Friday, June 19, 2009
Healthcare Funding
Can we definitively say who should be funded by the Feds in their healthcare? If we are going to do that, then maybe we should look at all entitlement programs meaning those programs where the government subsidizes how we survive. First, let’s establish a viable poverty line. We can do this by looking at how much our government gives to a totally disabled veteran returning from Iraq. The 100% disability pension to a young married man with no children is $33,876.00 a year, so set the poverty line at $34,000.00.
Next, overhaul the tax code by eliminating all exemptions, all deductions, all exclusions and all filing categories except “Citizen” and “Non-Citizen”. Now that the playing field is level, set a flat tax rate at 10% for citizens and 15% for non-citizens who exceed the poverty limit. The only “sliding-scale” should be between $34,000.00 and $38,000.00 (citizens) to $40,000.00 (non-citizens) to ensure that we do not “tax” anyone to below the poverty level. This level playing field would mean having more children would not get you more money, so the impetus for birth control would be greater.
Next are those entitlements for those “below” the poverty level. For housing entitlements, Chapter 8 should be rewritten to pay 100% for only those persons who are 100% disabled and unemployable. If you are employable, then we should be helping you get the training you need to work. The Feds have all types of job stats on what fields are really short of people and will be in the next five to ten years.
So now you are working, but you are still only making 50% of the poverty level, then the government subsidy would be 50% up to a point not to exceed the poverty level for combined income and subsidy. If you find an apartment for $900.00 a month, you pay the first $450.00 and the government subsidizes the other $450.00. Let’s say you have a “domestic partner” who is also making 50% of the poverty level. That would mean the two of you would share in a 25% subsidy. You take in a third adult room-mate, and the three of you share in a 17% subsidy. Children do not count as they are the sole responsibility of the person who brought them into this world. You want to have six children that is your business, not the governments.
Now we have made insurance rates less by placing insurance companies in direct competition with each other at the “feature” level, and we have raised the amount of revenue by instituting a “flat tax” across the board for individuals, companies and organizations. The only thing left to do is pass a Balanced Budget Amendment to the Constitution that would require the Federal Government to balance the budget within 10 years and keep it balanced thereafter.
In the spirit of keeping the playing field level, all income to elected officials would be taxable and for any elected official to receive a pension, they would have to serve for the same amount of time as a government employee (30 years). The only exception would be the 20 year pension for the military.
But wait, there’s more…
Next, overhaul the tax code by eliminating all exemptions, all deductions, all exclusions and all filing categories except “Citizen” and “Non-Citizen”. Now that the playing field is level, set a flat tax rate at 10% for citizens and 15% for non-citizens who exceed the poverty limit. The only “sliding-scale” should be between $34,000.00 and $38,000.00 (citizens) to $40,000.00 (non-citizens) to ensure that we do not “tax” anyone to below the poverty level. This level playing field would mean having more children would not get you more money, so the impetus for birth control would be greater.
Next are those entitlements for those “below” the poverty level. For housing entitlements, Chapter 8 should be rewritten to pay 100% for only those persons who are 100% disabled and unemployable. If you are employable, then we should be helping you get the training you need to work. The Feds have all types of job stats on what fields are really short of people and will be in the next five to ten years.
So now you are working, but you are still only making 50% of the poverty level, then the government subsidy would be 50% up to a point not to exceed the poverty level for combined income and subsidy. If you find an apartment for $900.00 a month, you pay the first $450.00 and the government subsidizes the other $450.00. Let’s say you have a “domestic partner” who is also making 50% of the poverty level. That would mean the two of you would share in a 25% subsidy. You take in a third adult room-mate, and the three of you share in a 17% subsidy. Children do not count as they are the sole responsibility of the person who brought them into this world. You want to have six children that is your business, not the governments.
Now we have made insurance rates less by placing insurance companies in direct competition with each other at the “feature” level, and we have raised the amount of revenue by instituting a “flat tax” across the board for individuals, companies and organizations. The only thing left to do is pass a Balanced Budget Amendment to the Constitution that would require the Federal Government to balance the budget within 10 years and keep it balanced thereafter.
In the spirit of keeping the playing field level, all income to elected officials would be taxable and for any elected official to receive a pension, they would have to serve for the same amount of time as a government employee (30 years). The only exception would be the 20 year pension for the military.
But wait, there’s more…
Thursday, June 18, 2009
Regulating Health Insurance
Here’s an idea. If the Federal Government wants to do something to help the American public better afford health care you do not enter into direct competition with health insurance companies. If you want to regulate the health insurance companies then try this.
