Monday, March 19, 2012

Government healthcare and questions of moral behavior

Who said this?

"We go to a young girl, who’s now 18 or 16 or even younger and this is what we say, 'abandon all of your hopes, your schools will not teach you, you will not learn to read or write, you will never have a decent job, you will live in the neighborhoods of endless unemployment and poverty with drugs and violence,' but then we say to this child, 'wait, there is a way, one way, you can be somebody to someone, that will give you an apartment and furniture to fill it; we will give you a TV set, and telephone, we will give you clothing and cheap food and free medical care and some spending money besides, and in turn you only have to do one thing, that is go out there and have a baby.'”[1]

Before I tell you who said it, let me tell you why I quoted it. 

In my most previous email I mentioned that American cultural dissolution plays a critical role in our frustrations attempting to redesign U.S. healthcare. My argument is that the way people live will, to a great extent, determine how much money we will be required to provide for their medical care. In this context, I mentioned the exploding ratio of children born to single mothers, and asserted it is and will be a major contributor to runaway healthcare spending.

A reader took me to task. He argued that writing about what are “private behaviors” is futile. Government cannot impose its morals on individuals who choose to give birth outside of marriage. I counter by asserting that our massive welfare support systems incent single parentage, and directly contributes to out of control healthcare spending. By deciding to generously provide “free” healthcare we encourage the behavior that drives use of the healthcare system. Ergo, public policy is imposing a set of morals on individuals, but in this case, the moral behavior is sexual intercourse outside of marriage.

Senator Ted Kennedy, D- Mass,  saw this in 1978 when he uttered the words quoted above. Kennedy, one of the most liberal members of Congress, in whose name Pres. Obama urged passage of the Affordable Care Act, knew that our welfare programs encouraged births out of wedlock. Furthermore, he acknowledged its deleterious effects on the single mother, and on society.

Take issue with me, if you will, but you take issue with reality (and I appreciate Kennedy’s support in this). Individual choices drive a good portion of healthcare spending, and this includes the choice of single parentage. Fact.

Knowing this as fact and doing something about it are two different things. Congress and our Presidents made decisions years ago that we would financially support any and all behavior. Thereby, Congress imposed a type of amorality on us which is, of course, the “new morality.” Right now, we have to deal with the consequences of this new morality.

What to do? Well, if you love the ACA and the Congress that passed it, you will love their solution.
Classifying sterilization as preventive care should excite you; this is one of ObamaCare’s solutions. So are the Independent Payment Advisory Boards (IPAB) which will decide whether to pay physicians and hospitals for various medical procedures – called rationing. 

Sterilization is the ultimate contraception (but causative for HPV, STDs, and HIV). Rationing is the ultimate choice for a government that condones all behaviors. 

Truly, we reap what we sow.   

[1] Ferrara, P. (2010) America’s Ticking Bankruptcy Bomb. Citing Robert Carleson in Government is the Problem: Memoirs of Ronald Reagan’s Welfare Reformer. Harper Collins, New York. P 150.

Thursday, March 8, 2012

The end of America? Healthcare is but one issue

In a way I felt badly for my listeners. They had to confront some very hard facts about our great country that go far beyond, but include the provision of and payment for healthcare.

The United States is in trouble – deep and serious trouble. This is what I said to the professional health insurance agents in Peoria, Illinois on March 6. Then I laid out overwhelming statistics about state and federal spending, the increase in the national debt (in dollars and as a percentage of the Gross Domestic Product), and most appallingly, the total unfunded debts and liabilities of American government. And I talked about cultural and moral decline.

Please, don’t stop reading. This is a vitally important message.

Dr. Larry Kotlikoff, a Boston University economics professor, totals the U.S. unfunded liabilities at $211 Trillion - $676,000 for every U.S. resident currently counted by the U.S. Census Bureau. These are funds that must be spent if we are to maintain the programs currently on the books. But that spending will never happen because it cannot happen. It cannot happen because we will be bankrupt before it can happen.

According to Peter Ferrara, in his must-read tome, America’s Ticking Bankruptcy Bomb, the U.S. public debt ratio to GPS will be 107 percent by the end of 2012. It will quickly climb thereafter to a level exceeding that which is destroying Greece today. If there is no sharp change in U.S. spending, it will lead to a world economic collapse.

I know, I know, these are harsh words and hard to read; not at all uplifting. Now, however, is time for sobriety and seriousness. Frankly, I wish I could give this same talk to all Americans. Maybe I could do it as a webinar. It is an urgent talk, a vital talk.

But there is more.

The U.S. at its root is not about money: it’s about ideas upon which we have built a great nation of free people, an exceptional nation in every way. One of our foundational ideas is moral integrity.

