I know that not all of you agree that my humor is in fact humorous. I get it. On the other hand,lots of folks actually do think it's funny, and they like to see it on the blog.
So, once a week or so, I'll post a humorous piece - some of them new, some of them recycled. The next piece, on "natural" gas, was a favorite when I distributed it last Spring.
By the way, if you like any particular essay, you can find this blog's essays on the same topic simply by clicking on the word or phrase following "Labels" at the bottom of the essay. For example, if you click on "Humor" at the bottom of this note, all of the humorous essays will pop up.
28 September 2009
Old Men and the Wonders of "Natural" Gas
Ever heard the phrase, “old and farty”? It’s kind of a cliché, maybe even a stereotype. Ok, I know we’re not supposed to stereotype people, but it seems to me that stereotypes become stereotypes for a reason – don’t they? In any case, as I get older, I definitely get gassier, and I’ve got plenty of Medicare-card-carrying friends in the same boat.
So, being a good engineer (I’m old, not feeble), I determined to make the best of the situation. I know the following is a bit of a smelly proposition that could get blown out of proportion, but hear me out.
All mammals are flatulent, but old men seem to be especially afflicted (this may in some strange way be related to the dietary preferences of old men). The primary gas in mammalian flatulence is methane, which, by the way, is odorless and tasteless (it’s those nasty trace gases like hydrogen sulfide that offend), and methane is a wonderful source of energy. It burns cleanly and is an efficient fuel. It can be used directly in vehicles or it can be used to make electricity.
So, isn’t it obvious? Old men are our greatest untapped natural resource!
All we need to tap this resource are local and regional gas collection centers. Many of the details have to be worked out, but some of the salient elements of these centers would be:
• an abundant supply of beer, beans and Mexican food, nicely complimented with an onion soup appetizer;
• a comfortable setting (Lazy-Boy recliners come to mind) to facilitate high level discussions of sports, the way things used to be, war stories, and the unfathomable complexity of feminine wiles and attributes;
• large TVs and a complete set of John Wayne movies – high level discussions can be debilitating and require periodic down time; and
• a built-in central vacuum system strategically located in the seats of the recliners.
Being the selfless patriots that we are, I predict that most of us old men would agree to provide this service to our fellow man in exchange for a nominal honorarium, say a wide screen LCD with a premium subscription to Direct TV.
Think of the benefits!
• To national security: no more dependence on foreign oil, and a permanent supply of low cost energy.
• To the economy: the proceeds from the sale of the methane could be used to bail out Social Security and Medicare and return them to solvency.
• To male senior citizens: enhanced self esteem resulting from the productive use of a heretofore constant source of criticism.
• To spouses of male senior citizens: what can I say, the benefits are inestimable!
So, being a good engineer (I’m old, not feeble), I determined to make the best of the situation. I know the following is a bit of a smelly proposition that could get blown out of proportion, but hear me out.
All mammals are flatulent, but old men seem to be especially afflicted (this may in some strange way be related to the dietary preferences of old men). The primary gas in mammalian flatulence is methane, which, by the way, is odorless and tasteless (it’s those nasty trace gases like hydrogen sulfide that offend), and methane is a wonderful source of energy. It burns cleanly and is an efficient fuel. It can be used directly in vehicles or it can be used to make electricity.
So, isn’t it obvious? Old men are our greatest untapped natural resource!
All we need to tap this resource are local and regional gas collection centers. Many of the details have to be worked out, but some of the salient elements of these centers would be:
• an abundant supply of beer, beans and Mexican food, nicely complimented with an onion soup appetizer;
• a comfortable setting (Lazy-Boy recliners come to mind) to facilitate high level discussions of sports, the way things used to be, war stories, and the unfathomable complexity of feminine wiles and attributes;
• large TVs and a complete set of John Wayne movies – high level discussions can be debilitating and require periodic down time; and
• a built-in central vacuum system strategically located in the seats of the recliners.
Being the selfless patriots that we are, I predict that most of us old men would agree to provide this service to our fellow man in exchange for a nominal honorarium, say a wide screen LCD with a premium subscription to Direct TV.
Think of the benefits!
• To national security: no more dependence on foreign oil, and a permanent supply of low cost energy.
• To the economy: the proceeds from the sale of the methane could be used to bail out Social Security and Medicare and return them to solvency.
• To male senior citizens: enhanced self esteem resulting from the productive use of a heretofore constant source of criticism.
• To spouses of male senior citizens: what can I say, the benefits are inestimable!
Letter From an MD on Proposed Health Care Reform
Hi folks,
I personally called the number listed in this letter and confirmed that the letter is genuine and that the author is an MD. I commend it to you all.
For my own comments on health care issues, simply click on "health care issues" at the end of Dr. Hess' letter.
Joe
September 23, 2009
Representative Ann Kirkpatrick
1123 Longworth House Office Building
Washington, DC 20515
Dear Congresswoman Kirkpatrick:
Over the past few months I have followed with great interest the debate about health care that has been unfolding in Washington, D.C. My interest led me to read HR 3200 in its entirety. The 1000 plus page House bill is a convoluted legal document that I suspect even my good friends at Arent & Fox LLP on K Street don’t understand.
Being both board certified in Internal Medicine and in Cardiovascular Disease and having practiced in both the academic and private sectors, I feel that I have some knowledge related to the issues that have been debated. In addition, my wife, Pamela Jones, holds a Master Degree in Healthcare Management from Duke University and has over twenty years of healthcare experience, consulting with large hospital systems and physician groups. Our collective observations and opinions are outlined below:
1. "Primum non nocere" – At the time a medical student examines his first patient, he is reminded constantly of the wisdom: “First do no harm”. It is a warning that Congress should itself heed. It is unfathomable to me that those in Congress believe they have the knowledge, experience, and wisdom to completely overhaul the manner in which payment for medical services is provided. This is especially appalling when, in fact, few in Congress have any medical experience what so ever. For instance, Senator Max Baucus of the Senate Finance Committee, is an attorney, with no experience in providing direct medical care or in working in the medical industry (such as a hospital administration, health insurance, pharmaceuticals, etc.) Yet, despite this lack of ‘hands on’ experience, Senator Baucus has just released a healthcare proposal every bit as overreaching as the ones currently in the House. Whenever I am asked what I think of the Congress ‘overhauling’ healthcare, I tell people: “It would be like having a group of cardiologists overhauling the air traffic control system of America. Would you want that to happen?”
Representative Ann Kirkpatrick
September 23, 2009
Page Two
The fact that Congress has undertaken such an endeavor in an expedited manner indicates to me a degree of hubris that is unlike any I have ever witnessed. By proceeding in this fashion Congress will undoubtedly produce an outcome far worse than the original problem itself.
2. Law of Unintended Consequences – Everyone agrees that there are issues related to the affordability, portability, and accessibility of health insurance. But what no one knows or can predict is the consequences of the proposals now before Congress. Why would the members of Congress believe they could create major changes to 17% of the nation’s economy and perfectly predict the outcome one will get – the outcome as to cost of care, quality of care, and accessibility of care?
Just for discussion lets take the issue of accessibility of care. Using the president’s estimates of 30 to 45 million uninsured people, what will happen when they suddenly have access to care? There are not enough doctors, nurses, or allied healthcare personnel to care for a 10 to 15% increase in patient volume. Yet, nowhere in the discussed proposals is this question addressed. It takes ten or more years to change the medical educational system to produce more physicians. Recently, when this ‘manpower shortage’ was questioned in the media, those in favor of a major overhaul have argued that there would be no major increase in utilization because the majority of the uninsured are young and healthy. If that is the case, why is it a crisis to change healthcare in such a rush to insure these healthy youngsters?
We caution you that the proposed changes are draconian and no one can predict the resulting outcome. However, based on prior Congressional programs one can predict that if a program is ‘passed’, it will be more costly and less effective than predicted.
3. American Medicine Exceptionalism – Why care if the proposed programs are not perfect? The answer to that question is hopefully clear to Washington: The United States is universally regarded as having the most advanced medical care in the world. There is a reason that more than 400,000 foreigners travel to the United States each year to undergo treatments and procedures. Radically changing a successful system is risky business, but Congress seems oblivious to the risks involved. America is the incubator from which medical advancements hatch. Just to name a few such ‘breakthroughs’:
Representative Ann Kirkpatrick
September 23, 2009
Page Three
In 1987, Dr. Eddie Joe Reddick, a private practice general surgeon in Nashville Tennessee, performed the first laparoscopic removal of a gallbladder, paving the way for the field of minimally invasive surgery. In 1985, patients undergoing gallbladder surgery were usually hospitalized for 5 to 10 days and were off from work for 4 to 6 weeks. In 2009, the same surgery is performed as an outpatient and most patients are back to work in less than a week. Dr. Reddick’s technique radically changed the way surgeons approached many surgical problems. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
In 1981, Dr. John Simpson, a private practice cardiologist in California, invented the ‘movable guidewire’ for coronary angioplasty catheters, thus revolutionizing our approach to the treatment of coronary artery disease. Something that once required open-heart surgery, a prolonged hospitalization, and weeks away from work, could suddenly be treated with a simple catheter procedure, a one-day stay in the hospital, and only a few days away from work. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
Drugs classified as ‘statins’, that lower cholesterol remarkably and have resulted in significantly lower mortality rates from heart disease, were developed in the United States. Americans have better access to these ‘wonder’ drugs than European patients. In the U.S. 56% of patients who would benefit from a statin drug are taking such a drug, whereas only 36% of Dutch, 29% of Swiss, and 23% of Britons are receiving them. Not only did America make this ‘breakthrough’ in heart disease prevention but has also proven more effective in disseminating the treatment to those who will most benefit from it.
American advances in the treatment of heart disease are producing dramatic reductions in mortality. In 1970 the death rate from heart disease in America was 448 per 100,000 population. In 1980 it was 345; in 1990 the rate was 250. By 2006 (the last year data are available) the death rate from heart disease was 135 per 100,000 population. One cannot merely view the increase in healthcare expenditures without evaluating the results produced by that expenditure. In heart disease care alone, there are 400,000 fewer deaths per year than there were in 1970. I would suggest that those saved by these new treatments and procedures would agree that the expenditures were well spent!
Representative Ann Kirkpatrick
September 23, 2009
Page Four
America sets the standard for cancer treatments. Breast cancer mortality is 52% higher in Germany than in the U.S. and 88% higher in Great Britain. The mortality rate for colorectal cancer patients is 40% higher in the United Kingdom than in the U.S. Why would we want to incorporate any aspects of health care from these European countries with inferior treatment outcomes?
During his treatment for malignant brain cancer, Senator Ted Kennedy received proton beam therapy at Massachusetts General Hospital, which spares viable tissue while attacking the cancerous tissue. It is only available to patients in the United States. The reason Senator Kennedy did not seek treatment overseas, is because the most advanced health care in the world is here in the United States.
There is no doubt that the proposals currently being debated in Washington will produce an end to the era of American Exceptionalism in Medicine – ask any doctor. The legacy of the 111th Congress will be the death of American Medical Exceptionalism if it passes any of the current health care proposals.
4. “Show me the Money” – The current proposals in Congress rely on savings generated from eliminating more than $500 billion in ‘fraud and abuse’ from the government’s Medicare and Medicaid programs. Every president and Congress since Nixon have made similar pledges, but you know what – the waste is still there. One does not have to pass a major ‘overhaul’ of health care to solve this problem. The government ‘owns’ Medicare and Medicaid – why not immediately begin to realize these savings if they can be identified and eliminated? If MasterCard and VISA can effectively control ‘fraud and abuse’ in their trillions of dollars in transactions yearly, why can’t the government do the same with a much smaller program? The reason the ‘fraud and abuse’ are still a part of those programs is the government does not have the expertise or technology to identify the ‘waste’.
Confidence in the government’s ability to manage a significant change in healthcare would be much greater if the government could demonstrate that it can fix the problems that currently exist in its present programs. Why not take the next two or three years and concentrate on the fraud and abuse in these government programs and prove to the American people the government can get results, not just make promises?
Representative Ann Kirkpatrick
September 23, 2009
Page Five
5. Inflammatory Rhetoric –The manner in which a proposed program is framed is an excellent indicator of the advocator’s beliefs. As a physician, I am terribly disturbed by the manner in which President Obama has characterized the medical profession. For the purpose of illustration I will give two such instances of this characterization:
• Portsmouth, New Hampshire August 11, 2009: Taken directly from transcripts of President’s Obama’s town hall meeting. President Obama states: “All I'm saying is let's take the example of something like diabetes, one of --- a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.” (Applause.)
• Press Conference, East Room, White House July 22, 2009: Taken directly from transcripts of President’s Obama’s press conference. President Obama states: “So if they're looking -- and you come in and you've got a bad sore throat, or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, you know what, I make a lot more money if I take this kid's tonsils out. Now that may be the right thing to do, but I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change -- maybe they have allergies, maybe they have something else that would make a difference. So part of what we want to do is to free doctors, patients, hospitals to make decisions based on what's best for patient care.”
For expediency I have bolded and highlighted the portions of the president’s speeches to indicate the inflammatory manner in which he has categorized physicians. In the first example he has stated that a surgeon would receive $30,000 to $50,000 for performing an amputation – nothing
Representative Ann Kirkpatrick
September 23, 2009
Page Six
could be further from the truth. The customary surgeon’s reimbursement for such a procedure is from $600 to $800 dollars. Not even the total hospital bill would approach the numbers ‘thrown out’ by the President.
