A guest essay submitted by Jack Riepe to stimulate sensible and thorough debate on health care reforms proposed for the United States. Please comment at length and sharpen your pencils to add your thoughts. All points of view are welcome, and will be printed by me unedited and uncensored, as will all comments in reply. My only time limit on this experiment is the day some sort of reform is finally passed, be it ever so inadequate, and signed into law by the President.
I am Conchscooter, aka Michael Beattie, 743 Indies Road, Ramrod Key, Florida 33042. Send essays to me at mikigboat@hotmail.com and post as many comments as you like below the essays. Unless you are the pornographic asian spammer, in which case send your pictures directly to Jack riepe at Twisted Roads (http://jackriepe.blogspot.com/)
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My Perspective: The Healthcare Debate-- Let's Start Over, the Right Way...
I want President Obama to put the brakes on the current healthcare public relations disaster and come up with three substantive, but different programs, that address all public concerns, to serve as the basis of a nation referendum on healthcare.
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Proposed legislation should come from the Democrats, the Republicans, and the insurance industry, (who should be advised that they can take the lead in offering an honest reform program, or be reformed by popular consensus and legislative action).
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The process should also be open to proposed programs set forth by labor unions or other social groups, like the Salvation Army. There has to be more than one answer to this problem. The proposed bills should be limited to 25 pages, plus an executive summary. A matrix for each plan (the size of a tabloid newspaper page) would also be prepared.
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Then I want President Obama to conduct a national referendum, that will be based on a factual analysis and presentation of the pros and cons of each program, conducted by an independent auditor and the US Government Accounting Office (GAO). Prior to the referendum, there will be be three one-hour television specials, with experts explaining how each plan would work. On three consecutive days (or as many days as it would take to present each program to the general public via various media outlets), newspapers across the country would run full-page ads, detailing each program using the executive summary and the appropriate matrix. The same data would be made available online. Proposed changes to these bills would be collected via e-mail and hard copy and tabulated prior to a final draft of each. (These could run into the millions.)
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It is to be hoped that each submitted program would include the input:
• Of respected medical authorities, who would be named in each bill.
• Of an accounting firm who would certify that all data, percentages,and cited costs were correct. (This means that all three proposalswould have to use the same base numbers regarding the nation's uninsured... And that means making an effort to accurately to define"uninsured" and count them.)
• Labor unions, professional associations, social networks, clubs, andlocal political groups would be encouraged to support or endorse one program, but not to criticize the other two. For example, rather than declaring one plan to be the national socialization of America, or the Nazification of the US lifestyle, it would be in the best interests of groups supporting another plan to point out the its benefits (i.e. keeping the US Congress out of the insurance business, while promoting a single payer concept).
• The bill would then be voted on in a special national referendum. Legislation may be necessary to accommodate such a vote. If so, Congress can make that happen.
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Now I realize this rational approach to resolving this problem will take at least six months to a year of dedicated legislation drafting, hearings and public coordination; and take all the fun out of name-calling and screaming, but it has some real benefits.
1) It will get the US public actively involved in solving a national problem -- in a constructive manner. (For presentation on television, I suggest canceling "Dancing With The Bullshit Stars," or "American Idol." unless the idols are school teachers, firemen, or single moms who hold two jobs and still find a way to pay for their kid's music lessons.)
2) No one will able to say a better alternative wasn't discussed or made available.
3) Every qualified social, political or professional entity (in addition to every US citizen) will have an opportunity to contribute to the finished legislation.
4) The final decision will be left to the voting public.
5) Politicians will be forced to work together, and adhere to public outcry, or face the consequences on election day.
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Republicans (and I am a Republican) will be forced to pull their heads out of their asses, and regard the common man and woman, with an income of $45,000 or less as their actual constituency. They are going to have to become known as "progressive Republicans" or "SRRs, Socially Responsible Republicans," committed to the man (and woman) on the street first. It may be easier to train tigers to ignore bloody gazelles.
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Democrats (and I supported a lot of these assholes) are going to have to acknowledge that the Continental United States is more than Boston, New York, Philadelphia, Chicago, Los Angeles and San Francisco. There are millions of people who live in between these places who do not trust government for good reason. Alienating these people further is not good politics. Acting like they don't count is the first step in declaring a single term Presidency.
