Thoughts Before The Alarm Sounds

What do these three events have in common? (1) December 7, 1941: Pearl Harbor was attacked. 2,402 Americans were killed and 1,282 were wounded. Eight battleships, three cruisers, three destroyers, an anti-aircraft training ship and one minelayer were either damaged or sunk. (2) September 11, 2001: Four suicide attacks against the United States resulted in almost 3,000 deaths. The twin towers of the World Trade Center in New York City were destroyed and a section of the Pentagon was demolished. The attackers intended to crash a fourth plane into the United States Capitol, but crashed in a field near Shanksville, Pa. (3) August 1, 2012: The Affordable Healthcare Act required new health insurance policies to include FDA-approved contraceptives, an annual well woman preventive care visit with her doctor, and screening for gestational diabetes, STIs, HIV/AIDS and HPV. Also required are screening and counseling for domestic violence, and breastfeeding support, supplies...

       It's pretty clear – if Obama wins the election, the Affordable Healthcare Act is here to stay. If he loses, its future is dependent upon the makeup of Congress.         Despite the claims of its friends and foes, it is almost impossible to see how it will play out, good or bad, until we try it for awhile.         The problem is that people like most of its provisions, but the foes have managed to cloud the overall discussion. It is now up to Obama to clarify the discussion in a way that people understand.         Can he do it? His job for the next four years may depend on it. ******        My books, “There Are Only Seven Jokes” and “The Spirit Runs Through It” are available in paperback , or at the Kindle Store.

As Americans, it seems as if we always need something, usually sexual, to get all worked up over. Last month it was the young lady who testified about the need to have contraceptives covered by medical insurance. It seems to me that if “ceptives” such as Viagra and Cialis are covered, it is only fair to cover their “contras.” It's fairly obvious that the healthcare law is written by men – women's needs are excluded. But this month the concern is about same-sex marriage. Now I know that the Bible says that says that homosexuality is an abomination, but it also says the same thing about eating shellfish. So I would be more impressed by the Biblical argument if those who are fighting so adamantly against same-sex marriage were to campaign just as vigorously against the crab and lobster industry. What about the argument that same-sex marriage will destroy conventional marriage? I doubt that I would love my wife any less if the couple next door to me turned out to be mar...

     I realize that the matter of Obama and the Catholic Bishops has been overworked lately, but I can't help weighing in with some thoughts on the subject.      In the first place, I can see both sides of the argument: freedom of religion vs. insurance-paid family planning.      But some columnists have been throwing around assumptions that appear to me to be a misuse of the English language. Recently I have read several columns in which the government, President Obama in particular, was accused of requiring the church to go against its “conscience.”      I do not believe that the Catholic Church or a corporation or a high school class or any other organized set of people can have a conscience, Organizations are groups of human beings; each member of the group has a unique conscience. There may be an average of individual consciences of the members, but such an average is as different from a true conscie...

     I live in a retirement community, which has, as a part of its facilities, a Healthcare Center for those elderly people who need 24/7 nursing care. As such, the Center is subject to state standards of operation.      Government inspectors come in, sometimes without warning, to assure that the required standards are being met. Such a drop-in occasion occurred on a recent Saturday morning.      Because no such center is perfect, our center received some deficiency tags; it is my understanding that the average inspection turns up an average of eight such tags. Here are a few of the deficiencies for which our Center got tagged: The inspectors were at our premises for four days. During that time they spotted three flies in the building. A tag was issued for a pest control deficiency. One patient arrived at the facility on Friday afternoon, the day before the inspector showed up at 9:00 am. The patient brought with her a sm...

     . . . or is it? On Monday August 29, 2009, Republican National Committee Chairman Michael Steele appeared on ABC-TV's Good Morning America . In introducing the Republican National Committee's “Seniors’ Health Care Bill of Rights” (SHCBoR), Mr. Steele stated, "We should protect the seniors' ability to access health care.”      The first item promised by the SHCBoR was, “. . . [to] protect Medicare and not cut it in the name of health care reform.” Mr. Steele claimed that the health care plan being proposed by the Democrats would cut Medicare funding by $500B. Actually the proposed savings, none of which came from cutting benefits to seniors , was $219B.      Jump forward to April 5, 2011. The new House Republican majority introduced a budget called The Path to Prosperity . If Congress follows “the path,” current recipients and future Medicare beneficiaries age 55 and older will see no change in benefits.   ...

     One of the ways Republicans are trying to sell their Medicare proposal is by claiming that beneficiaries would “be enrolled in the same kind of health-care program that members of Congress enjoy.” Let's examine that claim.      Suppose that on the date the “Roadmap for America's Future” becomes effective, a government employee and a non-government employee are enrolled in a family health care plan for which the total annual premium is $7,600. The government pays $5,700 (75%) of its employee's plan and allows a $5,700 tax credit for the non-government employee.      Assume that the next year the premium increases by $50 per month for an annual premium of $8,200. For the government employee his employer will pay $6,150 (75%) of the premium – he will pay the usual 25%.      The non-government employee will also see an increase in his tax credit, but it will be based on the inflation rate. Suppose the ra...

