Saturday, April 17, 2010

For Some People, the Past Only Began Yesterday

If America Already Faces a potential shortfall of 16,000 doctors within the next fifteen years, how can that possibly have been caused by last-month’s passage of the Patient Protection and Affordable Care Act? This shortage was reported this morning on Pajamas Media, on XM-Satellite Radio’s  P.O.T.U.S. station.*

I Understand That President Barack Obama reportedly can walk on water and part the loaves and the fishes. But it’s hard to believe that even the Anointed One could sign a law on 23 March 2010, and the downward spiral toward medical armageddon has already begun, just three and a half weeks later.

Something Must Have Gone Wrong a While Ago. And coming off three decades of a Republican agenda, it’s a little hard to believe that it’s not the Republicans’ fault. Unless you use the kind of Republican reasoning that the Republicans use.

How Long Will We, the People, have our reasoning faculties beclouded by the slings and arrows of outrageous, mis-informed opinion? At least with adults back in the White House, we get some facts with our opinions these days.

If Doctors Are Being Chased out of medical practice by bureaucracy, the red tape comes not so much from the Federal government, as it comes from the confusion and contusions imposed by the multiplicity of insurance companies:
  • Each insurance company has its own forms. Your doctor pays special personnel to handle these.
  • Each insurance company has its own ideas about what procedures a patient (you) needs, and how long a  patient (you) should be allowed to spend in the hospital for the surgery your doctor prescribes, and what medicines you should take in recovery. Your hospital has special “case managers” just to handle these rationing ideas.
  • Each insurance company has its own “disallows.” You yourself will likely have to pay for these.
  • Each insurance company has its own structure of fees negotiated for the payment of services you provide. You will either pay more or less than your neighbors because of these.
Now That’s a Lot of Red Tape. All in the name of illogical opinion and an ideology that has persistently failed the American people for much of recent history. Anything but “single-payer.” Anything but “socialism.” Anything but “health-care reform.” Anywhere else but here.

The Origin of Much of the Standardization of these terms of insurance coverage comes from coding by the Federal government, through Medicare. If anything in American medicine has worked to standardize the relationship between medical providers and medical insurers, it is the Medicare system

That Codification Is a Benefit of Government, not a curse. Without even just this little bit of standardization, every single transaction throughout American medicine would be subject not only to the preceding list of items, but also to different forms of terminology, and to different computer codes for different medical procedures, drugs, and routines.

“Different Strokes for Different Folks” may work for individual freedoms. But it does not work for medicine. It does not change the facts, no matter what the underlying opinions would have us believe.

The Laws of Cause and Effect
are often subject to interpretation. And the connection between what comes first and what comes later is not always cause and effect.

But You Don’t Get to Just Make Up your own reality. If the United States will suffer a substantial shortage of doctors in the next decade and a half, and the new reform law was just passed three and a half weeks ago, the opposition to the bill was not only lame, but was also contraindicated by those who oppose the reform law now.

We All Heard  the Republican Leadership in Congress repeat, over and over, through the long year of debate, “Go slow.”

We All Heard the Same Leaders Say, “We need to start over.”

We All Heard the Same Leaders Say, “We need to scrap this bill.”

If the System in Place before the three-week-old reform was already steering us toward a 16,000-doctor shortfall by 2025,* it was surely broken to start with. So how could America possibly afford to scrap this bill, start over, and go slow?

Someone Is Not Being Entirely Honest about This.

But at Least While the Republicans
and the angry Tea Party Movement folks keep debating it, the Obama administration and the Democratic Party will be working on getting more Americans insured, encouraging more Americans to go into medical practice, and keeping more Americans healthy.

Outrage Is Easy.

Talk Is Cheap.

Pajamas Media Has an Agenda
that defies logic.

But We Finally Have a Few Adults Back in the White House.

At Least For Now.....


*Pajamas Media broadcast on P.O.T.U.S. XM Satellite Radio (04/17/2010)

Friday, April 16, 2010

What Good Are Other People’s Opinions, Really?

It Seems Most of Us Forget that all of the columnists and commentators in all of the papers and on all of the networks make their living by putting out their opinions according to schedule.

Keith Olberman and Bill O’Reilly and Glen Beck and George F. Will and Maureen Dowd all make their living by how well they express their opinions. Not from the factual value of the opinions themselves.

Of Course, We Should All Know This, without saying. But judging by the verbal badinage flying back and forth over the Net, sadly, we don’t. It’s all pretty much “news” to us.

Our Responsibility as Readers is to filter those opinions through the prism of what we know about each commentator. When we listen to Charles Krauthammer in The Washington Post, we must look for any break in the Right-leaning perspective, and if to Eugene Robinson in the same paper, we should look for the same kind of break from the Left.

That Is, Mr. Krauthammer’s Praise of President Obama means more than Mr. Robinson’s. But Mr. Krauthammer’s condemnations may be taken as just “more of the same”: noisy opinions from a guy just writing to deadline.

Likewise, When Mr. Robinson takes the Left to task, it teaches more than when he lambastes the Right.

