Merry Christmas From Congress

Every Picture Tells a Story

Time For Lunch

Nobel's are cheap these days.

U.S. Health Care Versus England and Canada

Very interesting. Just so everyone can comprehend what President Obama means when he say's we will go broke without health care reform. This is the rationing he has in mind and what Harry Reid has placed under your Christmas Tree

A recent "Investor's Business Daily" article provided very interesting statistics from a
survey by the United Nations International Health Organization.

Percentage of men and women who survived a cancer five years after diagnosis:
U.S. 65%
England 46%
Canada 42%
Percentage of patients diagnosed with diabetes who received treatment within six months:
U.S. 93%
England 15%
Canada 43%
Percentage of seniors needing hip replacement who received it within six months:
U.S. 90%
England 15%
Canada 43%
Percentage referred to a medical specialist who see one within one month:
U.S. 77%
England 40%
Canada 43%
Number of MRI scanners (a prime diagnostic tool) per million people:

U.S. 71%
England 14

Canada 18%
Percentage of seniors (65+), with low income, who say they are in "excellent health":
U.S. 12%
England 2%
Canada 6%
I don't know about you, but I don't want "Universal Healthcare" comparable to England or Canada .

Moreover, it was Sen. Harry Reid who said, "Elderly Americans must learn to accept the inconveniences of old age."

Mitch McConnell and Olympia Snowe on Obamacare

Some truth from your minority America.

“This isn’t an energy bill. This is an attempt by a majority to take over one sixth of the U.S. economy — to vastly expand the reach and the role of government into the health care decisions of every single American — and they want to be done after one substantive amendment. This is absolutely inexcusable.
“I think Senator Snowe put it best on Tuesday:
‘Given the enormity and complexity,’ she said, ‘I don’t see anything magical about the Christmas deadline if this bill is going to become law in 2014.’
“And I think Senator Snowe’s comments on a lack of bipartisanship at the outset of this debate are also right on point.
“Here’s what she said in late November:
‘I am truly disappointed we are commencing our historic debate on one of the most significant and pressing domestic issues of our time with a process that has forestalled our ability to arrive at broader agreement on some of the most crucial elements of health care reform. The bottom line is, the most consequential health care legislation in the history of our country and the reordering of $33 trillion in health care spending over the coming decade shouldn’t be determined by one vote-margin strategies – surely we can and must do better.’
“The only conceivable justification for rushing this bill is the overwhelming opposition of the American people. Democrats know that the longer Americans see this bill the less they like it. Here’s the latest from Pew. It came out just yesterday.

“A majority (58 percent) of those who have heard a lot about the bills oppose them while only 32 percent favor them.”
“There is no justification for this blind rush — except a political one, and that’s not good enough for the American people.
“And there’s no justification for forcing the Senate to vote on a bill none of us has seen.
“Americans already oppose this bill. The process is just as bad.

“It’s completely reckless, completely irresponsible.”

Michelle Bachmann For The Win

Noticed this point by Michelle Bachmann yesterday and she is correct about the nationalization of American Industry. And all this is happening peacefully without a whimper.

“The number one thing is to fight right now the government takeover of our economy.”




To illustrate the scope of that takeover, she cited “an economist from Arizona State University” who calculated that by January 2009, government had already taken ownership or control of 30 percent of our economy. “Now if President Obama gets his way with health care, that’s an additional 18 percent of the economy” — for a total of 48 percent. Cap and trade would add another 8 percent, for 56 percent total. Rep. Barney Frank’s bill that the Financial Services Committee votes on tomorrow would raise that another 15 percent for a grand total of 69 percent, she calculated.



“It isn’t within our lifetime that we’ve gone to socialism,” Bachmann said. “It’s within 18 months!”

Spreading New Yorks Bad Medicine

The NY Post has an excellent op-ed column providing insight into what you can expect if the current Health Care Reform proposals are enacted into law.

Spreading New York's bad medicine


By STEPHEN T. PARENTE & TARREN BRAGDON

Last Updated: 9:05 PM, December 9, 2009
Posted: 1:42 AM, December 9, 2009
New York's individual health-insurance market is not often held up as a national model, and for good rea son. It's the most regulated, most expensive and, as a result, one of the smallest in the country, with only a few costly health plans available.

Since New York policymakers inflicted costly regulations on insurers in 1994, enrollment in the individual insurance market has plummeted by 96 percent.



Current prices are staggering. In New York City, the cheapest individual plan costs $9,036 a year for a single person and $26,460 for a family. In contrast, the Congressional Budget Office estimates the average national family premium at $12,000 to $15,000 a year.



Yet both the House and the Senate health-reform bills would make the rest of America look more like New York's dysfunctional market -- and then force New Yorkers to foot a larger share of the trillion-dollar cost.



Only five states now have New York-style insurance regulations, but both bills force those rules on all 50 states and then force people to buy coverage or face tax penalties. Think about it: If 45 states don't regulate insurance like New York does, there is probably a very good reason. And there is: These regulations drive up costs and limit choices.


Adding insult to expensive injury, Congress also plans to expand Medicaid coverage. Here, too, New York is an example of what not to do. The Empire State has the most expensive Medicaid program in the country -- spending as much as Texas, Florida and Illinois combined.

New York's Medicaid program is the fourth largest among all the states as a percentage of the population enrolled, yet the state's rate of uninsured ranks 24th highest in the country. Of the 26 states with a lower rate of uninsured than New York, only two have a larger share of residents on Medicaid.

Clearly, doubling down on Medicaid is not the right path to universal coverage -- yet Congress wants to push millions of Americans into Medicaid and thrust new costs onto the states.

Read more: http://www.nypost.com/p/news/opinion/opedcolumnists/spreading_new_york_bad_medicine_5f6AoI9hr8WKAjwlzuSj7H#ixzz0ZO8RazRX




Read more: http://www.nypost.com/p/news/opinion/opedcolumnists/spreading_new_york_bad_medicine_5f6AoI9hr8WKAjwlzuSj7H#ixzz0ZO85KC2p

Lies, Damn Lies and Statistics II

Secretary of  Health & Human Services Kathleen Sebelius has issued a fact sheet outlining the benefits of Health Reform for Business quoting CBO as the source for the claims below.

