It Is Not Reform Without Public Option

There has been a lot written lately about the possibility of scratching off the public option from the health care proposal now working its way through congress. What, then, can be implemented to control the rampant and out of control cost escalation since the health insurance giants have demonstrated that they are powerless to control these rising costs? We now have an absence of universal coverage and an industry-wide policy of denying coverage because of pre-existing conditions (among other reasons). Both of these factors, plus the health insurance companies’ deep pockets insure that health care costs continue to rise much faster than the current inflation rate.


Health care cost increases have outpaced inflation rates since the insurance companies got involved in health care to begin with. And health care has never been universal during that same time period (not that it was universal before, because it wasn’t). Still, insurance companies have amassed huge profits. And although it is not a bad thing for any company to make a profit, this profit further contributes to our skyrocketing health care costs. Add to this all of those people without insurance who must go to emergency rooms to get medical attention and you begin to get an idea of the disaster we now know of as the American health care system.

Most of us already knew this much. But when you realize that everything in the economy is connected in some way or another you begin to see that this problem has a ripple effect that extends out beyond healthcare into other vital areas of our economy. Everyone in the U.S. knows how uncomfortable it is to have your doctor tell you that you cannot have a treatment, a medical procedure or a prescription because it isn’t covered by the insurance. We also know what it is to have the doctor tell you that the reason for this denial is always the cost. Maybe you work for a small business that cannot afford a very comprehensive policy. And lately, it has become possible that you, the employee cannot afford the policy which provides the kind of coverage you need. It doesn’t really matter what the reason is. Maybe you need more care because you are aging. Maybe a member of your family has developed an expensive health maintenance issue.

Just this last year health insurance doubled for many and many of us were faced with higher costs for less coverage. If you are a small business owner, you may not be able to afford health insurance for your employees. That places your employees in the emergency room set. This has to stop. This is such a blatant problem that the government is stepping in and is working on reform. That’s nice. In the beginning the health insurance companies publicly joined the bandwagon and said, “Yes! We need to reform our health care system.” We aren’t reading statements like that from the health insurance industry anymore. This has turned into an old fashioned political dogfight.

Some argue that if the government enters the health care arena we will wind up with long lines and bureaucratic problems much like we have when we go to the DMV to renew our license plates. While that may conjure up bad images of long waits involving taking a number and waiting forever, Who wouldn’t much prefer that to finding out they have cancer and that they cannot get it treated unless they can find a way to come up with $40,000 because they don’t have health insurance? And who wouldn’t also prefer dealing with bureaucratic nonsense to having to come up with a $2,500 up front cost because of the conditions laid out in their current health insurance policy.

There are also those who are afraid that the public option is simply a way for the government to step in and completely eliminate the insurance companies from health care all together. So what! If the insurance companies want to stay in the health care business they should find a way to help provide universal care without costing the average citizen almost half their family income. American public health figures don’t stack up well on the world scale as it is. Sadly for the insurance companies, the competitive nature of the free enterprise system demands such efficiency that some potential customers will almost certainly be left out. And yes, to the health insurance companies we are customers—not patients.

Nobody wants their health care decisions made by some bureaucrat instead of collaboration between them and their doctor or doctors. The same people, who voice this concern out of fear that the bureaucrat in question might be a government one, forget that they are already in that position, only the bureaucrat they deal with now is working for the insurance company.

This brings us back to the latest development in Washington, which is the news that the public option may be scrapped. If this actually happens can we still call it reform? Which of our health care problems can possibly be fixed if we cut out the public option? Will we get universal coverage? How about affordability? Will the newly reformed system be able to exert any kind of cost control? Will it be possible for small businesses to provide employee health care?

Fixing our ailing health care system without the public option is no where near realistic. Our current system is not producing quality national health care anyway. On the world scale, we are lagging behind in life expectancy, cancer rates and infant mortality rates.  What kind of actual reform can we possibly achieve without the public option? It is naive to place stock in any solution that resembles the status quo. If we don’t find a way to address our out of control rate of rising health care costs we will eventually be in the situation where most of us cannot afford health care at all.