Right now you can select from a myriad of companies, some local, some regional, and some national. A quick look at the America’s Health Insurance Plans web site (http://www.ahip.org) will show you over 1,300 member companies – all offering health insurance. So it would be reasonable to ask, “With over 1300 choices, what’s the problem?” Well, there are several. For one thing, of the 1,300 members, there are 23 that start out “BlueCross and BlueShield”; several are really local providers who provide healthcare benefits for one company, or one union local. The bottom line is that you have to buy a “plan”, and if you’re local healthcare provider doesn’t offer what you want, or what you feel you need – that’s too bad. Hey, at least you have coverage, right?
If the Feds want to do something, let them build a database of insurance company “features”, and then let the American public log onto that web site and pick and choose the features they want, with the deductibles they want. You might want the outpatient coverage from BlueCross/BlueShield with the pharmacy coverage that Aetna provides and the preventative care from Kaiser Permanente. If you are employed and your employer says, “I’ll pick up half the tab”, then you enter your employers tax ID so the Feds can verify your employment (by looking at the IRS computers) and bill half of the cost to your employer with the rest coming from payroll deduction.
You get a plastic Smartcard that holds all your benefit information (and even a digitized thumb print if you want to get fancy) that you take to the doctors’ office, pharmacy, or hospital. This information is used for billing.
Speaking of billing; the backside of this great database is another database for billing. The computer doesn’t do the billing, but it does pass the billing information on to the insurance companies. The insurance companies get their premiums by EFT, much as they do now, and send out payments to doctors, hospitals, pharmacies, much the same as they do now. The notice we all get that says, “This is not a bill” from our insurance company showing what they are responsible for is done automatically by the government computer. When you pick your features, you can also select to be contacted by email, which would save the government tons of money.
Are there holes in this? Sure, but smarter people than I can figure those out. Biggest benefits to this idea are it keeps the government out of direct competition with insurance companies, it gives the American people better choice, and this isn’t 650 pages long!
Right now you can select from a myriad of companies, some local, some regional, and some national. A quick look at the America’s Health Insurance Plans web site (http://www.ahip.org) will show you over 1,300 member companies – all offering health insurance. So it would be reasonable to ask, “With over 1300 choices, what’s the problem?” Well, there are several. For one thing, of the 1,300 members, there are 23 that start out “BlueCross and BlueShield”; several are really local providers who provide healthcare benefits for one company, or one union local. The bottom line is that you have to buy a “plan”, and if you’re local healthcare provider doesn’t offer what you want, or what you feel you need – that’s too bad. Hey, at least you have coverage, right?
If the Feds want to do something, let them build a database of insurance company “features”, and then let the American public log onto that web site and pick and choose the features they want, with the deductibles they want. You might want the outpatient coverage from BlueCross/BlueShield with the pharmacy coverage that Aetna provides and the preventative care from Kaiser Permanente. If you are employed and your employer says, “I’ll pick up half the tab”, then you enter your employers tax ID so the Feds can verify your employment (by looking at the IRS computers) and bill half of the cost to your employer with the rest coming from payroll deduction.
You get a plastic Smartcard that holds all your benefit information (and even a digitized thumb print if you want to get fancy) that you take to the doctors’ office, pharmacy, or hospital. This information is used for billing.
Speaking of billing; the backside of this great database is another database for billing. The computer doesn’t do the billing, but it does pass the billing information on to the insurance companies. The insurance companies get their premiums by EFT, much as they do now, and send out payments to doctors, hospitals, pharmacies, much the same as they do now. The notice we all get that says, “This is not a bill” from our insurance company showing what they are responsible for is done automatically by the government computer. When you pick your features, you can also select to be contacted by email, which would save the government tons of money.
Are there holes in this? Sure, but smarter people than I can figure those out. Biggest benefits to this idea are it keeps the government out of direct competition with insurance companies, it gives the American people better choice, and this isn’t 650 pages long!
Wednesday, June 17, 2009
Who Are The Uninsured?
So let us look at who the uninsured in America currently happen to include. If we are to assume that the Medicare and Medicaid program will continue to care for our elderly, then by Census Bureau 2009 estimates[1], that would account for 38.8 million of the estimated 50 million (when did it move from 45 million to 50 million?) persons currently in the US. I can not see where a good argument could be made for moving the elderly from one government program to another; it just doesn’t make much sense.