In the second example, the President implies that physicians take into consideration what they will be reimbursed in making clinical decisions and only places like the Mayo Clinic base decisions on “what is best for the patient.” This statement is a vicious attack on the ethical values of physicians and is so egregious it does not even deserve a comment.
The use of rhetoric like this has only one purpose, not to disseminate the facts but to distort them to obtain a goal – in this case the President’s vision of medical care. By demonizing physicians as ‘money grubbing’ individuals, the administration seeks to gather support from the public. My disappointment in the President is only exceeded by my disappointment that no one in Congress stood tall and said – those statements are wrong! Do not think that these statements were overlooked by the medical profession; every physician I have talked with about the healthcare issue spontaneously brings up these two examples.
6. Absolute False Statements: One can intelligently debate issues without purposefully giving false statements to embellish one’s argument. The most glaring example was during President Obama’s speech before Congress on September 9, 2009 when he gave examples of abusive actions by insurers. Mr. Obama referred to a man in Illinois who “lost his coverage in the middle of chemotherapy because his insurer found he hadn’t reported gallstones that he didn’t even know about. They delayed treatment, and he died because of it.”
According to Scott Harrington of the Wall Street Journal: the President’s conclusion is contradicted by the transcript of a June 16 hearing of industry practices before the Subcommittee of Oversight and Investigation of the House Committee on Energy and Commerce. The deceased's sister testified that the insurer reinstated her brother's coverage following intervention by the Illinois Attorney General's Office. She testified that her brother received a prescribed stem-cell transplant within the desired three- to four-week "window of opportunity" from "one of the most renowned doctors in the whole world on the specific routine," that the procedure "was extremely successful," and that "it extended his life nearly three and a half years."
Representative Ann Kirkpatrick
September 23, 2009
Page Seven
Why would the President use a false statement on a nationally televised speech? Do we have to distort the facts to win our position? Why demonize the insurance industry in a fashion similar to the way he has demonized physicians? One can only conclude that the healthcare debate is really about President Obama delivering on a major social issue and not about what is best for the average American who is quite satisfied with their own personal health insurance situation. Once again Washington is about who wins and who loses – the people have been forgotten.
It is my sincere hope that you will vote against any of the current health care proposals before Congress (or any iteration of the same) and seek a more reasoned, incremental approach to addressing the major issues related to insurance ‘one problem at a time’. In the interim, this Congress and administration can immediately demonstrate its commitment to reform by implementing processes that actual identify and eliminate the ‘fraud and abuse’ in the current government medical programs.
Should you wish to discuss these issues in more depth, I would be happy to discuss them with you by phone, (928) 771-0978 or in person. Thank you for taking the time to read this lengthy letter.
Yours sincerely,
David S. Hess, M.D., F.A.C.C.
I personally called the number listed in this letter and confirmed that the letter is genuine and that the author is an MD. I commend it to you all.
For my own comments on health care issues, simply click on "health care issues" at the end of Dr. Hess' letter.
Joe
September 23, 2009
Representative Ann Kirkpatrick
1123 Longworth House Office Building
Washington, DC 20515
Dear Congresswoman Kirkpatrick:
Over the past few months I have followed with great interest the debate about health care that has been unfolding in Washington, D.C. My interest led me to read HR 3200 in its entirety. The 1000 plus page House bill is a convoluted legal document that I suspect even my good friends at Arent & Fox LLP on K Street don’t understand.
Being both board certified in Internal Medicine and in Cardiovascular Disease and having practiced in both the academic and private sectors, I feel that I have some knowledge related to the issues that have been debated. In addition, my wife, Pamela Jones, holds a Master Degree in Healthcare Management from Duke University and has over twenty years of healthcare experience, consulting with large hospital systems and physician groups. Our collective observations and opinions are outlined below:
1. "Primum non nocere" – At the time a medical student examines his first patient, he is reminded constantly of the wisdom: “First do no harm”. It is a warning that Congress should itself heed. It is unfathomable to me that those in Congress believe they have the knowledge, experience, and wisdom to completely overhaul the manner in which payment for medical services is provided. This is especially appalling when, in fact, few in Congress have any medical experience what so ever. For instance, Senator Max Baucus of the Senate Finance Committee, is an attorney, with no experience in providing direct medical care or in working in the medical industry (such as a hospital administration, health insurance, pharmaceuticals, etc.) Yet, despite this lack of ‘hands on’ experience, Senator Baucus has just released a healthcare proposal every bit as overreaching as the ones currently in the House. Whenever I am asked what I think of the Congress ‘overhauling’ healthcare, I tell people: “It would be like having a group of cardiologists overhauling the air traffic control system of America. Would you want that to happen?”
Representative Ann Kirkpatrick
September 23, 2009
Page Two
The fact that Congress has undertaken such an endeavor in an expedited manner indicates to me a degree of hubris that is unlike any I have ever witnessed. By proceeding in this fashion Congress will undoubtedly produce an outcome far worse than the original problem itself.
2. Law of Unintended Consequences – Everyone agrees that there are issues related to the affordability, portability, and accessibility of health insurance. But what no one knows or can predict is the consequences of the proposals now before Congress. Why would the members of Congress believe they could create major changes to 17% of the nation’s economy and perfectly predict the outcome one will get – the outcome as to cost of care, quality of care, and accessibility of care?
Just for discussion lets take the issue of accessibility of care. Using the president’s estimates of 30 to 45 million uninsured people, what will happen when they suddenly have access to care? There are not enough doctors, nurses, or allied healthcare personnel to care for a 10 to 15% increase in patient volume. Yet, nowhere in the discussed proposals is this question addressed. It takes ten or more years to change the medical educational system to produce more physicians. Recently, when this ‘manpower shortage’ was questioned in the media, those in favor of a major overhaul have argued that there would be no major increase in utilization because the majority of the uninsured are young and healthy. If that is the case, why is it a crisis to change healthcare in such a rush to insure these healthy youngsters?
We caution you that the proposed changes are draconian and no one can predict the resulting outcome. However, based on prior Congressional programs one can predict that if a program is ‘passed’, it will be more costly and less effective than predicted.
3. American Medicine Exceptionalism – Why care if the proposed programs are not perfect? The answer to that question is hopefully clear to Washington: The United States is universally regarded as having the most advanced medical care in the world. There is a reason that more than 400,000 foreigners travel to the United States each year to undergo treatments and procedures. Radically changing a successful system is risky business, but Congress seems oblivious to the risks involved. America is the incubator from which medical advancements hatch. Just to name a few such ‘breakthroughs’:
Representative Ann Kirkpatrick
September 23, 2009
Page Three
In 1987, Dr. Eddie Joe Reddick, a private practice general surgeon in Nashville Tennessee, performed the first laparoscopic removal of a gallbladder, paving the way for the field of minimally invasive surgery. In 1985, patients undergoing gallbladder surgery were usually hospitalized for 5 to 10 days and were off from work for 4 to 6 weeks. In 2009, the same surgery is performed as an outpatient and most patients are back to work in less than a week. Dr. Reddick’s technique radically changed the way surgeons approached many surgical problems. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
In 1981, Dr. John Simpson, a private practice cardiologist in California, invented the ‘movable guidewire’ for coronary angioplasty catheters, thus revolutionizing our approach to the treatment of coronary artery disease. Something that once required open-heart surgery, a prolonged hospitalization, and weeks away from work, could suddenly be treated with a simple catheter procedure, a one-day stay in the hospital, and only a few days away from work. A new approach that produced improved outcomes and significant cost savings to society. The rest of the world then followed our example.
Drugs classified as ‘statins’, that lower cholesterol remarkably and have resulted in significantly lower mortality rates from heart disease, were developed in the United States. Americans have better access to these ‘wonder’ drugs than European patients. In the U.S. 56% of patients who would benefit from a statin drug are taking such a drug, whereas only 36% of Dutch, 29% of Swiss, and 23% of Britons are receiving them. Not only did America make this ‘breakthrough’ in heart disease prevention but has also proven more effective in disseminating the treatment to those who will most benefit from it.
American advances in the treatment of heart disease are producing dramatic reductions in mortality. In 1970 the death rate from heart disease in America was 448 per 100,000 population. In 1980 it was 345; in 1990 the rate was 250. By 2006 (the last year data are available) the death rate from heart disease was 135 per 100,000 population. One cannot merely view the increase in healthcare expenditures without evaluating the results produced by that expenditure. In heart disease care alone, there are 400,000 fewer deaths per year than there were in 1970. I would suggest that those saved by these new treatments and procedures would agree that the expenditures were well spent!
Representative Ann Kirkpatrick
September 23, 2009
Page Four
America sets the standard for cancer treatments. Breast cancer mortality is 52% higher in Germany than in the U.S. and 88% higher in Great Britain. The mortality rate for colorectal cancer patients is 40% higher in the United Kingdom than in the U.S. Why would we want to incorporate any aspects of health care from these European countries with inferior treatment outcomes?
During his treatment for malignant brain cancer, Senator Ted Kennedy received proton beam therapy at Massachusetts General Hospital, which spares viable tissue while attacking the cancerous tissue. It is only available to patients in the United States. The reason Senator Kennedy did not seek treatment overseas, is because the most advanced health care in the world is here in the United States.
There is no doubt that the proposals currently being debated in Washington will produce an end to the era of American Exceptionalism in Medicine – ask any doctor. The legacy of the 111th Congress will be the death of American Medical Exceptionalism if it passes any of the current health care proposals.
4. “Show me the Money” – The current proposals in Congress rely on savings generated from eliminating more than $500 billion in ‘fraud and abuse’ from the government’s Medicare and Medicaid programs. Every president and Congress since Nixon have made similar pledges, but you know what – the waste is still there. One does not have to pass a major ‘overhaul’ of health care to solve this problem. The government ‘owns’ Medicare and Medicaid – why not immediately begin to realize these savings if they can be identified and eliminated? If MasterCard and VISA can effectively control ‘fraud and abuse’ in their trillions of dollars in transactions yearly, why can’t the government do the same with a much smaller program? The reason the ‘fraud and abuse’ are still a part of those programs is the government does not have the expertise or technology to identify the ‘waste’.
Confidence in the government’s ability to manage a significant change in healthcare would be much greater if the government could demonstrate that it can fix the problems that currently exist in its present programs. Why not take the next two or three years and concentrate on the fraud and abuse in these government programs and prove to the American people the government can get results, not just make promises?
Representative Ann Kirkpatrick
September 23, 2009
Page Five
5. Inflammatory Rhetoric –The manner in which a proposed program is framed is an excellent indicator of the advocator’s beliefs. As a physician, I am terribly disturbed by the manner in which President Obama has characterized the medical profession. For the purpose of illustration I will give two such instances of this characterization:
• Portsmouth, New Hampshire August 11, 2009: Taken directly from transcripts of President’s Obama’s town hall meeting. President Obama states: “All I'm saying is let's take the example of something like diabetes, one of --- a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money.” (Applause.)
• Press Conference, East Room, White House July 22, 2009: Taken directly from transcripts of President’s Obama’s press conference. President Obama states: “So if they're looking -- and you come in and you've got a bad sore throat, or your child has a bad sore throat or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, you know what, I make a lot more money if I take this kid's tonsils out. Now that may be the right thing to do, but I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change -- maybe they have allergies, maybe they have something else that would make a difference. So part of what we want to do is to free doctors, patients, hospitals to make decisions based on what's best for patient care.”
For expediency I have bolded and highlighted the portions of the president’s speeches to indicate the inflammatory manner in which he has categorized physicians. In the first example he has stated that a surgeon would receive $30,000 to $50,000 for performing an amputation – nothing
Representative Ann Kirkpatrick
September 23, 2009
Page Six
could be further from the truth. The customary surgeon’s reimbursement for such a procedure is from $600 to $800 dollars. Not even the total hospital bill would approach the numbers ‘thrown out’ by the President.
In the second example, the President implies that physicians take into consideration what they will be reimbursed in making clinical decisions and only places like the Mayo Clinic base decisions on “what is best for the patient.” This statement is a vicious attack on the ethical values of physicians and is so egregious it does not even deserve a comment.
The use of rhetoric like this has only one purpose, not to disseminate the facts but to distort them to obtain a goal – in this case the President’s vision of medical care. By demonizing physicians as ‘money grubbing’ individuals, the administration seeks to gather support from the public. My disappointment in the President is only exceeded by my disappointment that no one in Congress stood tall and said – those statements are wrong! Do not think that these statements were overlooked by the medical profession; every physician I have talked with about the healthcare issue spontaneously brings up these two examples.
6. Absolute False Statements: One can intelligently debate issues without purposefully giving false statements to embellish one’s argument. The most glaring example was during President Obama’s speech before Congress on September 9, 2009 when he gave examples of abusive actions by insurers. Mr. Obama referred to a man in Illinois who “lost his coverage in the middle of chemotherapy because his insurer found he hadn’t reported gallstones that he didn’t even know about. They delayed treatment, and he died because of it.”
According to Scott Harrington of the Wall Street Journal: the President’s conclusion is contradicted by the transcript of a June 16 hearing of industry practices before the Subcommittee of Oversight and Investigation of the House Committee on Energy and Commerce. The deceased's sister testified that the insurer reinstated her brother's coverage following intervention by the Illinois Attorney General's Office. She testified that her brother received a prescribed stem-cell transplant within the desired three- to four-week "window of opportunity" from "one of the most renowned doctors in the whole world on the specific routine," that the procedure "was extremely successful," and that "it extended his life nearly three and a half years."