Single Payer Healthcare Would Be Better

Thinking that we can solve our health care problems with one bill is wishful thinking at best, and is no where near realistic. Initially, the bills in the House and Senate are taking the approach that the Government should enter the health insurance business and offer health coverage that would ultimately make it all but impossible for the health insurance companies to compete in the healthcare arena. This is like trying to eliminate criminal behavior by allowing the Government to go into the rackets by creating its own gang with the objective of running the current gangs or mafia organizations out of business by out competing them. One of the biggest problems in our healthcare system is health insurance.

The insurance companies don’t make their money by providing insurance; they make their money by denying it. Insurance companies themselves need to be removed from the healthcare equation all together. They are not in the healthcare business. They are just in business. But they are not the entire problem.

While reading the editorial pages of the Denver Post on July 12, I noticed a letter from a Dr. Patrick Messerli, of Durango, CO, who mentioned that when the Mayo clinic takes on new patients, they regularly perform all lab tests over again so they can bill for them. This is a business model of generating revenue by duplicating all tests and procedures once the patient arrives at the clinic. The tests already performed by the patient’s doctors were good enough to get them into the Mayo clinic in the first place but not good enough for clinic doctors to study and decide upon the proper treatment. While it is understandable that an occasional test may need to be repeated to verify or even clarify what clinic doctors must troubleshoot, it is a wasteful policy that requires repeating them all. The Mayo clinic is not the only clinic our there that practices this way. Health insurance is what makes this all possible.

To make matters worse, Time magazine reported that “research by the Dartmouth Institute for Health Policy and Clinical Practice has found that as much as 30% of our annual $2 trillion–plus medical bill may be wasted on unnecessary care, mostly run-of-the-mill diagnostic tests, office visits, hospital stays, minor procedures and prescriptions for brand-name wonder drugs advertised on TV.” All of this is because they can get reimbursed for these items and procedures by the insurance companies.

Then there is the case of a European physician who was conducting research on human DNA years ago. The CBS news magazine 60 minutes did a feature study on him a few years back and found that this doctor, while his research was admirable and would ultimately result in many good applications and discoveries for mankind, was getting rich by selling all of his DNA data to major health insurance companies. The companies involved were in turn using this information to deny health coverage on procedures for ailments and afflictions that could be predicted by studying this DNA database under the guise of, you guessed it, pre-existing conditions. This is another situation made possible solely from the involvement of insurance companies in the healthcare business.

If you, or your family, decide to have your DNA tested to determine if one or all of you are risk for some hereditary disease with serious ramifications, you should not have to be concerned that your personal data will be used against you by your health insurance company when making your decision. But you now have no choice but to consider that possibility because your health care is not determined by your doctor. Your doctor merely recommends. The ultimate decision on your health care is made by some accountant, actuary scientist (insurance longevity predictor) or some other insurance executive or bureaucrat—and that decision is based upon the cost, not the health benefit.

These decisions that insurance companies make for you have much more far reaching effects on your life than whether or not you get the treatment you need. What if you are the minor bread winner for your family and you work for a small business with less than 100 employees. Maybe you are the one who has employer provided health insurance because, say the major bread winner is self employed or is in sales or some situation where there money is better than your income, but there is no health benefit.

So consider if you will, that you develop an expensive medical issue. You go to the doctor, who then refers you to a specialist. The specialist puts you on a treatment that is effective but extremely expensive. The insurance company covers it because it is not something they can refuse. The owner of the small business where you work is now faced with escalating health insurance costs. The company has no choice but to pay it, but now you are under scrutiny. They cannot just fire you, but they can watch you until you make a mistake. They document it and talk to you about it. It may take them a year or two, but eventually they will get you out of there. Now you are looking for a job.

That’s illegal, you say. True, but unfortunately any company can get rid of anyone for reasons other than what they will actually fire you for. If you watch someone long enough, they will make mistakes. Eventually, these mistakes will ad up to termination. Don’t be naïve enough to think that this does not go on, because it does. If the company where you work is small enough, it could make the difference for them between being able to provide health coverage for their employees or not. They could have very little choice but to take this action. This is more unfortunate collateral damage caused by health insurance.

Under the current system you lose access to healthcare when you lose your job. Yes, you can get cobra, but it costs more than your original healthcare coverage cost you when you were employed. The main difference here is that you no longer have any income with which to pay for it. This is a great system, huh?