“We do not have money problems,” Alan Keyes often said during his 1996 presidential campaign. “We have moral problems.” The moral problems are directly related to how and why we spend money, as individuals, families, and governments. How we spend money on healthcare is directly related to our moral dilemma.

What I am about to write is likely to cost me some readers, because some people do not want to deal with these disturbing trends. Each of them, and far more, contributes to our cultural, moral, and financial decline.

Recently, a British bio-ethicist opined that a newborn baby should be treated the same as an unborn child – only he uses the “scientific” term, fetus. This “ethicist” believes that abortion law should apply to newborn babies – meaning parents should be free to kill the unwanted infant, just as they are able to do with babies still in the womb. Dr. Peter Singer, of Dartmouth, made the same observation years ago.

Dr. Zeke Emmanuel, former adviser to President Obama on healthcare reform and brother to Chicago Mayor Rahm Emmanuel, believes we spend too much on healthcare for certain populations. In a 2010 Lancet article, Emmanuel and his co-authors suggested that we should reduce spending for children younger than about five, and adults older than about 62. He believes we should focus healthcare spending on others, healthier people with more life expectancy. Who should decide? Under ObamaCare, the Independent Payment Advisory Board, and others of the new federal MediCrats who know better than you, or me, or pastors, priests, rabbis, and Imams. 

An 18-month old girl toddler declared one day, “I am a boy.” As a result, her parents are raising her as a boy, and intend to treat her with hormones to delay the onset of puberty. By age 17 or 18, the parents reason, the girl can choose to be a boy for life, and undergo transsexual surgery. The story is told in the context of an article about an emerging pediatric practice, whereby children are choosing to live as genders different from the one God created (oh, of course, they do not see that God has a role to play a role in these issues).

Parents of children with gender confusion hope that health insurance will pay for their children’s treatment as preventive care.

Lastly, is the latest report on children born out of wedlock – excuse the old-fashioned term. If you wish, I can just say “born to single mothers.” These statistics should set off alarms for the social cost awaiting our country, none of which figure into Dr. Kotlikoff’s calculations.

According to the National Institutes of Health, 29 percent of Caucasian babies are born to single moms. As bad as this sounds, 53 percent of Hispanic babies are born to single moms; the number for African-American babies soars to 73 percent. Even during slavery, as Alan Keyes points out in Masters of the Dream, only 15 percent of African-American babies were born into families without a father present. 

We must integrate the underlying facts about our country’s financial and cultural demise with every decision we make about the future of U.S. healthcare. To pretend these are not relevant is to self-destruct.

The root cause and the real solution are the same: personal moral responsibility. A remnant still has it, but society in general seems to be tossing it aside. 

We will keep fighting for healthcare consumerism, a reduction in wasteful healthcare spending, doctor-patient relationships, healthier bodies, and all such pursuits. But, the one pursuit that overrides all this is that of moral character, at a far higher level than is apparent today.

In 2012, we can get started on one aspect of saving America; elect people of moral integrity to office, and throw the others out the door.

Wednesday, February 29, 2012

Go ahead, Try to make a wise prediction. Can't happen.

Predictability. Stability. These are two critical keys to success for any family, business, or government. Neither exist in our present day politics or economy.

Who among us can predict our health care or economic future? Not one of us. All we can do is guess, and guessing is the wrong way to build anything that will last.

The Good Book asks the question, “What person who is about to build a tower doesn’t first sit down and count the cost?” But how can anyone count the cost when the rules change almost daily?

A Washington Post article promoted the idea that President Obama might be open to giving states flexibility on Medicaid mandates. He might even grant states some leeway in the implementation of health benefit insurance exchanges. The test? Any flexible plans must meet the intent of the ACA? What does that mean? What flexibility? What, pray tell, is the intent of the ACA?

The Secretary of Health and Human Services has been woefully lax in issuing ObamaCare rules, and now President Obama suggests the rules that are not yet rules may change – if the federal government deems that states mean to do what the Affordable Care Act requires; as if anyone can figure out exactly what that means.

We await the ruling of the Supreme Court about the ACA. Will it overturn all of it, just the mandate, or let it stand? Which is worse?
 If it lets the ACA stand, then we face years of rules that are not rules, waivers that are not waivers, and endless political bickering. If the Court overturns the individual mandate, and lets everything else stand, we face the end of insurance companies (some would cheer this, but not stockholders). If the Court overturns everything, we face chaos.

Right now, today, someone somewhere is creating the next miracle medical device, discovering a new surgical procedure, harnessing some unknown element of creation that will revolutionize medical care. Why would anyone invest in the entrepreneur’s idea, when the investor knows that the rules will change?