Of Course, We Can Continue getting our “news” from these commentators—from the editorial pages and from MSNBC® and from FoxNEWS® and the like. We just need to put it to constructive use.

The One Objective We All Share—everybody who comes to comment pages such as those online, and everybody who writes letters to the editor anywhere—is the desire to make the world a better place. Or at least to see it become one.

Not Much of This Happens when we just keep cheering those we agree with and hurling insults at those we don’t—on “Letters to the Editor” pages. Or on “Comment” forums all across the WorldWideWeb.


Thursday, April 15, 2010

Virtually All of the American People Pay Federal Taxes

A Recent Statistic about Who Pays Income Taxes has been attracting quite a bit of attention lately. The statistic is that 47% of American citizens pay zero income taxes. It makes a compelling figure. But we respectfully disagree:

When You Buy Something in America, some of the money that you pay eventually goes to the Federal government in the form of income taxes. If you cook hamburgers and French fries and sell them through the drive-through at a fast-food restaurant, and you get paid $8.00 an hour, some of your labor that goes into selling that food earns money for your employer and eventually goes to the Federal government as income taxes.
Your Boss Pays These Taxes for You, and his boss pays some of them, too. All  of the way up to the CEO of, say, McDonald’s®, who earned more than $17,000,000 last year. Some of the taxes that he paid came out of money that he got as labor from you.

Now if You’re the CEO of McDonald’s® (which company’s last two years have been economically successful, despite the Great Recession and millions of other jobs lost by other entites), you not only can afford to pay your portion of your health-insurance premiums and any deductibles and co-pays; you could also afford to pay your entire medical bills, almost without regard for any preexisting condition or lifetime maximum or disallows. On the other hand, if you’re the guy making that $8.00 per hour, (which comes out to about $16,640 a year), you might find it harder to pay these deductibles and co-pays for yourself, let alone for the rest of your family. Along with housing and food, etc.

But Even with That Low Income,  you’re still part of the capitalist American economic engine. And of course you’re still free to go off and invest in a competitive business and sell more or better hamburgers at a lower or better price. And then you, too, can run your own hundred-billion-dollar publicly owned fast-food corporation.

Either Way, You’ll Still Get to Pay Your Fair Share of Taxes.


Tuesday, April 13, 2010

In Defense of Corporations

Citizens on the Political Left generally consider as suspect, two terms key to America’s economic greatness. Those terms, capitalism and corporation, have a mixed history in service to the “well-being” of the nation.

But as Any Student
of Adam Smith knows, nothing inherent in capitalism or incorporation creates the kinds of excesses that we, the people, have wrestled with for at least the last 150 years.

It Is Not “Capitalism” That Is the Evil.
It is the deadly sin of “greed” that is the culprit.

Some Few Large Corporations 
in America subscribe in practice to the more-socially oriented capitalist ideal. We keep our own personal list of American corporations which in practice exhibit the kind of business activities and stakeholder responsibility that would do Adam Smith proud.

Two Favorites, for the purposes of this discussion, are Warren Buffett’s Berkshire Hathaway and John Mackey’s Whole Foods:

One can hardly read Warren Buffett’s annual letter to the shareholders without an appreciation for what authentic corporate stewardship means. The link below leads to 32 years of such letters. If capitalism and investment mean anything to you, you could hardly do better than to read some of these letters.

For what it’s worth, Mr. Buffett claims to vote Democratic, and believes that we, the people, through our shared government, should limit the legal ability of corporations to damage the overall society.

The annual shareholder letter by Whole Foods founder and current CEO John Mackey is less-direct than Mr. Buffet’s letter, perhaps. But these letters convey Mr. Mackey’s sense of a “mission” for the company, which mission goes beyond the mere issue of profit. Mr. Mackey clearly believes in using the structure of incorporation to spread his ideals of healthful living. Mr. Mackey also advocates the “stakeholder” concept, rather than the more-common “shareholder” concept that is honored more in the breach than in practice.

For what it’s worth, Mr. Mackey considers himself to be a Libertarian. He notoriously wrote a letter on health-care reform, which letter was published in The Wall Street Journal in an edited version. Mr. Mackey argued the Libertarian view that health-care is best provided through the structure of the employer. (While his perspective seems naive, given general, corporate practices in relation to employee welfare, his ideological integrity is substantiated by practices at Whole Foods.)

Corporate Links:
(In the case of Mr. Mackey’s communication, I appreciated his most-recent blog post, entitled, “Creating the High Trust Organization”)


Tuesday, April 6, 2010

The Constitutionality of Health-Care Reform Is Clear

Article I, Section 8, of the Constitution legitimizes the Federal Government’s authority to enact the new Patient Protection and Affordable Care Act. Here are relevant passages of the Constitution. (The highlighing in bold italics is mine):

The Congress Shall Have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States;”

(This means that Congress has the power, as exercised under the PPACA, to collect taxes on those who fail to provide for their own health care, for the “general welfare of the United States.”)

“To Regulate Commerce with foreign Nations, and among the several States,”

(We know this clause as the catch-all clause of the Federal Government, which clause continues toirritate those who believe that the South should have won the War of Northern Aggression.)

“To Make All Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.”

What’s to Argue with That?