A single provider system, like the federal government, is a good solution to this. It won’t fix everything, but it is certainly a great place to start. And before you write in and say socialism, socialism, socialism. I have a question for those of you who believe that gobbledygook. Are you healthy and in no real need of healthcare? Because that is who usually hollers the socialism argument. With the single provider system you will not be sent home without treatment for the cancer you have just been diagnosed with simply because you don’t have health insurance or the $40,000 to pay for the treatment. Under the current system that is exactly what could happen to you.

Healthcare should be part of the national infrastructure of support services, just like police and fire protection, education, highways and protection from our enemies. Detractors will argue that to take healthcare out of the public sector will result in less advancement by removing competition from the system. Competition hasn’t produced an efficient system so far. Besides, this will not remove all competition. There would still be government contracts for everything that goes into any doctor’s office or hospital.

Having government provided Police and fire protection hasn’t resulted in lower quality protection, nor has it removed competition from those endeavors. Healthcare is eventually a life and death scenario for all of us, and we shouldn’t have our healthcare decisions made for us by someone who’s main concern is the profit of his or her company and their secondary concern (if that) is your health and well being.

Why Not Sonia Sonomayor?

Opponents to Sonia Sotomayor’s confirmation as the next appointee to the U.S. Supreme court have chosen to call her a racist based largely upon a single statement she made to the University of California, Berkley, School of Law eight years ago in a 2001 speech. This time it’s the Republicans who are hammering the point home. They are calling her a racist because she used the terms “Latina woman,” and “white male” in the same sentence which drew a comparison between the two stereotypes and offered a hope that a Latina woman would make a better decision than the white male because of how she had lived her life.

She was not discussing a particular, pending issue. What she was actually talking about in that speech was that there is plenty of historical evidence that individuals on the Supreme Court from all walks of life have made very high quality decisions—and there is also ample historical evidence available that members of the court from varied walks of life have made some very biased decisions. There is no Rosetta stone for jurisprudence.

McClatchy Newspapers reports that Sotomayor, herself has spoken for a three judge panel that ruled in support of a George Bush policy “which required foreign groups receiving U.S. funds to pledge that they do not support or promote abortion.” The three-judge panel ruled that this policy was constitutional. Abortion activists don’t like this at all. As a Democrat, it would be expected that she would have a different opinion on this matter. Clearly, she is quite capable of making decisions based solely upon the law without letting her personal opinions or experiences interfere with said law’s interpretation. Isn’t that what we need in a Supreme Court Justice?

But Sotomayor is a democrat, so the Republicans are using the amo they are able to dig up. This time it’s the racist card, and the only reason they are using it is because among everything they were able to find, they believe this item will have the greatest negative effect to her confirmation. If they had anything stronger at their disposal, they would certainly use it. But they don’t, so this is it. As is often the case with racism charges, those yelling the loudest have not checked their own glass house.

Rush Limbaugh would have called any Democrat nominee a party hack. That statement was no surprise. But Limbaugh is in no position to freely call anyone a reverse racist. He has frequently stated on his show that “the women’s movement exists solely to provide ugly women access to the mainstream of society.” Glass house, glass house, glass house.

Truthfully, with the nominee confirmation process as politically charged as it has been in our lifetime neither party can expect to get the type of justice they are looking for confirmed at all. They aren’t even telling the public the truth about what it is they want in a justice. Although the Republicans are saying they want someone who will set their personal feelings aside and just perform their job on the strict basis of the law, what they really want is someone who would willingly commit in advance to having the hidden agenda to vote to strike down Roe vs. Wade and reverse the tide on abortion without any deliberation at all.

And the Democrats would love to have their own type of activists on the court. They would like to eliminate the right to bear arms under the same afore mentioned, predetermined agenda styled conditions. Don’t make the mistake of thinking the Democrats have purer motives for what they want. Take away their points of view and both sides are basically cut from the same mold.

The American public, however, would very much like to have a judge who would argue and vote based upon the law as it is written and not allow his or her decisions to be influenced by their own opinions and beliefs. It is probably a pipe dream.

So what we have here are the makings of a good old cat fight. Right now the Democrats have the sharpest claws, so they will get what they want. I expect a lot of squawking from opponents, though. In a way, it is like watching two high school kids get into a fight over a pack of gum drops.

