If you are looking for something fun to read (and don’t have anything else to do) check out this blog post at http://agonist.org/ian_welsh/20080218/obama_and_health_care (The Agonist).  Here is an excerpt:

“I remain befuddled and bemused at the way Obama supporters seem to think their man is particularly progressive. He’s a centrist, who chose Joe Lieberman as his Senate mentor and whose voting record is not significantly different from Clinton’s, including on key issues like the occupation of Iraq. He has very effectively built up a large following, whom he will betray in 2009 and 2010 with triangulation to the right. If he does pass a health care bill, as Mike says, it will be a massive insurance company sell-out like the drug benefit.” 

So, Obama is a centrist?  This is the guy that wants to raise the top tax bracket to over 39% and raise Social Security withholding taxes on high wage earners.  According to the Wall Street Journal’s senior economic advisor, Stephen Moore (http://www.glennbeck.com/content/articles/article/196/6255/), upper end earners may end up paying over 50% of their income in Federal taxes (income, social security, and medicare).  Obama is the same guy that wants to sit down and talk to our enemies in the world, which would prop up those regime’s leaders.  I also think this is the same guy that wants to help people pay for college, pay bad credit card debt, make sure everyone is guarenteed health insurance, etc…. He just wants to help us all. 

If Obama is a centrist, we are all in trouble if a “left of center” person is ever elected President.

As most of you know today, an industry-wide investigation into the reimbursement practices of health insurers has been launched by New York Attorney General Andrew M. Cuomo.  From this, a threatened law suit is in play against Ingenix regarding Ingenix’s Usual and Customary database which it sells and most insurers use, to set reimbursement rates for out-of- network medical expense.  The AG described the U&C rates as “defective and manipulated.”

So, how could U&C be a problem in the commercial group health world?  Once a plan member goes out of network in some plans they will have the lesser of 80% of billed charges or U&C rates covered under the plan, but will pay higher premiums in exchange for the “right” to go out of network.  So, a $100 bill that is generated from an office visit to an out of network provider would lead to an $80 payout from the carrier to the provider leaving the plan member to pay $20.  Yet, if U&C takes the $100.00 bill down to $60 (being the lesser), then the patient could be on the hook to pay $40 instead of the $20.  In other words, the patient will be balanced billed.

The main problem with this potential suit to me is not if Ingenix’s data base of rates are perfect, but the fact that the AG of New York could be taking away a control mechanism for keeping medical costs down.  As usual, individuals in the government don’t completely understand how the system works, and that valid controls are in place.  Using U&C simply helps to control unfair billing.  The legal system will determine the validity of the U&C rates, but the concept is a good one.

On the other side of this of course is the fact that carriers need to represent correctly their plans and understand the states they are working in.  With so many laws and rules/regulations it is a challenge to keep up with them all.  So, I understand and agree that the AG has to defend the citizens against anything that is unfair.

Also, more than likely, Mr. Cuomo saw that attacking the insurance industry is good politics.  The last time this happened in New York the situation gave them a new governor, Mr. Spitzer.

Well, it is all set and the Presidential election is going to be John McCain vs. Hillary or Obama.  At this point it simply means the country is going to move left during the next 4 years.  Although McCain is a Republican, he is not a Reagan conservative.  Thus, with Hillary fully believing in socialism and Obama even more to the left of Hillary, we are almost guaranteed to move to a more liberal agenda.

McCain is a good man.  He has really served the country well in both the military and in the Senate.  However, he is really weak on domestic issues including important ones such as the security of the border.  However, foreign policy is strength for him.

A lot of the conservative talk shows are really bashing McCain, which I think is unwarranted.  I am not giving up my conservative ideas, but I will vote for McCain even though he is nowhere close to the benchmark of Ronald Reagan.  He is what he is, a slightly to the left of center Republican.  However, I do believe he will control spending and not support major new social programs.  Thus, he will be my candidate.  I hope other conservatives will at least choose the lesser of the evils instead of staying home on Election Day in November.

Well, I finally made up my mind.  Tomorrow in the Tennessee primary, I will cast my vote for Mitt Romney.  As I take my right and privilege to vote seriously, I studied all the candidates with great zeal.  In the end, my two choices were Mitt Romney and John McCain.

