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Wednesday, August 5, 2009

Building On A Broken Foundation

Leslie and I have had plans to remodel our kitchen since we moved into our home in 1998. Our home in the Bixby Knolls section of Long Beach dates to the late 1920s and sits on expansive clay soil, when the dirt gets wet it expands significantly, when it gets dry it contracts. This expansion and contraction over 80 years is not very good for the foundation, as a result we have some plates and braces around various parts of the foundation. Last year our front lawn was taken out and replaced with drought tolerant landscaping; drought tolerant but still in need of some water, especially the first year. Unfortunately one of the drip hoses was installed too close to our home and the result of a year of thrice weekly dripping has resulted in what we think is more damage to our foundation.

If our home was under the control of the Nancy Pelosi/Barack Obama group of Democrats, who I now label the "New Democrats" for their combination of power in Washington and station on the far left of the Democratic Party, if our home was under the control of the New Democrats then we would go right ahead with our kitchen remodel plans. Leslie and I would borrow several hundred thousand dollars, not read the architect's designs, over pay our contractors, and build our new kitchen on top of our foundation without fixing the cracks and soil issues that will lead to future damage and possible collapse of that section of the home. No regard for budget, no care about the details of the plan, no time taken to fix what is already wrong and without attention will get worse in the future, just build a new kitchen.

This is the approach the New Democrats are taking on their health care overhaul. Operating on the premise that most Americans agree with, that our current health care system is in need of repair, the New Democrats have crafted proposals that are in Congress that seemingly ignores any budget, is being pushed without reading the details and most importantly without fixing what is already in place and needs attention: Medicare.

There are many issues I have with many of the proposals I have read and read about in the thousand plus health care proposal being pushed around committees by New Democrats in Washington. Those issues are secondary however to the complete lack of focus on fixing what is already in place, a government controlled health insurance program, before expanding it from a $425+ billion program to a $1.6 trillion program. The ultimate goal of the New Democrats is a single payer, government run health care system--while some deny it they cannot hide from YouTube and the internet with videos of speeches and interviews in which many have been seen stating the path they are on will lead to one insurance program in America that is run by Washington.

Medicare covers approximately 45.5 million Americans and costs over $425 billion in fiscal year 2009. It accounts for sixteen cents of every Federal dollar spent, third in spending behind social security (which is also broken) and defense spending. In 1983 Medicare cost almost $53 billion, so it has grown over eight times in just over twenty-five years. Despite a $200 million budget within the Health and Human Services budget for fraud and abuse control within the Medicare programs, it is conservatively estimated that 10% of the Medicare budget goes to fraud and abuse--that is over $42 billion each year. These costs are despite the contributions every paycheck by working Americans who have Medicare insurance payments automatically deducted from their paychecks along with their taxes, 401(k) and private health insurance premiums.

Medicare, and its little brother Medicaid (Medical in California) provide models for a government run health care system. It dictates payments to doctors and hospitals, has prescription drug programs, collects additional premiums and deductibles from those covered or partially covered. It operates at a loss despite collecting what amounts to premiums from every working American. To cover the losses funds are taken from the general budget of the United States, which has as its largest contributors the wealthiest Americans who earn the most income and pay into the highest tax rate.

To recap, the Federal run health insurance program that covers only about 15% of the American population is paid for by every working American in their paychecks and since it operates at a loss is supplemented by the tax dollars of every working American with the majority of the supplemental support coming from those making the most money and in the highest tax brackets.

If passed, how will the health care proposal being pushed by the New Democrats differ significantly from the current Medicare system? Will it be run by the same bureaucrats who are currently unable to make Medicare work? Will it reduce the amount of fraud and abuse that bleeds over 10% of the existing budget? Will it be able to control the amount of "premiums" collected from working Americans?

The ultimate goal of the New Democrats is single payer insurance, a system that pretty much already is in place in the United States due to the Medicare deductions and use of tax revenue to pay for the program. Before trying to force onto Americans a hodge-podge of proposals and policies as detailed in the thousand page bill they have written, should they not show us they can run an effective and efficient health care insurance program? Before committing to several trillion dollars of costs paid for by you and me should they not show they can offer quality health care for Americans being covered in a system that "only" costs $425 billion this year? Before committing to every doctor, hospital and health care provider in America to becoming a government employee should they not work with the doctors, hospitals and health care providers currently receiving Medicare patients to strike that fine balance between proper compensation and quality care?

The debates and arguments and focus the past several weeks have been on the health care proposal that has been written by the New Democrats. Most of the coverage has been on specific proposals within the proposed legislation. What I would like to see is the call for reform of Medicare before any new health care overhaul is passed. Given the way $1 billion has become small change in Washington, use Medicare as an experiment if you will for how a bigger health care system may work. It has most of the elements being proposed and it has many flaws and inefficiencies that have been acknowledged vociferously by New Democrats as a reason the system needs to be overhauled. But instead of fixing what they acknowledge to be wrong they are looking to commit trillions of dollars to what appears to be essentially the same broken system.

Leslie and I know we need to move our drip hose and some plants away from our home and fill the area with a drainage system, rocks, and concrete to keep water away from the dirt around our foundation. We then need to repair the foundation in that section of our home with braces and plates. Only when the existing foundation is secure can we think about rebuilding what sits on top of that foundation, to do otherwise would be foolish. What is the difference between our remodeling our kitchen and the New Democrats' plans to remodel our health care system? The biggest difference is we know where we need to start.


1 comment:

Bob Schilling said...

I agree that we need to reform Medicare/Medicaid in some places. I agree it's expensive. I don't agree that we should hold up making health care reliably available to all of our citizens. If you're worried about the cost, take it out of the Defense budget, increase the ridiculously low royalties to mining and oil companies on federal lands, and double the taxes on incomes over $2 million.

All this pharumping over health care seems horribly misguided to me. We know we need to do it, and we know we're going to have to pay for it. Let's stop wrangling and get on with it.