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Holo Lukaloa
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7/28/2009 3:55:04 AM
Lobbyists own congress, special interests won the health care debate. No Government Option.
So much for affordable health care for everyone. It's business as usual. Obama isn't capable of changing the corrupt system when the budget committee is owned by special interests.
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Kevin White
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7/28/2009 3:08:39 PM
I've always maintained that health care could never be solved by the fed because it's too complex, is too easy to be beaten by aforementioned special interests -- because all they have to do is focus on killing it in one isolated place; and it still has to be administered at a grassroots level.
OTOH, 50 states is too much ground to cover for special interests to cover, and the people that write the laws have to live next door to the people who their writing laws for.
ALL the fed should do at this point, is provide standardization and guidelines for the states to follow as they redesign. The fed cannot solve health care. It's got to be done more at street level.
K-
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Kevin White
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7/28/2009 3:11:02 PM
---- Updated 7/28/2009 3:26:45 PM
btw ... the Obama plan didn't go far enough to solve the problem. It ignored addressing the underlying cost issues. On it's own, it would have collapsed under bureaucratic bloat.
This is something I just started to write for the Hartford Courant:
There are four legs to the platform of American health care:
1) Medical
2) Legal
3) Insurance
4) Access and Contribution
Systemic breakdown results from imbalance amongst the legs. Fixing the platform requires stabilizing each leg. To whit: Access provides Insurance. Insurance provides the fuel for usage. Medical usage drives base systemic cost via costs rising on higher demand (simple economics). Legal is byproduct of usage, and Insurance additionally provides that fuel, inflating the cost of Medical via malpractice.
It is folly to believe that without addressing each of the legs, that systemic cost can be contained. Yet only government has the power to effect the changes needed. I’ll leave the issue of government programs versus private aside, but providing Access addresses only the Insurance leg. No program can succeed without addressing all four legs and lower SYSTEMIC COST. Below is how government can best contribute to solutions.
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Kevin White
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7/28/2009 3:50:45 PM
---- Updated 7/28/2009 4:23:06 PM
Medical:
Outside of Legal issues (see below), two sub-elements drive costs: Usage and Education.
Allowing consumers immediate, low to no cost decision comfort regarding when to use the system promotes usage. All consumers must have more “skin in the game” when it comes to deciding when to use it; and it must be only when truly needed.
No to low personal cost=immediate usage=no decision; the system is used because low impact makes it easy. This is the fundamental driver of systemic cost. Higher deductibles, forcing need for a personal choice, puts medical consumption back at a decision level.
It is understood that this will require adjustments by those who enjoy Cadillac medical coverage currently, but EVERYONE should have one form of coverage which pulls public focus together as one.
As is, there are a thousand competing interests, fracturing public ability to deal with core problems via systemic chaotic conflicting interests. This must change fundamentally to effect change globally. One basic policy for all is required. In the end, everyone will understand what everyone has, and all public interests will be aligned.
To achieve, Government must provide uniform policy and form standardization, and the most basic policy should have a per person deductible of no less than one thousand dollars. Of course, persons falling under certain income levels would have their deductible subsidized accordingly.
On a second, more subtle level, the cost of educating a doctor is enormous. It saddles a new professional with incredible start up debt, and it limits the pool of talent to those who can afford versus the best and brightest. High costs of education are then passed along to the consumer.
Government should train our doctors, on merit basis, free. The only requirement being, like any public service, that they work in this country for a certain period of time or pay the taxpayer back for the lapse.
By forcing a reduction in easy usage, coupled with alleviating back breaking costs of education; systemic costs are reduced.
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Kevin White
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7/28/2009 4:12:16 PM
---- Updated 7/28/2009 4:28:30 PM
Legal:
The two components are Accountability and Fairness.
No one wants to remove fair due from medical malpractice. Yet, if there were no bad doctors, and if the legal profession were prevented from pursuing “unexpected things happen sometimes, and it's not always the physician's fault” cases, then this leg would be fine.
This leg is a battle between the American Medical Assocation and the American Trial Lawyers Association. It must be settled fairly for the benefit of the public. Both have their valid concerns.
The AMA and AAJ must give up self governance over their wayward. It’s become more protect than prevent. Systems at odds create conflict. Conflict creates cost. The AAJ must also accept that future controls will be built that will reduce their overall revenue through fairness and justice, and not fight them.
Government should track doctors’ and lawyers’ performance and hold them accountable. Bad professionals need to be weeded. The AMA and AAJ fumble this core responsibility, in a fox watching the henhouse fashion.
The cost of the watchdog agency should be funded by flat fee from both doctors and lawyers, collected at license renewals. It should operate at state level, with standards promoting inter-state connectivity.
Doctors who repeatedly err must be tracked and punished, including loss of license to practice.
Tort reform is integral to reducing systemic cost, with fairness to the injured in mind. This includes limiting attorney fees, and exposing lawyers who bring continuous frivolous cases to sanctions, fines, court costs and loss of license. Cap guidelines should be established, BUT allowances for removal of caps must also be in place. The same agency that watchdogs physicians and lawyers could be tasked with expert panel making case by case decisions on validity, award limitations and/or cap removal.
Once all parties involved are held truly Accountable, and Fairness is addressed; Legal systemic costs will be reduced, lowering the Insurance cost of malpractice, which lowers systemic cost passed on to Medical consumers.