To be honest, I am not sure that either of these two gentleman are the best that America has to offer.  Yet, these are the only two that have a realistic chance of winning the Republican nomination.  Both have qualities that I admire, such as McCain’s military service and Romney’s executive experience.  Yet, I feel that Romney is a stronger conservative, at least in his rhetoric.

As for their positions on healthcare, I can’t say I am completely comfortable with either.  McCain seems to not really know that much about the subject and Romney’s plan in Massachusetts has had marginal success.  The good news is that both don’t desire government programs such as Hillary’s or Obama’s.

So, tomorrow night I will be kicked back in my chair watching the results role in.  At the least, it’s always fun to watch American politics in action.  If you want to share your thoughts on who you voted for and why, I would love to see your comments.

Hmm, this is one of those posts that I might see totally different in 6 months, but feel the need to get this one off my chest.  I keep hearing the media talk about how bad the economy is right now, or is expected to get in 2008.  Yet, I wonder how many of these talking heads on TV or people in general remember what a really bad economy looks like?

I am old enough to remember Jimmy Carter and his “Misery Index”.  I also remember my parent’s generation of the late 1970’s paying around 15% interest rate on a mortgage. During this same time period, a gallon of gas adjusted for inflation was still higher than it is today.  I also remember the feeling that America just could not do anything right and the Soviets were going to take us over.  The late 1970s and 1980-1982 resulted in some real economic down times.  The unemployment rate in 1982 peaked at 9.7% as a result of the Carter years. See http://www.bls.gov/cps/prev_yrs.htm

The “stock market crash” of 1987 hurt a lot of people, but it was the market correction that led to a major market boom. The 1990-1991 recession under George H. Bush was pretty mild as far as recessions go, but it was a recession.  The market does correct itself.  I bought my first house in 1990 with an interest rate of 10%.  I sure don’t miss the 10% rate, it was painful.

Yet, in 2006, the unemployment rate was 4.6% and around 5% in 2007.  When I went to college, this was considered full employment.  In other words, anyone that wanted a job had a job.  Home ownership is still at a high, and interest rates on mortgages are still incredibly low.  Sure gas is high, but as I said earlier it’s still not higher than in the early 1980’s adjusted for inflation. It may be true that the economy is in for a downturn.  We may even see a recession.  Yet, a recession is a necessary part of capitalism.  I guess the bottom could drop out one day and Chicken Little will have been right all along.  However, for goodness sake, let’s all keep in perspective that the economy is still in great shape overall.  Todays younger generations just have not seen a bad economy.  It will come, but is it now?  I don’t know, but I do know this.  The economy, according to my public education from high school, is basically sound.  We have a financial lending crisis going on, but not an overall economic downturn.  The GDP was 5% growth in the 3rd quarter and .5% in the 4th quarter of 2007.  Those numbers are not a recession.

Only time will tell, but I can tell you I will take 2007/early 2008 any day over the Jimmy Carter years and early 1980s.  We can thank Ronald Reagan, and a brave congress, for cutting taxes which saved us all at that time.

I have always wondered how I could be so differently wired politically than some of my best friends.  We make our livings in the same field (healthcare related), share similar hobbies, went to the same schools, etc…. but look at politics totally differently.

So, I was intrigued by seeing the following survey http://www.medpagetoday.com/PublicHealthPolicy/HealthPolicy/tb/8084 results of a telephone survey, a joint venture between the Harvard School of Public Health and the Kaiser Family Foundation, which was conducted from Nov. 1 through Nov. 11, 2007 and responses were statistically weighted to reflect the U.S. population. 

The researchers also considered data from 10 other recent surveys by national media polling organizations. Among the findings:

• 43% of Republicans approved of Bush’s handling of health care compared with 14% of Democrats
• 44% of Republicans rated the nation’s health care system as excellent, but only 20% of Democrats gave it those high marks
• 66% of Republicans are dissatisfied with the cost of health care in the U.S. compared with 89% of Democrats
• 58% of Republicans are satisfied with the quality of care in the U.S. but only 20% of Democrats feel that way

So, take a look at how differently Republicans and Democrats view healthcare.  For example, the survey found that 58% of Republicans are satisfied with the quality of care in the US.  Yet, only 20% of Democrats are satisfied.  So, are we all being treated by the same healthcare providers?  Maybe not when you account for age, education, income, etc… However, I would assume with some reason that we are seeing the same providers, both Democrats and Republicans.  Instead, I think politically, we are just wired differently.  We all bring our own experiences, biases, and backgrounds into the healthcare and political arena.  I don’t see how a 38% difference can be accounted for other than bias of being in favor of our healthcare system (Republicans) or not in favor (Democrats) long before any treatment occurs.

