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.