As reported by Craig, et al (2005)[2]:
“…foreign-born Hispanics who are not citizens and have lived less than one year in the United States have the highest uninsured rate (82 percent) as compared with those who have lived in the United States longer. Foreign-born non-citizen Hispanics who lived in the United States for 15 or more years had an uninsured rate of 46 percent.”
So again turning to Census Bureau estimates, the number of Hispanics who are uninsured currently in the US account for 15.3 million[3], with the majority of those (82%) being non-citizens in the US for less than a year.
So 38.8 million plus 15.3 million makes 54.1 million, or more than the government has given as an estimated, so that would certainly account for one of your first cost overruns. If you look at the latest commentary by Jeffrey A. Miron, a senior lecturer on economics at Harvard University, (who estimates 46 million uninsured), he offers a good piece of advice, “A … way to reduce subsidies is to gradually increase the age of eligibility for Medicare from its current level of 65, to 70 or more. This makes sense because of the improvements in life expectancy and health status of the elderly that have occurred over the past 40 years.”[4]
Let’s turn to the Census Bureau again for some data – Raising the Medicare eligibility from 65 to 70 would immediately remove 11.3 million people from Medicare this year. By 2014 that number will have grown to over 15 million.
This still leaves a lot of people without health insurance, but we will look at some options
Later…
[1] United States Census Bureau. Annual Estimates of the Resident Population by Sex, Race, and Hispanic Origen for The United States: April 1, 2000 to July 1, 2008 (NC-EST2008-03). Retrieved from http://www.census.gov/popest/national/arsh/NC-Est2008-03/NC-EST2008-03.xls
[2] Craig, S., Turner, J, and O’Hara, B (2005). Investigating the Role of Hispanic Origin in Estimating the Number of Uninsured. United States Census Bureau retrieved from http://www.census.gov/hhes/www/sahie.
[3] United States Census Bureau, People With or Without Health Insurance Coverage by Selected Characteristics: 2005 and 2005. Retrieved from http://www.census.gov/hhes/www/hlthins/hlthin06/p60no233_table6.pdf
[4] Miron, Jeffrey A. (June 15, 2009) Commentary: US health costs our of control. Retrieved: Jun 17, 2009 from http://www.cnn.com/2009/POLITICS/06/15/miron.health.costs/index.html
As reported by Craig, et al (2005)[2]:
“…foreign-born Hispanics who are not citizens and have lived less than one year in the United States have the highest uninsured rate (82 percent) as compared with those who have lived in the United States longer. Foreign-born non-citizen Hispanics who lived in the United States for 15 or more years had an uninsured rate of 46 percent.”
So again turning to Census Bureau estimates, the number of Hispanics who are uninsured currently in the US account for 15.3 million[3], with the majority of those (82%) being non-citizens in the US for less than a year.
So 38.8 million plus 15.3 million makes 54.1 million, or more than the government has given as an estimated, so that would certainly account for one of your first cost overruns. If you look at the latest commentary by Jeffrey A. Miron, a senior lecturer on economics at Harvard University, (who estimates 46 million uninsured), he offers a good piece of advice, “A … way to reduce subsidies is to gradually increase the age of eligibility for Medicare from its current level of 65, to 70 or more. This makes sense because of the improvements in life expectancy and health status of the elderly that have occurred over the past 40 years.”[4]
Let’s turn to the Census Bureau again for some data – Raising the Medicare eligibility from 65 to 70 would immediately remove 11.3 million people from Medicare this year. By 2014 that number will have grown to over 15 million.
This still leaves a lot of people without health insurance, but we will look at some options
Later…
[1] United States Census Bureau. Annual Estimates of the Resident Population by Sex, Race, and Hispanic Origen for The United States: April 1, 2000 to July 1, 2008 (NC-EST2008-03). Retrieved from http://www.census.gov/popest/national/arsh/NC-Est2008-03/NC-EST2008-03.xls
[2] Craig, S., Turner, J, and O’Hara, B (2005). Investigating the Role of Hispanic Origin in Estimating the Number of Uninsured. United States Census Bureau retrieved from http://www.census.gov/hhes/www/sahie.
[3] United States Census Bureau, People With or Without Health Insurance Coverage by Selected Characteristics: 2005 and 2005. Retrieved from http://www.census.gov/hhes/www/hlthins/hlthin06/p60no233_table6.pdf
[4] Miron, Jeffrey A. (June 15, 2009) Commentary: US health costs our of control. Retrieved: Jun 17, 2009 from http://www.cnn.com/2009/POLITICS/06/15/miron.health.costs/index.html
Tuesday, June 16, 2009
Health Insurance Lobby Won't Stop
It is just as important that business keep out of government as that government keep out of business.