Premiums for small business will go down. Small businesses are likely to see premiums drop by 1 to 4 percent under the proposal due to lower prices. These lower prices come from:

 

Lower administrative overhead. Right now, each small business has to consult with a broker or hire someone to collate plan information, assist employees with decisions, and handle issues as they arise. Under reform, in the exchange, there will be people whose job it is to provide plan information and facilitate enrollment. The exchange centralizes what is otherwise a process that is extremely duplicative, streamlining administrative costs and lowering premiums.

 

Greater competition. CBO attributes savings to “providing a centralized marketplace in which consumers could compare the premiums of relatively standardized insurance products.” This includes competitive pressure from a public health insurance option.

 

Administrative simplification. Physicians spend on average about 140 hours and $68,000 a year just dealing with health insurance bureaucracy.[v] By simplifying and standardizing paperwork and computerizing medical records, doctors will be able to focus on caring for their patients instead of dealing with bureaucracy. CBO estimates nearly $20 billion in Federal savings over 10 years, with additional savings accruing to businesses and families.[vi]

 

Here we have the former Kansas State Insurance Commissioner, who ought to know better, telling some Orwellian whoppers such as;
 

•  Small businesses are likely to see premiums drop by 1 to 4. Really? No underwriting, no pre-eexisting conditions and the price will drop?  Try dropping the crack pipe.
• Right now, each small business has to consult with a broker or hire someone to collate plan information, assist employees with decisions, and handle issues as they arise. Under reform, in the exchange, there will be people whose job it is to provide plan information and facilitate enrollment. You can keep the plan you have but you won't need your broker any longer as a government employee will now come out to your location, explain the coverage and collate all your enrollment data as part of facillitating enrollment. These new federal exchange employees will no doubt possess all the answers to your questions regarding HIPAA, ADA, FMLA, COBRA, ARRA.
• CBO attributes savings to “providing a centralized marketplace in which consumers could compare the premiums of relatively standardized insurance products.” This includes competitive pressure from a public health insurance option. You mean like the brokers did before the state took on this role?
• 
  Physicians spend on average about 140 hours and $68,000 a year just dealing with health insurance bureaucracy.[v] By simplifying and standardizing paperwork and computerizing medical records, doctors will be able to focus on caring for their patients instead of dealing with bureaucracy. CBO estimates nearly $20 billion in Federal savings over 10 years, with additional savings accruing to businesses and families.[vi] This is great news. The government can just hand over that slick paperless system Medicare and Medicaid use today to eliminate waste. Medicare has been around since 1965 so they must have a bulletproof administrative process worked out by now right? I guess that's the $20B handed over to special interests as part of the spendulous package that has seized up investment in EHR's like the potion they poured into the cash for clunkers while HHS defined "meaningful use"?
  

So there you have it. Unemployment will be solved by all those new jobs in the exchange. But wait how does one reconcile the apparent 1-4% savings under reform with this statement?

• Businesses can keep what they have.
  
• CBO affirms that any proposed benefit mandates would not affect the small or large group markets: “The requirement would have relatively little effect on premiums in the small group market, however, because most policies sold in that market already cover those services and would continue to cover them under current law.”

 

Recently I spoke with the CEO of a large insurer with a significant presence in the U.S. individual health insurance marketplace. The CEO told me the average policyholder the firm covered would experience a 23% increase premiums due to the inclusion of mandates the government requires be in their plans. These are policies people purchased for catastrophic coverage the government has now decreed as inadequate. So ultimately its the healthy prudent Americans who secured their own catastrophic coverage who will pay dearly when some bureaucrat decides the appropriate premium ratio is 2-1 for those over 50 to those under 30 years of age. Theres your change suckers.

 

Wellness Revisited

I read an interesting article in the New York Times about a company targeting Health Care savings for employers through subsidized healthy meals at the workplace as well as discounts on health foods purchased at the grocery store. These paragraph caught my eye;

A study in the January-February 2009 issue of the journal Health Affairs concluded that 75 percent of the country’s $2.5 trillion in health care spending has to do with four increasingly prevalent chronic diseases: obesity, Type 2 diabetes, heart disease and cancer. Most cases of these diseases, the report stated, are preventable because they are caused by behaviors like poor diets, inadequate exercise and smoking.



Obesity alone threatens to overwhelm the system. In a recent study, Kenneth Thorpe, chairman of the department of health policy and management at the Rollins School of Public Health at Emory University, found that if trends continued, annual health care costs related to obesity would total $344 billion by 2018, or more than 20 percent of total health care spending. (It now accounts for 9 percent.)

Dr. Thorpe also said that if the incidence of obesity fell to its 1987 level, it would free enough money to cover the nation’s uninsured population.

Of course the New York Times would never think of pointing out such an obvious fact during the health care debate on its editorial page.

For the record I made the same point about the cost of unhealthy behavior on this blog in April 2007.

Psst...Obamacare will cost $6B not $1B over 10 years

Don not miss this little gem

Happy Thanksgiving To All

In honor of this years Texas A&M- t.u. game tomorrow here are some pictures from last nights student run non-sanctioned bonfire in College Station, TX.

B.T.H.O.t.u!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Tenth Anniversary Of Texas A&M Bonfire Collapse

Today is the Tenth Anniversary of the Texas A&M Bonfire Collapse which killed 12 students.
I still cannot watch the video of the Longhorn Band  performing at halftime without tearing up.

And The Abysmal Timing Award Goes To...

The U.S. Preventive Services Task Force has issued new guidelines suggesting women should wait until 50 to begin routine mammograms for breast cancer early detection in a front page story in today's Houston Comical. It seems that false positives are very expensive you see and the costs outweigh the benefits involved unless it happens to be you or your mother, wife, daughter, aunt, girlfriend or sister.

The task force also recommends against teaching breast self-examination because no data exists to show it reduces deaths. That would be news to many women including my best friends wife who recently detected a lump which turned out to be malignant breast cancer. I suppose if you are a professional athlete wearing pink the last few weeks you were duped and 25 years of messaging to raise awareness was pointless?