     ...or starve the government beast – take your pick.      On April 24th I wrote about Rep. Paul Ryan's (R-Wis) “Roadmap For America's Future,” and its planned changes to our income tax structure. Today I will look at the Roadmap's proposals for the health care system. Although there is a connection between the health care system and Medicare, I will defer discussion of Medicare/Medicaid/Social Security until a later date.      Under the traditional system, people buy medical treatment either by paying cash for services or by buying insurance. Those who cannot afford either method may be eligible for Medicaid, and those over 65 years of age get partial coverage under Medicare. Medigap insurance is also available to cover the difference between Medicare coverage and actual medical expenses.      The Patient Protection and Affordable Care Act (PPACA) is a federal statute that was signed into law by Presi...

     Just when you think President Obama has abdicated his leadership, he comes through with something to indicate that the ability is down there waiting to assert itself. For example, witness the flurry of progressive activity that he has got through the Congress since his party's “shellacking” on November 2 (see Dec. 23, “An Early Christmas for the President”).      Now he has done it again. According to the New York Times, an early December Medicare regulation deals with annual wellness visits, and includes "voluntary advance care planning" as an item that will be covered. Beginning January 1, Medicare will reimburse physicians who advise patients, in voluntary discussions, about their preferences for end-of-life care treatment during their annual Medicare "wellness visit." By having Medicare cover these voluntary consultations, beneficiaries will be able to get information that will help them make their own decisions about their care and what...

     I think most people would agree that a candidate for U.S. Senator or Representative should have some modicum of personal responsibillity, although some of the current crop seem to be lacking in that respect. So when I saw the responses that the GOP senate nominee from Delaware, Christine O'Donnell, made on a nationally televised debate, I thought I would take a quick look into her background.      She was born on August 27, 1969, and has been a marketing consultant, worked in public relations, and appeared as a political commentator on several news media outlets including Fox News. In 2006 and 2008 she ran for Senator in the primary elections, and was soundly defeated both times.      In 2010 she scored a surprising primary upset against nine-term Representative and ex-governor Mike Castle. Her victory was due to backing by Sarah Palin and an infusion of cash in the amount of $150,000 from the Tea Party. Her campaign als...

      Lancaster General Health is about to open four walk-in clinics in Lancaster County. Three of the clinics, called Wellcare Express, will treat minor problems such as bronchitis, colds, strains and rashes. The fourth, named Urgent Care, will be available for more serious problems: sprains, burns, cuts, etc. The Wellcare Express clinics will be attended by a nurse practitioner and a staff person, while the Urgent Care clinic will have a physician in attendance.       Although the Urgent Care clinic will be equipped with X-ray and laboratory equipment, the Wellcare Express clinics will not, neither will they draw blood. All will offer shots, health screenings, and school and camp physicals.       A visit to the clinics will cost $59, payable by insurance, cash or credit card. This covers the cost of being seen – the news release did not specify whether additional charges may apply, although I assume they...

      When the Founding Fathers created the U.S Constitution, they did not agree on everything at the beginning. On the contrary, they discussed and argued and compromised for three and a half months. I believe that by so doing they set up a model for later generations of Americans to follow.       Of all the many freedoms they enshrined in the document, freedom of speech was basic. They knew that controversial matters would come up in later years, and free discussion and open debate between citizens was the way to resolve them. As far as I know, not one of the delegates to the Constitutional Convention threatened, or even considered threatening, any of the others with whom he disagreed.       We seem to have forgotten that principle. This morning the media is reporting that politicians who voted for the Healthcare plan are being pilloried. They have been called vile names, spat upon, threatened and even had th...

      Capitalism: An economic system in which investment in and ownership of the means of production, distribution, and exchange of wealth is made and maintained chiefly by private individuals or corporations, esp. as contrasted to cooperatively or state-owned means of wealth.*       The basic idea underlying a capitalistic system is that of individual ownership and control of the assets of commerce. Using one’s innate abilities, energy, ideas, etc. to better oneself is the driving force, and success or failure is measured by the bottom line. The “rugged individual” and the “small entrepreneur” are the natural heroes. Individual freedom is paramount.       Unfortunately, unbridled incentive can lead to unbridled greed, which if followed far enough, can bring down the system. Let me give you an example:       When you buy a life insurance policy, you are buying a contract under which t...