Right now, today, banks and venture capitalists are pondering how to grow their money. The safest bet is not to bet on stability and predictability, because there is none. Keep the money in the vaults until America decides who and what it is. Speculate on the stock market, but avoid new ventures. For certain, keep your money far from Solyndra projects, because when the clouds carrying financial collapse produce economic thunderstorms, and America is caught up in a flood of bankruptcies, no one will worry about green energy. 

Or, maybe the rules will change and none of this will happen.

The greatest damage President Obama has done to America is to leave us without any sense of stability, or ability to predict with some rational certainty, where we are headed. On the other hand, it is possible to rationally predict that we are headed for a financial disaster. 

One other prediction: The election of 2012 will determine our survival as a nation of free people. That prediction you can take to the bank.

Wednesday, February 15, 2012

Health Care Threatens Your Liberty

Take a few minutes to view this YouTube speech. It's one I gave to the Association of American Physicians and Surgeons, on January 20, 2012, at a Las Vegas meeting.

Wednesday, August 3, 2011

Private behavior has a public cost: We all will spend more

Cigarette smokers have taught us that private behavior has a great public cost. Governments have no problem imputing large taxes on smokers and shaming them through tax-supported public service announcements. When it comes to smoking, we get it. But, when it comes to sex, not so much.

“Don’t impose your morals on me,” is the common cry of not just libertines, but all of us. The idea here is that private behavior is private and, as long as it does not affect others, people should be left to their own wills. This worked well when society expected people to exercise personal restraint. It was enough that public consensus kept people in line; few government sanctions were necessary. Healthcare reform, however, is exposing flaws in that argument as it applies today.

The Federal Secretary of Health and Human Services, under the authority granted by the Affordable Care Act of 2010 (ACA), recently issued eight mandates on private health insurance. The Secretary’s order means that in the future, health insurance must pay 100 percent of the cost of preventive care for these eight mandated categories. At least five of these mandates are directly related to sexual promiscuity. We will all pay the cost in higher insurance premiums.

Specifically, the new Federal guidelines require that all Health Insurance policies must cover preventive care for these five behavior-oriented conditions:   
  • Human papillomavirus (HPV) DNA testing for women 30 years and older;
  •  Sexually-transmitted infection counseling;          
  • Human immunodeficiency virus (HIV) screening and counseling;  
  • FDA-approved contraception methods and contraceptive counseling; 
  •  Domestic violence screening and counseling.

Before moving on, read the list again. It is true, of course, that even the most careful, pious person or monogamous married couple could conceivably suffer from one or more of these conditions: but the incidence of such is certainly low enough not to allow a federal official to order preventive healthcare payments for medical tests related to these behaviors.
HPV, STDs, and HIV, for the most part, are diseases resulting from promiscuous sexual behavior. American society has, for the most part, considered medicinal contraception acceptable, although tens of millions reject it on religious grounds. No one that I know of considers domestic violence acceptable behavior; about this, society continues to impose moral and legal strictures.
Physicians are expected to withhold moral judgment while deciding whether to treat an individual. No matter the cause, a hurting or ill person needs medical attention. The man infected with HIV or AIDS should get medical care. The woman suffering from STDs or cervical cancer should get medical care. Despite potential medical, emotional, and psychological dangers, we do not withhold medicinal contraceptives from single or married women who desire to prevent pregnancy. We tolerate cohabitating partners as a price we pay to keep government out of private lives (and we celebrate it in our popular culture). These all come with a price tag, and now, the Secretary has increased it for everyone.
You see, there really is a financial cost to all of us for not embracing the “old” morality, the morality that reserved sexual intimacy for marriage between a man and woman. We have fallen so far from this higher moral standard that today, a Federal official orders that everyone must pay more just to screen for diseases that naturally follow promiscuous behavior.
“We cannot put enough policemen on the street if there is no policeman in the heart,” to paraphrase Alan Keyes, who has sent this on numerous occasions. Public morality flows from private morality, and a lack of it costs all of us.
We do not want government to impose morals on us, but we should not want government to order us to pay for the results of immorality.

Wednesday, June 29, 2011

“Mandatory Life Insurance,” Cries California Congress Person

Perfect Match for Health Insurance Exchanges

BROADMOOR, CA. June 29, 2011: “Tomorrow I plan to introduce the Affordable Life Insurance Empowerment Act in Congress,” said Arly Esperson, Congressperson from California’s 54th Congressional District. “Now that the Sixth Circuit Court of Appeals has ruled the health insurance mandate is constitutional, I think it’s time we take the next step.”

Today, a three-judge federal appeals court in the Sixth District upheld the cornerstone of the Affordable Care Act of 2010. “The progressives in Congress wanted to be sure the court upheld the mandate before we started moving ahead with the rest of our agenda,” Esperson explained. Esperson spoke about the controversial ACA provision known as the individual mandate that will require every American resident to enroll in a health insurance plan by 2014.

