Category Archives: ObamaCare

Finding the Faults and Repairing the Unaffordable Care Act

Throw Cash at It

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My friend Lido (“Lee”) Bruhl is a true believer in universal health care. He continues to campaign for a single payer system. “And yet we still have all these vehement protests that our health care system is fine just the way it is,” he said this morning.

Not from me. I vehemently protest that ObamaCare will take a health care system that delivers decent care for way too much money and turn it it to a system that delivers lesser care for way more than way too much money.

Lee took a new tack. “The US already spends more on health care than most other nations, but it gets less,” he said.

Semi-true. Here’s another one: The US already spends more on primary and secondary education than most other nations, but it gets less. And this: The US spent more “stimulus money” on job creation than any other nation, but it got fewer jobs created.

A better question to examine is this: Why do we as a nation throw so much cash at problems and get such a (relatively) poor return?

One Piece At A Time

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With apologies to Johnny Cash and writer Wayne Kemp who inadvertently chronicled our present health care delivery system, One Piece At A Time: Mr. Cash left Kentucky back in ’49 and went to Detroit workin’ on the assembly line. He smuggled out a piece, he smuggled out a pair, and sooner or later he had a car out there.

Well I left Kentucky back in ’49 and
Went to Washington work on the assembly line
The first year they had me puttin’ peeps on Medicare
Every day I’d watch them beauties roll by
And sometimes I’d hang my head and cry
Cuz I always wanted me one that was big and fair
One day I devised myself a plan
That should be the envy of most any man
I’d sneak it outta there in a lunchbox in my hand
Now gettin’ caught meant gettin’ fired
But I figured I’d have it all by the time I retired
I’d have me a plan worth at least 100 grand

I’d get it one piece at a time
And it wouldn’t cost me a dime
You’ll know it’s me when I come through your town
I’m gonna ride around in style
I’m gonna drive everybody wild
Cuz I’ll have the only one there is around

So the very next day when I punched in
With my big lunchbox and with help from my friend
I left that day with a lunchbox of blood smears
I’ve never considered myself a thief
But America wouldn’t miss one little piece
Especially if I strung it out over several years
The first day I found me a breast lump
And the next day I got me a freestanding birth center
Then I got me an ambulance and all the chrome
The little things I could get in my big lunchbox
Like pins and gowns and electroshocks
But the big stuff we snuck out my buddy’s mobile home
Now up to now my plan went alright
‘Til we tried to put it all together one night
And that’s when we noticed that somethin’ was definitely wrong
The insurance checks were from ’53 and
The hospital bill was a ’73 and
When we tried to put in the bolts all the holes were gone
So we drilled it out so that it would fit and
With a little help from an adapter kit
We had that hospital runnin’ like a song
Now the OR lights, they was another sight
We had 2 on the left and 1 on the right
But when we pulled out the switch all 3 of ’em come on
The back end looked kinda funny too
But we put it together and when we got through
Well that’s when we noticed that we only had 1 bed pan
About that time my wife walked out and
I could see in her eyes that she had her doubts
But she opened the door and said
“Honey, take me for a spin”
Drove uptown just to get our subsidies and
I headed her right on down main drag
I could hear everybody cryin’ for blocks around
But up there at the Congress they didn’t laugh
Cuz to type it up it took the whole staff and
The final Health Care Reform Act weighed 60 pounds

I’d got it one piece at a time
And it didn’t cost me a dime
You’ll know taxes ain’t never going down
I’m gonna ride around in style
I’m gonna drive everybody wild
Cuz I’ll have the only one there is around

Uh, yeah Red Rider this is the Cotton Mouth in the
Psycho Billy HMO, come on
Huh?
Uh, this is the Cotton Mouth and neg-a-tory on the
Cost of this moe-sheen there Red Rider
You might say I went right up to the factory and
Picked it up, it’s cheaper that way
Uh, what model is it?
It’s a 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59
patchwork blanket
It’s a 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70
holey basket.

We built our Health Care system pretty much that way. One Piece At A Time. And just like that 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70 automobile, the gas tank leaks and the engine makes funny noises.

Everybody in this discussion, from the most fervent ObamaCare supporter to the most ardent contrarian, has a good answer for patching up a rusty old car that runs on three cylinders and has two flat tires. It might keep us going to the next exit, but it won’t carry the family across the country on vacation.

The same Democrats pushing patches on the current system want to reinvent the automobile from the ground up but all they want to do with health care is find a few more people to cover and another way to pay for it.

The same Republicans opposing changes to the current system want to keep that clunker but all they can to do with health care is keep the money from flowing to Washington.

We deserve better. We need to start from scratch. And if your Congress Critter or President tries to pay this new 1,000 page tax bill with your wallet, throw da bum out.

Sing it with me now,
It’s a 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59
patchwork angina
It’s a 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70
insurance black hole.

Big Cuts or Flummery?

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“We’ll cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies that do nothing to improve care and everything to improve their profits.” President Obama wrote in the NYTimes.

Cool.

Um, wait a minute, Mr. President. Aren’t Medicare and Medicaid already government programs? Why do we need a brand new 1,000 page bill to “cut hundreds of billions of dollars in waste and inefficiency” from the programs you are already the boss of?