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If the President were to adopt the policy I have outlined above, it will do the following:
a) Give him more time to get this right.
b) Enable him to act upon new data regarding the acceptance of a program of this nature by the American public. Let's face it, the self-congratulatory Democrats were under the impression there would be no or limited opposition to this "40 acres and a mule" legislation. It blew up in their smarter-than-thou faces. (And their first reaction was to call the opposition organized stupidity bereft of social awareness, and nothing more than a neanderthal diversion tactic -- in an effort to discount resistance to a poorly communicated, over-complex document that is being rushed through Congress.
c) Tell the Democratic party not to mix issues with this program, and to assure (not just tell) the voters, "We're going to fix it." Of course, this means Obama will have to become the real leader of the Democratic Party. Democratic leaders have been waiting for their turn to screw the American public for so long that it may be easier to train tigers to ignore bleeding gazelles.
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So Conch, this would be my approach. I didn't mean to clutter up a great blog with this, but I rather got the impression you thought that I didn't think healthcare was important, or that I wasn't thinking about this, or that I was an idiot. It's just that I have no patience with government bullshit and no confidence in their bullshit promises. Among the things that President Obama promised were two elements of real change... They wouldn't cost any real money... They wouldn't raise taxes... They wouldn't even make a real splash at first, considering the average American is as dumb as dog shit and incapable of reading anything longer than a Twitter message. And yet, Obama couldn't drop these promises fast enough.
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The first was the promise that all legislation would be presented to the general public in plain language, 5 days before a vote would be taken. A nicer touch by a powerful leader eager to promote change would also have been to eliminate the rider system of passing legislation in the dark. But it was stupid of me to get my hopes up even for the initial offering. Can you imagine the value of the above legislative action in the promotion of a well-written bill, the acceptance of which by the American pubic was crucial to a major enhancement of the US lifestyle? You could use the healthcare bill as an example. But Co-President Pelosi and company is not really interested in smartening up the US voter.
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The second promise made by Obama was to eliminate all lobbyists and special interest representatives from his administration; and to require that all dialogues between elected officials and lobbyists be recorded and reported. This took my breath away. Only leaders like Attila, Pope Gregory, Napoleon, Washington, and Ghengis Khan make promises like that. As you can imagine, Co-President Pelosi and banking industry sexual aid Chris Dodd -- in addition to the rest of the occupants in the "Little Whorehouse on the D.C. Prairie" -- got real quiet on that one.
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It was for these two campaign promises, and because the Republican Party performed so poorly over eight years (treating rank and file Republicans, let alone the American public like they were idiots and cannon fodder), that I supported President Obama. He has performed like a true ward-heeler since getting into office.
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I routinely write to my elected officials, and my name is on hundreds of press releases that urge the feds to act responsibly (albeit on transportation issues), and with forethought, as opposed to highlyemotional responses that get headlines, but no results.
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So these are the kind of blog comments I write when I am not thinking about motorcycles, or women, or rum, or nude beaches in Key West.
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Fondest regards, Jack Riepe Twisted Roads
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"I have a good mind to join a club and beat you to death with it."--- Groucho Marx
15 comments:
How about the simple approach: Medicare for everybody. Or VA Health System for everybody. Or Congressional Health Plan for everybody.
Or anything that removes the insurance industry from the equation. It is the insurance industry that is directly and completely responsible for the fact that the U.S. spends twice as much per capita on health care than any other wealthy nation. Take the profit motive out of health care. Doctors should treat patients based on medical needs, not the need to generate fees.
Making everyone buy health insurance doesn't solve the problem. And in my case, I'm 54 and diabetic. Who's going to sell me health insurance? Nobody, that's who. And a government subsidy isn't going to lower my cost much, if at all.
I've received treatment by the British National Health Service that was far better than anything the corrupt, drive-thru Medical/Industrial Complex offers. I'd like to see that, but it ain't gonna happen unless there's some kind of, I dunno, Great Depression. Which could still happen. The first one didn't happen overnight...
__Orin
Scootin' Old Skool
I don't think the congressional system would work because they pay 7.5 percent of their income to buy family insurance and for most people (who don't earn $175,000 a year) that would be a burden.
The interesting thing to me is that for people with medical conditions and experience with single payer, the answer is obvious. For everyone else politics intervenes.
