The votes are in and the health care war has now begun. Dozens of states are preparing their legal cases to negate the verdict of the politicians. Republicans are on the campaign trail and crying repeal.
In the last few weeks it has been “just pass anything.” Show leadership! The protracted debate has built such impatience that has obscured the workability and indeed the validity of the legislation. Early results showed that most health care stocks rose yesterday. This might mean health care providers are happy. This stock-trading vindicates the criticism that inadequate attention was given to the unit cost of American health care by the bill’s writers. Should this bill remain roughly intact, the emerging dispute will involve money. People are very skeptical of the CBO report. There are so many unknown unknowns, as well as the known unknowns. to get reasonable accounting. The reduction of personal responsibility in this legislation means, philosophically, we are drifting, at a pretty good pace, toward Europe. At times, during this debate, it seems like we were boasting as emulators of Europe. Why? Europe, for a few decades now has been a decadent continent. Country after country in the EU has been faced with a variety of seemingly intractable problems, both economic and social. European countries, for the most part and more or less, are socialist countries. They are on the decline as a power and as a culture. Even the demographics are working against them, and will sharpen in the projections of the coming years. Why do we want to be like them? In the final hours before the vote a number of Stupak Democrats folded like an accordion on the matter of abortion. It was hard to watch. For weeks, the Stupak’s had refused to sign on to the health bill due to the fact that language effectively provided federal funding for abortion. At the end they accepted the President’s promise to prohibit the funding by executive order and not statue. This would facilitate passage, as their votes were absolutely critical. It was this “get it done” mentality that provided steady pressure on this group and they were not strong enough to hold out. Now, the President can wake up any morning and rescind the executive order. I don’t look for him to break his promise on the matter, but it is an open call for his successor as well. So, the federal funding, reversing the Hyde Amendment is now left in jeopardy. There are some matters so weighty, so sharply defined, self-contained, and so well understood that it does not lend itself to compromise. Abortion is that issue. All in all, health reform was a job poorly done, in most every respect. Par for Congress.
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Bart Stupak, a pro-life Democrat from Michigan, is trying to get language inserted into any health legislation that will prohibit federal funding for abortion. He has been met with a lot of resistance. Now, he says his fellow legislators are ignoring him. Stupak says Democratic leaders are saying,”if you pass the Stupak amendment, more children will be born, and therefore it will cost us millions more.” Everything is about money. Values don’t count. Neither do ethics and morals count. Money is what matters!
In the January-February issue of Foreign Affairs a lead article was ” The New Population Bomb.” The article discusses population growth and the trends associated with that growth. The demographic weight of the developed world will drop 25% in the next 40 years. People have been writing and talking about this trend for some time. Nine of ten children under the age of 15 now live in the developing countries. The developed countries, such as ours, are having trouble finding enough young people to make their economies work. We immigrate, as does Europe, out of necessity. The Foreign Affairs article offers ways to stabilize the distorted demographic trends. The first reform listed is for developed countries, such as ours, to have more babies. Our young people should be considering not having just one or two children, but maybe three or four. Having more children demands we rid ourselves of selfishness. But, that is also a good thing. The politicians in Washington are wanting to reduce the population and saving our culture demands we have more babies and increase the population. Nobody should be surprised! Warren Buffett is speaking his mind on health care. He says the focus should be on cost reduction first. He is right, but the administration sees it differently. They are interested in coverage, for the 30 million they say cannot purchase insurance. Buffett disputes the “best medical system in the world ” claims. He cites doctors per thousand and nurses per thousand favoring competing systems as he calls it. Buffett says he would support the Senate bill rather then keep the status quo. Close call there! The Senate bill is deeply flawed and a lot of people think less of it than that.
At the so-called health care summit last week I kept thinking the Republican group still like the status quo. Buffett and many, many others have said the status quo will bankrupt us, but that has not moved the Republicans. Actually, some of the Republican ideas, maybe produced by political duress, seem to make sense, but their heart is not in it. Sometimes, I listen to talk radio, albeit briefly, just to see how extreme and irrational they present things. Last week, low and behold, there was Sen. Lamar Alexander on a recorded exerpt defending insurance company profits. Alexander, if I understood him correctly, said the insurance company profits amounted to 2 days of health care costs. He contrasted that with the 363 days of paying the bills. Alexander did not bother to define costs or to define profits. Better, what is the relationship, if any, on insurance company profits and health care costs. For instance, if a health insurance policy pays 12K for a surgical procedure that is worth 4K; what market influences or Medicare reform will produce 4K? Where is the incentive to reduce costs? Profits could be a constant. It would have been fun to see him quizzed on his statement. But, talk radio specializes in simple answers and catch phrases. The best estimates that I go on shows that around 30% of health care costs involve fraud or waste. That should be the first order of business for Congress. |
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April 2016
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