Affordable Healthcare and the related search for Aliens, Munchkins and Utopia

I just heard someone on the radio defend the new Healthcare Mandate by citing how efficient the post office is running. Huh???

The USPS is hemorrhaging money these days but to be fair, it wasn't that long ago (early 2000's) that they in fact WERE generating a net gain. That is of course until Congress did something unusually sensible during the Bush Administration (2006).  They started requiring the the USPS to pay 5.5 billion per year into an account to fund their future retirees' healthcare 75 years in advance. This quickly converted their net profits into net losses. Actually, they should have been funding them all along.  This tells me that the USPS was perhaps fibbing on its books or at least finding creative ways to leave certain things off of the liabilties column on their balance sheet. This is a huge no-no.  Even if you can disregard it legally it is highly unethical and self-destructive.  Paid employee benefits even if in the future are considered liabilities. Did they not report those in order to allow what would have been the offsetting asset values to be moved over into the revenue pile?  If they did report it, how did they offset them on the balance sheet with assets while showing a profit?  I thought the government REALLY hating "book-cooking" a la Enron.

Accountant friends, chime in here and help me out if I am incorrect on this.

It must be because of their big, mean CEO that makes $800,000 a year while the average CEO in this country makes about $145,000.  Ok that wasn't necessary but it doesn't hurt pointing that out.

Anyway, the comment was in lieu of a debate on the The Affordable Healthcare Act.

The problem I am seeing is I'm not exactly sure what is "affordable" about it.

Admit it - you could care less about making health care more affordable, you just want someone else to pay for it for you.  Kids being allowed to stay on their parents policy until they are 26? Sure - that won't drive the price of their parents policy up.

Before your blood pressure spikes, allow me to explain based on tangible reality....

The new Affordable Healthcare Act is going to force both public (Medicaid) and private insurers to cover the costs of preventative health care maintenance such as obesity counseling and smoking cessation programs.  When Obama says that investing in preventative health measures will lead to overall lower costs of health care for the masses, in theory, he'd be correct - if the plan would actually work.

Just like a politician, he has discounted the element of Human Nature and how it will ultimately neutralize these efforts.  Human nature, which is genetically and evolutionally hard-wired into each and every one of us, brings out the best in some while bringing out the worst in others.  Now I believe his intentions of getting American healthy are noble and decent but I can't insult his intelligence by suggesting he actually "believes" this will work.

Here is a scary thought.  1 in 3 Americans are overweight now. That's 100,000,000 of our roughly 300,000,000 citizens.  Let's just say only half of them agree to the counseling. Let's also pretend that these counselors don't take advantage of the suddenly bullish job market in their favor created by the government and don't charge anything astronomical for their services. Let's say maybe $1000 for a year's worth of therapy. This equates to $50,000,000,000. And of that number, how many of those people will succeed? If all 100,000,000 people decided to jump on the service and were charged maybe $5000 per year, this is now half of a trillion dollars for ONE YEAR. Where will they get that money? eBay? Oh that's right, China again - the holding bank of the National Credit Card!  Then of course there are the other preventative counseling services for other ailments and conditions and there are plenty of unhealthy people that will require more than one.

Keep this in mind; obese people know how to lose weight. Smokers know how to quit smoking.  They just don't want to. And quite frankly, if they are happy living this way, I say let them as long as it doesn't cost me any money.

Ah, but wait... it does.

Roughly 18,000,000 more Americans will qualify for Medicaid under this new Act.   Medicaid is known for only paying about half of what they owe to healthcare providers. This new windfall of patients with lousy coverage will lead to greater losses by the providers as they get stiffed.  This in turn leaves the providers with limited options of which to make up for the lost revenue.  They will have to either deny Medicaid patients all together OR start raising what they charge for services in order to compensate for their shortfalls.  (Kind of like when you wanted that 1:00 AM curfew so you asked for 4:00 AM and negotiated down.) They will in turn charge the private insurance company more which will in turn cause them to raise their rates. This and of course dropping some people which I still don't see how the government can stop them from doing that. If they force them by law, they are literally forcing a business to sell a service to someone at a tremendous loss. When this goes uncorrected with not enough positive net cash with which to offset it, it can cause insolvency with some insurers which only takes a few years at the most to completely shut some of them down.  Then what? Oops!

