If the stimulus is working better than they thought I would hate to see what the worst case scenario was.  Losing 500 thousand or more jobs for like the past 6 months but I guess they saved 14 million right.

 I am guess that the worst case scenario was just cut and pasted out of the last book of the bible.

I know that many politicians feel that the people that vote for them are ignorant morons but it is very rare and rather refreshing, if being hit the face with bucket shit is refreshing, for them to actually state it to their constituents faces.  As Massa states so clearly “I will vote adamantly against the interests of my district if I actually think what I am doing is going to be helpful.”  If we were talking about funding for a bridge that would be great for the district but wasteful, then he has a point.  But we are talking about riping the whole health-care industry apart and starting a new government entitlement program during a severe recession and increasing debt.

One last thing, Jon I will miss seeing you in movies and biting the occasional TV star.

p.s.  Jon Voight has not annouced his retirement as far as I know.  It is just satire.

Somehow this article tries to spin this as a good thing for everybody.  Although the people involved in this are better off it actually shows a large problem in the canadian system.  Because the canadian system cannot respond to demand in it’s own system it must outsource the care to the United States.  This is a direct result of government mishandling of the healthcare system and inability because of cost to increase supply.  Proving that Socialized anything only brings shortages and rationing while free markets bring excess supply. 

A quick lesson on markets, I only have time for a sanitized version.  Anytime a product has a demand that outstrips supply the price will rise.  This is a simple thing to understand.  What comes next is the correction of this problem (high cost is a problem to everyone but the guy selling it).  Others seeing the great profit potential get into the market.  Once they enter the market the price of the product will begin to come down as the supply of the product increases.   The increase in suppply will drop the price. 

The only two cures for high prices are increased supply or decreased demand.  All other ways of controlling price are fool hardy.  When it comes to healthcare that means more hospitals, more doctors, and more nurses.  Or decrease demand, which can only go so far as people age.  Although a large supply of guns and liquer can help  (Sarcasm).

In the following blog post I hope to address what is good about the current system. Explain what is bad about the current system. Finally I will explain my plan to change it without resorting to a public option.

In the United States if you have a good health insurance plan you get the best care in the world. If you need to see your personal doctor you can generally walk in that day.  Perhaps you need to see a specialist well maybe that will take a week. Perhaps you need a MRI, which takes a week at the most.  In comparison all of these tasks in many of the socialized medicine world would take much longer.  Statistics are readily available on the web from Canada’s and Britain’s own healthcare websites.

Canada: http://www.hc-sc.gc.ca/hcs-sss/qual/acces/wait-attente/index-eng.php

Some more: http://www.hrsrh.on.ca/PortalEn/tabid/859/Default.aspx

Britain: http://www.performance.doh.gov.uk/rtt/index.htm

and in english: http://www.guardian.co.uk/uk/2007/jun/07/politics.health

And England meets its goal: http://news.bbc.co.uk/2/hi/health/7966404.stm

So in the United States when you have good Health Insurance you are taken care of pretty well.  But the problems come in those who don’t have health insurance or those people that are impossible to insure.  The costs associated with these individuals are the problem.  It is not the profits that the insurance companies make that are causing the rising cost of insurance.  Even if the profits were paid back to the individuals most would be minimal reductions in premiums at best. 

Now let us talk about one solution to this problem.  We should take what works and keep that.  This is the traditional private insurance model, where premiums are pooled and costs taken from these pools.  Next we try to address the two primary reasons why the market is broken.  Those without insurance not paying for care and those that have such horrible health problems they are impossible to insure for premium that those individuals can afford. 

This is the point that government can step in.  The government can begin a plan as the catastrophic insurer, essentially taking over the costs of those who are too expensive to insure.  They would not do this directly but indirectly through the first party insurance company.  This is done on an individual basis, where the premiums paid by the individuals have been less than one third the cost of treatment over the past five years.  In other words, if an individual pays $3000 in premiums but their treatment is costing $10000 the government would pick up $1000(The numbers I chose are for simplicity and should be adjusted in any real world situation).  This solves a major problem which is the person who uses far more health resources then they have paid. They are still costing the insurance company more money then the premiums, but because it will only take two other people’s premiums to break even on this, rates will not have to be increased.