Single payer ( VA or Medicare) is the cheapest and most efficent way to offer healthcare, but the anti Big Government argument intervenes and derails common sense. A critic of health insurance reform addressed the President at a forum and asked how could private insurance compete with government run not-for-profit health care and thus answered his own question: profit based insurance is expensive and inefficient. And anyone who fears government bureacrats has never met an insurance industry bureaucrat.
As a member of my Inventor's group told me how he learned engineering in Poland, decouple the variables.
From what I see are:
1. the patients
2. the health care providers
3. Medical Insurance
4. Medical Malpractice Insurance
5. the Court system for liability and its followers
6. the drug companies
7. the workers expectation that businesses provide heath insurance
8. businesses expectation they will not provide health insurance
9. regulatory agencies
Now without getting into all the nuances, there are multiple, crossing relationships, many antagonistic relationships countering a beneficial relationship (I am saving that for my possible essay).
However, laying out the obvious is needed to see the true problem (which I have done only 1/2 here, the relationships should be spelled out - I think charts will be in order).
I think the solution will lie in aligning all the relationships so they are all beneficial, with the patient and health care provider with little compromise as possible.
I will have to ponder this, but I wanted to open it up to my thought process as I expand on the decoupled variables.
I should note, I am also a diabetic, dependent on insurance - recently unemployed after 12 years loyal to a large global company. Luckily my wife was able to add me to her insurance and I was able to work freelance. That said, this a debate I am thoroughly following.
It may be interesting to have any contributors mention how they currently get healtcare. Employer provided ins., individual policy, medicare, none. Also the cost of the insurance including the amount the employer pays if applicable.
If you want to get more people genuinely interested and involved in the issue do away with employer provided health ins. Suddenly you will have a lot more people interested in the problem instead of tied up in politcal rhetoric.
Currently with an indivual ins. policy, now with pre-existing conditions and held hostage by my current health ins. company. Over 30% increase so far this calendar year. At least I have something but shopping around is out of the question without reform. Sooner rather than later please.
Dear Sir:
You started out with three good responses to my slow moving target. Very impressive. You wanted dialogue? I gave it to you. You can buy me a nice present later.
Fondest regards,
Jack
Death by drowning is too good for you. I moved my essay about riding the bonneville round town to tomorrow.
I would love to hear from somebody who thinks no change is needed (one of those screaming people from the 9-12 clubs). Weird isn't it how you can raise a premium 30%in a deflationary year? And this is by a private company which is supposedly so much better for us than those horrid government bureacrats. Ha!
Dear Conch:
I never said the current form of private insurance was good for us... What I said is that the US government has no place in private business. I don't even like them in Amtrack, and I love Amtrack.
Can I go back to writing funny stuff now?
Fondest regards,
Jack
Twisted Roads
I think America has spoken and they want a plan. I just think Obama is going about it the wrong way. Jack has the idea of coming up with three or more options. From there the Federal government should use a process similar to that of what is done with an Environmental Impact Study (EIS). It's about building consensus...not dividing people along political lines.
It's impossible to build consensus when the people you are trying to reason with are screaming lies at you. They are excluding themselves from the debate. Republicans now agree (having been shown to support them themselves) that death panels are bullshit and living will discussion is valuable and to be encouraged. I want discussion here in my small corner to prove that reasonable people can discuss all these issues. Thanks for particpatinbg I encourage anyone to write their thoughts at leisure and send them to me for inclusion.
I am going to continue to pepper my Keys photo essays with comments i can glean from the Internet that support my point of view because repeating myself over and over will get boring. But I do want to the record to show, when the debate is done, that I spoke up for what I beleive in. You are welcome to send me your thoughts, especially if you think I'm full of shit.
Jack riepe is forbidden by Order of the People's Democratic Socialist Tribunal from mentioning anything remotely funny until the debate is over. Or he goes bankrupt paying for his pills, which isn't the least bit funny.
Dear Conch:
The way to eliminate sceaming people is to encourage them to work their own plan, or to have their representatives work on a plan for them. Then a public analysis of multiple plans will create an environment by which key elements from one plan may be incorporared into another. You will never be able to please everyone, but 66% would be a great starting point.