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Kevin White
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7/28/2009 5:13:27 PM
Insurance:
Insurance makes its money off of being grease. It facilitates. It benefits from the total cost of system. It is mirrored reflection that without systemic support would be rendered unnecessary.
Insurance has only ONE driver: Usage. The more any system is utilized, the more grease is needed to make it work smoothly. The more money Insurance collects as percentage of whole activity.
The more lawsuits launched, a.k.a. higher usage, the greater the cost. No lawsuits would equal no cost, hence no malpractice Insurance cost. If Medical costs were reasonable, again, pooling of risk (by virtue of collective premiums) to cover costs would be unnecessary.
Insurance needs to be forced to stick to being grease, and in no way, shape or form should become a method for health coverage rationing, a role the industry maintains is needed to control costs, but though true of the current system, needs to be completely eliminated as a future consideration.
Again, in fox protecting the henhouse fashion, Profit is a conflict ripe motivator driving Insurance coverage decisions, and denial of coverage should NEVER be placed in the hands of a simple grease mechanism. Health Care is a Medical concern; it should NEVER be an insurance concern.
Any questions regarding coverage issues can be covered by the same watchdog agency (established above), setting such decisions outside the dark shadow of profit conflicts.
Insurance should be made bought on an individual basis, and the same policy follow said person from birth to grave. Employers can contribute to an individual’s cost of coverage, but Employers would be completely eliminated from it being a requirement, and the contribution would NOT be tax deductible AND would be considered an income benefit. (See Government Standardization above)
All individuals are responsible for their own coverage AND payment for dependents and payment would be made compulsive for all. (Again via Government Standardization mentioned above) Everyone must contribute to the health care system, not only those most at risk; for one never knows when one will be at risk.
There would be a complete revision of Insurance rate setting that abandons traditional actuarial risk tables in favor of a stepped basis. (Also courtesy of Government Standardization) As is, actuarial tables disproportionately disfavor the aging, making premiums so burdensome, it violates the “affordability” fundamental of insurance; effectively rationing coverage due to cost at a time need most rises.
Most of all, Government regulation should remove Insurance from any Medical rationing function and put it back solely where it belongs: administrative grease.
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Kevin White
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7/28/2009 6:14:02 PM
I'll get to Access and Contribution later, but basically all people must have equal medical access, equal insurance policies, and they must be held individually responsible for payment of all commensurate expenses - down to each and every individual in this nation.
And each and every individual in this nation has a duty to contribute individually ... avoiding insurance expense fundamentally passes the cost onto your neighbors who contribute. Participation is mandatory, and payment compulsory.
It's time to put individuals at the fore of their own health care, and put the system into a supporting role versus dominant player and determinant of who gets what.
Oh, and Medicare and Medicaid would be eventually deconstructed into the new paradigm.
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Holo Lukaloa
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7/28/2009 7:55:35 PM
from Huffpo
The seven Blue Dog Democrats holding up health care reform legislation in the House Energy and Commerce Committee have received tens of thousands more dollars from health and insurance interests than other Democrats on the same committee, a new report finds.
An analysis of campaign finance data by the Public Campaign Action Fund finds a fairly strong correlation between private industry donations and opposition to health care reform. Lawmakers in both the House and Senate who voted against proposed legislation this congressional cycle, the report found, received roughly 65 percent more money from health and insurance interests than those who supported the bills.
When it came to the Blue Dogs in particular, that data showed that the seven members who sit on the Energy and Commerce Committee -- Reps. Mike Ross (Ala.), Baron Hill (Ind.), Charlie Melancon (La.), Jim Matheson (Utah), John Barrow (Ga.), Bart Gordon (Tenn.) and Zach Space (Ohio) -- have received, on average, $711,828 from the health and insurance sectors. Other Democrats on the committee, by contrast, have received an average of $628,023.
Not all the Blue Dogs partook at such high levels. Space, for instance, has raised only slightly more than $200,000 from those two sectors, according to Public Campaign Action Fund. But on the whole, these self-proclaimed fiscal conservatives have found their coffers filled by the industries over which they now have massive legislative sway. Gordon has received more than $1.4 million in donations; Matheson got slightly more than $1 million. Ross, who is leading the Blue Dog negotiations, took in more than $980,000.
In the world of campaign finance, it is almost always the case that money follows power. And on the Energy and Commerce Committee, the Blue Dogs have carved out a powerful niche for themselves through their willingness to buck the party leadership. In recent weeks, the seven members of the committee have held up the passage of health care reform legislation by demanding further negotiations and compromises on measures they say would contain costs. In short order, they have become the crucial votes for health care in the House.
Good government groups have questioned whether their demands are driven by philosophical or electoral motives.
The connections between the Blue Dogs and the health and insurance industries extend beyond campaign donations. An analysis of lobbying reports done by the Huffington Post reveals that several former staffers for these seven Energy and Commerce Committee members have also served as lobbyists for major pharmaceutical companies. For instance, after serving as Gordon's legislative director, Louis Finkel was employed by Lent, Scrivner & Roth. The firm earned $920,000 in lobbying fees from Pfizer between 2001 and 2006, with Finkel acting as a lobbyist for the client.
And since leaving Barrow's office as a legislative assistant, Carl Gist Jr., has taken a position with the firm TCH Group. In the first quarter of 2009, he lobbied on behalf of AMGEN -- another major pharmaceutical company -- charging a fee of $40,000.
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Kevin White
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7/29/2009 2:07:24 AM
Not surprising ...
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