The second point at which the government can step in is regulating that all people in the country must purchase health insurance.  Those without health insurance will be penalized much like those without car insurance are today.  If you don’t have health insurance you will be reported to the proper authorities.  Maybe some type of subsidy can be provided but the market should be allowed to function.  And much like car insurance was very expensive it too will come down in price once competition and cost savings are implemented.

Now let us move on to what the private health insurance companies will have to give up.  Health Insurance companies must cover all non-cosmetic procedures, either pre-existing or not.  All people must be able to be covered and the difference between the highest premium and the lowest premium may not exceed a certain amount (or some other price capping mechanism, although the government stepping in as the catastrophic coverer should help with this).  This will eliminate those that can not buy insurance and everyone will be able to afford some type of insurance.  It may hurt for some but they will be able to purchase the insurance needed.

Some other miscellaneous things I would like to add to the debate. 

• Some form of tort reform is needed.  Loser pays is a nice option.  Also a cap on non-gross-negligence problems.  Nicking a blood vessel while doing all that is humanly possible, although tragic for those involved, should not award an ownership stake in the hospital, but cutting off the wrong leg should result in a hefty cash settlement.
• Keep the “health saving accounts” alive.  Allow people to put away a certain amount of money tax free that could go to health care related expenses.
• Move some medical school interns out of the hospital and into the doctor’s office.  These students could be cheaper alternatives for the run of the mill doctors visits.  A real doctor must be present in the office but let’s be honest how many times did the visit to the doctor’s office result in a prescription for an anti-biotic and some bed rest.  These could also be nurses with some additional training.  Or think of it as Doctor-Lite.
• Allow for both employer and self employed to purchase plans with pre-tax dollars. 
• Allow for people to form groups that can purchase insurance as a block and not as individuals
• Remove the State Restrictions from insurance sales.  Even this means the implementation of Federal Minimum Standards.  States could still come in to offer non-binding approvals.
• Finally an easy to read rating system would be very helpful.  Much of the problem of health insurance purchase it that there is too much lawyer speak and not enough easy to understand language. 

I want to end with one more observation.  The reason that such strides have been made in health care in the recent decades have been made is because of the money that can be made in the field. From the creation of the next Jack-Pot drug to a new surgical technique that revolutionizes the industry, most of these advances came about from people working long hours to become the leader in a particular market to make lots of money. 

1.       Late 1920’s “Everybody makes money with stocks!” 

2.       Late 1990’s “Everybody makes money with tech-stocks!”

3.       Mid 2000’s “Everybody makes money with real-estate!”

Granted most of this is hind sight but I did warn those around me in late 2006 that this whole housing thing was getting out of control.  I know that I am freaking genius (sarcasm). Many people lose their head when it comes to the purchase of investments.  What people should look to when it comes to any investment be it a house that your live in (not really an investment) or a share of a business is what is it really worth. 

In the case of house, are the mortgage payment and other expenses, worth the joy and security you get by living in it?  How much is it really worth to stay dry when it rains. How much is it worth to have all your friends envy your place of residence?  How much is it worth to not hear the whore in the apartment next to you?

Is the business you are becoming part of worth the initial investment?  Will the business turn a profit quickly or will it take years to turn a profit?  Will the business be such a thorn in the side of another business it will be bought out (which was a viable tactic in the dot.com days)?  Or finally can you convince some other fool that it is worth more then what you paid for it (this is the case of just about every tech stock in the late 90’s)?

Do these people really think that the public option will compete on a level playing field? Of course it will not.  The public plan will be able to run at a severe loss and just ask for more tax payer money.  The private plans will not be able to do this.  Ironically the profits the private companies will be making will be taxed, and this tax will go to help the public plan undercut the profits for the private company.  In addition, because current private insurance will be taxed as income, the private insurance companies will have to drop the prices of their plans to account for increased cost of the plans. 