The timing of such an announcement during breast cancer awareness month is suspect and at a time when healthcare reform awaits a senate vote is simply outright stupid. Yet it does foretell what we can expect under Obamacare  when clinical guidelines rooted in data supplant physician judgement. I thought the American Cancer Society's chief medical officer succinctly summarized the core issue;

Dr. Otis Brawley, the American Cancer Society's chief medical officer...said the statistics suggest the task force is “essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.”

Brawley added that the task force is saying screening 1,339 women in their 50s to save one life makes it worthwhile in that age group, but that screening 1,904 women in their 40s to save one life isn't.

The American Cancer Society, he said, believes the benefit outweighs the harm in both cases.

And this is precisely why The US survival rates for breast cancer surpass nations worldwide with socialized medicine. Women's groups should be rightly up in arms over this edict. Watch it hit the fan over the next few days.

Meet My New Pup Zeus

Zeus is 9 weeks old and he is Trouble on 4 legs. Above is a pic from Saturday.

Business is Not Whispering

Big U.S. Companies Balk at Health Care Public Option

Excerpt: "Some of the nation's largest companies pushed back against U.S. Democrats' plans to deliver a government-run insurance option in a healthcare overhaul, decrying it as a step backward that would drive up costs for employers and their workers. The Business Roundtable, comprised of chief executives at Verizon Communications . . ., JPMorgan . . ., General Electric . . ., Wal-Mart . . . and other companies that together employ more than 12 million people, said the federal government is inefficient and would underpay providers. That would result in providers boosting prices for private insurers and employers, the group said on Wednesday." (Reuters)





Business Groups Push Hard Against the Senate Health Reform Bill

Excerpt: "Lobbyists for employers thought they had staved off a public plan in the Senate after the Finance Committee opted not to include the idea in its version of the health legislation. They were caught by surprise when the public plan resurfaced and Majority Leader Harry Reid (D., Nev.) said it would be in the bill brought to the Senate floor, albeit with an option for states not to participate." (The Wall Street Journal)



Constitutionality of Health Overhaul Questioned: Legal Scholars Divided Over Congress' Authority

Excerpt: "On top of all the other obstacles facing President Obama in his quest to pass health reform is this one: Does the U.S. Constitution allow the government to require uninsured Americans to buy medical insurance or impose a tax penalty if they refuse? Congress has never before required citizens to purchase any good or service, but that is what both House and Senate health bills would mandate." (The Washington Times)

Health Care Reform

Harry Reid thinks he knows whats best for you. He's back with the public option again.

Here is a great blog that offers insights into the real objective of the public option.

Now the democrats are starting to eat their own, witness Robert Reich here pointing out how obamacare shafts the middle class and ignores the current economic woes our nation faces that are the elephant in the living room.

Got Subrogation?

Got Subrogation? Where ERISA And Workers’ Compensation Claims Intersect - An Insider’s Guide by Roy Harmon whose blog is a must read for benefit professionals interested in legal matters http://bit.ly/43zOPL

NY State Extends Cobra to 36 Months & Dependent eligibility to age 29

The State of New York recently enacted two laws that will dramatically impact insured employee benefit plans, and the group health insurance industry as a whole, in the Empire State. The first law effectively extends the maximum length of federal COBRA and state-mandated continuation coverage to three years, while the second law allows certain children to continue coverage under their parents’ employer-based group health plans through age 29. Full text

“The budget should be balanced, the treasury should be refilled, public debt should be reduced, the arrogance of officialdom should be tempered and controlled, assistance to foreign lands should be curtailed lest Rome become bankrupt, the mobs should be forced to work and not depend on government for subsistence.”


- Marcus Tullus Cicero (106-43 B.C.)

Competing to be The Biggest Loser;Got EAP?

Ever spend any time on itunes looking at random app's? I admit I do. I look at the free ones because I'm cheap. Anyhow I run across one called FML and its very popular. I click and look at it to find;

If you’ve never been the website FMyLife, it’s kind of like Twitter for losers who just can’t get a break… people post very short anecdotes about how F’d their lives are, always ending with the abbreviated mantra “FML”, and then the rest of the world votes on whether the person’s life is truly F’d or if they got what they deserved. Here are a few:

There is something sad about a culture that competes to demonstrate how terrible their life is, not too mention how shallow is the individual who lifts himself by tearing down another in the comments section of a website or blog? But we have all seen such individuals. The web has coarsened our national rhetoric. Just another reminder why you need to communicate the access to your EAP.

What's Wrong With This Photo Op?

I have to be home by 5:30 pm these days to take my son to football practice. Passing by the tv on ABC during the national news last night and I see the image of Senator Baucus at the podium. Alone. Charlie Gibson is wondering why the plan has no bi-partisan support from republicans since Baucus has met all the Presidents objectives. Gibson never notices the podium void of any Democratic supporters. Nor does he notice Harry Reid being quoted the bill wont work for Nevada due to the oppressive burden it places on States after the Medicaid Mandates remain long after the funding dries up which I wrote about last month.
Meanwhile, The President is slated for a full Ginsburg on the Sunday talk shows followed by Letterman on Monday for a full hour. Making dogfood is just not a pretty sight.

Centralizing Healthcare

“The proletariat will use its political supremacy to wrest, by degree, all capital from the bourgeoisie, to centralize all instruments of production in the hands of the state… Of course, in the beginning, this cannot be effected except by means of despotic inroads on the rights of property”


— Karl Marx

Another Aspect Of Baucus Plan

From the Senator Baucus's press release

Responsibility for Employers – The Mark would not require employers to offer health insurance. However, effective January 1, 2013, all employers with more than 50 employees who do not offer coverage will have to reimburse the government for each full-time employee (defined as those working 30 or more hours a week) receiving a health care affordability tax credit in the exchange equal to 100 percent of the average exchange subsidy up to a cap of $400 per total number of employees whether they are receiving a tax credit or not.

 As a general matter, if an employee is offered employer-provided health insurance coverage, the individual would be ineligible for a health care affordability tax credit for health insurance purchased through a state exchange. An employee who is offered coverage that does not have an actuarial value of at least 65 percent or who is offered unaffordable coverage by their employer, however, can be eligible for the tax credit. Unaffordable is defined as 13 percent of the employee’s income. A Medicaid-eligible individual can always choose to leave the employer’s coverage and enroll in Medicaid. In this circumstance, the employer is not required to pay a fee.