Representative Ann Kirkpatrick
September 23, 2009
Page Seven
Why would the President use a false statement on a nationally televised speech? Do we have to distort the facts to win our position? Why demonize the insurance industry in a fashion similar to the way he has demonized physicians? One can only conclude that the healthcare debate is really about President Obama delivering on a major social issue and not about what is best for the average American who is quite satisfied with their own personal health insurance situation. Once again Washington is about who wins and who loses – the people have been forgotten.
It is my sincere hope that you will vote against any of the current health care proposals before Congress (or any iteration of the same) and seek a more reasoned, incremental approach to addressing the major issues related to insurance ‘one problem at a time’. In the interim, this Congress and administration can immediately demonstrate its commitment to reform by implementing processes that actual identify and eliminate the ‘fraud and abuse’ in the current government medical programs.
Should you wish to discuss these issues in more depth, I would be happy to discuss them with you by phone, (928) 771-0978 or in person. Thank you for taking the time to read this lengthy letter.
Yours sincerely,
David S. Hess, M.D., F.A.C.C.
26 September 2009
Dump the United Nations
Why, exactly, do we still belong to the United Nations? We provide about 25% of the funding for the U.N., apparently because it must be expensive to talk a lot without actually doing anything and to fund anti-American hate propaganda. Well, I guess the money doesn’t just go for propaganda. Does anyone remember the Oil for Food scandal? Does anyone remember the corrupt U.N. leadership getting fabulously rich, with no significant repercussions, even when they were caught? Does anyone remember Saddam Hussein chairing the U.N. human rights commission? Does anyone seriously believe the corruption has abated? So, why do we continue to support this corrupt organization that offers nothing but empty rhetoric and hates us?
While we’re at it, we should also note that we continue to send foreign aid to many corrupt regimes that subjugate their people and regularly vote against us in the U.N. Our foreign aid policy seems to center around enriching the corrupt leaders of poor countries, while congratulating ourselves that a few pennies actually make it down to those in need. So, in these troubled financial times (or any other times, for that matter), why do we keep throwing money at dictators?
I agree that we have a moral obligation to help those less fortunate than us, but does that extend to our enemies, especially the corrupt ones? Should we continue to prop up totalitarian regimes in the prayer that some of the money will dribble down to the truly needy? The issue here is not whether we are willing to help others – clearly we are, witness our largess with foreign aid and our willingness to spend a huge proportion of our budget to fund a military that protects the whole world. The real issue is whether we should continue to throw good money after bad – whether we should try to bribe others into liking us, or, phrased differently, whether we should continue to pay the extortion money they demand. In any case, clearly none of this is working.
How about a different approach? Why don’t we try giving foreign aid to charitable organizations and other NGOs and encourage them to work in countries where they are allowed to freely bring food and medicine to those actually in need. If there are good diplomatic or other reasons why we should give foreign aid directly to countries, how about limiting it to free and democratic ones?
Why don’t we just quit the U.N.? Let’s form an alternative international association of freedom loving, democratic nations. Call it, say, the United Free Nations – something like NATO on a world-wide scale. NATO countries don’t always agree with us, but they don’t hate us. Let’s support and associate with countries without dictators and with human rights. It’s not that we would be denying support to those in need – it’s that we would quit supporting oppression. Let’s see how all those totalitarian regimes do without our support.
The really bad guys like Ahmadinejad, Kim, and Chavez will no doubt continue to spread their anti-American vitriol, and the conniving bastards like the Russians and the Chinese will continue their Machiavellian ploys; but I suspect that many of the less whacko nations may clean up their act if they lose our support and suddenly have to depend on the likes of Iran, North Korea, Venezuela, Russia and China.
I say we should begin to follow the advice our grandfathers gave us: choose your friends carefully.
While we’re at it, we should also note that we continue to send foreign aid to many corrupt regimes that subjugate their people and regularly vote against us in the U.N. Our foreign aid policy seems to center around enriching the corrupt leaders of poor countries, while congratulating ourselves that a few pennies actually make it down to those in need. So, in these troubled financial times (or any other times, for that matter), why do we keep throwing money at dictators?
I agree that we have a moral obligation to help those less fortunate than us, but does that extend to our enemies, especially the corrupt ones? Should we continue to prop up totalitarian regimes in the prayer that some of the money will dribble down to the truly needy? The issue here is not whether we are willing to help others – clearly we are, witness our largess with foreign aid and our willingness to spend a huge proportion of our budget to fund a military that protects the whole world. The real issue is whether we should continue to throw good money after bad – whether we should try to bribe others into liking us, or, phrased differently, whether we should continue to pay the extortion money they demand. In any case, clearly none of this is working.
How about a different approach? Why don’t we try giving foreign aid to charitable organizations and other NGOs and encourage them to work in countries where they are allowed to freely bring food and medicine to those actually in need. If there are good diplomatic or other reasons why we should give foreign aid directly to countries, how about limiting it to free and democratic ones?
Why don’t we just quit the U.N.? Let’s form an alternative international association of freedom loving, democratic nations. Call it, say, the United Free Nations – something like NATO on a world-wide scale. NATO countries don’t always agree with us, but they don’t hate us. Let’s support and associate with countries without dictators and with human rights. It’s not that we would be denying support to those in need – it’s that we would quit supporting oppression. Let’s see how all those totalitarian regimes do without our support.
The really bad guys like Ahmadinejad, Kim, and Chavez will no doubt continue to spread their anti-American vitriol, and the conniving bastards like the Russians and the Chinese will continue their Machiavellian ploys; but I suspect that many of the less whacko nations may clean up their act if they lose our support and suddenly have to depend on the likes of Iran, North Korea, Venezuela, Russia and China.
I say we should begin to follow the advice our grandfathers gave us: choose your friends carefully.
23 September 2009
Humor: Drooping and Sagging
The scariest movie I ever saw was, “The Attack of the Body Snatchers”. Nasty aliens planted giant seed pods all over the place and inside each pod grew a human body that was an exact replica of a real person. Once the pod body was fully grown, it took over the person it duplicated. Ok, maybe you don’t think it’s all that scary, but it still gives me the jitters.
And, just like in the movies, my worst nightmare has come true. The other day I was having trouble with the ear pieces on my glasses (these are called the “temples”, by the way – I looked it up). No matter how carefully I straightened them, my glasses were crooked – tipped to the right. Finally, I went into the bathroom to see if I was imagining the crookedness. I looked in the mirror and there was the root cause, plain as day. My right ear was quite a bit lower than my left ear.
Now, that ear has been on my head for 65 years, on the right, behind my sideburn, and beneath my hair. I’m pretty sure I would have noticed by now if it had always been out of place. I’m positive it has consistently been situated at the same elevation as my left ear. Yet, there it was, a full half inch low. There can only be one explanation: the pod body that replaced me was slightly defective.
In the movie, the replacement pod people were kind of numb and robotic, but my mind seems not to have been affected. I still have the same keen razor-sharp mind that remembers every detail except why to hell I came into this room. Just goes to show you that Hollywood doesn’t always get it right.
My wife doesn’t buy the pod thing. She thinks my ear is just sagging a little faster than the rest of my body, and the other ear will likely soon catch up. Now, I find that thought more than a little disconcerting. If things don’t droop symmetrically, all sorts of problems could develop: shirts with one long and one short sleeve; pants with one high water leg and the other dragging on the floor; bow legs that look like a figure 8; eyebrows that look like one caterpillar is farther up the tree; and, a potbelly that looks like a dumbbell with too many weights on one side. My God, what if the droops were on random sides. I’ll end up looking like Disney’s Goofy (or is it Pluto - I always get those characters mixed up).
This is all too much to contemplate. I’m going with the pod thing. Now that I think about it, this new pod body never smoked or drank or otherwise abused itself. I’ve got a whole new body to dissipate, and now I’m experienced. I’ll get it done in no time.
And, just like in the movies, my worst nightmare has come true. The other day I was having trouble with the ear pieces on my glasses (these are called the “temples”, by the way – I looked it up). No matter how carefully I straightened them, my glasses were crooked – tipped to the right. Finally, I went into the bathroom to see if I was imagining the crookedness. I looked in the mirror and there was the root cause, plain as day. My right ear was quite a bit lower than my left ear.
Now, that ear has been on my head for 65 years, on the right, behind my sideburn, and beneath my hair. I’m pretty sure I would have noticed by now if it had always been out of place. I’m positive it has consistently been situated at the same elevation as my left ear. Yet, there it was, a full half inch low. There can only be one explanation: the pod body that replaced me was slightly defective.
In the movie, the replacement pod people were kind of numb and robotic, but my mind seems not to have been affected. I still have the same keen razor-sharp mind that remembers every detail except why to hell I came into this room. Just goes to show you that Hollywood doesn’t always get it right.
My wife doesn’t buy the pod thing. She thinks my ear is just sagging a little faster than the rest of my body, and the other ear will likely soon catch up. Now, I find that thought more than a little disconcerting. If things don’t droop symmetrically, all sorts of problems could develop: shirts with one long and one short sleeve; pants with one high water leg and the other dragging on the floor; bow legs that look like a figure 8; eyebrows that look like one caterpillar is farther up the tree; and, a potbelly that looks like a dumbbell with too many weights on one side. My God, what if the droops were on random sides. I’ll end up looking like Disney’s Goofy (or is it Pluto - I always get those characters mixed up).
This is all too much to contemplate. I’m going with the pod thing. Now that I think about it, this new pod body never smoked or drank or otherwise abused itself. I’ve got a whole new body to dissipate, and now I’m experienced. I’ll get it done in no time.
21 September 2009
Playing the Race Card
In general, I have found that stereotypes get to be stereotypes for a reason: there is some truth to them. The big problem with stereotypes is that, even if they cease to be valid, they are as difficult to remove as a government program.
For example, there is a stereotype in this country that liberals are much less likely to be racists than conservatives, yet most conservatives I know get really pissed off if you call them racists. There’s another stereotype in this country that liberals are much more likely to be anti-American than conservatives, yet most liberals I know get really pissed off if you call them un-American or unpatriotic. Stereotypes are often wrong and they are always aggravating.
I lived in the South during the civil rights/Vietnam protest years, and I remember many conservatives who were segregationists, and proud of it. I also remember that many liberals from that era burned flags and supported Ho Chi Minh - some even did stuff like blow up the Pentagon - blatant un-American and unpatriotic behavior, yet they, too, were proud of themselves.
Times do change, and so do people. For example, some of my current conservative friends and acquaintances were liberal activists during the civil rights movement. Their politics have changed, but not their strong opposition to prejudice in general and racism in particular. I still know a few conservatives who are racists, but even their views have softened considerably. They seem to be frustrated more than angry, and much of their angst is about subjects like reverse discrimination and victimization.
Fifty years ago, the “n” word was as common as the “f” word is today, but these days the “n” word is a rare occurrence, except of course from black rappers who seem to revel in both words. Now there’s a deserving stereotype: “gangsta rappers”. I attribute all sorts of misogynistic, criminal, anti-social, uncivilized, racist, and other nasty sentiments to gangsta rappers and their music. But those attributions are directed toward their genre, not their race. I certainly do not think that way about the black lawyer, carpenter, businessman, plumber, clergyman, etc. who lives down the street or across the country. Like most of my conservative friends, I am very likely to judge people on their competence, character, and behavior, but I could care less about their race or ethnicity. I don’t mean to suggest that racism no longer exists among conservatives – it does – but it is usually considered unacceptable and backward and it has been relegated to the periphery.
In any case, if we’re going to be comparing liberals and conservatives, the discussion is about politics, not race. Conservatives generally agree that Clarence Thomas and Condoleezza Rice are wonderful role models to be respected and admired by all, and that Nancy Pelosi and Howard Dean are beneath contempt. My liberal friends, on the other hand, are very critical of both Thomas and Rice, and generally supportive of Pelosi and Dean. Does this mean my liberal friends are racists? Of course not - in both cases, the nasty remarks are about politics, not race. So much for racism.
Up until recently, I’m pleased to say that I don’t ever remember being called a racist or a bigot. Lately, though, it seems to be happening more and more – by folks who leap to the incredibly false and insulting assumption that any person or group that disagrees with President Obama does so because of his race. For many Obama supporters, the definition of racism has now become disagreement with the President or his policies. Countless politicians, clergy, media and press reporters, and other liberals, have publicly referred to people who oppose the President’s health care plan, or bailouts, or deficit spending, or corporate takeovers, as racists. Some of the same people have called folks who participated in “tea parties” or the recent “9.12 march on Washington” fascists, racists, bigots, and other epithets. In fact, the accusations seem to have come most quickly and most often from black politicians, clergy, and celebrities.
By any definition, this is “playing the race card”. Just because I disagree with a black president, politician, clergyman, or any other black person, does not mean that I am a racist. It simply means that I disagree with the person. I have a right, indeed a bounden duty, to express my political opinions, and the real agenda of those who would label me a racist is to censure my right of free speech – to shut me up.
This “race card” game is dangerous sport. Everyone knows how sensitive black people are to racial slurs, but I’m less certain that liberals know how sensitive conservatives are to charges of racism. For many years now, Hollywood and television and video games have featured black characters hurling racial epithets at black and white people. This has been considered acceptable, perhaps out of some sense of “white guilt”. But now the epithets have crossed over from the entertainment world to the real world.
A few days ago, I heard a well educated and reasonable conservative friend say, “When black liberals brand me a racist, that’s a slur, and I get so pissed off that I want to hurl the “n” word right back at them.” That’s the way it is with slurs, racial or otherwise. As soon as you use one, the discussion stops and the fight begins.
