Thursday, July 23, 2009

"Obamacare" on hold ...maybe

I love how the world has change and we can all get the word out...

One of the truly great things about technology is the ability to get the “word” out, whatever that word may be. I have been in the computer game for nearly two decades and have seen many changes. When I was in high school, the school district computer guys allowed a few of us “chosen ones” an chance to lay hands on what was at the time the state of the art in computer technology, the HP 2000 mini computer which was the main computer for the entire district. This thing had all the lights, bells and whistles one would expect a design of the late 60’s to early 70’s vintage machine to have. It had punch card readers and reel to reel tape drives and punch tape encoders and readers and made the devil’s own racket when all the gizmos were turned on. The terminals were a hodgepodge of dumb monochrome (no color, folks) workstations with integrated keyboards, to really antiquated (even then) teletype stations that made the lab sound like the set for the CBS Evening New room set, just no Walter Cronkite. The sound of teletype chatter could be heard for 100 yards in any direction from the class where they were located. I can’t remember how many “nudie cutie” posters made from wingdings and symbols and how many games of “TREK 73” we played in those years, but it was a bunch. I know Mr. Eklund, the computer and Physics teacher could tell you, but I hope he doesn’t as it would be embarrassingly high.

Now here I am nearly 30 years later, looking at a computer screen, powered by a machine as infinitely more advanced from the seemingly “advanced” mini-computer of that time as an Model T Ford is from a Formula 1 race car today. We use computers for a dizzying array of things as common and innocuous as keeping our financial house in order to indexing the family collection of recipes, to playing video games against people half a world away.

In the modern political context, the computer is the best tool to keep those in power honest. Cyberspace is the one place without borders, culture, or complete “Big Brother” control. It is ALL out there….. Cyberspace makes no distinctions between race, creed, color, national origin, religion, language, or political persuasion. Everyone is equal and the battle of ideas is can be fought on relatively equal and hopefully civil terms. It comes down to who can persuade through use of language and ideas, people to follow and act on a thought or idea. If America has done nothing else for mankind, the development of computing and networking technology for the mass market will be as important, if not the most important contribution to civilization.

I sit here at my desk, typing away, exchanging views with many all over the world, and all over the political spectrum. Most will agree with some of what I say, but many will think me a reactionary fascist who hates the human race and has no heart or conscience. The beauty is that we can exchange those thoughts and views and all who wish can react and participate in the dialog. It all comes down to that exchange of ideas. It is the epitome of the “town hall meeting” but in a virtual world of our creation. It is a great tool that must be protected and cherished.

The recent actions of those who hold power in Washington D.C. have put all of us who are involved in the process of sharing ideas and participating in the dynamic political and economic life of our nation, on notice that there is a new game afoot. That game is one of stealth politics and power plays in the early morning hours while our nation slumbers. They who exercise power know in their hearts that they are in the wrong by their actions, and by their methods. They have denied the mass of the American people a chance to act as we always have historically. They are arrogant, condescending and dangerous to our republic as the Nazis or the Communists were in days past. They are the sort of people who won’t let any opportunity pass them by, to enact their agenda even if prudence and fact dictate sober reflection and debate, even if that agenda has to be accomplished by cutting deals and twisting arms and casting votes on unfamiliar texts at pre-dawn sessions of Congress. Why did they do this? Why are the congressional leadership and the White House folks so willing and able to run rough shot over all of us to get their way?

They do it because they KNOW that if WE knew the truth, the WHOLE truth and had all the facts before us, that we might run the whole bunch of them out of D.C. on a rail. To be sure, they deserve it with the shenanigans we have seen in the last few months.

The health care reform bill is now on Capitol Hill in committee, stalled as the Democratic leadership tries to figure out a way to move foreword. “Blue Dog” Democrats have balked at the costs and the speed of implementation. Many face stiff opposition from the home folks who actually know more than their representatives about what is going on. The talk show circuits are filled with those who are keeping tabs on the bill and its changes minute by minute and then putting out that information on the web and over the airwaves. It is making life miserable for President Obama and Speaker of the House Pelosi as more people tune in on the web and on their radios to get the straight dope on the soon to be nationalized health care delivery system, but only if the Democrats get their way.

One thing seems certain. If more conservative and reasoned heads prevail, Obama still has another card to play with when the fiscal 2010 Federal Budget comes to the hill. He and the Democrat leadership only have to put the health care plan they want into the 2010 budget and then let it end up in the reconciliation process. According to the Committee on Rules:

In the Senate, total debate on a reconciliation bill is limited to 20 hours, although the actual time for consideration of the omnibus package often exceeds this time limit set in the Budget Act. Motions and amendments may be offered and considered without debate at the end of this time period. There are also restrictions on the content of a reconciliation package and on the amendments which may be offered to it. For example, any amendment to the bill that is not germane, would add extraneous material, would cause deficit levels to increase, or that contains recommendations with respect to the Social Security program, is not in order. The Budget Act also maintains that reconciliation provisions must be related to reconciling the budget. For example, section 313 of the Budget Act, more commonly known as the "Byrd Rule", provides a point of order in the Senate against extraneous matter in reconciliation bills. Determining what is extraneous is often a procedural and political quagmire navigated in part by the Senate Parliamentarian. The Byrd Rule and other points of order in the Budget Act may only be waived in the Senate by a three-fifths vote. Furthermore, the Budget Act prevents reconciliation legislation from being filibustered on the Senate floor.

Why is this important to us and why is it important to the Democrats?