Progressives breathed  a sigh of relief over the decision, Esperson said. Esperson leads the Latte Party Caucus in Congress, a group of lawmakers who believe government needs to do more for “working people. And that’s why I am moving ahead with this new bill.”

The Affordable Life Insurance Empowerment Act (ALIE), Esperson explained, would require all United States’ residents to purchase a minimum of $10,000 in what Esperson called “lifetime coverage.” Ron Kelly, a spokesman for New Mexico Life Insurance clarified the term: “Esperson means whole life or cash value insurance, and it lasts a lifetime, or, well, until death.”

Esperson’s bill would go farther and require everyone older than 35 to own a minimum of $250,000 in term life insurance in addition to the $10,000 whole life policy.  “This will do several things for working people,” Esperson explained. “First, there will be money for burial cost. Second, it will help settle estates. And third, and just as important, the federal tax of 25 percent on the death benefit will help to reduce the national debt.”

ALIE overcomes two hurdles that might otherwise doom the bill: premium cost for low-income people, and accessibility coverage. 

First, Esperson explained that low-income people – the threshold is set at family income of less than $50,000 a year – will receive help paying their mandatory life insurance premiums. “America’s richest individuals often use life insurance to dodge paying estate taxes,” Esperson said. “We will levy a 35 percent tax on the life insurance proceeds of all plans that exceed $500,000.” In this manner, “we will make sure the rich pay their fair share.”

Second, Esperson plans to fold enrollment in mandatory life insurance plans in the Health Insurance Exchanges required by the ACA. “Hey, every state must have the Exchanges, and it would be nothing for Exchange enrollers to fill out life insurance applications.” 

Under ALIE, insurance companies will have to issue life insurance to anyone, regardless of their medical condition or age. “That’s why we mandate ownership,” Esperson explained, “to eliminate cherry picking of insured people, as the life insurance companies do now.”

The other ALIE key feature will help keep the premiums low for everyone, according to Esperson. “We will limit the premium rates on a three to one ratio, so that the younger people will not get stuck paying too high of premiums.” People under 33, according to ALIE, would pay one-third as much as people older than 65.

“This is the perfect adjunct to the Affordable Care Act,” Esperson said. “For the first time in our nation’s history, everyone will have health and life insurance.”

President Obama has remained silent on ALIE.

Saturday, June 18, 2011

We elected Sue Johnson as President proving girls can govern

Cong. Michelle Bachmann
Michelle Bachmann wants to be President of the United States. She’s a girl. I can attest to this because I have met her personally. You can take my word for it.

But can a girl win the presidency? Yes, and on this you can also take my word for it.

In 1961, Sue Johnson defeated me, Dave Racer, for the Presidency of Dr. James Phillips’ Ninth Grade Core Class. Sue served admirably. I think I became secretary of something.

Alright, running a Ninth Grade class isn’t exactly like being The Most Powerful Leader in the World. I grant you that.

But what makes a good U.S. President? It depends on the times and the challenges.

For my money, the next president have a demonstrable record of commitment to solid principles of faith, family, thrift, limited government, and understand that we are going broke. In my family, it’s the girl that worries most about budget – and not overspending.

Okay. I am convinced that Michelle Bachmann is qualified to be President of the United States for the times in which we live. She may not be the only candidate so qualified, but she is the Real Thing.
In fact, I am willing to say it straight: If any one of the GOP boys want to be President, they should quickly adopt Bachmann’s convictions. I’m pretty sure that Mitt Romney can’t do it, and I wonder about Newt Gingrich. Ron Paul has convictions, but not for these times (he is either two centuries too late or 10 years too soon).

I see Tim Pawlenty, my governor, as an enigma. This is because I am not a pragmatist, and because I am an idealist. Pawlenty governed exceptionally well, but faced a Democrat legislature most of the time. Pawlenty also had to deal with Minnesota’s GOP “conservatives,” many  of whom are to the left of a Missouri Democrat. Clearly, he can do the job, but he also knows how to cut a deal – and I’m thinking this is not the era where we need deal-cutters.

But I got off course. My purpose in this odd piece is to demonstrate that the problems we face in the United States are so ponderous that we have to throw aside the trivial arguments about race and gender, and find someone to bring about a change in course. The change, of course, is to give Barrack Obama the chance to play golf everyday – even twice daily if he wishes, and keep him away from the White House.

Don’t carp at me that Michelle Bachmann kissed George Bush, or said something silly about Paul Revere. Every politician is flawed. This is because they are human beings. Even Sue Johnson had flaws, but far fewer than mine. 

If you don’t want a girl to be president (or at least the girl named Bachmann) then lean on the boys to prove they can do it.