For example, there is a stereotype in this country that liberals are much less likely to be racists than conservatives, yet most conservatives I know get really pissed off if you call them racists. There’s another stereotype in this country that liberals are much more likely to be anti-American than conservatives, yet most liberals I know get really pissed off if you call them un-American or unpatriotic. Stereotypes are often wrong and they are always aggravating.
I lived in the South during the civil rights/Vietnam protest years, and I remember many conservatives who were segregationists, and proud of it. I also remember that many liberals from that era burned flags and supported Ho Chi Minh - some even did stuff like blow up the Pentagon - blatant un-American and unpatriotic behavior, yet they, too, were proud of themselves.
Times do change, and so do people. For example, some of my current conservative friends and acquaintances were liberal activists during the civil rights movement. Their politics have changed, but not their strong opposition to prejudice in general and racism in particular. I still know a few conservatives who are racists, but even their views have softened considerably. They seem to be frustrated more than angry, and much of their angst is about subjects like reverse discrimination and victimization.
Fifty years ago, the “n” word was as common as the “f” word is today, but these days the “n” word is a rare occurrence, except of course from black rappers who seem to revel in both words. Now there’s a deserving stereotype: “gangsta rappers”. I attribute all sorts of misogynistic, criminal, anti-social, uncivilized, racist, and other nasty sentiments to gangsta rappers and their music. But those attributions are directed toward their genre, not their race. I certainly do not think that way about the black lawyer, carpenter, businessman, plumber, clergyman, etc. who lives down the street or across the country. Like most of my conservative friends, I am very likely to judge people on their competence, character, and behavior, but I could care less about their race or ethnicity. I don’t mean to suggest that racism no longer exists among conservatives – it does – but it is usually considered unacceptable and backward and it has been relegated to the periphery.
In any case, if we’re going to be comparing liberals and conservatives, the discussion is about politics, not race. Conservatives generally agree that Clarence Thomas and Condoleezza Rice are wonderful role models to be respected and admired by all, and that Nancy Pelosi and Howard Dean are beneath contempt. My liberal friends, on the other hand, are very critical of both Thomas and Rice, and generally supportive of Pelosi and Dean. Does this mean my liberal friends are racists? Of course not - in both cases, the nasty remarks are about politics, not race. So much for racism.
Up until recently, I’m pleased to say that I don’t ever remember being called a racist or a bigot. Lately, though, it seems to be happening more and more – by folks who leap to the incredibly false and insulting assumption that any person or group that disagrees with President Obama does so because of his race. For many Obama supporters, the definition of racism has now become disagreement with the President or his policies. Countless politicians, clergy, media and press reporters, and other liberals, have publicly referred to people who oppose the President’s health care plan, or bailouts, or deficit spending, or corporate takeovers, as racists. Some of the same people have called folks who participated in “tea parties” or the recent “9.12 march on Washington” fascists, racists, bigots, and other epithets. In fact, the accusations seem to have come most quickly and most often from black politicians, clergy, and celebrities.
By any definition, this is “playing the race card”. Just because I disagree with a black president, politician, clergyman, or any other black person, does not mean that I am a racist. It simply means that I disagree with the person. I have a right, indeed a bounden duty, to express my political opinions, and the real agenda of those who would label me a racist is to censure my right of free speech – to shut me up.
This “race card” game is dangerous sport. Everyone knows how sensitive black people are to racial slurs, but I’m less certain that liberals know how sensitive conservatives are to charges of racism. For many years now, Hollywood and television and video games have featured black characters hurling racial epithets at black and white people. This has been considered acceptable, perhaps out of some sense of “white guilt”. But now the epithets have crossed over from the entertainment world to the real world.
A few days ago, I heard a well educated and reasonable conservative friend say, “When black liberals brand me a racist, that’s a slur, and I get so pissed off that I want to hurl the “n” word right back at them.” That’s the way it is with slurs, racial or otherwise. As soon as you use one, the discussion stops and the fight begins.
17 September 2009
Socialism On The Rise
America was founded on two great principles: democracy and capitalism - freedom and private enterprise. They are intrinsically entwined. If you stifle one, you stifle the other. They stand in perfect contrast to autocracy and socialism. In democratic societies, the people have the ultimate say. In autocracies, the government has the ultimate say. In capitalism, companies are owned by private people. In socialism, companies are owned by the government.
So much for economic and political science theory – here in the real world, there are no pure democracies and no country is purely capitalistic. We definitely need some government in our lives. You don’t have to be a socialist to recognize that there are some things that are better run by the government, e.g., the military, homeland defense, mail (UPS and Fedex wouldn’t touch daily mail delivery), highways and roads, police and fire departments, etc. Some other things seem to function best when they are regulated, but not run, by the government, e.g., the airlines, food and drug quality, electric power and natural gas distribution, and interstate transportation. But, in a democracy, these are the exceptions - most things seem to function best when the government stays out of the way and capitalism (free enterprise) is allowed to run its course. And that’s the way things have always been here in America … all the way up to 2009.
Then came CHANGE! Incredibly, everything has been turned on its head during the past few months. The government has taken over more and more businesses and activities, ostensibly to protect us from one “crisis” or another. First we were told that some large insurance companies needed a huge “stimulus” cash injection or they would fail. Then some large banks needed to be bailed out or they would fail. Next came General Motors and Chrysler: bail them out or they would fail. Before we could catch our breath, much less digest the issues or have a national debate, a completely partisan congress passed several huge spending bills, and presto: the government is running insurance companies, banks, and automobile manufacturers, and the national deficit and debt have skyrocketed. How on earth did we ever agree to all this? Well, we didn’t. President Obama and congress just did it. They didn’t ask our permission. Oh, they did keep us informed, sort of: the takeovers were couched in phraseology like “the American people now own a major share of General Motors”. What? I already owned shares of General Motors – shares that I could sell. That’s what it means to own a share of General Motors: you have a stock certificate that you can sell. Does anyone remember getting AIG, Citybank, or General Motors stock certificates when the government took over? These are not takeovers by the American people. These are takeovers by the government. Let’s see, what is it called when the government takes over major industries? Oh yeah, socialism! What is it called when smooth talk convinces you that something you have always instinctively opposed is actually a good idea? Oh, yeah, a con-job!
When 52% of American voters elected President Obama and a Democrat majority in the House and Senate, they were convinced they were voting for hope and change. How many of them were hoping for a change from capitalism to socialism, from democracy to autocracy?
Exactly how critical were all those “crises”, anyway? Most of the “stimulus” money is not scheduled to be spent until 2010 – how critical could that have been? (Oh, I see. It is critical that the money be spent during the political campaign season next year … hmmm.) What would have happened if some insurance, banking, and automobile companies had “failed”. Well, when a company “fails”, it can’t pay its bills, and it is forced to declare bankruptcy. Our economic and legal systems have anticipated such happenstances, and are fully prepared to deal with them. The bankruptcy code includes several types of bankruptcies, and the one that is usually most applicable to large companies is called Chapter 11. In that case, a judge or administrator is placed in charge of reorganizing the company. This means the company renegotiates its contracts with its vendors, suppliers and employees. Everyone initially settles for less than they are owed, but everyone gets something, including a possibility of future payment of the balance. In many cases, the more favorable contracts allow the company to once again become profitable and they are able to pay off their old bills.
Let’s look at General Motors. If the government had not interfered, General Motors would have declared bankruptcy and reorganized by renegotiating its untenable union contracts, closing unprofitable dealerships, and eliminating some models, among other things. Most likely, a smaller, leaner, but profitable GM would have emerged. Then stockholders like me would have seen the value of their shares rise, GM stock would have once again become attractive to investors, and capitalism would have done the rest. Instead, GM went bankrupt anyway, but now the government and the autoworkers union are the majority shareholders – General Motors became Government Motors.
Does anyone really believe that the government and the union will do a better job of making GM profitable?
When has the government ever been efficient or turned a profit? The government owns Amtrak, Medicare, Social Security, and the Post Office. All of them are supposedly self sufficient and all of them are broke! The only reason they continue to operate is that the government keeps infusing tax dollars. (It’s much easier to keep a badly managed enterprise afloat if you can just print more money.)
And does anyone really expect the union to turn a profit? Fat and fatter union contracts have been one of the major problems with the U.S. auto industry. The ever-fatter union contracts have strangled the companies and made them less and less profitable (yes, the company management is also complicit and should be fired). And now the President uses our tax dollars to give a huge share of GM to the unions? As they say in the South, we have put the fox in charge of the hen-house. But, you have to give the President credit: he has kept his promises to the unions who were so instrumental in getting him elected. Wait a minute? Isn’t this the guy who vowed never to be influenced by special interests? I guess that depends on what your definition of “never” is.
Now the government is maneuvering to take over the health care industry: 17% of our economy. Is there an economist anywhere that would disagree with the notion that, when the government gains increasing control of the insurance, banking, automobile and health care industries, capitalism is dying and socialism is on the rise? Is that really the change we had in mind? Seriously? Socialists depend on the government to take care of everyone. Capitalists take care of themselves. Which are we, dependent or independent?
Think about it folks. All of this has happened in less than a year. Congress and the Obama Administration have employed “crisis” tactics to scare us into throwing away capitalistic free enterprise in favor of socialism – competition in favor of regulation. Capitalism is America’s powerhouse, the heart of the strongest economy on earth, the most consistently productive country in history, a meritocracy where excellence and accomplishment lead to achievement and advancement, the mother ship of entrepreneurism and enterprise. We abandon all this for socialism? The heart of socialism is regulated equality – not equality of opportunity, but sameness. Unions, for example, are socialistic ventures. Since seniority is the only basis for advancement, and neither exceptional skill level nor superior competence are factors, everyone is obviously presumed to have equal levels of skill and competence. If the only basis of promotion or advancement is seniority, why would anyone work harder or try to perform better? Why indeed? Welcome to socialism.
America derives is strength and greatness not from equality but from equality of opportunity! Democracy and capitalism strive to treat everyone equally but recognize that we are not all the same. Everyone has the same opportunity to succeed, but the degree of success depends on competence, willingness to work hard, and competitive drive. Socialism, on the other hand, stifles competition and work ethic in the name of sameness, and thus drowns out excellence.
One of the biggest problems with socialism on a national scale is the size of centralized government and the bureaucracy required to run it. Take socialized medicine (national health care) as an example. In the current debate on national health care, many folks have been frustrated by the complexity of the 1,000+ page bill that is working its way through congress. It is so long and complex that many of the politicians who are pushing the bill have admittedly not read either the bill or its many proposed amendments and alternatives. As if that were not sufficiently frustrating, consider this. Whichever bill is ultimately enacted, the resulting law will only prescribe things like purpose, objectives, guidelines, parameters, and limitations. That’s what laws do. The implementation of the law, i.e., how the national health care system will function day to day, will be governed by rules and regulations that will be developed by various government bureaucracies – some existing and some new. If you think this proposed law is long and complicated, wait until you see the resulting rules and regulations. They will comprise tens of thousands of pages, no one will understand the whole thing, there will be dozens of agencies with conflicting rules and competing agendas, and the bureaucrats who administer the rules and regulations will be hopelessly bound in red tape. I can envision a national health care system with the compassion of the IRS and the efficiency of the INS.
As Ronald Reagan once said, “The closest thing to eternal life here on earth is a government program.” Well standby, folks, the government programs are raining down on us and we’re going to have the devil’s own time getting rid of them. By the time our first opportunity comes around in November of 2010, Obama and his socialist secular progressives will be well entrenched. We had better get in shape because we’re in for a helluva fight. The early skirmishes have already been fought by those who participated in the “tea parties” and the “9-12 march on Washington” – truly civilized, non-violent, grass roots protests by good solid Americans. The silent majority is finally finding its voice. Kind of energizing, isn’t it?
So much for economic and political science theory – here in the real world, there are no pure democracies and no country is purely capitalistic. We definitely need some government in our lives. You don’t have to be a socialist to recognize that there are some things that are better run by the government, e.g., the military, homeland defense, mail (UPS and Fedex wouldn’t touch daily mail delivery), highways and roads, police and fire departments, etc. Some other things seem to function best when they are regulated, but not run, by the government, e.g., the airlines, food and drug quality, electric power and natural gas distribution, and interstate transportation. But, in a democracy, these are the exceptions - most things seem to function best when the government stays out of the way and capitalism (free enterprise) is allowed to run its course. And that’s the way things have always been here in America … all the way up to 2009.
Then came CHANGE! Incredibly, everything has been turned on its head during the past few months. The government has taken over more and more businesses and activities, ostensibly to protect us from one “crisis” or another. First we were told that some large insurance companies needed a huge “stimulus” cash injection or they would fail. Then some large banks needed to be bailed out or they would fail. Next came General Motors and Chrysler: bail them out or they would fail. Before we could catch our breath, much less digest the issues or have a national debate, a completely partisan congress passed several huge spending bills, and presto: the government is running insurance companies, banks, and automobile manufacturers, and the national deficit and debt have skyrocketed. How on earth did we ever agree to all this? Well, we didn’t. President Obama and congress just did it. They didn’t ask our permission. Oh, they did keep us informed, sort of: the takeovers were couched in phraseology like “the American people now own a major share of General Motors”. What? I already owned shares of General Motors – shares that I could sell. That’s what it means to own a share of General Motors: you have a stock certificate that you can sell. Does anyone remember getting AIG, Citybank, or General Motors stock certificates when the government took over? These are not takeovers by the American people. These are takeovers by the government. Let’s see, what is it called when the government takes over major industries? Oh yeah, socialism! What is it called when smooth talk convinces you that something you have always instinctively opposed is actually a good idea? Oh, yeah, a con-job!