      According to recent polls, Joe Sixpack and his friends are overwhelmingly against President Obama’s healthcare plan. I must say I can hardly blame them; the pharmaceutical industry has made a $12 million dollar investment in negative advertising in order to defeat it. Joe and his buddies should consider this: At today’s price of medicines, can what is good for the drug companies also be good for Joe and his friends?       In addition, a group of businesses led by the U.S. Chamber of Commerce has spent $11 million in this month alone, trying to influence 40 Democratic lawmakers to vote against the bill. Follow the money, Joe.       The advertisers have been trying to sell three myths about the plan: 1.) The President is proposing to take over one-sixth of the U.S. economy; the portion of the GDP which is currently being spent on healthcare. Actually, the government already controls half of that amount th...

      When Bill Clinton was running for the presidency against George H. W. Bush, the catch phrase for his campaign was “It’s the economy, stupid.” Just as James Carville hung a sign containing that slogan in Clinton’s campaign headquarters, so should Barack Obama have the same reminder on banners all over the White House.       Obama’s campaign promised change and hope, but change has gotten out of control, and hope seems to be retreating into the hills. Every poll indicates that healthcare is way down on the list of voters’ concerns. Now the primary focus is on jobs, jobs, jobs.       Presently there is a bill in the Senate which would grant an exemption to an employer for each new hire during 2010. In addition, if the employee stays on the job for 52 weeks, the employer will get a $1,000 business tax credit in 2011.       I have a bit of trouble understanding how this will do much t...

      The much ballyhooed healthcare summit between President Obama and the Republicans generated quite a bit of heat, but little fire. Pundits from both the left and the right are claiming their side “won,” but is that what is really important? Is this a war? Both sides scored a few brownie points with their constituents, but what about those members of the American public that have no health insurance? As usual, they lost.       The Republicans came into the meeting shouting “start over,” and never budged, while the President kept calling for bipartisanship, and he was just a voice calling in the wilderness. To be honest, he didn’t offer any compromises either. The whole meeting was just a “tempest in a teacup, signifying nothing;” an exercise in political posturing.       So where do we go from here? I may be slightly overstating the standoff; this morning’s news reports that the President has approached Sen...

      President Obama has finally presented a healthcare plan that he would like to see enacted. It’s about time – if he had done this months ago we would have a plan by this time.       Instead he has been leaving it up to Congress to develop a plan. That’s about as likely to happen as finding a herd of cats forming a straight line. So much for leadership. Anyway, as of February 22nd he has finally decided to take the reins.       His plan makes a few changes to the Senate plan which was passed a few weeks ago. It would cover 31 million presently uninsured people.       Almost everyone would need to either have insurance or pay a fine. Exceptions to the fine would be available for certain low income people; they would receive generous subsidies to help them buy insurance.       Certain reforms would be mandated for the insurance industry, e.g., no one could b...

      President Obama has included an amount of $371 billion over ten years to pay for the cost of preventing the reduction of Medicare payments to doctors. It may well do that, but in essence it freezes those payments for the next decade. I would expect that will not sit too well with the medical profession.       Not only that, but he has left the details of the freeze up to Congress. Considering the politicians’ penchant for pork, that could be a disaster for MDs who do not live in the district of a powerful Congressman.       Regardless of any other healthcare reform, it is a foregone conclusion that certain Medicare plans, in particular the so-called Medicare Advantage plans, will see changes in the near future, in the form of cuts in reimbursements to insurance companies and other providers. Undoubtedly MA customers will see substantial increases in cost and decreases in service.     ...

      I believe that listening to ideas from the right side of the aisle is a good idea, and I certainly hope that the bipartisan healthcare summit to be held on February 25th does not degenerate into political posturing and name-calling by either party. Not all ideas put forth by either Democrats or Republicans are necessarily born without blemish, but almost all deserve some consideration.      One good idea from the right is to make health insurance available across state lines. Here is a true life example:       When Barbara retired, she lost the health insurance that came with her job. When she applied for private coverage, it was denied because she was taking two blood pressure medicines; if she had been taking only one, she could have got it. So she opted for the high-risk coverage offered by the state of California, at a cost of almost $900 per month; upon moving to Pennsylvania, the same coverage was $240 p...

      In my blog A Good Idea From the Right of 02/13/10, I mentioned the cost of preventive medicine which physicians are almost compelled to perform in order to avoid litigation. Without doing something to mitigate this problem, healthcare costs will continue to rise.       In a nutshell, what makes this cost difficult to control is that medical suppliers are paid according to the number of procedures they perform. The more procedures they perform, the more they get paid.        Republicans are concerned that the establishment of information-gathering panels (Sarah Palin’s “death panels”) to determine what treatments are most effective for specific medical conditions would result in government micromanagement of the healthcare system. The fear is that such management would lead to the rationing of treatment by government bureaucrats. In fact, Senate Republicans recently introduced "antirationing" legisla...