Herbert Hoover (1874-1964)
Today, Health and Human Services Secretary Kathleen Sebelius stated as Alonso-Zaldivar and Werner (2009) reported "the insurance lobby won't be able to block a public health plan because most Americans realize they would be better off if the industry had competition".
For government to enter into the private market place does not "promote" competition, it ends competition. Once we arrive at the point of giving the government carte blanche to "help" us, then we have concluded that we are powerless to help ourselves. Ronald Reagan (1911 - 2004) is quoted as saying, "The nine most terrifying words in the English language are, 'I'm from the government and I'm here to help.'" It would do us well to remember the aftermath of 9/11 when "most Americans" were clamoring for the government to "keep us safe". This mandate to the government got us War in Iraq, the Patriot Act, and Gitmo. Now "most Americans" are saying it is only the government that can provide the competition they desire to the insurance industry. This competition is to be funded largely by cuts to Medicare and Medicaid which is scaring the pants off of large hospitals and a large number of doctors, and rightfully so. What "most Americans" are asking the government to do is trade one, largely inefficient, fraught with the ability to de-fraud government bureaucracy, with another. The only difference would be this new government agency would be in direct competition with American business.
Please do not misunderstand - I am not a great fan of the American insurance industry, but I am fervent opponent to the American government intervening in business. I seriously thought we would have another round of "tea parties" when the President became the de-jure CEO of Government Motors, but that did not happen. Do we need some type of oversight on the insurance industry? I believe we do, especially with allegations of the industry trying to recover from bad investments by raising rates (particularly malpractice insurance rates). When they raise rates, it trickles down to the patients who have to pay more, which initiates the market forces of raising their rates. When rates reach the point where small business no longer can afford to supply their employees with any type of health coverage, then you have a problem - but not the one we are facing now. We will look later at the actual basis for this problem based on reports from Health and Human Services and the Census Bureau.
Later...
Alonso-Zaldivar, R., Werner, E. (2009, June) AP Interview: Sebelius says insurers won't succeed (June 16, 2009) Retrieved June 16, 2009 from http://news.yahoo.com/s/ap/us_sebelius_health_overhaul.
Herbert Hoover (1874-1964)
Today, Health and Human Services Secretary Kathleen Sebelius stated as Alonso-Zaldivar and Werner (2009) reported "the insurance lobby won't be able to block a public health plan because most Americans realize they would be better off if the industry had competition".
For government to enter into the private market place does not "promote" competition, it ends competition. Once we arrive at the point of giving the government carte blanche to "help" us, then we have concluded that we are powerless to help ourselves. Ronald Reagan (1911 - 2004) is quoted as saying, "The nine most terrifying words in the English language are, 'I'm from the government and I'm here to help.'" It would do us well to remember the aftermath of 9/11 when "most Americans" were clamoring for the government to "keep us safe". This mandate to the government got us War in Iraq, the Patriot Act, and Gitmo. Now "most Americans" are saying it is only the government that can provide the competition they desire to the insurance industry. This competition is to be funded largely by cuts to Medicare and Medicaid which is scaring the pants off of large hospitals and a large number of doctors, and rightfully so. What "most Americans" are asking the government to do is trade one, largely inefficient, fraught with the ability to de-fraud government bureaucracy, with another. The only difference would be this new government agency would be in direct competition with American business.
Please do not misunderstand - I am not a great fan of the American insurance industry, but I am fervent opponent to the American government intervening in business. I seriously thought we would have another round of "tea parties" when the President became the de-jure CEO of Government Motors, but that did not happen. Do we need some type of oversight on the insurance industry? I believe we do, especially with allegations of the industry trying to recover from bad investments by raising rates (particularly malpractice insurance rates). When they raise rates, it trickles down to the patients who have to pay more, which initiates the market forces of raising their rates. When rates reach the point where small business no longer can afford to supply their employees with any type of health coverage, then you have a problem - but not the one we are facing now. We will look later at the actual basis for this problem based on reports from Health and Human Services and the Census Bureau.
Later...
Alonso-Zaldivar, R., Werner, E. (2009, June) AP Interview: Sebelius says insurers won't succeed (June 16, 2009) Retrieved June 16, 2009 from http://news.yahoo.com/s/ap/us_sebelius_health_overhaul.