When 52% of American voters elected President Obama and a Democrat majority in the House and Senate, they were convinced they were voting for hope and change. How many of them were hoping for a change from capitalism to socialism, from democracy to autocracy?
Exactly how critical were all those “crises”, anyway? Most of the “stimulus” money is not scheduled to be spent until 2010 – how critical could that have been? (Oh, I see. It is critical that the money be spent during the political campaign season next year … hmmm.) What would have happened if some insurance, banking, and automobile companies had “failed”. Well, when a company “fails”, it can’t pay its bills, and it is forced to declare bankruptcy. Our economic and legal systems have anticipated such happenstances, and are fully prepared to deal with them. The bankruptcy code includes several types of bankruptcies, and the one that is usually most applicable to large companies is called Chapter 11. In that case, a judge or administrator is placed in charge of reorganizing the company. This means the company renegotiates its contracts with its vendors, suppliers and employees. Everyone initially settles for less than they are owed, but everyone gets something, including a possibility of future payment of the balance. In many cases, the more favorable contracts allow the company to once again become profitable and they are able to pay off their old bills.
Let’s look at General Motors. If the government had not interfered, General Motors would have declared bankruptcy and reorganized by renegotiating its untenable union contracts, closing unprofitable dealerships, and eliminating some models, among other things. Most likely, a smaller, leaner, but profitable GM would have emerged. Then stockholders like me would have seen the value of their shares rise, GM stock would have once again become attractive to investors, and capitalism would have done the rest. Instead, GM went bankrupt anyway, but now the government and the autoworkers union are the majority shareholders – General Motors became Government Motors.
Does anyone really believe that the government and the union will do a better job of making GM profitable?
When has the government ever been efficient or turned a profit? The government owns Amtrak, Medicare, Social Security, and the Post Office. All of them are supposedly self sufficient and all of them are broke! The only reason they continue to operate is that the government keeps infusing tax dollars. (It’s much easier to keep a badly managed enterprise afloat if you can just print more money.)
And does anyone really expect the union to turn a profit? Fat and fatter union contracts have been one of the major problems with the U.S. auto industry. The ever-fatter union contracts have strangled the companies and made them less and less profitable (yes, the company management is also complicit and should be fired). And now the President uses our tax dollars to give a huge share of GM to the unions? As they say in the South, we have put the fox in charge of the hen-house. But, you have to give the President credit: he has kept his promises to the unions who were so instrumental in getting him elected. Wait a minute? Isn’t this the guy who vowed never to be influenced by special interests? I guess that depends on what your definition of “never” is.
Now the government is maneuvering to take over the health care industry: 17% of our economy. Is there an economist anywhere that would disagree with the notion that, when the government gains increasing control of the insurance, banking, automobile and health care industries, capitalism is dying and socialism is on the rise? Is that really the change we had in mind? Seriously? Socialists depend on the government to take care of everyone. Capitalists take care of themselves. Which are we, dependent or independent?
Think about it folks. All of this has happened in less than a year. Congress and the Obama Administration have employed “crisis” tactics to scare us into throwing away capitalistic free enterprise in favor of socialism – competition in favor of regulation. Capitalism is America’s powerhouse, the heart of the strongest economy on earth, the most consistently productive country in history, a meritocracy where excellence and accomplishment lead to achievement and advancement, the mother ship of entrepreneurism and enterprise. We abandon all this for socialism? The heart of socialism is regulated equality – not equality of opportunity, but sameness. Unions, for example, are socialistic ventures. Since seniority is the only basis for advancement, and neither exceptional skill level nor superior competence are factors, everyone is obviously presumed to have equal levels of skill and competence. If the only basis of promotion or advancement is seniority, why would anyone work harder or try to perform better? Why indeed? Welcome to socialism.
America derives is strength and greatness not from equality but from equality of opportunity! Democracy and capitalism strive to treat everyone equally but recognize that we are not all the same. Everyone has the same opportunity to succeed, but the degree of success depends on competence, willingness to work hard, and competitive drive. Socialism, on the other hand, stifles competition and work ethic in the name of sameness, and thus drowns out excellence.
One of the biggest problems with socialism on a national scale is the size of centralized government and the bureaucracy required to run it. Take socialized medicine (national health care) as an example. In the current debate on national health care, many folks have been frustrated by the complexity of the 1,000+ page bill that is working its way through congress. It is so long and complex that many of the politicians who are pushing the bill have admittedly not read either the bill or its many proposed amendments and alternatives. As if that were not sufficiently frustrating, consider this. Whichever bill is ultimately enacted, the resulting law will only prescribe things like purpose, objectives, guidelines, parameters, and limitations. That’s what laws do. The implementation of the law, i.e., how the national health care system will function day to day, will be governed by rules and regulations that will be developed by various government bureaucracies – some existing and some new. If you think this proposed law is long and complicated, wait until you see the resulting rules and regulations. They will comprise tens of thousands of pages, no one will understand the whole thing, there will be dozens of agencies with conflicting rules and competing agendas, and the bureaucrats who administer the rules and regulations will be hopelessly bound in red tape. I can envision a national health care system with the compassion of the IRS and the efficiency of the INS.
As Ronald Reagan once said, “The closest thing to eternal life here on earth is a government program.” Well standby, folks, the government programs are raining down on us and we’re going to have the devil’s own time getting rid of them. By the time our first opportunity comes around in November of 2010, Obama and his socialist secular progressives will be well entrenched. We had better get in shape because we’re in for a helluva fight. The early skirmishes have already been fought by those who participated in the “tea parties” and the “9-12 march on Washington” – truly civilized, non-violent, grass roots protests by good solid Americans. The silent majority is finally finding its voice. Kind of energizing, isn’t it?
15 September 2009
Overview of Heath Care Issues
I try for due diligence in my research for serious essays, and then I try even harder to condense the essence of my conclusions into short essays. Recognizing that most folks expect blogs to be succinct, I limit my essays to a couple pages or so.
On the topic of health care in the U.S., the complexities and considerations of public versus private health care systems alone would require many books to address in detail. Consequently, the essays on current health care issues I have posted in this blog hardly scratch the surface, and even that surface treatment required three essays. I hope that readers of this blog will recognize that the three essays are intrinsically entwined.
You can review all three essays together by simply clicking on "Health Care Issues" below.
On the topic of health care in the U.S., the complexities and considerations of public versus private health care systems alone would require many books to address in detail. Consequently, the essays on current health care issues I have posted in this blog hardly scratch the surface, and even that surface treatment required three essays. I hope that readers of this blog will recognize that the three essays are intrinsically entwined.
You can review all three essays together by simply clicking on "Health Care Issues" below.
Reforming Our Great but Flawed Health Care System: Some Alternative Solutions to National Health Care
Obamacare supporters often charge that Republicans and other opponents only complain, without offering alternative solutions to address the problems with our current health care system. They claim that Republicans are opposed to any changes in the current system. This is absurd. Virtually everyone I know, Republicans, Democrats, and Independents alike, agree that our current system has problems that must be addressed; but, most also agree that the system should not be scrapped in favor of national health care. In fact, there are a half dozen or more proposed Republican health care bills that the Democrat leadership has so far refused to consider and the liberal media have ignored. Even President Obama has repeatedly said that his opposition has offered no alternatives. Although he maintains that his door remains open to any legislators who would like to offer alternatives, he has actually refused to meet with any Republican who has an alternative to offer. During his most recent televised address, the President completely ignored several Republicans who stood and waved their alternative proposals - partisan politics as usual.
So, in the hope that some Obamacare supporters are willing to transcend partisan politics, the following is a compilation of some of the alternatives that are commonly discussed in conservative circles, but receive scant attention by the liberal media and press. These proposals would go a long way toward solving the two greatest problems with our current health care system: decreasing the spiraling costs of healthcare, and providing healthcare insurance for those who cannot obtain or afford it.
• Transportability. Nearly everyone agrees that healthcare insurance should become transportable. Employees should be able to own their own insurance, and pay for it with pre-tax dollars just like the corporations now do. Employers could of course contribute toward the cost of this insurance just as many of them now do with employees’ 401Ks. Since individual employees, and not the corporations, would own the policies, the employees could take the insurance with them if they change jobs.
• Buying healthcare insurance across State lines. Again, nearly everyone agrees that individuals and corporations should be able to purchase health insurance from the most competitive bidder, regardless of State boundaries. Currently, most States prohibit the purchase of health insurance from any company that has not been pre-approved by the State. Such restrictions on purchasing health insurance should be eliminated. Purchase of health insurance should be open, just like automobile and property insurance. Some policies will be better or cheaper than others and the free market will sort them out.
• Pre-existing conditions. Again, nearly everyone agrees that people should not be refused health insurance coverage because of pre-existing conditions. There is no problem, of course with insurance companies offering a discount to healthy folks who don’t smoke, and do exercise and maintain proper weight, etc.
• Health Savings Accounts (HSAs) - this one is apparently controversial, because it is currently available and quite popular, yet all of the current legislation proposed by Democrats eliminates it. An HSA allows individuals and families to purchase catastrophic health insurance coverage, i.e., a very high deductible, while assuming responsibility for all health care expenses below the deductible. Except for small co-pays, health care expenses above the deductible are paid for by the insurer. The purchaser must then contribute funds into a Health Savings Account using pre-tax dollars. Once the purchaser has deposited an amount equal to the deductible, contributions can of course stop. The money in the HSA can be withdrawn, with no tax penalty, for certain expenses such as education, purchase of a home, or health care. When any amount is withdrawn, contributions must of course resume until the deductible is met.
• National Catastrophic Health Care Insurance (NCI). Again, the insurance would only cover catastrophic costs above a certain limit, and the purchaser would be responsible for routine costs below the limit. The coverage would be standardized and the implementation would be similar to the existing national flood insurance.
• Routine health care. The primary feature of both HSAs and NCI is that routine health care is paid for by the individuals, as opposed to the insurer. This feature has the great benefit of decreasing the overall amount spent on health care for the following reason. People who have only a small health insurance co-pay and/or deductible tend to go to the Doctor or the ER for minor problems; and, they have no incentive to object to, or even inquire about the need for, expensive tests and procedures. When such visits, tests, and procedures are paid for by the individuals themselves, as opposed to insurance, they visit the doctor less, and question the necessity of tests and procedures.
• No medical bankruptcy. Because both plans pay for virtually all healthcare above the deductible/limit, HSAs and NCI would both preclude any participant from ever being bankrupted by medical bills.
• Advantages of HSA. The advantages of HSAs over NCI are that the HSA savings are required and are made with pre-tax dollars. Additionally, once an amount equal to the deductible has been deposited, no further contributions are required. With the National plan, individuals would have to either pay the initial health care costs out of pocket, with after tax dollars, or use the ER.
• Tort reform. This is a complex process that must simultaneously protect the rights of individuals who have been harmed, while precluding spurious lawsuits. A reform that is often mentioned is that the fee collected by the suing attorneys should be limited. These attorneys should of course be reimbursed for all of their out of pocket expenses, but their fees should be capped, say at $1,000,000. Another reform might be to contribute any punitive damages above $1,000,000 toward providing indigent health care insurance, for example, rather than enriching tort attorneys. There are many other tort reforms to be considered, but the end result must protect the individual right to sue while ending spurious law suits.
• Living wills. For most of us, a huge proportion of our lifetime medical expenses will be encumbered during the last year of our lives. Other cultures allow you to die peacefully at home, in no pain or discomfort (drugged to the hilt if necessary), as opposed to undergoing terribly expensive, horribly intrusive, demeaning, and often painful, medical procedures. However heroic such medical intervention may be, I'll take the peaceful death at home, thank you. The primary culprits here are loved ones who cannot bear the thought of parting with the patient (particularly if the patient is young), urged on by medical personnel trained to save the patient at any cost. We need a nationwide campaign in the media, churches, synagogues, community centers, hospitals, rehabilitation centers, and nursing homes, etc. to convince everyone, especially those with terminal illnesses or conditions, to prepare a living will. A living will specifies the patient’s choices regarding various medical procedures, and thus spares loved ones the trauma of making those difficult decisions for them. Please note that I am not suggesting we require anyone to refuse care, and I am certainly not suggesting that any provider be required to deny care or procedures - only that the dying person should retain the option to refuse care and die with dignity.
• Local clinics. Emergency Rooms should be supplemented by local urgent care clinics, whose function it would be to provide routine care such as treating cuts, sprains, colds, flu, minor infections, etc. – more serious problems would be referred to ERs. Such clinics could be headed by Nurse Practitioners and/or Physician Assistants without the involvement or supervision of MDs or DOs (Federal and State regulations would have to be changed to allow this), and the required medical equipment would be minimal. Whether paid for by individuals, insurers, or public funds in the case of the indigent, the routine care provided by such clinics would cost a fraction of ER care. The clinics would also reduce ER overcrowding and allow ERs to treat emergencies as opposed to routine health problems.
All of these are ideas that could be enacted or encouraged by the federal government. All of them would greatly improve, yet be consistent with, the current system. No one would have to give up any benefits they already have. Most importantly, none of them require a national health care system.