Another example from above is that only 44% of Republicans rate our U.S system as excellent.  I think that number should be higher, but there are improvements to be made for sure.  Yet, it seems amazing to me that only 20% of Democrats would rate our system as excellent.  So, again, I guess we are just wired differently???

As I knew would happen, the first of the year has brought a lot of travel.  Last week I posted about my trip to Philadelphia, which was a great trip, especially since I missed all the cold weather and snow in the Northeast.  

On Friday I returned from a trip to the Northwest, specifically the Seattle area.  As I understand is normal this time of year, it was cloudy and cold, but no snow.  As I always have time to think on long trips, and this was a long one in the air, I turned my attention to medicare and the structure of that program.  This was on my mind due to the client I was visiting.

My understanding is that Presidential candidate Dennis Kucinich is the only candidate that wants a true single payer system for healthcare in America.  The other candidates on the Democrat side want at least a government ran program as an option for the uninsured or for those that might choose it based on certain criteria.  It sure concerns me that any program like those proposed by Hillary Clinton or Obama might turn into a single payer system (meaning the government controls our healthcare).  For all the potential problems with a similar model proposed by Hillary, study the Tenncare mess that occurred in Tennessee.

However, getting back to Medicare, my “air time” brought me to the conclusion that we of course already have a single payer system in Medicare.  It just happens to be for a certain age range.  As I recall, Kucinich would like for Medicare to just be turned into the program for us all, a single payer  healthcare system.  Yet, the more I learn about Medicare and the government regulations via CMS; I know that we must create free enterprise and competition into our healthcare system, not government control.  So, I am studying all the candidates’ healthcare plans before I cast my primary vote on February 5^th.

I hate to keep picking on Joe Paduda’s blog and his thoughts, but here is another example of just how far off Joe can be on www.joepaduda.com. In his recent post, Joe states the following:

“I (and others) have long opined that HSAs are thinly-disguised tax breaks for the well-to-do. Touted as a solution to the growing number of the uninsured and cited as the plan of choice for the newly-insured, HSAs have been the darling of the conservative think-tank set.”

He also writes the following:

“The article notes that the “biggest beneficiaries” of health savings accounts “are proving to be well-to-do investors looking for another way to fund their retirement savings.”

My company offers an HSA plan to all of our Full –Time employees. As I have said on this blog before, a single employee only pays a net of $31 a month in premium, which of course is one of the benefits of the HSA. The trade off for lower premiums is that the policy holder has to pay a high deduction, $2,500 prior to any financial coverage kicking in for the calendar year. For example, every Jan 1 all of my employee’s deduction starts over and they must meet the $2,500 threshold before the plan kicks in paying on medical bills. They do receive PPO discounts on the first $2,500, but these are first dollars out of their pockets.

This is where the actual HSA account comes to play. Each of our employees holds a MasterCard and or checks to be used to pay for the $2,500 deductible. Thus, many of our employees get into a cycle to where they never have to pay out of their normal assets for medical care. Instead, they have saved money in the HSA account, (We, the employer deposit money in their HSA account along with the employee) to pay for their expenses. Once the $2,500 has been met, the insurance plan pays 100% of any medical expenses including pharmacy.

In reality the HSA plans are better than a traditional 80/20 plan. As a single employee, you know in our company that the most you will spend out of pocket in a year is $2,500. Under an 80/20 plan like so many have, a $30,000 hospital and related expenses bill will mean the employee would pay $6,000 out of pocket. The HSA is a better deal.

So, how can HSAs be a disguised tax break for the well to do? I have no idea. Our employees with health insurance range from employees that make below 20K a year to ones that do very well. I don’t know of any employee of our company that believes HSAs are for their retirement. Come on Joe, the HSA money is for medical expenses, not retirement. Real companies that have HSAs know they are a good deal for all.

As many of you know, I often disagree with Joe Paduda regarding his healthcare views. I don’t have to look far to find good examples of where I disagree with him. Below is a post from Joe on 01.03.2007 the day of the Iowa Caucus at, www.joepaduda.com

“Hillary’s strength - health care

Among Democrats polled in Iowa who are most concerned about health care, Hillary Clinton has a substantial lead (38% v 21% for Edwards and 18% for Obama). While health care is not the top issue (the economy is), it is for 24% of Iowa Democrats.