Although her opponents can make a lot of noise on this issue, there is nothing in her judicial record to indicate that she would be anything other than a prudent and conscientious member of the court.

Insurance Is The Problem

Many of us have this dream that we could have less government in our lives and a better quality of life at the same time. Seems silly doesn’t it? When you look at it objectively, we give the government a lot of money with our taxes. The only thing we need in life from government is a good, safe life and the ability to exercise our freedom.

To have this we need a proper education, good health, safety and the ability to move freely throughout the country at will. This translates into needs for police and fire protection, good schools, protection from our enemies by the military and good health care. If those things were the only things government concerned itself with there would be no reason why Americans could not enjoy good laws, education, health care, highways, parks and recreation facilities—all paid for by the government via our taxes—and our government would probably have money left over. I realize that this is not what we have.

In the case of our national health care we are way behind the curve and our representatives at both state and federal levels are still thinking inside the box. This is bad, very bad. The U.S. is the last democracy that hasn’t yet gone to national health care and we are nowhere near the top 25 on the list of countries with the best quality of national health. Everyone in congress knows this and both political parties are trying to come up with plans to fix our ailing national health care system. The trouble is that nobody is trying to fix this problem. They are looking at this situation all wrong. What they are trying to do is change our current system so that everyone can have affordable health insurance. Looking at our health care crisis from that point of view will produce no better result than continuing to fix an old, broken down piece of machinery instead of replacing it with a new one.

Changing things around so that everyone can afford health insurance will not address the problem. It will not fix the problems that arise when people lose their job while members of their families are going through complicated or expensive on-going medical treatments. Nor will it fix things so that people can have a needed operation that they cannot pay for. Today, nobody gets health care unless they can pay for it—even if it means they will die if they don’t get the treatment. Under the insurance system many people will have their health care interrupted while a family member who just lost their job scrapes and scrambles to find other employment. No matter what fix congress comes up with that includes insurance, that type of problem will not be addressed because in most cases the health insurance probably comes from having the job in the first place. Once the job is gone, so is the insurance. And don’t even think of Cobra. That is simply a way for you to keep your health coverage at three times the original price while you no longer have an income to pay for it.

Insurance is not the solution, it is the problem. We will not get our health care system fixed by changing the cost of our insurance. What we need to do is take the profit out of the health care industry. As a business, insurance companies have to make a profit. In order for there to be profit people must pay enough for the insurance company to provide the health care and have some funds left over after the health care has been provided. This simply cannot happen if everyone’s health care is provided for. Insurance companies don’t make money by providing for people’s medical needs, they make money by not covering them. Did you notice that statement above? “Enough for the insurance company to provide the health care.” That is just it. The insurance companies are really just middlemen. Medical coverage should come from medical professionals, not insurance companies. Letting insurance companies get involved in individual health care played a significant role in the escalation of health care costs in the first place.

Medical care cost increases have outpaced inflation all along. At no time since the introduction of insurance into our health care system has inflation outpaced rising health care costs. If the government really wants to address our health care problems it should bring about national health care and cut the insurance industry completely out of the picture. The system needs an amputation. Only then will it be possible for families to continue to get health care while one or both of the bread winners are out of work.

National health care would fix a number of problems. It would remove from any business's bottom line the need to provide health insurance for their employees. In a large corporation this would be an enormous savings, but in a small business it could make the difference between surviving the start up period and failing to become a viable concern. And we would no longer need to fund Medicare and Medicaid, since national health care would provide for everyone. (Many doctors don't take Medicare or Medicaid anyway.) It would also reduce the cost of health care by at least as much as whatever the profit is. This means that our national health care would be more affordable for the many, than it now is for the few. Since with national health care everyone would receive care, there would be no uninsured people flocking to emergency rooms for the care they cannot afford, which is another factor that drives costs up in our current system. Yet there are still profits.

Changing our system, not altering it, is the cure. Altering things so that more people can afford health insurance isn’t even humane, really. That type of improvement cannot possibly include everyone; it will simply include more than are included now. There will inevitably be some who are left out. Profit is not maximized unless some are denied coverage, and as businesses all insurance companies are responsible to their shareholders for maximized profits. As long as people can be denied coverage for any reason at all, some will die because of the inadequacies of our system. National health care will have some weaknesses, surely, but it can hardly be worse than what we have now. Sadly, judging by the way things are going in congress this type of change doesn’t look likely in the near future.