Adding these extra people to Medicaid is moronic because it doesn't take 18,000,000 poor people that were ineligible for it before, but rather it takes 18,000,000 people that didn't need it in the first place.  Some are just irresponsible young people that choose to pocket the $100 per month and party with the money instead. By the way, yes, catastrophic insurance is about $100 a month or less. It's not expensive.  Get it with the big deductible and a very basic Rx plan and you can pull it off. I've done it. If you catch a cold you'll have to get some Afrin and wait it out. If you break bones in a car crash, you're covered. You'll get by I promise. 

People never seem to look at the big picture and think things through. (Human nature at it again).  Once people are happy about how something affects them, they stop caring about everyone else.  If the government forced your employer to give everyone a 50% raise, you'd think it is good thing because it benefits you.  This despite the added that costs could literally drive them into bankruptcy or at least to the point where you and some others could lose your jobs. Now what?

Remember that health CARE and health COVERAGE are two different things. And people like to say you are entitled to one or the other or both. I say you can declare yourself entitled to anything you'd like provided it doesn't also include you being entitled to someone else's money or making someone pay for your stuff.  If you get in a car crash and get rushed to the emergency room, you will get care. That is protected not only by law but a doctor's Hypocratic oath. You will however be stuck with a bill you have to pay if you don't have the insurance coverage to do so.  If it was the other driver's fault, he can pay. If it was yours, hey - be grateful that some people came to your rescue, put you back together and you're alive now. You couldn't do it on your own now could you?  And don't ask the doctors to do this for free considering they give up about 12 years of their life to education and start working with well over $100,000 in debt. They have to feed, clothe and shelter their families just like you do.

There are two primary reasons our health insurance is so expensive:

1) I say this at the risk of insulting my lawyer friends but LAWYERS (well, some of them). For every lawyer that is doing something frivolous, there is one fighting them and I thank God for their efforts. But the dark-side of the legal profession drives costs up with law suit after law suit keeping doctors, hospitals and drug companies tied up in expensive legal battles and then some of these same lawyers eventually get into public office and continue their assault - only with greater firepower. This is scary. I appreciate a good lawyer but why so many in Washington? What about economists? What about financial experts or accountants or even MBAs?

2) It should be.  We abuse it and expect them to pay for everything. You want them to pick up the tab on prescription DKNY glasses.  You want to go on prescription anti-depressants because your cat died  You want your high blood pressure medication paid for even though you eat fast food every day and smoke a pack of cigarettes.  The more they are going to cover, the more you are going to pay for your premiums.  When the insurance company pays for something, you add a third-party payer into the mix.   When you create a third-party payer, costs go up. People will be frugal with his or her own money but not someone else's.

When you take your dog in for an MRI and pay $250 dollars for it, it is the exact same machine as the one hospitals charge us $3000 to sit in for 30 minutes. Why is this the case? Because it is a single-payer system that comes out-of-pocket.  The veterinary industry has has done its price-optimum homework and have calculated that if it is much higher than what they charge, then the out-of-pocket payers won't even bother with the service and they will make nothing.  The medical industry knows that with a 3rd party payer, they CAN in fact charge as much as they do. This is THEIR optimum price.  And this cost issue is worsened when your insurance refuses to pay for your MRI when you truly need one. I suffered through this personally for almost 20 years before I was finally approved for one.