I ran out of the pain killer for my knees over the weekend, and was reduced to taking the dog's medicine. He has the exact same prescription Ultram) in the same strength, except his is cheaper. I was advised that taking his medicine often could cause me to try and sniff Leslie's butt when she walks through my office. If nothing else, I could use the excuse.
You wrote, "You are welcome to send me your thoughts, especially if you think I'm full of shit."
Now, what happens if people think you are full of shit unrelated to healthcare? I don't feel that way. But I know of others who do.
Fondest regards,
Jack • Reep • Toad
Twisted Roads
I am sensing the rigid proponents of no change have overplayed their hand. It's obvious that private helath insurance doesn't work well and it would seem obvious to me that government health insurance would have to be better, and cheaper. However people reduced to eating their pets' medications have the capacity to bamboozle themselves into thinking a rigid attitude works better. I honestly don't get it.I am smart well traveled and not a socialist but I KNOW single payer works great. Its not perfect but it removes the element of fear that pervades our system with its promise of refusals to pay and imminent bankruptcy. Yet, smart people like yourself are certain that your political theories will work better for you than proven results. 84 percent of Canadians don't want to lose single payer. 70percent of Americans want something to change in our private provider system.
Somebody please tell me why a public option, if not single payer proper, needs to be on offer?
I am sensing the rigid proponents of no change have overplayed their hand. It's obvious that private helath insurance doesn't work well and it would seem obvious to me that government health insurance would have to be better, and cheaper. However people reduced to eating their pets' medications have the capacity to bamboozle themselves into thinking a rigid attitude works better. I honestly don't get it.I am smart well traveled and not a socialist but I KNOW single payer works great. Its not perfect but it removes the element of fear that pervades our system with its promise of refusals to pay and imminent bankruptcy. Yet, smart people like yourself are certain that your political theories will work better for you than proven results. 84 percent of Canadians don't want to lose single payer. 70percent of Americans want something to change in our private provider system.
Somebody please tell me why a public option, if not single payer proper, needs to be on offer?
I think Jack is onto something here. If "they" could come up with 3 different plans, maybe we could cherry pick between them, getting the best out of them all, and cobble together one good plan. Hmm. What a concept: government working WITH and FOR the People? If only. I'll jump for joy if it actually happens, but I'm not holding my breath. Blue is my favorite color, but not for my face. Good luck, Jack!
If the public option is such a non starter why are the private coporations so afraid of it? Let's bring it on and have the private provider show us how superior they are to government provided services.
We are privileged to live ina democracy and a majority of people who bothered to show up elected President Obama on a promise of change. he's offering change and yet we still hear the tire dold anti- gummint rhetoric that government isn't responsive.
Let's see private corporations who screw us daily respond with the same openness that President Obama's administration has used to approach this issue (too much willingness to listen in my opinion, to a bunch of right wing crackpots).
If the best you can do in your democracy is hold your breath your a pretty poor excuse for a citizen.
Dear Conchscooter:
You and I actually agree on a number of key points. In reality, I do not believe that the insurance companies will ever step up to the plate and do the right thng.
I do advocate change in the national healthcare system and I think we are close to it... But I doubt very much it will come the form that the present administration is attempting to market.
I also like the concept of the single-payer. What I do not like is the idea of the government being in the insurance business -- and creating a huge beaurocracy to deal with it.
And I think there are millions of people across the United States who are in opposition to the whole health care situation because they are afraid they are going to lose the little they have.
What you are witnessing is a vote of no confidence in the government. Now you are willing to credit the current levelsof hysteria and misinformation to "right wig crackpots." I am looking at beautifully produced commercials running on television both for and against the healthcare proposal, and wondering, "Who paid for these?" The answer is special interests.
Insurance companies, hospital holding companies, political groups, legal concerns and others, all have their oars in this boat. The result will be a watered down proposal that no one will like, or no bill.
By the way, my dog Atticus has arthritis. The cost of replacing his hips is $6,000 per hip. If he can be kept in a dog crate for 6 months (tough to do as he weighs 150 pounds without an ounce of fat), he will make a full recovery. The cost of replacing my two hips is $150,000. Why is that?
The vet says that with new hips, and proper recovery, Atticus will be able to jump a six-foot fence. I just want to ride a motorcycle all day.
I'm thinking of going to a vet.
Fondest regards,
Jack
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