Perhaps we will someday conclude that a national health care system is in our best interests. But let’s not be impulsive about reaching that conclusion. Let’s be prudent and proceed deliberately. Let’s debate the issues at length and hold a long and detailed national discussion. Let’s try to fix the problems before we consider scrapping the entire system. Let’s take some baby steps before we jump off the cliff. We do not have to do this immediately. This has been an ongoing problem for at least 25 years – it is not a crisis. We should address the issues rationally and sensibly. We must resist the attempt by the President and congress to rush through the biggest and most expensive legislation in our history without giving the nation a chance to consider options and understand the wide-ranging implications. Let’s take a deep breath, and really think about it.
So, in the hope that some Obamacare supporters are willing to transcend partisan politics, the following is a compilation of some of the alternatives that are commonly discussed in conservative circles, but receive scant attention by the liberal media and press. These proposals would go a long way toward solving the two greatest problems with our current health care system: decreasing the spiraling costs of healthcare, and providing healthcare insurance for those who cannot obtain or afford it.
• Transportability. Nearly everyone agrees that healthcare insurance should become transportable. Employees should be able to own their own insurance, and pay for it with pre-tax dollars just like the corporations now do. Employers could of course contribute toward the cost of this insurance just as many of them now do with employees’ 401Ks. Since individual employees, and not the corporations, would own the policies, the employees could take the insurance with them if they change jobs.
• Buying healthcare insurance across State lines. Again, nearly everyone agrees that individuals and corporations should be able to purchase health insurance from the most competitive bidder, regardless of State boundaries. Currently, most States prohibit the purchase of health insurance from any company that has not been pre-approved by the State. Such restrictions on purchasing health insurance should be eliminated. Purchase of health insurance should be open, just like automobile and property insurance. Some policies will be better or cheaper than others and the free market will sort them out.
• Pre-existing conditions. Again, nearly everyone agrees that people should not be refused health insurance coverage because of pre-existing conditions. There is no problem, of course with insurance companies offering a discount to healthy folks who don’t smoke, and do exercise and maintain proper weight, etc.
• Health Savings Accounts (HSAs) - this one is apparently controversial, because it is currently available and quite popular, yet all of the current legislation proposed by Democrats eliminates it. An HSA allows individuals and families to purchase catastrophic health insurance coverage, i.e., a very high deductible, while assuming responsibility for all health care expenses below the deductible. Except for small co-pays, health care expenses above the deductible are paid for by the insurer. The purchaser must then contribute funds into a Health Savings Account using pre-tax dollars. Once the purchaser has deposited an amount equal to the deductible, contributions can of course stop. The money in the HSA can be withdrawn, with no tax penalty, for certain expenses such as education, purchase of a home, or health care. When any amount is withdrawn, contributions must of course resume until the deductible is met.
• National Catastrophic Health Care Insurance (NCI). Again, the insurance would only cover catastrophic costs above a certain limit, and the purchaser would be responsible for routine costs below the limit. The coverage would be standardized and the implementation would be similar to the existing national flood insurance.
• Routine health care. The primary feature of both HSAs and NCI is that routine health care is paid for by the individuals, as opposed to the insurer. This feature has the great benefit of decreasing the overall amount spent on health care for the following reason. People who have only a small health insurance co-pay and/or deductible tend to go to the Doctor or the ER for minor problems; and, they have no incentive to object to, or even inquire about the need for, expensive tests and procedures. When such visits, tests, and procedures are paid for by the individuals themselves, as opposed to insurance, they visit the doctor less, and question the necessity of tests and procedures.
• No medical bankruptcy. Because both plans pay for virtually all healthcare above the deductible/limit, HSAs and NCI would both preclude any participant from ever being bankrupted by medical bills.
• Advantages of HSA. The advantages of HSAs over NCI are that the HSA savings are required and are made with pre-tax dollars. Additionally, once an amount equal to the deductible has been deposited, no further contributions are required. With the National plan, individuals would have to either pay the initial health care costs out of pocket, with after tax dollars, or use the ER.
• Tort reform. This is a complex process that must simultaneously protect the rights of individuals who have been harmed, while precluding spurious lawsuits. A reform that is often mentioned is that the fee collected by the suing attorneys should be limited. These attorneys should of course be reimbursed for all of their out of pocket expenses, but their fees should be capped, say at $1,000,000. Another reform might be to contribute any punitive damages above $1,000,000 toward providing indigent health care insurance, for example, rather than enriching tort attorneys. There are many other tort reforms to be considered, but the end result must protect the individual right to sue while ending spurious law suits.
• Living wills. For most of us, a huge proportion of our lifetime medical expenses will be encumbered during the last year of our lives. Other cultures allow you to die peacefully at home, in no pain or discomfort (drugged to the hilt if necessary), as opposed to undergoing terribly expensive, horribly intrusive, demeaning, and often painful, medical procedures. However heroic such medical intervention may be, I'll take the peaceful death at home, thank you. The primary culprits here are loved ones who cannot bear the thought of parting with the patient (particularly if the patient is young), urged on by medical personnel trained to save the patient at any cost. We need a nationwide campaign in the media, churches, synagogues, community centers, hospitals, rehabilitation centers, and nursing homes, etc. to convince everyone, especially those with terminal illnesses or conditions, to prepare a living will. A living will specifies the patient’s choices regarding various medical procedures, and thus spares loved ones the trauma of making those difficult decisions for them. Please note that I am not suggesting we require anyone to refuse care, and I am certainly not suggesting that any provider be required to deny care or procedures - only that the dying person should retain the option to refuse care and die with dignity.
• Local clinics. Emergency Rooms should be supplemented by local urgent care clinics, whose function it would be to provide routine care such as treating cuts, sprains, colds, flu, minor infections, etc. – more serious problems would be referred to ERs. Such clinics could be headed by Nurse Practitioners and/or Physician Assistants without the involvement or supervision of MDs or DOs (Federal and State regulations would have to be changed to allow this), and the required medical equipment would be minimal. Whether paid for by individuals, insurers, or public funds in the case of the indigent, the routine care provided by such clinics would cost a fraction of ER care. The clinics would also reduce ER overcrowding and allow ERs to treat emergencies as opposed to routine health problems.
All of these are ideas that could be enacted or encouraged by the federal government. All of them would greatly improve, yet be consistent with, the current system. No one would have to give up any benefits they already have. Most importantly, none of them require a national health care system.
Perhaps we will someday conclude that a national health care system is in our best interests. But let’s not be impulsive about reaching that conclusion. Let’s be prudent and proceed deliberately. Let’s debate the issues at length and hold a long and detailed national discussion. Let’s try to fix the problems before we consider scrapping the entire system. Let’s take some baby steps before we jump off the cliff. We do not have to do this immediately. This has been an ongoing problem for at least 25 years – it is not a crisis. We should address the issues rationally and sensibly. We must resist the attempt by the President and congress to rush through the biggest and most expensive legislation in our history without giving the nation a chance to consider options and understand the wide-ranging implications. Let’s take a deep breath, and really think about it.
14 September 2009
Why is national health care so popular in other countries?
President Obama’s supporters often complain that opponents of national health care are opposed to any reform. Baloney. We who oppose the currently proposed health care bills are not opposed to reforming our health care system. We know it has problems and we want to fix those problems, but we also know that, although our heath care system is not perfect, it also is not completely broken. For more than 75% of us, the system works well, so we are opposed to a complete transformation from a private to a public system. We want change, not revolution.
So, at this point, it seems the debate boils down to whether we prefer a public or private health care system. One of the major arguments in favor of a national system is that virtually all western countries have some form of national health care. The major benefits seem to be that everyone is covered and it is less expensive. These notions are very interesting. They suggest that government can provide more service at a lower cost than private enterprise and the free market. This seems counter-intuitive to most of us and flies in the face of our very successful capitalist economic system, not to mention that most Americans consider government programs to be bureaucratic, hide-bound, inefficient, and financially profligate. Nonetheless, all those other countries that seem to like their national health care cannot be ignored. Why do they like their national health care so much?
The answer is actually fairly straight-forward. It is a classical demonstration of the difficulty of applying statistics to human endeavor. We begin by noting that western societies generally provide living conditions that are quite safe and healthy. Consequently, prior to attaining the “end of life” years, most of us encounter relatively few serious medical problems. We rarely seek medical help, and then usually for fairly simple problems that any reasonably competent provider can adequately address – cuts and sprains, colds and flu, acid stomachs, high blood pressure, and such. For most of us, these routine types of medical issues will be all we ever encounter until we are old. Since any health care system can adequately deal with such routine issues, national health care is as good as any other. Simply stated, 90% or more of young and middle aged westerners only require routine medical care, so those 90% are perfectly satisfied with national health care. Additionally, routine heath care usually does not require expensive tests, procedures, or specialists, so the cost is relatively low. So, since any system can deal with routine medical issues, and such issues are relatively inexpensive to treat, national health care systems can treat them effectively and at a reasonable cost. In summary, national health care systems do fine 90% or more of the time. By any statistical measure, they work well.
But this is not a study in statistics. Medical issues are personal. Although national health care may be fine 90% of the time, the care received by the other 10% is an equally important measure of the quality of the health care system. Quality care means treating individual people, not the average person or even the 90% majority. When you become seriously injured or ill, when you have a serious medical condition that requires expensive tests, specialists, complex operations, intensive care, and long term recovery, you could care less what the polling data say or what most folks think of the system. You need comprehensive quality care, now!
In countries that have national health care, people who seek care for serious medical conditions often complain about the competency of their specialists and surgeons, and about the long waits necessary to get approval for expensive tests or specialists or surgery. Additionally, once approval is granted, they encounter more long waits to actually obtain the tests, see the specialists, or have the surgery. These are people with serious medical conditions – the kind that require timely care before they deteriorate too far. Yet these are the very people that are forced to wait. These are the other 10%. These are the people who need health care the most and receive it the least. That’s why those that can afford it come to the U.S. for treatment of serious conditions.
Try this analogy. Assume the tap water in 90% of the neighborhoods in a town is clean and healthy, but the water in the other 10% of the neighborhoods is dangerous and can cause serious bodily harm if consumed. If you poll the residents of the town, 90% will say their water is fine, but who would argue that this town has a water crisis that must be addressed? Even though 90% of the residents are perfectly happy with their water, the town’s water system is terribly flawed and unsatisfactory.
That’s exactly the situation with national health care. For 90% of the people, it is fine, but, because of the serious problems encountered by the other 10%, the overall system is flawed and unsatisfactory. Polls are statistics that measure quantity, not quality. That’s why polls show that residents are overwhelmingly satisfied with national health care systems.
Here at home, most of us agree that two of the major problems with the U.S. health care system are the escalating costs and the 5% or so of our citizens that cannot obtain or afford health insurance. While a national health care system might well address both of these problems, it would doubtlessly decrease the quality of health care in America.
The problem with national health care is that, like most large bureaucracies, it handles routine reasonably well, but it wilts in the face of the unusual or abnormal. National health care systems provide an adequate quantity of heath care, but poor quality to those in greatest need. Private health care in the U.S. provides excellent but expensive quality, but inadequate quantity. Our goal must be to provide excellent quality and quantity at a reasonable price. This is indeed an ambitious goal, and one that can never be achieved by a government run program.
So, at this point, it seems the debate boils down to whether we prefer a public or private health care system. One of the major arguments in favor of a national system is that virtually all western countries have some form of national health care. The major benefits seem to be that everyone is covered and it is less expensive. These notions are very interesting. They suggest that government can provide more service at a lower cost than private enterprise and the free market. This seems counter-intuitive to most of us and flies in the face of our very successful capitalist economic system, not to mention that most Americans consider government programs to be bureaucratic, hide-bound, inefficient, and financially profligate. Nonetheless, all those other countries that seem to like their national health care cannot be ignored. Why do they like their national health care so much?
The answer is actually fairly straight-forward. It is a classical demonstration of the difficulty of applying statistics to human endeavor. We begin by noting that western societies generally provide living conditions that are quite safe and healthy. Consequently, prior to attaining the “end of life” years, most of us encounter relatively few serious medical problems. We rarely seek medical help, and then usually for fairly simple problems that any reasonably competent provider can adequately address – cuts and sprains, colds and flu, acid stomachs, high blood pressure, and such. For most of us, these routine types of medical issues will be all we ever encounter until we are old. Since any health care system can adequately deal with such routine issues, national health care is as good as any other. Simply stated, 90% or more of young and middle aged westerners only require routine medical care, so those 90% are perfectly satisfied with national health care. Additionally, routine heath care usually does not require expensive tests, procedures, or specialists, so the cost is relatively low. So, since any system can deal with routine medical issues, and such issues are relatively inexpensive to treat, national health care systems can treat them effectively and at a reasonable cost. In summary, national health care systems do fine 90% or more of the time. By any statistical measure, they work well.
But this is not a study in statistics. Medical issues are personal. Although national health care may be fine 90% of the time, the care received by the other 10% is an equally important measure of the quality of the health care system. Quality care means treating individual people, not the average person or even the 90% majority. When you become seriously injured or ill, when you have a serious medical condition that requires expensive tests, specialists, complex operations, intensive care, and long term recovery, you could care less what the polling data say or what most folks think of the system. You need comprehensive quality care, now!
In countries that have national health care, people who seek care for serious medical conditions often complain about the competency of their specialists and surgeons, and about the long waits necessary to get approval for expensive tests or specialists or surgery. Additionally, once approval is granted, they encounter more long waits to actually obtain the tests, see the specialists, or have the surgery. These are people with serious medical conditions – the kind that require timely care before they deteriorate too far. Yet these are the very people that are forced to wait. These are the other 10%. These are the people who need health care the most and receive it the least. That’s why those that can afford it come to the U.S. for treatment of serious conditions.