Why can’t we just cut hundreds of billions of dollars in waste and inefficiency out of those right now?

Disinformation?

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The White House is on a mission to clarify what it calls “disinformation” about what they call health care reform and I call two trillion dollars of new taxes.

The president went to in Portsmouth, New Hampshire, on August 11 to sell his plan to the voters. He had a great crowd. Unlike the House member “Town Halls” that Nancy Pelosi says Republicans pack with “un-American” hooligans, ABC noted the Democrats packed the President’s gathering with yes-men while outside was packed with the (disenfranchised) nay-sayers.

In selling his plan, President Obama said, “the American people will be glad we acted to change an unsustainable system.” Too bad the news reports refuted that.

Nobody in Washington — not even the President — listens. “The problem is people become frustrated because they can’t get their voices heard,” Corey Lewandowski, of the activist group Americans for Prosperity said. The President apparently still believes even the frustrated people will be glad.

In selling his plan, President Obama said, “We have the AARP on board” to endorse the bill. Too bad AARP refuted that statement.

“Indications that we have endorsed any of the major health care reform bills currently under consideration in Congress are inaccurate,” an AARP statement said.

In selling his plan, President Obama said, “Under the reform we’re proposing, if you like your doctor you can keep your doctor. If you like you health care plan, you can keep your health care plan.” Too bad our experience in Vermont refuted that claim, too.

ABC News aired a periodic “Fact Check.” It didn’t dig deeply enough to see the expectation (born in Vermont) that insurance companies would flee.

Reporter David Wright supported the president. “Opponents of health care reform claim that the proposed changes would put private insurance companies out of business,” he reported. “That’s false.” Wright went to the bill itself to to show that insurers will continue in business. Section 102 of the current House bill actually says “Insurance companies have five years to comply with new government standards.”

They won’t.

See, Vermonters have a little experience with voluntary compliance with government standards. In 1992, then-Governor Howard Dean signed into law a program to force universal health care on Vermont by 1995. (Governor Dean opposed a competing single-payer plan as too expensive. “Their package would have cost $500 million in a state with a total budget of $1.3 billion,” Governor Dean said at the time.) His new law banned “cherry picking” and enacted many of the rules present in the current House bill.

Strangely, insurance companies did not flock to Vermont.

In fact, Vermonters found just the opposite happened.

In 1990 the state had more than a dozen companies writing health insurance for Vermonters. By 1995, the state had three companies writing health insurance for Vermonters.

The current House bill also includes tax breaks and mandates to keep employers from exercising their free market right to drop existing (expensive) insurance plans. Mandates may make good sound bites; they don’t work if no one sticks around to obey them.

What have we learned today?

Maybe, just maybe our trust that our politicians could tell the truth should match our expectation that used car dealers ever tell the truth.

Milk Duds

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Milking cows is a faster way to lose your shirt than building boats. I should know. I’ve done both. At least boat builders aren’t mandated to sell their boats for less than it costs to build them.

Etienne Desmarais has a dairy farm down the road a piece. It costs him about a buck and a half to make a gallon of milk he can now sell for a buck even. We used to dip our milk out of the bulk tank from Dory Simon’s dairy farm on the other side of us; 30 years ago we paid him a buck a gallon for the freshest, sweetest milk around. Dory sold his herd to Etienne some years ago because the production costs were bankrupting him. Etienne still rents his land.

The economics of farming haven’t gotten any better since we were dipping the bulk tank.

New England dairy farms produce 20% of the country’s milk and employ about 145,000 people. Vermont has 1,045 dairy farms today. A few are like Etienne’s, milking more than 300 or 400 head. Many milk less than 100. Vermont lost about six dairy farms last month alone. Guess why.

Uncle Sam essentially sets the milk price that farms receive through the 2008 Farm Bill (the Food, Conservation, and Energy Act of 2008) and its MILC (Milk Income Loss Contract) Program. That USDA program “provides direct counter-cyclical style payments to milk producers on a monthly basis when the Boston Federal Milk Marketing Order Class I price for fluid milk falls below the benchmark of $16.94 per hundredweight (cwt).” Milk prices have been a political cow pie since the first Farm Bill set a benchmark decades ago.

  • Somehow I’m thinking $11/hundredweight (about a dollar a gallon) is below the benchmark.
  • I’m also thinking three bucks or more is a lot to pay in the store for a bottle that cost one dollar at the farm.

Roger Allbee, the real Vermont Agriculture Secretary, just returned from Washington, D.C., where he asked for emergency money via increased payments through the MILC program.

This (latest) decision is expected to take months.

I have to wonder why we should pass the two trillion dollar health plan tomorrow when it takes months (or years) to fix milk prices.

“We’re from the government. We’re here to help.”

Hmmm.

Here’s an interesting progression for the reader’s further consideration:

Since the same Federal Government that mandates milk prices will now set car prices at Government Motors, I reckon your next new Chevrolet or GMC pickup truck will cost the same as I paid for one in 1988. About $10,000, right?

Cool.

I don’t know what to do about the price of milk, though.