I think many of the regular Joe’s pushing for the public opinion are primarily looking at this through hate filled eyes.  Much of this is probably warranted as the private insurance companies have pulled some very dirty tricks on people.  Issues from pre-existing conditions, dropping people for minor infractions, and just charging too much are all valid reasons.  I think in this case the cure is worse than the sickness.

Simply being opposed to something is usually not enough for an argument.  Unless of course you believe the current situation is perfect.  I do not think the current situation is perfect but the alternative of increased government intervention will result in a worse situation.  Although a few additional people will have health insurance the vast majority will see their current coverage slowly die.  The reasons for this are multiple but most of the reasons have to do with the government run plan being subsidized by the tax revenue more and more till the private insurance companies cannot compete.

If we assume that the current plan is similar to a government run health insurance provider, similar to Aetna or United Healthcare.  The difference would be that, instead of being run for profit it would be run for the good of the people.  Those familiar with the term “good of the people” know that it means it will be thousands of jobs for the campaign workers of the winning party.  The most important difference although is not in how the theory of how the company is to be run, but by the sources of funding for the company.  While a private health insurance company is paid primarily by premiums paid by the policy holders, the public plan will be paid by a combination of “affordable premiums” and government taxes.

So far we outlined the future of the system under the current plan but what makes the current system so broken it needs such radical fixes?  There are a few pieces of the current system that are broken.  The first is the current price of insurance premiums.  Many people cannot buy health insurance because it is priced too high.  The reason for this is primarily that the person is trying to buy a policy just for their family.  While businesses have bulk policy leverage to bring the price down the individual does not.  The second problem with the current system is paying for coverage and not getting coverage.  This can range from “preexisting condition” to “uncovered procedure” problems.

I personally believe that when someone buys health insurance it should pay for all non-cosmetic issues a person should encounter.  How much of it the insurance covers can vary, but everything should be covered.  The counter to this is that a company simply cannot cover certain illnesses and still be in business.  So how do we fix this issue?  In this case I think the government can help.  I just don’t see any other way to solve this problem besides including the government. The government would simply have a catastrophic fund.  A person and the insurance company could register a person’s illness, be it cancer or another very expensive illness, at which point all treatments for this illness can be subsidized.  Other rules would of course be needed but the primary purpose of handling high risk cases would be handled.

 The other problem is of course with pricing.  The price of an individual family getting health insurance can be daunting.  The local corporation does not pay that price for its employee’s coverage.  Why? Because it is buying so much that it has leverage to bring the price down.  John and Jane Doe can’t do this.  To solve this problem, coops are the answer.  These coops would be non-profit and run by a small group of individuals.  The coops would charge a nominal membership fee that would be pay for the people negotiating the rates. 

The last problem is very simple to fix.  Although not outlined as a problem earlier it seems the simplest to fix.  All health insurance should be income tax deductible, both for the guy working for the corporation and the guy running a three person landscaping company.

The alternative to all this is a government insurance system that when it is run poorly it will simply ask for more funding from the tax base.  The private companies without this access to taxpayer’s piggy bank will slowly disappear.  Each one that disappears will put more pressure on the government system and more pressure on the tax base.  Because let us not forget that billions of tax income come from the people in the insurance industry.  Each one of the insurance companies that goes out of business means thousands of call center reps, secretaries, IT workers, and managers.  The great majority of these people are not different then me or you.  Although some executive loses his job and multi-million dollar salary, many more Joe Six-Packs are standing next to him at the unemployment line.

“The unanimous three-judge panel ruled today that a U.S. Supreme Court decision last year, which recognized an individual right to bear arms under the U.S. Constitution’s Second Amendment, didn’t apply to states and municipalities.”

I can only ask what the hell these jerks were smoking when they came up with this rational.  This above statement, and precedent this sets, can now be applied to the rest of the bill of rights.  Whichever side of the gun debate you come down on you must understand that the rational for upholding Chicago’s ban on hand-guns to be at best just damn scary.  This statement essentially says that states and smaller municipalities can disregard the United State’s constitution and the bill of rights.  What is stopping your po-dunk little town from restricting free speech?  According to this ruling nothing is stopping them.