And it remains a big issue for the rest of America - a gut issue, one that keeps voters up at night, worried about coverage for their moms, dads, and kids. It bleeds over to the economy and jobs - with health insurance tied to employment, many middle-class voters are keenly aware that losing a job means losing health insurance. This is not an esoteric, remote intellectual issue - it is the neighbor who just lost her job, the “pennies for a cancer victim” tin can at the convenience store, the parent too young for Medicare and too wealthy for Medicaid.

With the Iowa race wide open, the gut issue of health care could be a deciding factor.

The caucus environment is one where neighbors talk to neighbors about issues that concern them, and about which candidate is best suited to fix that problem. Yes, Hillary Clinton has her share of detractors, but many are undecided and Hillary owns health care. And that may just make the difference for her in Iowa.”

The results of the Iowa Caucus are in, and Hillary came in THIRD. If healthcare is owned by Hillary, as Joe states, then democrat voters in Iowa must not be as interested in the topic as Joe believes. Yes, polls indicate it is an important issue. Yet, they also have indicated for some time that the economy is very important as Joe states, despite what is still a great economy in the US. Voters will ultimately decide who our next President will be, but don’t be so sure that Hillary owns healthcare. She nearly socialized our system in 1993/1994 and I don’t know that voters have forgotten.

What does global warming and healthcare have in common? It would seem not much on the surface. Yet, when it is examined more closely there are many connections. Let’s examine one of the most important to me, which is the political outlook of both the global warming enthusiast and the person that wants universal healthcare. Now, to set the stage further, I am not talking about your average guy on the street that thinks we need universal healthcare and also believes we should take care of the environment. No, I am talking about the Al Gore types that are extreme alarmist (Healthcare and Global Warming) who assume mankind is bad, heartless, and uncaring toward our planet and fellow man. Oh yea, let’s not forget they tend to be political types that believe they know better than the rest of us, which is the ultimate connection between them and global warming/healthcare.

I am a conservative, not Republican or Democrat. But, something funny happens in the debate on healthcare and global warming, extremist on both topics seem to be Democrat party supporters and liberal, not Republican. These extremist are convinced that Global Warming must be caused by people. Why, well because it can’t be a natural cycle of the earth they reason, it must instead be caused by people. Reagan optimism in people is not something they posses. They also believe that we as American’s are heartless because we don’t’ provide healthcare to all of our citizens. The problem I have is that liberals, and some democrats, have high jacked these two topics for political gain. As I said above, these people simply believe they know better than the rest of us. Unfortunately, they gain political power from both of these topics, Global Warming and Universal Healthcare, and thus have a stage to influence us all.

For example, Al Gore has been an advocate of Global warming caused by man. Yet, his personal life has contributed more to carbon emissions than most of us will ever contribute. He also says the debate is over, attempting to make everyone who disagrees seem unknowing and ignorant. Yet, good ole Al is the ignorant one on top of being a hypocrite. In his movie An Inconvenient Truth, he fails to tell everyone that Carbon emissions over history only go up AFTER the temperature has risen (usually by several hundred years). For me, that simply blows every explanation this crowd has of global warming. Instead, it is a natural cycle of the earth. Is it getting warmer, sure, it seems that is true. But, it is not caused by human activity, in my opinion. Most of the warming in the twentieth century occurred in the early part, prior to the 1940s. Check out the 10 biggest myths of global warming.

What about a healthcare example? Well, look no further than Michael Moore. In Sicko he tries to tell us how wonderful the Cuban healthcare system is for their people. Do you want to go to Cuba for healthcare? I kind of doubt it. Yet, Mr. Moore has political clout and would rather trust his fellow American’s healthcare, in my opinion, to the government instead of to people’s choices. Again, healthcare high jacked as a topic to advance his liberal extreme political beliefs. So, let’s debate both topics in our society, Universal Healthcare and Global Warming. However, let’s not let the extremist highjack these topics for political gain. Americans as a whole are very smart when they have the facts, not when the media presents biased one sided arguments to the public such as Gore’s Inconvenient Truth. At least in Great Briton a high judge had the sense to point out the inaccuracies in the documentary. I wish we had public officials with the same guts in America. If you have kids, ask them if they saw An Inconvenient Truth in school, mine had no choice but to watch it.