Try this analogy. Assume the tap water in 90% of the neighborhoods in a town is clean and healthy, but the water in the other 10% of the neighborhoods is dangerous and can cause serious bodily harm if consumed. If you poll the residents of the town, 90% will say their water is fine, but who would argue that this town has a water crisis that must be addressed? Even though 90% of the residents are perfectly happy with their water, the town’s water system is terribly flawed and unsatisfactory.
That’s exactly the situation with national health care. For 90% of the people, it is fine, but, because of the serious problems encountered by the other 10%, the overall system is flawed and unsatisfactory. Polls are statistics that measure quantity, not quality. That’s why polls show that residents are overwhelmingly satisfied with national health care systems.
Here at home, most of us agree that two of the major problems with the U.S. health care system are the escalating costs and the 5% or so of our citizens that cannot obtain or afford health insurance. While a national health care system might well address both of these problems, it would doubtlessly decrease the quality of health care in America.
The problem with national health care is that, like most large bureaucracies, it handles routine reasonably well, but it wilts in the face of the unusual or abnormal. National health care systems provide an adequate quantity of heath care, but poor quality to those in greatest need. Private health care in the U.S. provides excellent but expensive quality, but inadequate quantity. Our goal must be to provide excellent quality and quantity at a reasonable price. This is indeed an ambitious goal, and one that can never be achieved by a government run program.
09 September 2009
Gun Control
HB-45 is currently working its way through the U.S. House of Representatives. The Senate will consider a comparable bill. This is a large and comprehensive bill that applies to all handguns and all guns with removable magazines (that includes nearly all hunting rifles). You should read the bill for yourself - it is clearly a blatant effort at gun control. Michael Bloomberg, the billionaire Mayor of New York City, has recently founded and funded an organization called “Americans United for Safe Streets”, whose primary purpose is gun control. This organization is currently running TV ads against any pro-gun candidates in Virginia and elsewhere. President Obama has also made it abundantly clear that he has never met a gun control bill he didn’t like, witness the fact that he has voted in favor of every single gun control measure that has ever come before him. It goes without saying that most of the liberal left, and therefore most of the media and the press, strongly support gun control.
I get it. I have many friends who also strongly support gun control. In many cases, these friends of mine are willing to calmly discuss any topic except gun control (and abortion, of course). The issue seems to engender extreme positions (guess which extreme I’m at). You are either for it or against it. In any case, there is little public debate or national discussion on the issue – just agenda driven ads, TV and news shows, and newspaper articles. I get that too. Some things are too important to negotiate.
That having been said, let’s agree that this essay is a waste of time. I am unlikely to convince anyone that currently disagrees with me, and the others already agree. Nonetheless, all this pressure pushing for gun control has me squirming, so here goes anyway. I address this essay to those folks who support gun control.
First the smoke screen. Nearly all politicians’ platforms, including Obama in the last election, support hunting. Many also support shooting sports such as competitive target and skeet shooting. Even liberal politicians support these - why not? By taking this stance, politicians who actually support gun control can lull firearm owners into believing that they are not really anti-gun, while they continue to assure their liberal base that they remain true to the gun control agenda. Hunting and shooting sports are the “soft ball” issues – the smoke screen. I like to do these things, but I don’t have to. If I have to stop, I have only lost a pastime.
The real issue is personal firearms used as weapons against those who would harm us. I’m talking about owning/carrying/using a firearm (usually a handgun) to defend against criminals.
Now the constitutional issue. I believe the Second Amendment to the Constitution is clear as day. It says I, as an individual, have a right to own firearms. If you want to argue the militia thing, ok. The militia is all of our armed citizenry - the National Guard is merely its organized element. The founding fathers, American history, federal law, and the courts, are very clear that our armed citizenry is our militia. I am the militia. I am what stands between our freedom and anarchy/totalitarianism/despotism, and all the other bad “isms”. Every despot in history has first disarmed his people before taking over. The only way to confront a despot is through strength, and, if he has all the guns, you’re not strong enough.
Next the cultural issue. I believe that men (and women, if they choose) have a right, indeed a bounden duty, to protect themselves and their loved ones. The protective duty also extends to others who are defenseless and to our nation and way of life. If you take away my guns, I will not be able to protect myself, my loved ones, my country, or anyone else, from anyone who is bigger and stronger than me (at my age and stature, that list is growing fast). I understand that many folks do not agree with this notion. They believe, for example, that the best ways to protect are through negotiation and reconciliation. I hope they are right and I think they should always get to try first. However, when the big guy gets violent, it’s my turn. It’s fine with me if some men choose not to perform their protective duty, so long as they don’t seek to impede me from doing so.
How about the moral issue? Is it ever right to kill someone? That’s a personal issue between each of us and our creator. Nonetheless, I would like to remind my pacifist Judeo-Christian friends that the correct translation of the Hebrew text is, “Thou shall not murder”, not, “Thou shall not kill”. I suspect that, in the end, most of us would kill to defend our loved ones. If you agree that you would shoot a rapist in the act of attacking your daughter or wife, or send your army to destroy attacking hordes or evil despots, it shouldn’t be too much of a stretch for you to expect me to protect my loved ones (as well as you and yours, while I’m at it).
Then there is the “ick” factor. Many folks I know just think that guns are nasty and icky and they don’t even want to look at them, much less touch them. Frankly, I feel pretty much the same about tofu, the metro-sexual craze, and rap music, but it doesn’t bother me one bit if you like those things - which, of course, begs the question of why it bothers you so much that I have guns that you can’t see or touch.
Do not even think about quoting those tired and phony statistics about a child being shot every 20 seconds or whatever. Those statistics include everyone under 21, or even 25 in some cases. The statistics and those who quote them imply that these are innocent toddlers shot by gun-toting, careless, dinosaur, knuckle-dragging, rednecks. In fact, all but a tiny few are gang-related shootings, and even the most rabid anti-gun folks surely must know that gang members will obtain guns no matter what the law says. In fact, most armed assaults are committed by felons who are already legally prohibited from having guns. Do you seriously believe that a law prohibiting guns will take away the felons’ guns? It will only take away the law-abiding citizens’ guns. The old saw is correct, “If you outlaw guns, only outlaws will have guns.” In fact, violent crime rates are highest in those cities and states that have the most gun control laws. Violent criminals are not dumb. They understand that it is much more dangerous to pick on me than someone whose local or state government does not allow him to have guns. Every year, there are many thousands of documented instances in the U.S. of people successfully defending themselves or others with their personal firearms. If that’s so, why don’t we ever read about it in the press or hear about it in the media? Why, indeed – can you say “press and media with a liberal agenda”? In every non-totalitarian country that has outlawed guns, home invasions have increased dramatically. Duh. An armed citizenry really is your best protection against criminals and despots!
I suspect there may be another underlying issue. I sense that some folks who argue for gun control do so because they feel somehow threatened. They feel that, if I have a gun and they don’t, I will have some kind of advantage over them. In fact, I will have an advantage - over the criminals. If you are uncomfortable with my owning guns for this or any reason, you should know that I don’t really care why you don’t want a gun. I only want you not to interfere with my right to have one and thus protect my loved ones, as well as you and yours if I can.
Look, I know you believe that, if we outlaw guns, the world will be safer and the police will protect us. But, do you really think the police can protect you from violent criminals or gangsters? The criminals and gangsters are not dumb. They don’t attack when the police are standing there. They simply wait until there are no cops around. Then it’s up to you to provide the protection. Feel up to it?
Like all generalizations, there are many exceptions, but, in general, it seems that most city people, and city cops, and all criminals, are in favor of gun control. Similarly, it seems that most rural people and rural cops are not in favor of gun control. I suspect it has to do with whether you trust the government to take care of you or whether you prefer to take care of yourself. Personally, I prefer to take care of myself. I am, by all measures, a responsible citizen, and I can be trusted to be equally responsible with my guns. I am a law abiding, hard working, church going, moderately successful and reasonably happy man, with a great family, a great church, and a great profession. I live in a great town in a great country. I intend to do all in my power, including using my guns, to keep it all that way.
Without my guns, I am a 65 year old, overweight guy that will hardly cause a criminal to even take notice, much less quake in his boots. With my guns I am a formidable force for good. I like and need my guns. You don’t like my guns, but I think you should feel safer that I have them, and perhaps agree that both of us need me to have them.
Here’s the bottom line. I am a free man with a bounden duty to protect myself and those around me. You should know that, in my heart, I believe that surrendering my guns would be tantamount to surrendering to the forces of evil. I will not relinquish my guns peacefully. If you come to get my guns, bring a lot of help – you’re really going to need it.
I get it. I have many friends who also strongly support gun control. In many cases, these friends of mine are willing to calmly discuss any topic except gun control (and abortion, of course). The issue seems to engender extreme positions (guess which extreme I’m at). You are either for it or against it. In any case, there is little public debate or national discussion on the issue – just agenda driven ads, TV and news shows, and newspaper articles. I get that too. Some things are too important to negotiate.
That having been said, let’s agree that this essay is a waste of time. I am unlikely to convince anyone that currently disagrees with me, and the others already agree. Nonetheless, all this pressure pushing for gun control has me squirming, so here goes anyway. I address this essay to those folks who support gun control.
First the smoke screen. Nearly all politicians’ platforms, including Obama in the last election, support hunting. Many also support shooting sports such as competitive target and skeet shooting. Even liberal politicians support these - why not? By taking this stance, politicians who actually support gun control can lull firearm owners into believing that they are not really anti-gun, while they continue to assure their liberal base that they remain true to the gun control agenda. Hunting and shooting sports are the “soft ball” issues – the smoke screen. I like to do these things, but I don’t have to. If I have to stop, I have only lost a pastime.
The real issue is personal firearms used as weapons against those who would harm us. I’m talking about owning/carrying/using a firearm (usually a handgun) to defend against criminals.
Now the constitutional issue. I believe the Second Amendment to the Constitution is clear as day. It says I, as an individual, have a right to own firearms. If you want to argue the militia thing, ok. The militia is all of our armed citizenry - the National Guard is merely its organized element. The founding fathers, American history, federal law, and the courts, are very clear that our armed citizenry is our militia. I am the militia. I am what stands between our freedom and anarchy/totalitarianism/despotism, and all the other bad “isms”. Every despot in history has first disarmed his people before taking over. The only way to confront a despot is through strength, and, if he has all the guns, you’re not strong enough.
Next the cultural issue. I believe that men (and women, if they choose) have a right, indeed a bounden duty, to protect themselves and their loved ones. The protective duty also extends to others who are defenseless and to our nation and way of life. If you take away my guns, I will not be able to protect myself, my loved ones, my country, or anyone else, from anyone who is bigger and stronger than me (at my age and stature, that list is growing fast). I understand that many folks do not agree with this notion. They believe, for example, that the best ways to protect are through negotiation and reconciliation. I hope they are right and I think they should always get to try first. However, when the big guy gets violent, it’s my turn. It’s fine with me if some men choose not to perform their protective duty, so long as they don’t seek to impede me from doing so.
How about the moral issue? Is it ever right to kill someone? That’s a personal issue between each of us and our creator. Nonetheless, I would like to remind my pacifist Judeo-Christian friends that the correct translation of the Hebrew text is, “Thou shall not murder”, not, “Thou shall not kill”. I suspect that, in the end, most of us would kill to defend our loved ones. If you agree that you would shoot a rapist in the act of attacking your daughter or wife, or send your army to destroy attacking hordes or evil despots, it shouldn’t be too much of a stretch for you to expect me to protect my loved ones (as well as you and yours, while I’m at it).
Then there is the “ick” factor. Many folks I know just think that guns are nasty and icky and they don’t even want to look at them, much less touch them. Frankly, I feel pretty much the same about tofu, the metro-sexual craze, and rap music, but it doesn’t bother me one bit if you like those things - which, of course, begs the question of why it bothers you so much that I have guns that you can’t see or touch.
Do not even think about quoting those tired and phony statistics about a child being shot every 20 seconds or whatever. Those statistics include everyone under 21, or even 25 in some cases. The statistics and those who quote them imply that these are innocent toddlers shot by gun-toting, careless, dinosaur, knuckle-dragging, rednecks. In fact, all but a tiny few are gang-related shootings, and even the most rabid anti-gun folks surely must know that gang members will obtain guns no matter what the law says. In fact, most armed assaults are committed by felons who are already legally prohibited from having guns. Do you seriously believe that a law prohibiting guns will take away the felons’ guns? It will only take away the law-abiding citizens’ guns. The old saw is correct, “If you outlaw guns, only outlaws will have guns.” In fact, violent crime rates are highest in those cities and states that have the most gun control laws. Violent criminals are not dumb. They understand that it is much more dangerous to pick on me than someone whose local or state government does not allow him to have guns. Every year, there are many thousands of documented instances in the U.S. of people successfully defending themselves or others with their personal firearms. If that’s so, why don’t we ever read about it in the press or hear about it in the media? Why, indeed – can you say “press and media with a liberal agenda”? In every non-totalitarian country that has outlawed guns, home invasions have increased dramatically. Duh. An armed citizenry really is your best protection against criminals and despots!
I suspect there may be another underlying issue. I sense that some folks who argue for gun control do so because they feel somehow threatened. They feel that, if I have a gun and they don’t, I will have some kind of advantage over them. In fact, I will have an advantage - over the criminals. If you are uncomfortable with my owning guns for this or any reason, you should know that I don’t really care why you don’t want a gun. I only want you not to interfere with my right to have one and thus protect my loved ones, as well as you and yours if I can.