First the numbers must be understood.
1. The proportion of Democrats to Republican is such that it would take little effort to pass with a simple majority of 219 votes needed.
2. In the Senate, the ratio is 60-40 with a Democrat majority.

Simply put, the Senate could NOT stop bad legislation that is tacked on to a Reconciliation Budget bill. In short, if Obama and the rest of their sycophants in Congress put the Health care bill in the 2010 budget, it might get passed because there are too few votes (from Republicans and what “Blue Dog” Democrats can be brought on to oppose it ) to outright defeat it by a majority vote, and only simple majorities are needed to pass the bill. According to the Byrd Rule, no filer busters are allowed to stop the budget, hence stop the health care bill from passing.

This is another form “Stealth Attack” that has been considered by the President. He articulated this in a conference call to bloggers loyal to the party position the evening of July 20th. According to a report by the Huffington Post, “Obama floated the possibility that if it appears that health care reform lacks the 60 votes needed for passage, he might be open to reconciliation, which would allow for an up-or-down vote on budgetary and tax aspects of the bill.”. In the Senate, that would be a simple majority vote of 51.

Correcting the problem of health insurance availability and pricing could be corrected in ways that don’t require massive federal intervention. Many uninsured people are uninsured by choice. They have made a conscience decision not to buy coverage because they don’t see a doctor often enough to warrant the expense. In their mind, it’s a waste of money for something they may or may not need, especially if they are young and generally healthy. They would rather have a better lifestyle; a nicer car, better apartment or house, take a trip, go out more…. Why spend cash on something I don’t use all the time? We all know people like this who take risks like this. It’s their right to take that chance, but it isn’t our collective responsibility to pay for their choices. The folks who make these choices should not be pitied, or coddled. If a guy making $50,000 a year without coverage gets sick, I don’t want to have to pay for his medical bills. If he has to fork out $200-$300 a month for insurance, that is what he needs to do. He should not become a burden to the rest of society. It’s true that he may not get to party as much as he used to and he might not be able to get as nice a car on payments as he might have before, or live in as big a house or apartment as he might want, but that’s the breaks.

For those who are in the country illegally, and uninsured, you should get nothing…..Nada, zilch, nothing…..

You are, after all essentially, criminals who do not deserve to partake of the benefits of our society under false pretences. The only thing you will get would be that care necessary (we are a generous and humane people, after all…) to make you ambulatory enough to be deported (repatriated) back from whence you came. Let your native land care for you, not the American taxpayer or the American insurance subscriber who pays higher premiums to cover the losses hospitals suffer for treating the likes of you.

For those who can’t afford it at all, there should be National/State PPO Pools that individuals can subscribe to that can be shopped and compared. Federal regulations should also allow all citizens regardless of where they reside, to shop for the best deal to meet their needs. If an insurance company in Oregon has a policy that a guy in New Jersey wants because it is less expensive than what he can get neared to home, he should be able to buy it. That would force the insurers to be more flexible and to be more competitive in their pricing. Many states regulate coverage’s to the point that the cost become prohibitive, while other states are less restrictive or heavily regulated, making coverage there less expensive. Also, it would be helpful if an ale carte menu of services covered by insurance providers was available so customers could tailor their coverage to reduce costs. The customer could pick coverage’s for those things that are beyond his ability to pay for such as catastrophic illnesses or injury coverage. That would leave the basic services like wellness checks and visits for non-life threatening issues to the patient to pay out of pocket if the insured chooses.

Another program that could be put into place would be the Health Services Marketplace where a patient or potential patient would be able to negotiate a price for known and common procedures, such as birthing, certain cosmetic procedures, bariatric surgeries, dental, vision correction, and fertility issues. They would post a “cash and carry” price that would be charged for these services, and the cost would be fixed at the price when the service is rendered. If there were no complications, there would be no additional cost. If there were complications, then the cost would be passed on the insured person to pay out of pocket or to work out a deal for reimbursement with his regular insurance company. There would be much less administrative cost this way, thus less cost to all parties concerned.

Recently, I heard of a woman who was due to deliver her new child. The birth was due in a couple of weeks, and her husband had limited maternity coverage with his insurance plan at his work. The cost as quoted by the local hospital, where most of his fellow employee’s went was between $20,000 to $25,000 for the delivery and hospital stay, if he put it on his PPO plan from his job. The plan he had would only cover 75% of the costs, leaving him to pay anywhere from $5000 to $6250 out of pocket.

This did not include cost if there were complications. Nor did it discount costs if all went well and mother and baby were without adverse affects and released early.

Rather than going this route, the soon to be father did some smart shopping and determined that cost could be reduced by using his head rather than his check book. He and his wife explored alternatives like shopping all the local and regional hospitals to find out who had the best deal. As it turned out, a hospital in a city where a close relative lived was willing to take cash payments and charge only $4000.00, all inclusive, if there were no complications. The cost could further be reduced if a midwife at a birthing center rather than a doctor in a hospital was used. Eventually, the cost to this family was further reduced to around $3000.00, including travel expenses and a stay with relatives. The insurance company was then approached post delivery and they agreed to pay the cost in full as it was less than the $15,000 that was projected for the insurance Companies’ share of costs.

This was accomplished with without government intervention, without government mandate, without nationalized health care.

Most important was that it was done by free people who saw an issue, and dealt with it as all free people do, with resolute, responsible and timely action. It was a creative solution for a common and sometimes expensive problem. Why can’t politicians be this creative, this efficient, and this reasonable when they propose solutions? Why can’t people like Obama, Pelosi, and Reed leave well enough alone and let us fend for ourselves?

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