Your  government has deemed spending 12.99% of your before tax income on health care premiums is affordable and you do not qualify for a health care affordability tax credit.

How's that change working out for you now?

America’s Health Future Act; Don't Drink The Kool-Aid

Senator Baucus has released his long awaited Health Care legislation.The full text of the America’s Health Future Act is available here

Let me call your attention to just one aspect of the proposed bill from Senator Baucus's press release.

Americans who like their health insurance and want to keep it can do so.

Unfortunately you will not be able to keep your own health insurance if you like it. You see with this bill existing health insurance will be grandfathered. That means the insurance companies will not have any new customers in those plans after 1/1/2013. How many companies would stick with a product when by law they could not offer the product to new customers? Would you? If I told a customer this at best I would be guilty of an error of ommision--the failure to mention a material fact--and at worst I would be lying. The only plans insurers can sell after 1/1/2013 are those whose rates and benefits conform with an as yet uncreated health exchange whose edicts on rate setting will be enforcable or the grandfathered plans that have no growth prospects. But have no fear the government will be using the internet to make it easier for you to buy coverage they have defined through their newly created exchange.If you like Medicare.gov and find it and the 1-800-medicare a bastion of information staffed by knowledgable call center personell who are unfailingly polite and extrardinarily helpful you are in luck.They should have trotted out the Guinness Guys for the Press conference. Brilliant! Politicans who missed the hundreds of thousands of Americans protesting on 912 in DC must think the average American has stupid painted across their forehead. Read for yourself from the press release.

 

Individual Market Reforms – The Mark would require insurance companies to issue coverage to all individuals regardless of health status; insurers would no longer be allowed to limit coverage based on pre-existing conditions. Limited variation in premium rates would be permitted for tobacco use, age, and family composition. Variation in rating would be allowed between geographic areas, but would not differ within a geographic area.

Small Group Market Reforms – Rating rules for the individual market would also apply to the small group market, as defined by states. This would include groups of one to 50 employees, but could include companies with up to 100 employees, depending on current state law.

Health Insurance Exchanges – The Mark would make purchasing health insurance coverage easier and more understandable by using the Internet to present consumers with available plans. The Mark would create state-based web portals, or “exchanges” that would direct consumers purchasing plans on the individual market to every health coverage option available in their zip code. The exchanges would offer standardized health insurance enrollment applications, a standard format companies would use to present their insurance plans, and standardized marketing materials. The exchanges would have a call center for customer support. The exchanges would also enable users to determine whether they are eligible for health care affordability tax credits or public programs and would enable consumers without access to the Internet to enroll through the mail or in person in a variety of locations.

Small Group Purchasing Through SHOP Exchanges − Under the Chairman’s Mark, small businesses would have access to state-based Small Business Health Options Program (SHOP) exchanges. These exchanges – like the individual market exchanges – would be web portals that make comparing and purchasing health care coverage easier for small businesses.

Transitioning to a Reformed Insurance Market – Once the insurance market reforms take effect, people who want to keep the insurance they have today can do so. Plans would be allowed to continue to offer the coverage they offer today and this coverage would be grandfathered. These grandfathered plans would only be available to those people who are enrolled today or, in the case of a small employer, to new employees and their dependents. People who qualify for the health care affordability tax credits in the reformed market would not be able to use the credits to purchase grandfathered plans. Tax credits would be offered only to purchase plans created in the reformed market that meet the new benefit standards.

 

Transitioning for Rating Requirements − Federal rating rules for the individual market (other than for grandfathered plans) would take effect by January 1, 2013. Federal rating rules for the small group market would be phased in over a period of up to five years, as determined by each state, with approval from the Secretary of HHS

The American Risk Pool & Heart Disease

Excellent summary of the challenges our nation faces in bending the health care cost curve down.

Fewer and fewer Americans are at low risk for cardiovascular disease, according to an important and frightening new report on long term trends from the National Health and Nutrition Examination Surveys (NHANES) of adults 25-74 years of age.




In the most recent survey (1999-2004) only about 8% of US adults had a low risk profile, despite favorable trends in reducing smoking and cutting cholesterol. The overall increase in risk was due to the increased prevalence of diabetes, obesity, and hypertension, said the CDC’s Earl Ford, and his colleagues, in their report in Circulation.
Of major concern, the long term trend observed by the study was troubling. Following the early 1970s, when very few people had low risk factor profiles, progress appeared to be made, as the survey found substantial increases in the proportion of people with low risk profiles in the late 1980s and early 1990s. But then the hopeful trend reversed in the mid 1990s, apparently in accord with the increase in obesity and diabetes
Low risk was defined as;
•not currently smoking

•total cholesterol <200 mg/dL and not using cholesterol-lowering drugs

•blood pressure <120/80 mm Hg and not using antihypertensive drugs

•BMI <25 kg/m²

•no previous diagnosis of diabetese

Prescription Drug Non-compliance

WSJ Health Blog has an interesting piece up on just how prevalent non compliance for prescription medicines is today that will be of interest to those benchmarking pharmaceutical compliance. This is a coachable moment for wellness advocates as 1/3 of americans do not adhere to their prescription routine.

If you misrepresent this plan We will call you out

What is the deductible?
What is the out of pocket maximum?
Who is in the network?
What is the co-pay, if there is one?
What are the coinsurance levels?
What does the plan cover?
What is excluded?
What does it cost?
Does my HSA go away?
What coverage is available for prescription drugs?

"While there are some difficult issues to be worked out...If you misrepresent this plan We will call you out"

How could someone possibly misrepresent the plan? There is no plan. There is only the expectation a newly created government bureaucracy free from any political pressure will create an insurance exchange that will define a plan options that will reduce out of pocket costs for all Americans while expanding coverage to the uninsured allowing everyone to retain coverage they like, with the doctor they like, without rationing, while preserving Medicare and not adding a penny to the deficit  while simultaneously bending the cost curve down on Medicare spending. Call me a skeptic, hell call me out Mr President but just how you propose to do these things would interest many Americans. Do tell. Americans who ask the questions above deserve answers and by the way it coarsens the national debate when David Axlerod goes on television and suggests they are wrong for asking the basic questions anyone purchasing healthcare would ask. If you are going to sell health care reform you need to have answers for basic questions about costs and benefits or else your're just asking Americans to trust you and congress to get it right. We trust you, Nancy Pelosi & Harry Reid like the Shamwow salesman on cable TVwho you increasingly resemble except that shamwow guy at least covers costs and benefits. The shamwow guy does not pretend to be anything but a salesman, a charlatan and a snakeoil salesman. You could learn from him.