You Can't Negotiate With Pirates

In view of the fact that piracy off the Somali coast has taken on such huge proportions in the number of vessels taken, monetary value of captured cargo, the number of hostages taken and the distance from their own coast the pirates are traveling to commit these acts—it is unfortunately time for the world to take the long view when planning solutions. Trying to negotiate our way through this is being short-sighted. Yes, we are trying to get through this without losing any lives. But that tactic is probably costing us lives in the long run. They are collecting hefty ransoms for their efforts and as a result, they are growing bolder and upgrading their capabilities. This is not making any solution easier to achieve and is in the long run endangering more lives than it is protecting in the short run. At last report, pirates currently have control of at least 12 ships plus a tug boat and have over 200 hostages.

These pirates, who have stated to the world’s press that they are acting as a form of Coast Guard to protect Somali waters, are now venturing over 200 miles from the Somali coast to board and take ships. No country in the world has ever been able to claim that distance away from their land mass as coastal waters. Although these pirates have told the press that they confront all ships be they fishing vessels or merchant ships carrying oil or containers, they are clearly working for profit here. Among the ships taken are a French yacht, tankers, container ships and a ship carrying tanks and military armaments bound for neighboring Kenya.

They have three potential revenue streams from each vessel taken. They can ransom the crew, ransom or sell the freight and ransom or sell the ship itself. The Pirates have made over $35 million in little over three years and have upgraded their technology to include GPS, sophisticated electronics and upgraded armaments such as RPGs and automatic weaponry. This is a growth industry and it is clearly nothing more complicated than organized crime.

During the most recent confrontation with pirates concerning an American ship, an FBI hostage negotiator working with the U.S. Navy on a case involving a ship’s captain who volunteered to be taken hostage, told the press that the pirates’ actions are all about the money. In his opinion they are not motivated by patriotism or ideology and have no ties to terrorist organizations. Regardless of their motivation, they are presenting themselves as a threat to shipping lane stability that affects the entire world.

The patriotic angle professed by these pirates doesn’t wash, since they are reaching out farther than 200 miles off the Somali coast. Eventually the piracy problem will be eliminated. An Indian warship has sunk one pirate ship and French commandos captured a pirate crew and freed all but one hostage on a sailing yacht. The hostage who wasn’t freed was killed during the rescue. If the French are getting into the actual fight, this problem is serious.

However, taking the cautious approach we are currently trying may be costing the world more lives in the long run than the more ruthless, but prudent action in this case. By paying the ransoms, ship owners and shipping companies are perpetuating this situation by making it profitable. Although it will seem ruthless to much of the world, we should consider how many lives will be saved in the long run by refusing to allow this type of action culminate in a payoff of any kind.

In fact, as horrid as this may sound to many people out there and as unfortunate as it would be for any current hostages and their families—it is just possible that the best solution to this particular problem would be a full scale military action that quite possibly could cost the lives of many hostages. The Joint Chiefs probably have a much better plan of action than I am suggesting here, but a U.S. Navy escort on all American merchant ships in the area seems appropriate. Guided missile frigate escorts in full view for every merchant ship and a permanently deployed submarine to patrol the general area, both with rules of engagement orders to treat the zone as a free fire zone in order to protect shipping lanes and prevent further disruption by piracy seems in order here.

This may sound cruel to some, but we have already missed the opportunity to nip this one in the bud and the net result is that we now have a full fledged piracy problem on our hands in waters that are considered by every country of the world to be open sea. If that isn’t a clear and present danger, what is? These pirates have to know that not only is there is no profit in this type of endeavor, but that this type of activity will immediately cost them there very lives.

To them this is a business model. It may be immoral and it may be wrong, but as long as it is profitable it is viable. If the pirates believe they will be blown out of the water by simply being there at the wrong time they will stop. There is no profit in dying. We have to make the risk too high for them to be willing to continue. If we don’t, we will see it continue and it will escalate. The sooner we stop this, the fewer lives and the less shipping freight will be lost. We cannot negotiate our way to the end of this particular problem. It is the negotiation that leads to their profit.