Healthcare

“We hold these truths to be self-evident: that all men are created equal; that they are endowed by their Creator with certain unalienable rights; that among these are life, liberty, and the pursuit of happiness.” — Thomas Jefferson

I believe Healthcare to be the fundamental issue of our day.  Our politicians either avoid the question entirely, or engage in mud-slinging contests of “You don’t want to empower the government to make health decisions for you – to decide what medication or procedure you are allowed to get… do you?” Or “You don’t want to deprive your grandparents of their necessary medication… you don’t want to just let them hurt and die… do you?”  As if the issue was black and white, as if there was one “great” solution that both balanced the budget and provided care to anyone and everyone, no matter to their age, health condition, or financial situation, our politicians point only to the negatives of any proposal and then rest contentedly in the broken system that is bankrupting us.  America, I suggest we choose our future course, I suggest we look at the issue, present the facts, and make a decision.  I suggest that We the People vote the solution in – before our creditors decide it for our children through “austerity” measures.

“I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts.” – Abraham Lincoln

With pun intended, this issue is very much gray – and those of us who are gray or graying, we owe our children a better America than this – a bankrupt country with future entitlement obligations to our seniors that we can never meet, record low taxes on our wealthy, and a middle class left to watch as both the rich and the poor demand more from them.  We owe our children our best product, we owe them our generation’s recommendation for the future, we own them more than simply refusing to reform the broken system we have, burying them in a mountain of debt, and letting the chips fall where they may.

When Jesus saw this, he was indignant.  He said to them, “Let the little children come to me, and do not hinder them, for the kingdom of God belongs to such as these.” – Mark 10:14

As for yours truly, I turned 42 this year.  And middle age has arrived – my annual check up consisted of my first pair of eyeglasses and my first introduction to the possibility that I may need to take daily pills.  You see, I have a family history of hypertension, my Dad and my older brother are on blood pressure medication, and this year the doctor said it might be best if I started as well.  We’re in the monitoring phase.  But in any case, as we say in the pilot business, I am now on the back side of the power curve.

Don’t cry because it’s over. Smile because it happened.” – Dr. Seuss

I fully realize that as I continue to get older, I will need to spend more money on medications, surgeries, and procedures in order to live.  Like it or not, that’s the way it is.  I prefer living to dying, but I also realize that I am going to die one day.  I’m good with that – in many ways, I’m looking forward to that.  And here’s the deal:  I certainly don’t want my children to owe their livelihoods, I don’t want them to mortgage their future, just so that I can have a longer present.  I mean it, with every fiber of my body, when I say that I’d rather die first.  Kids, I fully suspect that you will have developed some sort of healthcare plan in the next 50 years.  But, if We’re as bad then as we are today, if 50 years from now our Healthcare “system” is still:

– Businesses that hire Americans must pay for healthcare expenses… and, by extension, if they outsource the job to a non-American, they get a competitive advantage over their competitors.

– Providers of healthcare are allowed to charge different rates for those people on an insurance plan and those people that are not.

– Individuals working as independents, part-time employees, people in-between jobs, our unemployed – they have an opportunity to purchase high-cost individual health insurance which subsidizes the uninsured or they can take their chances with no health insurance (Supreme Court ruling on this part of a broken plan to follow).

– Health Providers are not permitted to deny emergency services to anyone, regardless of procedure needed or status of patient.

– Retired, poor, Veterans, and others are covered on various Government Healthcare programs, providing payments to providers based on a series of directives, bureaucracies, and regulations.

– These costs get passed on to our working middle class or as debt to our unborn children.

If, 50 years from now, this outdated and untenable notion is somehow still our plan, please recognize this truth.  If I am 92 years old, living in your house or any home I didn’t choose to live in, if I am penniless, and particularly if I can’t remember what your name is, please don’t borrow another $200,000 from your kids so that I can get whatever new procedure they have in that day.  Really, truly, I do not want to live past my usefulness on this planet – my only wish is that you allow me to leave my grandchildren in a better place than they would be if I had not existed.  (It’s still weird when I think about it:  Our generation marks the beginning on an age where, quite literally for some of us, we will choose when and how we will pass into the next world).