Can You Hear Me Now?

911 Remember

Today we mark the eighth anniversary of 9-11.
The following two videos are 'moving' to say the least. They are must views by all, lest we forget that horrific day in our history and those who are sacrificing to ensure America never has to experience that again.

NEVER forget and ALWAYS remember there are evil people who want to harm us and our nation - some of which are right here on our soil.
And, do not let this Day be remade into a day of 'national service' by those in government who do not appreciate nor understand the greatness of our nation, the wisdom of our Founders or the cost of freedom.
September 11 is, and must remain a day of rememberance, reflection, thanks, prayer, honor, and a reminder of our vulnerabilty.
May God bless our great nation.

Dan

http://www.youtube.com/watch?v=kv4s3fn8jDc&feature=related




http://www.youtube.com/watch?v=WSPpQZiVXhk&feature=player_embedded

Teddy Roosevelt on Reform

Teddy Roosevelt was a giant in the progressive era. As our nation debates health care reform and the President addresses congress next week I am struck by the prescience of TR articulating his famous man in the arena speech in one of the lesser known passages. My own belief is that it offers great insight into the outcry President Obama faces as evidenced by his rapidly dropping poll numbers. The comparison between two Presidents is striking.

The citizen must have high ideals, and yet he must be able to achieve them in practical fashion. No permanent good comes from aspirations so lofty that they have grown fantastic and have become impossible and indeed undesirable to realize. The impractical visionary is far less often the guide and precursor than he is the embittered foe of the real reformer, of the man who, with stumblings and shortcoming, yet does in some shape, in practical fashion, give effect to the hopes and desires of those who strive for better things. Woe to the empty phrase-maker, to the empty idealist, who, instead of making ready the ground for the man of action, turns against him when he appears and hampers him when he does work! Moreover, the preacher of ideals must remember how sorry and contemptible is the figure which he will cut, how great the damage that he will do, if he does not himself, in his own life, strive measurably to realize the ideals that he preaches for others. Let him remember also that the worth of the ideal must be largely determined by the success with which it can in practice be realized. We should abhor the so-called "practical" men whose practicality assumes the shape of that peculiar baseness which finds its expression in disbelief in morality and decency, in disregard of high standards of living and conduct. Such a creature is the worst enemy of the body of politic. But only less desirable as a citizen is his nominal opponent and real ally, the man of fantastic vision who makes the impossible better forever the enemy of the possible good.

If You Build It They Will Come

As I observe the debate on health care reform, and I do use the term debate loosely, there is a fascinating battle raging underneath the surface.

On the one hand we have avowed statists like the President, Speaker Pelosi, Majority Leader Harry Reid and many congressional democrats who favor what I call the Field of Dreams approach. The essence of this approach is if you build it they will come. Components include an entirely new Federal Bureacracy including a healhcare exchange to sell you the coverage you are required to buy from the public plan which was designed by a federal committee largely appointed by the President. Proponents of this approach know they cannot come right out and take a stand for single payer for many reasons;

1. The blue dogs would be savaged in future elections by seniors who lost the Medicare Advantage coverage they loved when the reimbursement was cut to fund the coverage for the uninsured.

2. The vanguard of the proletariat that is our present near supermajority does not believe the American people are smart enough to understand the intricate issues involved in health care reform like rationing. No  matter they will act for all us little people. It is why we elected them in their minds.

3. Demonizing the insurance companies, the HMO's ( a federal creation by the way) and the rich doctors is a proven tactic which tosses red meat to their base while diverting attention from the fact the government accounts for 60% of the health care spend today.

4. Incrementalism works and Medicare remains the sacred cow.

5. Polls show many Americans are satisfied with their own coverage and their own doctors and will resist overt change as congress is learning at the townhalls.

6. Someone might point out that universal coverage mandated by the states and controlled has not stopped medical inflation in workers compensation.

On the other hand we have voices speaking out for market solutions that are being shouted down as obstructionists, mere drones who articulate platitudes from Fox News or talk radio. No one is focused on what unites us as American's. We have only the extremes and no statesman. No one is looking at the root cause of the current crisis but is rather seeking to exploit the crisis for their own self interest.

One of the insurance companies I worked for years ago developed a fully integrated product to cover health care, workers compensation, short term disability, long term disability. If we build it they will come said the visionaries in marketing. Very few employers bought the product because they wanted the flexibility to replace vendors by product. They resisted also resisted having all their products with one vendor as a problem in one area would require them to move all products. Nothing was unbundled you see. An infamous story circulated at the company where an executive stood before senior management pleading for more money time until the market recognized the value and was chastised by the CFO; "You keep coming in hereselling the same dog food and the dog just won't eat that crap". He built it but they did not come. Obamacare reminds me of that dog food. And the dog still won't eat that crap.

COBRA Elections and Costs Accelerating

In January I blogged about the impact on COBRA the ARRA spendulous package would have. Evidence is emerging that COBRA elections have doubled on average and in savaged areas of the economy like manufacturing COBRA elections are up 800% according to a Hewitt survey.

Health Care reform is all over the news yet according to the Hewitt survey COBRA elections saw the smallest increase of any segment increasing from 10% to 12%. Why is that you might ask? It is due to the fact that employment remains strong in this economic segment and those who lose their job can find another.

I find it ironic that amidst the highest unemployment figures in the U.S. since the great depresssion and facing a recovery which the only economist who predicted the subprime meltdown predicts will be anaemic and below trend in advanced economies with a big risk of a double dip recession one who questions the wisdom of enacting central planning in the healthcare sector is dismissed as bearing false witness by the leader of the free world.

ObamaCare Sails Into A Hurricane

If you look at the polls today Congress and President Obama are sinking fast but neither side seems to care and the public continues to get angrier. Why is this so?

