(Mike Zahara) – We’ve determined that what’s currently moving through Congress is not real reform, but more Medical Industrial Complex protections, posing as reform. Congress is beholden to too many special interests and a bad bill, at this point, is far worse than no bill at all.
In this final piece before the US Senate begins debate, we’ll continue with issues 4 through 7 that the National Commission should address.
4. Citizen lifestyles and risk factor containment
5. Legal Issues and 10th Amendment concerns
6. Revenue streams and cost containment
7. Unintended consequences and adjustments
Citizen lifestyles and risk factor containment: America is unique in all of human history’s cultures and societies in that we are the only people where our poorer people can be identified by how big their behinds are.
The American Medical Association holds that 1/3 of all Americans are clinically obese—that’s 100 or more pounds overweight.
That’s also more than 100 million people!
We eat poorly, drink, smoke, eat high fatty food, loaded with sugar and salt, don’t exercise, and eventually that lifestyle also contributes to killing 1/3 of us too early too—and it costs our healthcare systems tens of billions in care.
The current healthcare reform bills don’t address that and outright bars pricing insurance to reward avoidable risk factors; a hallmark of single-payer healthcare, which is their ultimate goal.
Without some incentive to reward healthier lifestyles via premium pricing tiers, there is no healthcare reform at all.
The National Commission would address this issue.
Legal Issues and 10th Amendment concerns: Most people, most notably the Speaker of the House, don’t seem to believe there are 10th Amendment implications in requiring all Americans to purchase something. They believe the Interstate Commerce clause of the Constitution somehow allows for a federal mandate to buy health insurance and I’ve read the legal opinions on both sides and am not sure where I’m at on this.
What I am sure of that whatever may pass will end up in front of a conservative leaning US Supreme Court.
This is also why I believe nothing is viable unless the health insurance portion of the McCarran-Ferguson Act is repealed either way and one federal standard established for all 50 states.
Another matter is end-of-life care and Medicare as was excellently reported on 60 Minutes on November 22, 2009 titled ‘The Cost of Dying’:
Steve Kroft, one of the nation’s best investigative reporters, brought home to millions of us just how difficult ‘reform’ will be, and how arrogant that our Congress believes it can affect a solution in a few months for such a gargantuan problem.
Another major issue is if we can somehow legally limit end-of-life care when Medicare currently bars that and we’re spending 50 billion dollars just on the last 2 months of care.
Are we seriously going to give transplants to 85 years olds? To 68 year olds whose organs are failing because of chronic disease?
Without question, the National Commission would have to address these issues.
Revenue streams and cost containment: We’ve already established that nothing in the current bills does anything to contain costs largely because it does nothing to force private insurers to compete with each other, or cap their reimbursement rates to a fixed percentage of Medicare’s reimbursement rates.
I’m reluctant to bring this up but there are two revenue options that no one is talking about, but that Democrats and some Republicans might find viable to pay for everything!
Speaker Pelosi was on PBS’s Charlie Rose show in October candidly talking about moving the US to Europe’s VAT; Value Added Tax. Most of Europe taxes this way and it’s basically adding a tax at each and every stage from manufacture/production to consumption.
It’s also a blind tax in that consumers don’t see the tax like we do on our purchase receipts, but it is a mammoth taxing vehicle, nonetheless.
Democrats may covet such a switch, but this will never fly in the United States.
What would be more palatable politically is a National Sales Tax on goods and consumer services. They would be positively gleeful in Washington because the revenue would be trillions; enough to fully pay for healthcare for everyone with no reforms at all, and pay down some of the debt.
But Washington being Washington, they wouldn’t target spend it, they’d just create more and more programs and that’s really the biggest concern in all of these healthcare ‘reform’ efforts.
President Obama recently returned from China after begging them to continue to keep buying our debt. President Bush made similar trips. We are so messed up financially that if they or anyone else stops buying our debt, we would collapse within hours.
Our currency has no value; we have no money. That means major cuts and major tax increases are the only option. Everyone knows this in both parties, but they are too paralyzed to do anything about it.
One of the reasons there’s not a big effort to create jobs or stimulate hiring with payroll tax cuts is that everyone in Washington also fears Americans returning to their hyper-wasteful, uber-consumption of the last 60 years. It’s much cheaper and easier to manage extending unemployment benefits and COBRA and such, than rolling the dice on inflationary pressures.
More than 70% of our economy is based on our mindless consumption; less than 40 years ago, it was based on our production. That hyper-consumption means we have to borrow money from others to buy the things we buy!
You can’t have inflation without the public spending, and currently, we are in the minus on inflation and may be in a period of deflation.
Sounds good at first glance, but deflation is just as bad as inflation! But the higher the inflation rate, the more it costs to borrow the money we need to feed the spending beast.
Couple all of this with healthcare ‘reform’ and the National Commission has a truly enormous issue to tackle.
Unintended consequences and adjustments: Any credible commission can’t just be one sitting and out. This is such an important issue that consecutive commissions must be sat in order that we may adjust and change course as unintended consequences arise.
There is a cause and effect to every single thing they are currently dealing with and the hundreds of other issues they are ignoring.
The BRAC formula seems to be the best platform to remove political considerations from the tough decisions.
As various groups are reading this proposed legislation, they are seeing the red flags waving and asking the questions any credible commission would be addressing. From the left Leaning Urban Institute, to the right leaning columnists, both sides are seeing that they’re creating a monster that still leaves 18 million people uninsured.
That’s not reform.
Is it too late? No, Congress should vote this down, but they likely won’t. They believe they have gone too far to come up empty-handed with mid-terms closer and closer each day, and they will send something to the White House. Only a handful realize that sending up something bad is just as bad as nothing, but they are unlikely to prevail.
Unless the brakes are slammed, that leaves the President to veto something and as we’ve written before, I think that is in the realm of possibilities.
Imagine a grateful nation saluting and cheering his wisdom in starting over and calling for a National Commission because Congress could not send him the bill he asked for.
All politicians in both parties are about their own survival and nothing else; yes, that includes President Obama.
Today, we are about 6 seats away from the Democrats losing the US House in 2010, and the damage to the US Senate grows exponentially each day too, but is less likely to flip in 2010, but will flip in 2012.
The country is angry, agitated, confused, and still reeling from economic collapse. There is just way too much on their plates to absorb it all and they’ll respond at the ballot box in 2010.
Whether the President and Congress are wise enough to listen to the country and change course, remains to be seen.
Again, a National Commission on Healthcare Reform is the only viable option.
(Mr. Zahara publishes the WatchdogWag.com blog)