But I digress, because for the time being, We the People need to figure out how we are going to manage in this world and in this time.  And bankrupting our children for our seniors is the wrong answer, that much has been the true since the beginning of Man – it had to be for Us to survive.  Since this great nation’s founding, our marching orders have always been to take care of our next generation.

We may consider each generation as a distinct nation, with a right, by the will of its majority, to bind themselves, but none to bind the succeeding generation, more than the inhabitants of another country.” – Thomas Jefferson

It’s high time we ask ourselves, what are We the People going to do?  For in our Democracy, it truly is our choice.  And not choosing is a choice, avoiding the issue only further bankrupts our great nation.

If there must be trouble, let it be in my day, that my child may have peace.” – Thomas Paine

With that in mind, let’s attempt to develop our society’s path forward as far as healthcare goes – for we have reached a new era in mankind’s societal evolution.  Regardless of whether or not we want to be here, we now live in a day where, for a mere $10 million, a person can live for 2 more years… or 3… maybe even 7.  Or if a person becomes disabled, we can give them a prosthetic for “only” $2 million.  Or AIDS drugs to improve the quality of life of our neighbor… or his child.  Or we can nurse a 24 week old pre-mature fetus to life…  or give shoulder surgery to my 95 year old grandma after she fell again.

Yes my friends, technological breakthroughs now allow us to outlive our resources, and that’s precisely what we are doing — living beyond our resources.  And as such, it’s time for our society to make some tough decisions.  We are foolish to think otherwise.  You see, funding Medicare, Medicaid, and prescription drug benefits for our seniors and then passing the bill of those programs onto our grandchildren is a decision.  And in my humble opinion, it is a terrible one.   It’s time we develop our future plan to achieve both a balanced budget and Healthcare in America.

It is incumbent on every generation to pay its own debts as it goes. A principle which if acted on would save one-half the wars of the world.” – Thomas Jefferson

Medicare and Medicaid make up over 23 percent of our budget as we subsidize Healthcare for our poor, disabled, and elderly… and that amount is growing rapidly.  By 2025, the GAO predicts our entitlement and interest payments alone will consume our entire GDP (http://www.economist.com/blogs/dailychart/2011/03/americas_budget).  President Obama’s 2012 budget is for $2.6 trillion of revenue and $3.7 trillion of spending, a deficit of $1.1 trillion dollars.  The “opposing” Republican plan called for $2.5 trillion of revenue and $3.5 trillion in expenditures (http://en.wikipedia.org/wiki/2012_United_States_federal_budget), for a deficit of $1 trillion.  The enacted budget numbers composed $2.5 trillion in revenues and $3.8 trillion in expenditures, for a massive $1.3 trillion deficit… to get us to over $15 trillion in debt!  This unsustainable trajectory will change, there is no doubt… I don’t claim to have “the answer,” no, none of us do – but that doesn’t mean we shouldn’t try for a better course.  America, the question for our day is this:  Looking at what we have, evaluating what others have, examining the results of other attempts at providing a service to a people, what healthcare system would be the best for Us?

I do not look upon these United States as a finished product. We are still in the making.”
Franklin D. Roosevelt

We all need access to healthcare in order to survive.  America is not heartless and I, like you, want everyone to live the best life possible.   But I’m no fool either…  I realize that our resources are limited and, as such, if society dedicates all its resources and then some so that one man lives the longest life possible, another will be unable to.  That is the honest truth.

Honesty is the first chapter in the book of wisdom.” – Thomas Jefferson

Our current course has been to borrow on the heads of our future generations to finance the current one.  I do take issue with this position as I believe, if anything, it should be the inverse.  In my humble opinion, our generation should be sacrificing ourselves to ensure that our future generation is not enslaved under a mountain of debt, high taxes, and minimal infrastructure.  Reasonable men can disagree but I ask you, where is your line?  What is the “right” approach?  How should America attempt to address the reality of the world we live in when it comes to Healthcare for our citizens?