John Avalon has written probably the most succinct explanation on the status of the health debate I have read in The Coming Liberal Suicide. I do not agree on the co-ops but he got everything else right. Writing about the failure of the leftists in congress to acknowledge a public plan leading to single payer cannot happen in today's budget environment for simple fiscal reasons both CBO and the public have pointed out.

Of the 21 top Democratic House leadership members and chairmen, five come
from districts carried by John McCain, but the average vote in the other 16
districts was 71 percent to 27 percent for Obama. Like Los Angeles’ Maxine
Waters and New York’s Anthony Weiner, they are ideologically and geographically
insulated from the skepticism generating from the great middle of the
country.

It’s a mistake that the architect of Medicaid and Medicare, Lyndon Johnson, never made. A Southern Democrat—sometimes derided by liberals as an “Eisenhower Democrat” when he was Majority Leader of the Senate—understood the need for bipartisan support for any major social reforms: His Medicare bill received the support of 70 House Republicans and 16 Senate Republicans. Even Newt Gingrich got it—his Welfare reforms gained the support of 101 Democrats at the high-water mark of the second Republican Revolution.

Liberals are in deep denial about the source of the president’s falling poll numbers during this summer’s health-care debate. They think the problem—perceptions of arrogant over-reaching liberalism—is the cure. It’s the same self-serving mistake that the extremes always make.

President Obama needs to depolarize the health-care debate. He got off-message because he got off-center. Embracing a bipartisan bill that replaces the public option with a nonprofit co-op will not “muddy” the debate but help clarify it. It will not
be a retreat but a way forward.

Lyndon Johnson once joked that “the difference between liberals and cannibals is that cannibals don’t eat their friends and family members.” In half-century-long history of failed health-care reforms from Harry Truman on down, liberal cannibalism has been as much to blame for defeats as fear-mongering from the far right.

The perfect cannot be the enemy of the good. The goal is to decrease costs and increase coverage. If today’s liberals don’t understand the lesson of their own political history and insist on attacking their president, they will have the failure of
this health-care reform on their hands.

.

5 Factual Errors In Obamacare & One Big Truth

President Obama asked All Americans yesterday to speak with their neighbors about Health Care Reform and to share the facts and since The New York Times cannot be trusted to even discern all the facts fit to print I will share just 5 of my favorite Facts.

• Fact #1 Health Care reform will include coverage for illegal aliens. What Obama is not stating is that he favors immigration reform in 2010 that places illegal immigrants on a glide path to citizenship. In the insurance industry we would call that an error of omission--the failure to mention a material fact.
• Fact#2 Americans already pay taxes to cover the uninsured in Federal Taxes and Local Taxes. Further expanding Medicaid will only add to the unfunded mandates imposed on Americans by Washington as we have all noticed by the emergence of tea parties on the news each evening. To quote the bi-partisan CBO ;

"The tables included in the report summarize our preliminary assessment of the coverage provisions’ budgetary effects and their likely impact on rates and sources of insurance coverage for the nonelderly population. According to that assessment, enacting those provisions by themselves would result in a net increase in federal budget deficits of $1,042 billion over the 2010–2019 period. By 2019, CBO and the JCT staff estimate, the number of nonelderly people who are uninsured would be reduced by about 37 million, leaving about 17 million nonelderly residents uninsured (nearly half of whom would be unauthorized immigrants)."

So lets just say fact #2 is essentially that Americans already know they pay for illegal immigrants today and are mad as hell the supermajority is seeking to increase what they pay by a $trillion while the President and congressional democrats tell us we are uninformed and that any health care reform cannot add to our debt. In America we call that **&%#^%!!! Is it any wonder today's Rassussen Poll shows that 54% of all Americans who fear government will do too much is up ten points from 44% in January... BTW see all my uninsured posts here. Illegal aliens know how to access free health care and thus lack an incentive as well as the income frequently to purchase their own.

• Fact #3 You can keep your coverage and no one will be forced into government run healthcare. Lets once again see what the CBO has to say on this whopper of a lie.

Under the proposal, nearly 90 percent of workers would be employed by firms that
would either have to offer qualified coverage and contribute a significant share
toward the premium or pay a tax equal to 8 percent of their total payroll. That “playor-
pay” penalty would constitute a substantial portion of the average cost of providing
insurance coverage, which has been estimated at about 12 percent of payroll currently
(but which would rise over time). In dollar terms, the penalty would obviously vary
depending on a firm’s payroll; for example, a firm with average wages of $40,000 per
year that did not offer qualified coverage would have to pay a penalty of $3,200 per
worker. Moreover, that penalty would make no direct contribution to those workers’
insurance costs; they would then need to obtain coverage from another source in
order to fulfill the individual mandate.

Its pretty clear to me and to most American's that in today's economic environment many businesses faced with a choice between an 8% payroll tax and a 12% cost for health insurance that would rise by 8% annually would drop health insurance in a heartbeat because as a nation we are simply not that bad at simple math. But it gets worse. recall that promise not to raise taxes except on the rich? lets again look at what CBO has to say on the matter of the tax impact of proposed health reform for the average worker.


Workers who get insurance through their employer receive a significant subsidy
because the cost of that insurance is not treated as taxable earnings for the worker and
thus avoids both income and payroll taxes. In most cases, that exclusion applies to the
portion of the premium that workers pay as well as the amount the employer
contributes. On average, that tax exclusion gives workers a subsidy of roughly
30 percent for purchasing insurance through their employer—a subsidy that would be forgone if the employer chose not to offer coverage and the workers instead obtained coverage in the new insurance exchanges.

Bottom line is that the lie that you can keep your present coverage is patently false on multiple levels.

1. It does not account for the behavior rational employers will display faced with a tax or mandate to offer health coverage. Unintended consequences abound in politics.
2. It does not account for the tax impact on workers who not only get to purchase their own heath care when their employer drops coverage but also lose the tax advantage CBO cites at 30% of the value of employer provided health care. I thought it was John McCain who wanted to tax American's on the value of their health care?
3. Access to private insurers for individuals whose employers drop group coverage will be through an exchange created by the federal government which will be up running and ready to guide you in your coverage selection. Really? Sort of like Medicare.Gov does so well now?
4. Self-funded plans will face mandates to cover items which they do not today and employers who have spent years investing in wellness and behavioral incentives to achieve a competitive advantage in their industry and have actually bent their own health care cost curve down will now face audits by the government who has no experience or expertise in achieving the same.