The only thing that will drive costs down are when people have to pay more out of pocket. Consumer mentality kicks in and people begin to shop around for better deals and make wiser purchasing decisions.  Perhaps make some lifestyle choices like eating healthier and exercises and maybe "dealing" with a broken heart sans the medication. This in turns forces the providers to become more competitive with one another.  This is not a panacea for everything. Illnesses and accidents will still occur but it will be more manageable if not abused by the consumer driving costs back up. And the greatest part? With some leftover money we can legitimately insure those that really need the help - those that are trying their best but still can't make ends meet and have health issues they are unable to manage on their own. See? I do care. I just don't like being taken advantage of.

This will never happen though. Main reason is because who'd like to go first? Will someone step up and say "I'm not going to use my Rx card to pay for my prescription? No. I challenge Washington to step up and think of creative ways to encourage people to start driving the costs back DOWN.  Reward good decisions and let those who do not learn the hard way. THEN we can help them out.  People have to be allowed to make mistakes. They don't have to be fatal ones - just harsh enough to drive the lesson home.

Promoting tough-love is not a realistic task for most career politicians though.  It may in fact be career suicide trying to promote this behavior.  Telling someone you're not going to take care of them anymore nor give them someone else's money is just not in their language. Politicians can't say "no" to anyone. 

Suggestions for how the GOP can stop sucking at elections

     As the GOP begins to get on with its life after another tough loss and begins to "soul search" as the media so likes to call it, there are some very simple quick-fix changes that would benefit the party by as early as 2016 if their leadership could set aside its stubbornness and accept the new reality. 

     First, accept the fact that America as a majority does not like us right now.  It is now considered mainstream and socially acceptable to do so.  We are expected to be tolerant of others' opinions while they are not expected to be tolerant of ours.  And the more we whine about it, the worse it will get.  Bite your tongue and take the high road and realize that we have a destroyed image that we need to address first and foremost.  It will not happen overnight but by focusing on the key elements, it will happen eventually. 

     Second, stop arguing on "WHO" or "WHAT" is the definition of a "true conservative".  Conservatism is based very simply on "personal responsibility".  All other principles are rooted from that. It is not a race, a religion, a gender, an income level, a region of the country nor a sexual orientation. Those are just examples of our diversity. Yes, I said "diversity". We have it too.  We have women, African Americans, Latinos, homosexuals and other minorities on our leadership teams.  Just because we find it inappropriate to parade them around as trophies of social acceptance, it does not need we should bypass the opportunity to make them known to the outside.  They are on our team so let's use it as a basis for unity and not segregation. 

     Third, gay marriage. Leave it the heck alone. Some of us are fine with it like myself and others are not.  Personal opinion is where it should remain.  You don't have to all agree but it's not your life. It's someone else's.  When someone asks your opinion, simply say "It's none of the government's business" or better yet, "I think the government should get out of the marriage business." Marriage is an institution that is dictated freely by different religions.  If a church wants to recognize same sex marriage, the government's stance should be irrelevant. 

     Next, start readdressing the Latino population and the fact that you recently pissed off the largest minority in the United States with your attempts to make immigration the number one hot topic in the last election. It's not. There is a concept called "prioritization" that I suggest you review the definition of a few times. Immigration is not the #1 problem in this country and those that sneak across the U.S. / Mexico border are far from a statistically bad group of people no matter how hard some try to paint them as hardened criminals for trying to escape Mexico's economy for a better life in ours.  

     Next is abortion. You can't change this from your pulpit.  If Roe v. Wade ever changes it will have to be a non-partisan grassroots effort but the moment you take a side from the perspective of your party, you lose at least 50% of the vote.  Stay out of it.  But if you are absolutely compelled to take a public stance, use my answer which just so happens to be accurate: "I personally hate abortion but at the same time understand that sometimes it is the lesser of two evils when certain conditions exist such as the mother being the victim of rape or if their is a major risk to her life in carrying to term." 