The only limit to our realization of tomorrow will be our doubts of today.” – Franklin D. Roosevelt

I offer the following as a thought from an ignorant man, yours truly.  I’ve done my research, but my hope is that we can engage in some constructive dialogue.  I fully realize there are smarter folks than me out there, but I also believe that we can all see the end state of our current course (if we so choose to look).  So without further ado, here is my proposal for our generation’s “New Deal” on Healthcare in America:

“One thing is sure. We have to do something. We have to do the best we know how at the moment… If it doesn’t turn out right, we can modify it as we go along.” – Franklin D Roosevelt

Our country is right to champion the cause that all of Us, regardless of income level or past choices, can benefit from needed medical treatment.  However, our current healthcare policy of employer-mandated healthcare plans is outdated in today’s world as it encourages the outsourcing of jobs, is not portable, and does not apply to our unemployed, poor, part time employees, and small business employees.  Further, our attempts to work within the outdated system have produced multiple federal, state, and private programs that unduly complicate the system, as well as complicated tax law, regulations, and requirements that unduly burden the healthcare system.  Further complicating this issue is the aging of our population – the increasing population size of our older members as compared to our young and working makes our current system unsustainable going forward.   The result has been an over-promise of benefits in a government program that our middle class cannot afford.  Although a plan for Healthcare is not easy, it is obvious that We the People need to chart a new course…

It is common sense to take a method and try it. If it fails, admit it frankly and try another. But above all, try something.” – Franklin D. Roosevelt

I believe that We the People, America, US, is better served by reforming Veteran’s hospitals, Medicare, Medicaid, S-Chip, Free Clinics, Cobra, and other healthcare programs and low income subsidies into one comprehensive healthcare system.  But how do We do that?  There is justifiably high interest in the Supreme Court hearing on the mandate, as well as Americans questioning the plan in general… as well we should.

Delay is preferable to error. – Thomas Jefferson

I believe there is a better answer than our politicians are offering Us.  We are asked:  “Do you want the federal government to have more power over both the states in our nation and over you as an individual, or do you want to keep our broken healthcare system?”  as if those were the only two choices.  There are other ideas, better ideas, ones that recognize that private industry, regulated by government, ensuring an equal and fair environment for all is what this country is all about.

So confident am I in the intentions, as well as wisdom, of the government, that I shall always be satisfied that what is not done, either cannot, or ought not to be done.” – Thomas Jefferson

In order to ensure that health services remain in the private sector, to ensure that all of us are able to obtain required health services, and to ensure that free market competition works to keep prices down, I recommend that our government provides all American citizens with Health Savings Accounts (HSAs) to pay for health expenses and prescription drugs.  Private industry continues to provide the health services, and the federal government’s role is only to:

1.  Tax

2.  Distribute revenue to citizens via Health Savings Accounts.

3.  Define the environment for both the Health Industry and the People:  The government determines HSA expendable health services, regulates health providers, and sets the environment in which health insurance companies must operate.

Catastrophic insurance, covered by tax dollars in your HSA, will not cover some things, particularly those things that affect you as you age.  Therefore, it will be up to you to let your HSA build up as you age – to plan for a long retirement if you want to have one.  Be a good steward of your HSA today, plan for your golden years, because the HSA amount that is given to every American each year is all that you will ever be entitled to.  As you get older, the HSA will most likely not cover all your age-related expenses – and at that point, it will be up to you to pay for them.  Additionally, Tort reform and capped lawsuit judgment awards should be instituted as it is in our collective interest to keep our healthcare costs down for all.  That’s my thought on a New Deal for Healthcare – I welcome yours.