Fact #4 It is the Democratic Majority not Radical Republicans, Insurance companies, Doctors, pharmaceutical Companies and Fringe Elements Bearing False Witness who are obstructing Passage of Health Reform.

Rather than share my own thoughts on this matter let me quote Camille Paglia writing in Salon who very succinctly captures the state of our nation.

But who would have thought that the sober, deliberative Barack Obama would have nothing to propose but vague and slippery promises -- or that he would so easily cede the leadership clout of the executive branch to a chaotic, rapacious, solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens. She is doing grievous damage to the party and should immediately step down.

There is plenty of blame to go around. Obama's aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.

You can keep your doctor; you can keep your insurance, if you're happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor? Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing.

I just don't get it. Why the insane rush to pass a bill, any bill, in three weeks? And why such an abject failure by the Obama administration to present the issues to the public in a rational, detailed, informational way? The U.S. is gigantic; many of our states are bigger than whole European nations. The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made. And the transition period would be a nightmare of red tape and mammoth screw-ups, which we can ill afford with a faltering economy.

As with the massive boondoggle of the stimulus package, which Obama foolishly let Congress turn into a pork rut, too much has been attempted all at once; focused, targeted initiatives would, instead, have won wide public support. How is it possible that Democrats, through their own clumsiness and arrogance, have sabotaged healthcare reform yet again? Blaming obstructionist Republicans is nonsensical, because Democrats control the White House and both Houses of Congress. It isn't conservative rumors or lies that are stopping healthcare legislation; it's the justifiable alarm of an electorate that has been cut out of the loop and is watching its representatives construct a tangled labyrinth for others but not for themselves. No, the airheads of Congress will keep their own plush healthcare plan -- it's the rest of us guinea pigs who will be thrown to the wolves.

Fact # 5 Health Reform Will Raise Not Lower The Cost of Health Care For The Average American It Will raise Costs

Under the proposed exchanges being considered the government will mandate all benefits which must be offered by either public or private plans and will audit self funded plans. Larger employers who self fund have frequently achieved lower health care costs than insured plans. Thats what happens when you invest in wellness since as I have posted here about 70% of health care costs are attributable to behaviors that we control namely not exercising, smoking, drinking, not eating correctly and all the other things your Mom warned you about. Where I ask in the health reform proposals are the sections which specify the wellness incentives necessary to change the behaviors which drive 70% of the cost? They do not exist today but wait for the regualtions to show up by bureaucratic edict in 5 years along with the junk food taxes,soda taxes, higher alcohol taxes, couch potato tax and BMI tax.

There is an excellent summary here of why health insurance costs so much.

Recently I was listening to a radio program in which the host explained that in a few states health insurance policies issued by Blue Cross/Blue Shield were available at extremely reasonable prices, about $100 a month. The very first caller into the program demanded to know exactly what the annual deductible was in plans like this. When the host said $3,000 to $5,000 the caller responded, that isn't health insurance but catastrophic insurance. It's too expensive and that's why we need health care reform from Washington, he continued.

And there lies one of the problems with the health insurance reform debate. State government mandates and favorable tax treatment in Washington have so distorted the market for health insurance that a generation of Americans now look on medical coverage as something very different from other kinds of insurance that we buy. While we will pay several hundred bucks out of our own pockets to have a plumber come repair a leaky pipe, we'll balk at deductibles and a $50 co-pay for a doctor's visit. We've been schooled in this attitude by politicians who have mandated that health insurance do things that we'd never expect from other kinds of insurance, and by consumer advocates who will demand our legislators do something about a health insurance company that doesn't cover some optional procedure that has nothing to do with life and death.

What effect do you think imposing congresses vision of an appropriate health benefit package including every special interest mandate imaginable on America's largest self-funded employers would have on America's ability to compete in a global economy?

About 20% of the cost of health care for working Americans can be attributed to Prescription Drugs. While the average American does not go to the doctor or hospital each month they do use their health plan for presciption drugs each month on average. The White house proudly announced they had secured $8B in cost reductions annually from the pharmaceutical industry for the next 10 years. In contrast, Medicare spends $800B annually on prescription drugs but the white house deal leaves intact an agreement with pharmaceutical companies and the PBM's that handle Medicare not to negotiate prescription drug prices. This is madness. This is insane. It is incompetence. And one might reasonably question the ethics and judgement of an administration which cuts a deal on pharmaceuticals with parties that are now funding tv ads in support of health reform through an ad agency formerly owned by a current advisor to the president David Axlerod. But I digress, he point not negotiating over drug prices raises costs for Medicare and Senior citizens and makes American companies less competitive

One Big Truth

So why is health reform so urgent now? It's simply a matter of convenience. There is the fiscal crisis followed by the bailouts and the stimulus that all require new taxation. Obama's agenda is Education, Energy and Health Care. On the health care front reform was supposed to bend the cost of Medicare/Medicaid and reduce the deficit but since he cannot overtly mention his intention to tax the hell out of the middle class along with the rich he is going to do so under the guise of cap and trade and health care reform. You see the way health insurance works is that young healthy people subsidize generally older and sicker people. Medicare has a $38T deficit and Part D is just getting rolling. By requiring all Ameicans to purchase insurance through a government exchange including mandated benefits you do not want or need you eliminate the private insurance markets while simultaneously generating all the excess revenue you need to continue the enormous ponzi scheme we all know Medicare to be at its core. Once the insurer's are gone Uncle Sugar can dictate terms while using exploding costs to achieve the holy grail of single payer when the rationing can begin.Madoff gets prosecuted and Obama gets re-elected and the Democrats get to run in 2010 having delivered health insurance reform. Yet Obama and congressional leaders are discovering American's are on to the scam and we are sick of the lies and fingerpointing.

The Real Astroturf In Health Care Reform

The Hill is reporting on the White Houses deal to fund advertising by special interest in support of health reform.