I believe that the founding fathers really thought they had some very specific rights that shall not be infringed upon.  Well they outlined with the bill of rights.  Each one had a specific purpose that was to ensure that no matter what happens, the people will always have the government of their liking or at the very least one they do not want to throw off a cliff.

Let us go through the bill of rights and do a quick scan of what each can mean.

The 1^st amendment

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

Ok this amendment is to ensure that people can still bitch and moan about the crappy government they have.  It also ensures that they can go to whatever church they want or not to go at all.  In other words six days out of the week we can bitch about all the jerks in the government and on the seventh day we get to have someone tell us how we are big jerks

The 2^nd amendment

A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed

This amendment was actually intended for two things.  Ironically neither is the primary reason it is defended today.  The most obvious reading is to protect the people from an outside threat.  But upon closer reading it is actually the constitutional reset button.  Nothing keeps a room full of people honest like knowing everyone is armed.

The 3^rd amendment

No Soldier shall, in time of peace be quartered in any house, without the consent of the Owner, nor in time of war, but in a manner to be prescribed by law.

The idea behind this amendment has more to do with the time period then almost anything else.  But upon closer inspection an additional purpose could be derived from it.  I would imagine that exercising your free speech rights would be a little dicey sitting across the table from someone with an M-16.

The 4^th amendment

The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause, supported by Oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.

This amendment was most notably under scrutiny during the Bush years for the unwarranted wire-taps.  The primary reason behind this amendment was to make sure that the government could not go on fishing expeditions in your house looking for anything to charge you with.  After all I think everyone has something in their closets that could at the very least get them a fine.

The 5^th amendment

No person shall be held to answer for any capital, or otherwise infamous crime, unless on a presentment or indictment of a Grand Jury, except in cases arising in the land or naval forces, or in the Militia, when in actual service in time of War or public danger; nor shall any person be subject for the same offence to be twice put in jeopardy of life or limb; nor shall be compelled in any criminal case to be a witness against himself, nor be deprived of life, liberty, or property, without due process of law; nor shall private property be taken for public use, without just compensation.

This amendment is to ensure that people just don’t get thrown into prison.  It is also intended to set up the judicial system in such a way as to ensure that the prosecution must prove guilt. This amendment was also setup so that the government cannot willy-nilly take your private property.  The last part was blasted apart by the Kelo vs City of New London. 

The 6^th amendment

In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the State and district where in the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation; to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the Assistance of Counsel for his defense.

This amendment is also to ensure that people cannot be railroaded into prison.  It also ensured great day-time TV during the OJ Simpson trial.

The 7^th amendment

In suits at common law, where the value in controversy shall exceed twenty dollars, the right of trial by jury shall be preserved, and no fact tried by a jury, shall be otherwise re-examined in any court of the United States, than according to the rules of the common law.

I will honest with you, I have no idea about this one.  I think it has something to do with making sure cases involving large sums of money have a jury look at them.  I also think that it states that a jury decision shall not be overturned.

The 8^th amendment

Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted.

If this amendment was actually followed we would not have shows like Dogg the bounty hunter.  But the idea behind this was to ensure that while people were to be tried for a crime they would not have to stay in prison.  Given that anyone can be arrested on the flimsiest of evidence, in theory a person could be held in prison indefinitely by continuous re-arrest.  In addition it was intended to make sure that there was no Tower of Philadelphia, which would obvious have to be just a little taller than the tower of London.

The 9^th amendment

The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people

Even the founding fathers had to write a catch all amendment just in case, during the all day beer drinking feasts they forgot something.  If you are wondering what this really means, then let me explain.  Basically this states that if there is no-law against something and it does not interfere with any of the other amendments you can indulge to your heart’s content.

The 10^th amendment

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people

This amendment has been frequently misused by the federal government.  The original idea of the federal government was that it handled international matters and disagreements between states.  If states did not want to handle everything exactly like every other states then they could do as they please, provided it did not break with constitution.  Which of course the above ruling screws up but who is counting.

Well that was your constitutional lesson for the day.  I am sure that the four of you reading this are happy that this long post is finally done.

I got the constitutional stuff from wikipedia