who is going to fund this “public” insurance? The public or the government? All insurance companies are “public” today, they trade on public exchanges, they provide insurance to the public, the raise money from the public, their profits are distributed to the public. I think he means a government insurance plan, not a public plan. So who would put up the capital for a government plan? who would get the profits? who would run the plan? who would be on the board of directors? who would manage the company?

When I first heard him promote a public plan equal to private plans my  thought was “will private insurance companies be allowed to raise my taxes?” I know it is a strange question, but I assume that the government plan would have such a right, so if the government can do it and they are equal to the private companies then the private companies must have the right to do it. You probably are thinking that I am crazy, or as someone said to me recently, that I engage in hyperbole. Well it turns out that I was right. Regular  insurance companies will, under the Obama plan, be able to raise my taxes, at least indirectly, by skewing the cost curve. The government, i.e. my taxes, will under the laws of economics have to match the private plans, so basically my taxes will be paying for other people’s premiums which means that my taxes will be controlled by insurance companies while my employer will pay for my insurance.

The result will be a system whereby the only insurance that I will NOT be deciding or paying is my own!!

I think this is the ultimate goal of the Democratic plan: create a system so confusing, so open to abuse, so out of control that in a few years we will all be screaming for someone to step in and fix it. Then, enter single payer health, where it will be illegal to get health insurance, and illegal to pay for ones own health care and ultimately illegal to get any health care unless you can convince that “single payer” that you are worthy to be treated. I think this is called a slippery slope. Let’s hope we don’t slip, that might not be covered.