PhRMA has joined Health Economy Now, a coalition that is spending tens of millions of dollars on an advertising campaign aimed at convincing Americans to support a broad restructuring of the country’s healthcare system. Other members include the AARP, the largest advocacy group for retirees; the Advanced Medical Technology Association; the Business Roundtable; Families USA; the Service Employees International Union; and the American Medical Association.

The healthcare coalition’s advertising campaign is also facing scrutiny for hiring two firms that received $343.3 million to handle advertising for Obama’s White House run last year. AKPD Message and Media was run by David Axeldrod until he left at the end of December to serve as a senior adviser to the president. The other firm is GMMB Campaign Group, whose partner Jim Margolis also served as an Obama strategist. Over the weekend, Bloomberg News reported that AKPD still owes Axelrod $2 million, which it is set to begin paying in installments starting on Dec. 31. Axelrod’s son, Michael, also still works there. Calls to AKPD and Health Economy Now were not immediately returned.

"Some may wonder whether White House senior advisers earning millions of dollars paid for in part by the pharmaceutical industry represents the kind of change Americans can believe in,” House Republican Conference Chairman Mike Pence (Ind.) said in a Tuesday release.

PhRMA’s Johnson said his organization was only one member of the Healthy Economy Now coalition, but noted that no one at the association made the decision to hire AKPD and GMMB. “We trust and respect the decisions made by the campaign,” he said. Johnson also denied reports that the coalition would spend $150 million on the advertising campaign, calling them “speculative.” He would not say, however, how much PhRMA planned to spend or how much it had spent on the campaign so far, saying only that it would make a “substantial investment

Great Take On The Nature of Co-op's

Bob Laszewski provides good insight on just how "innovative" a co-op truly is on examination.

This whole debate gets back to the simple question I have not heard any of
the co-op proponents answer: Just how will a co-op turn out to be any different
than North Dakota Blue Cross with its profit percentage of less than 1% and its
board a cross section of the provider, business, and consumer community?

Happy Birthday Mom

Mom passed away February 8, 2009 from cancer but today would be her 77th birthday. With all Today's news about birthers, deathers and life support for the government plan I am most grateful for the common sense Mom instilled in my brothers & I. For example, Mom was hosptitalized last election Day and she was adamant about getting released early enough to go vote. Life was the ultimate issue for Mom and she knew that when a society placed so little value on it as to label abortion as a simple "choice" instead of a childs life a slide down the slippery ethical slope was inevitable. It is no wonder today that the left simply cannot understand why senior citizens would oppose rationing with Pete Singer writing in the NY Times about QALY's and stunning deficits being generated. But Mom knew Obama's record on Life defined him as a politician and he had pledged to make his first presidential action to sign the FOCA.

I wonder when the left is going to discover the fact dissent at town halls is being generated by a an awakening in America?

Protestors;Harry Reid Called You an Evil Monger

Harry Reid, the Senate majority leader, characterized people disrupting town halls as "evil-mongers"

Support for Health Care Reform Falls to New Low

Rasmussen poll shows Americans are not drinking the Kool-Aid on health care/insurance reform.

Public support for the health care reform plan proposed by President Obama and congressional Democrats has fallen to a new low as just 42% of U.S. voters now favor the plan. That’s down five points from two weeks ago and down eight points from six weeks ago.
A new Rasmussen Reports national telephone survey shows that opposition to the plan has increased to 53%, up nine points since late June.

More significantly, 44% of voters strongly oppose the health care reform effort versus 26% who strongly favor it. Intensity has been stronger among opponents of the plan since the debate began.

Sixty-seven percent (67%) of those under 30 favor the plan while 56% of those over 65 are opposed. Among senior citizens, 46% are strongly opposed.

The Left Is Self-Destructing Over Health Care reform

Everyone should read Camille Paglia's post on The Obama Healthcare Horror.

Obama seems to be surrounded by juvenile tinhorns, bumbling mediocrities
and crass bully boys.
Case in point: the administration's grotesque
mishandling of healthcare reform, one of the most vital issues facing the
nation. Ever since Hillary Clinton's megalomaniacal annihilation of our last
best chance at reform in 1993 (all of which was suppressed by the mainstream
media when she was running for president), Democrats have been longing for that
happy day when this issue would once again be front and center.

But who
would have thought that the sober, deliberative Barack Obama would have nothing
to propose but vague and slippery promises -- or that he would so easily cede
the leadership clout of the executive branch to a chaotic, rapacious,
solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her
smooth aplomb under pressure, has clearly gone off the deep end with her bizarre
rants about legitimate town-hall protests by American citizens. She is doing
grievous damage to the party and should immediately step down.

The president is promoting the most colossal, brazen bait-and-switch
operation since the Bush administration snookered the country into invading Iraq
with apocalyptic visions of mushroom clouds over American cities.

You can keep your doctor; you can keep your insurance, if you're happy
with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And
what if my doctor is not the one appointed by the new government medical boards
for ruling on my access to tests and specialists? And what if my insurance
company goes belly up because of undercutting by its government-bankrolled
competitor? Face it: Virtually all nationalized health systems, neither
nourished nor updated by profit-driven private investment, eventually lead to
rationing.

I just don't get it. Why the insane rush to pass a bill, any bill, in
three weeks? And why such an abject failure by the Obama administration to
present the issues to the public in a rational, detailed, informational way? The
U.S. is gigantic; many of our states are bigger than whole European nations. The
bureaucracy required to institute and manage a nationalized health system here
would be Byzantine beyond belief and would vampirically absorb whatever savings
Obama thinks could be made. And the transition period would be a nightmare of
red tape and mammoth screw-ups, which we can ill afford with a faltering
economy.

As with the massive boondoggle of the stimulus package, which Obama
foolishly let Congress turn into a pork rut, too much has been attempted all at
once; focused, targeted initiatives would, instead, have won wide public
support. How is it possible that Democrats, through their own clumsiness and
arrogance, have sabotaged healthcare reform yet again? Blaming obstructionist
Republicans is nonsensical because Democrats control all three branches of
government. It isn't conservative rumors or lies that are stopping healthcare
legislation; it's the justifiable alarm of an electorate that has been cut out
of the loop and is watching its representatives construct a tangled labyrinth
for others but not for themselves. No, the airheads of Congress will keep their
own plush healthcare plan -- it's the rest of us guinea pigs who will be thrown
to the wolves.