“Errors of opinion may be tolerated where reason is left free to combat it.” – Thomas Jefferson

In any case, let’s go the numbers of this proposal:  Looking at our 2012 federal budget, it appears our government spent about $846 billion dollars on health-related expenses in 2012 and is projected to spend $916 billion in 2013.  Now there are only 313 million of us in the United States.  This means, using the projected $916 billion dollars of government spending in 2013, we could instead each have an HSA in the amount of $2,926 – we could eliminate all the various government programs and, instead, empower the people who need healthcare.  With the same cost to the taxpayer, each American citizen could have an HSA of nearly $3,000.  Every American with a $3k HSA – a family of 4 with a $12,000 health allowance every year, each individual’s HSA growing as another year of healthy check-ups passes by, and all this for the same cost that we spend now… this sounds like a better course forward for “Us.”

Bear with me for a moment longer, keeping in mind that such a system gives the power to the individual – instead of entrusting our future to the hands of big business or government, we keep the power of the dollar in the individual’s hands.  So, by re-allocating our current spending to a consumer based Health Savings Account, what would a $3,000 HSA purchase anyway?

I’m no expert, but I can google the cost of health insurance for a 42 year old man in California.  There are several plans to choose from – I’d opt for the top rated Blue Cross Blue Shield PPO at $197 a month, a deductible of $900, and an annual visit of $40.  In this plan, my health insurance and annual visit could be covered by a top rated PPO for $2,404 a year, leaving me nearly $600 to roll over each year that I am healthy.  When the inevitable comes and I need to come up with my $900 deductible, I should be able to do so.  The numbers get only better for younger Americans, those wishing to enroll their family into the system, and people residing outside of California’s high cost of living.

Yes, as we age, we will likely have to pay some costs out of pocket.  If we live long past our working years, we may have to reach out to family or charity for assistance – for eventually the HSA will be unable to fund all the necessary medications, procedures, and expenses that come with age.  That is the simple truth that we, as a people, must come to acknowledge and joyfully accept.

Adults are obsolete children. – Dr. Seuss 

Not only would this new system ensure all Americans have access to health services, it would also remove the burden of health insurance costs from our employers.  In today’s “flat” world, we simply cannot have a healthcare system that puts companies hiring Americans at a disadvantage to companies that hire outside of our borders.  Additionally, such a Healthcare system would again empower the consumer, the individual, the people, instead of our employers, insurance companies, and government officials.  Lastly, it would allow us to come together on a course for the future… an understanding of our desired end state.  We will have a workable and sustainable health care system for our future generations.  We the People will have an understanding – an agreement that those of us who pay taxes will provide a fundamental Health Savings Account for all American citizens.  But as we age and eventually retire, all of us will have to save and plan for our ever-increasing future medical costs.  We agree that our children will not be legally bound by government to pay for our elderly.

“What you don’t want to do is to hang on to the aging superstar past his prime and take resources away you can otherwise use to build a better overall team.” – Tom Hicks

Kids, please, I implore you, plan for your retirements – for your generation will most likely live to be well over a hundred, but you will most likely still not be able to work much past 70.  Don’t do what your preceeding generation did… don’t ask your government, employer, or your grandchildren to take care of you.  I assure you, it is a failed philosophy destined to leave you bankrupt.  And trust me, you too will get old.

“Time crumbles things; everything grows old and is forgotten under the power of time.” – Aristotle

We the People do not need more than a basic health allowance, common defense, and the opportunity to educate and better ourselves.  That is what the limited role of government should be in ensuring “Life, Liberty, and the Pursuit of Happiness.”  The chance to see a doctor and get healthy, the freedom to choose my course, and a path in which I can succeed if I try hard.  If our federal government limited the taxes on our wealthy to fund the limited arenas of healthcare, military, and education, if We the People limit the federal government’s role to only those things, our wealthiest will answer the call for a tax hike to balance our budget.  And that’s all we need, We the People can take it from there…

In the end, it’s not the years in your life that count. It’s the life in your years.” – Abraham Lincoln

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