      And stop treating liberals like they are horrible people.  When you do, you strengthen their resolve and make the walls of communication that much more difficult to penetrate.  Liberalism is founded by the notion that seeing one person struggling while others are affluent upsets them.  This is a noble attribute that stems from human decency.  This is also compounded by the fact that we are all emotional creatures that when faced with stresses, we seek the path of least resistance in order to remove the source of that stress. We're not pre-wired to care about the financial aspects involved or perhaps why that stress is there in the first place.  It takes too long to think that through and it fails to satisfy our basic human need to find what upsets us and make it go away now.  They are not stupid.  Just probably a little nicer than we are and don't necessarily believe in using "tough love" on someone in order to motivate them to do better.  In a variation of the proverb, we prefer to teach someone to fish while they choose to simply give them a fish (or someone else's fish). They care about people too, just not the same way. 

      And stop getting pushed back on your heels and start swinging.  Democrats have the courage to aggressively defend their convictions and we have a tendency to be their punching bags.  Remember, the best defense is a strong offense.  They take jabs at us so throw some back for a change.  Here is some ammunition backed by the U.S. Census; Democrats statistically have higher salaries than Republicans, donate less money and time to charitable causes and actually have a slightly lower effective tax rate. How they pull that off I still don't exactly understand.  But they have hidden this fact for decades by going on the offense and accusing us of being rich, cheap and uncharitable.  Oh, and regions that tend to lean Democrat also have higher crime and pollution rates.  I'm just pointing out a statistic. If you choose not to use it against your opponent than he will most certainly use it against you.  And while we're at it, don't hesitate to point out that a Republican pushed for the 13th Amendment abolishing slavery while the Democrats in the South lobbied for Jim Crow laws and built up the Ku Klux Klan. FDR had former Klansmen in his administration including his successor, Harry Truman. The Republican party supported the Civil Rights Act of 1964 by margins in the 80's percentile range while Democrats were down in the 60's. Ronald Reagan signed Martin Luther King Day into law at the same time the Democratic Senate MInority leader, Robert Byrd was a former Klansman. And lastly, George W. Bush had more black Americans on his staff than any other president including Obama today. Quote me on these facts the next time a Democrat quotes Kanye West. 

     In closing, Mitt Romney is good human being with nice family and an impeccable resumé.  Nobody bats .1000 in the business world and occasionally, painful decisions must to be made in order to make room for a higher proportion of good ones.  He may or may not have done a fine job as president but sadly, a majority of people in this country wanted to hate him so much that they fabricated facts and repeated them among their constituents so many times until people began to believe them as gospel.  It's not his fault that he looks like the stereotypical tycoon as painted by his detractors.  But selling someone like that to over 50% of the American voter is a P.R. nightmare.  We have become a pop-culture society to selects leaders based on a perception of coolness regardless as to whether or not that person has any degree of competency.  So it is OK to drape your jacket over a chair, loosen your tie and go casual from time to time.  Stop being so stuffy at your local meetings.  These are stupid rules I agree but the era of the "statesman" is over. 

      Fortunately for us, presidential performance is dictated more so by the people he or she surrounds themselves with and less by his or her immediate qualifications.  Let's face it.  Most presidents have no military experience.  Yet they become in a sense the CEO of the military once elected by default.  Nobody is expecting he or she to make extremely difficult life and death military decisions alone.  That is what their top military advisors and decorated experts on their team are for.  The president makes most  if not all decisions based on a committee of his or her different leadership panels.  Everything else is just a good sales pitch made to the American voters in order to keep him or her in that position to select those teams that make those decisions.  This requires salesmanship in being a good speaker and knowing how to address your target audience. Democrats are exceptional at this.  Republicans are not.  Republicans have been trying to force more people into their predetermined market segment against their will and this never works.  If you guys try to use the angle that our society should function like a business then you need to back track and Google some articles on basic marketing.  The majority in power gets the set the rules and you can either learn to play by the rules of engagement or lose.  It really IS that simple.