Look, I know you believe that, if we outlaw guns, the world will be safer and the police will protect us. But, do you really think the police can protect you from violent criminals or gangsters? The criminals and gangsters are not dumb. They don’t attack when the police are standing there. They simply wait until there are no cops around. Then it’s up to you to provide the protection. Feel up to it?
Like all generalizations, there are many exceptions, but, in general, it seems that most city people, and city cops, and all criminals, are in favor of gun control. Similarly, it seems that most rural people and rural cops are not in favor of gun control. I suspect it has to do with whether you trust the government to take care of you or whether you prefer to take care of yourself. Personally, I prefer to take care of myself. I am, by all measures, a responsible citizen, and I can be trusted to be equally responsible with my guns. I am a law abiding, hard working, church going, moderately successful and reasonably happy man, with a great family, a great church, and a great profession. I live in a great town in a great country. I intend to do all in my power, including using my guns, to keep it all that way.
Without my guns, I am a 65 year old, overweight guy that will hardly cause a criminal to even take notice, much less quake in his boots. With my guns I am a formidable force for good. I like and need my guns. You don’t like my guns, but I think you should feel safer that I have them, and perhaps agree that both of us need me to have them.
Here’s the bottom line. I am a free man with a bounden duty to protect myself and those around me. You should know that, in my heart, I believe that surrendering my guns would be tantamount to surrendering to the forces of evil. I will not relinquish my guns peacefully. If you come to get my guns, bring a lot of help – you’re really going to need it.
Afghanistan moment
WHEN THE MUSIC STOPPED
To understand this story, you need to know that, in military theaters, the
National Anthem is played before every movie.
This was written by Chaplain Jim Higgins, who is stationed in Iraq :
I recently attended a showing of "Superman 3" here at LSA Anaconda (an
American base camp north of Baghdad ). We have a large auditorium we use
for movies, as well as memorial services and other large gatherings. As is the
custom back in the States, we stood and snapped to attention when the
National Anthem began before the main feature.
All was going as planned until about three-quarters of the way through The
National Anthem the music stopped.
Now, what would happen if this occurred with 1,000 18-22 year-olds back in
the States? I imagine there would be hoots, catcalls, laughter, a few rude
comments; and everyone would sit down and call for a movie. Of course,
that is, if they had stood for the National Anthem in the first place.
Here, the 1,000 Soldiers continued to stand at attention, eyes fixed
forward. The music started again. The Soldiers continued to quietly stand
at attention. And again, at the same point, the music stopped.
What would you expect to happen? Even here I would imagine laughter, as
everyone finally sat down and expected the movie to start.
But here, you could have heard a pin drop. Every Soldier continued to
stand at attention. Suddenly there was a lone voice, then a dozen, and quickly
the room was filled with the voices of a thousand soldiers, finishing where
the recording left off:
"And the rockets red glare,
the bombs bursting in air,
gave proof through the night
that our flag was still there.
Oh, say does that Star Spangled Banner yet wave,
o'er the land of the free,
and the home of the brave."
It was the most inspiring moment I have had here in Iraq . I wanted you to
know what kind of Soldiers are serving you here. Remember them as they
fight for you!
Pass this along as a reminder to others to be ever in prayer for all our
soldiers serving us here at home and abroad. For many have already paid
the ultimate price.
To understand this story, you need to know that, in military theaters, the
National Anthem is played before every movie.
This was written by Chaplain Jim Higgins, who is stationed in Iraq :
I recently attended a showing of "Superman 3" here at LSA Anaconda (an
American base camp north of Baghdad ). We have a large auditorium we use
for movies, as well as memorial services and other large gatherings. As is the
custom back in the States, we stood and snapped to attention when the
National Anthem began before the main feature.
All was going as planned until about three-quarters of the way through The
National Anthem the music stopped.
Now, what would happen if this occurred with 1,000 18-22 year-olds back in
the States? I imagine there would be hoots, catcalls, laughter, a few rude
comments; and everyone would sit down and call for a movie. Of course,
that is, if they had stood for the National Anthem in the first place.
Here, the 1,000 Soldiers continued to stand at attention, eyes fixed
forward. The music started again. The Soldiers continued to quietly stand
at attention. And again, at the same point, the music stopped.
What would you expect to happen? Even here I would imagine laughter, as
everyone finally sat down and expected the movie to start.
But here, you could have heard a pin drop. Every Soldier continued to
stand at attention. Suddenly there was a lone voice, then a dozen, and quickly
the room was filled with the voices of a thousand soldiers, finishing where
the recording left off:
"And the rockets red glare,
the bombs bursting in air,
gave proof through the night
that our flag was still there.
Oh, say does that Star Spangled Banner yet wave,
o'er the land of the free,
and the home of the brave."
It was the most inspiring moment I have had here in Iraq . I wanted you to
know what kind of Soldiers are serving you here. Remember them as they
fight for you!
Pass this along as a reminder to others to be ever in prayer for all our
soldiers serving us here at home and abroad. For many have already paid
the ultimate price.
08 September 2009
Humor: Annual Physicals
16 October 2008
I think we can all agree that, for many years now, the cost of health care has been increasing at a rate many times higher than the CPI; and, the out of control increase in the cost of heath care is a systemic problem that affects every sector of our society.
My dedicated, if not extensive, research has determined the following major reasons health care costs keep increasing so fast: 1) engineers keep inventing ever more effective and expensive medical testing equipment; 2) plaintiff’s lawyers are deeply and personally committed to never letting a potential malpractice lawsuit go un-filed; 3) doctors keep ordering expensive medical equipment tests in order to protect themselves from malpractice lawsuits; and, 4) annual physicals.
Since we have plenty of politicians willing to address the first three reasons, I will limit my comments to annual physicals. The scientific and statistical bases for the following comments are a little suspect, since the evidence is admittedly anecdotal and based on a pretty small population: me. In other words, the science and statistics are generally comparable to the widely proclaimed charges that global warming, teen pregnancies, reality TV, and Tom Brady’s ACL injury, are all caused by George Bush.
Ok, here’s my case. I recently went to see my family doctor for a simple annual physical. I walked in as a perfectly healthy man in his mid-sixties. I hobbled out as a decrepit old man with several new ailments, two new prescriptions, and appointments with no less than five specialists. A month later, I have been X-Ray’ed, MRI’ed, CT’ed, Edoscopy’ed, had enough blood drawn to save a battalion of wounded Marines, and I’ve had one surgery and I’m scheduled for another. The surgeries may be quite minor, but they more than make up for their lack of complexity by being very expensive. All told, these office visits, medical procedures, tests, and surgeries cost approximately 2.73 gazillion dollars – all because I had an annual physical. I rest my case.
All of the pain, inconvenience and expenditures that have been visited upon me the past several weeks beg the obvious question, “Is it all worth it?” Sure it is. I have been assured that, provided I keep having a few hundred or so procedures each week, I can expect to live for up to 20 years. Otherwise, I can expect to die within two decades.
If I ever completely recover from this bout of “annual physicalitis”, I figure it will have robbed me of months of blissful unawareness, most of my dignity, and hundreds of zillions of dollars in co-pays alone. My fellow dotagers, it’s time to stand up to this terrible insult to the chronologically challenged! Fight the good fight, rise up and let the world know that we are united on this issue. If we must be subjected to annual victimization, then we must also be spared the humiliation of having to do it in front of our friends and neighbors. Petition medicare, doctors, insurance companies, and our families, that, if we must have an annual physical, then have the decency to conduct it on an Annual Physical Cruise (the Cruise Lines will no doubt jump at the chance to inaugurate “Annual Physical” cruises). The highlight of Annual Physical Cruises will be a certification that we will receive the finest care by highly trained caregivers, bartenders, waiters, and masseuses, and we will be guaranteed excellent physical evaluations in a comforting and supportive environment. Best of all, this superb medical care can no doubt be delivered by the Cruise Lines at a fraction of the present cost!
* * *
I think we can all agree that, for many years now, the cost of health care has been increasing at a rate many times higher than the CPI; and, the out of control increase in the cost of heath care is a systemic problem that affects every sector of our society.
My dedicated, if not extensive, research has determined the following major reasons health care costs keep increasing so fast: 1) engineers keep inventing ever more effective and expensive medical testing equipment; 2) plaintiff’s lawyers are deeply and personally committed to never letting a potential malpractice lawsuit go un-filed; 3) doctors keep ordering expensive medical equipment tests in order to protect themselves from malpractice lawsuits; and, 4) annual physicals.
Since we have plenty of politicians willing to address the first three reasons, I will limit my comments to annual physicals. The scientific and statistical bases for the following comments are a little suspect, since the evidence is admittedly anecdotal and based on a pretty small population: me. In other words, the science and statistics are generally comparable to the widely proclaimed charges that global warming, teen pregnancies, reality TV, and Tom Brady’s ACL injury, are all caused by George Bush.
Ok, here’s my case. I recently went to see my family doctor for a simple annual physical. I walked in as a perfectly healthy man in his mid-sixties. I hobbled out as a decrepit old man with several new ailments, two new prescriptions, and appointments with no less than five specialists. A month later, I have been X-Ray’ed, MRI’ed, CT’ed, Edoscopy’ed, had enough blood drawn to save a battalion of wounded Marines, and I’ve had one surgery and I’m scheduled for another. The surgeries may be quite minor, but they more than make up for their lack of complexity by being very expensive. All told, these office visits, medical procedures, tests, and surgeries cost approximately 2.73 gazillion dollars – all because I had an annual physical. I rest my case.
All of the pain, inconvenience and expenditures that have been visited upon me the past several weeks beg the obvious question, “Is it all worth it?” Sure it is. I have been assured that, provided I keep having a few hundred or so procedures each week, I can expect to live for up to 20 years. Otherwise, I can expect to die within two decades.
If I ever completely recover from this bout of “annual physicalitis”, I figure it will have robbed me of months of blissful unawareness, most of my dignity, and hundreds of zillions of dollars in co-pays alone. My fellow dotagers, it’s time to stand up to this terrible insult to the chronologically challenged! Fight the good fight, rise up and let the world know that we are united on this issue. If we must be subjected to annual victimization, then we must also be spared the humiliation of having to do it in front of our friends and neighbors. Petition medicare, doctors, insurance companies, and our families, that, if we must have an annual physical, then have the decency to conduct it on an Annual Physical Cruise (the Cruise Lines will no doubt jump at the chance to inaugurate “Annual Physical” cruises). The highlight of Annual Physical Cruises will be a certification that we will receive the finest care by highly trained caregivers, bartenders, waiters, and masseuses, and we will be guaranteed excellent physical evaluations in a comforting and supportive environment. Best of all, this superb medical care can no doubt be delivered by the Cruise Lines at a fraction of the present cost!
* * *
The So Called Heath Care Crisis
The President of the United States United States
In fact, we have the best health care in the world, witness all the muckety-mucks from all over the world coming here for critical care. How many of our muckety-mucks go abroad for health care? Some of us do go abroad for medical procedures or drugs, but only to save money. Americans do not seriously believe they will receive better heath care abroad, just cheaper heath care. Ask yourself, if you get some horrible disease or suffer some terrible injury, would you rather be treated at Mass General, the Mayo Clinic, or any of dozens of other great medical centers here in the U.S., or, would you rather be treated in Spain, or Sweden, or India, or Mexico, or anywhere else? For fabulous health care, this is the place – the good old U.S.A.
So, we do not have a heath care crisis. In fact, we have the best health care in the world, but our health care system is not perfect. There are problems (not crises), and the major ones are two-fold: our health care costs too much, and some of us are either uninsured or underinsured (that’s the 45 million you hear about so often).
The Obama administration and the Democratic leadership are pushing with all their might to address these issues by throwing out our present, mostly private, heath care coverage system and replacing it with a public national heath care system. Seriously? About 75% of us are perfectly satisfied with our present insurance coverage. Our only complaint is that the costs keep rising. Hey Washington, here’s a piece of advice from an engineer and businessman. Fit the solution to the problem. Do not impose a 100% solution to fix a 25% problem. When a system is working fine 75% of the time, do not attempt to fix the 25% problem by throwing out the entire system and starting over. Bulletin: your new system will inevitably cost too much and it will have problems of its own! For example, if your house has a plumbing problem, do not tear it down and build a new house. Fix the plumbing. If you build a new house, it will cost more that you thought and it will have problems of its own. In the case of health care in the U.S.
What about the 45 million that we keep hearing about who do not have coverage? As most folks have already heard, recent studies have shown that more than 10 million of these are illegal aliens, millions more are healthy young people who freely choose not to pay for coverage, millions more are workers who are between jobs and choose not to pay for the COBRA coverage that is available to them, etc., etc.. In the end, there are about 10 – 15 million actual Americans who cannot get or afford heath insurance. There can be no doubt we must do something about these unfortunate folks. We must care for the least of us. So, let’s see. 15 million is about 5% of our population. Obama wants to throw out the entire system to fix a 5% problem? Here’s another bulletin: just provide national coverage for the 5%! Don’t impose a national health care system on the rest of us! If you want to raise my taxes to pay for the 5%, go for it. I should and I will pay. But do not endanger my excellent health care and my excellent heath care coverage and force me and my grandchildren to pay for a national health care system that we do not need, we do not want, and we cannot afford! If the bathwater is dirty, change the water; do not throw out the tub and the baby!
* * *
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