The Political Downside of Health Care Reform

First of all, I consider providing all Americans with health care coverage to be a moral imperative.  It is the right thing to do.  Having said that, some people say it will be a disaster for the Democrats if health care reform does not pass.  Unfortunately, looking beyond the immediate timeframe, passing health care reform may have a looming downside for Democrats.  Here is the analysis.

For years, people have complained (and rightfully so) about rising premiums, long waits at hospital emergency rooms, long waits in doctor’s offices, etc. etc. etc.  Now once health care reform passes later this year, we go into 2010 and 2011.  The average voter has a job and health care insurance.  After health care reform, he will still experience rising premiums, long waits at hospital emergency rooms, long waits in doctor’s offices, etc. etc. etc.  But now, the fact that nothing changed immediately for the “average voter” opens the door to the conclusion, “Gee, health care reform is meaningless.  Nothing has changed.  This is health care reform!”

The point is the “ills of system” can and will be seen as a “failure” of health care reform as opposed to the contunuing problems which over time (several years) the reform is intended to control.  It is  a small step to go further and say, “gee, my tax dollars are being spent on supposed health care reform and nothing has changed for me; in fact it continues to get worst.”  Now the “average voter” is close to concluding that health care reform was a sham.  Who does he or she blame?  Obama and the Democrats.

I can hear it now.  “Have things gotten better for you under health care reform?  Has your coverage improved?  Have your premiums gone down?”  Now the only retort will be but wait things would have gotten much worse without the reforms.  That is the same argument being used to justify the stimulus spending.  We would have lost even more jobs if we hadn’t spent that money is the refrain. 

This I fear is the political downside of health care reform passing.  Unless the “average working insured” American sees an immediate improvement in his or her health coverage “universe” (which no one even argues will occur) that voter will slowly conclude that reform was a failure.  If, as is unfortunately likely, premiums continue to rise and coverage continues to shrink, there will be a voter backlast to health care reform passing.

When health care reform passes and it will in some form, there will be jubilant celebrations claiming victory and triumph.  Remember the old saying, “Be careful what you wish for.”

The only sustainable justification for health care reform is to state that it is morally repugnant for any poor man, woman or child to be denied health care access and treatment because they can’t afford it.  It’s like food stamps; a civilized nation must feed the hungry among them.  Unfortunately, this is not how health care reform is being justified.  Instead “down the road”, “hard to calculate” “systemic” benefits are being debated.  That won’t cut it next year when the average voter sees no benefit from health care reform. 

The spin masters can roll out example after example of unisureds who are now proudly holding their insurance card and are genuinely relieved to have it.  Unfortunately, that won’t mean anything to the person who “trusted” health care reform advocates and sees no improvement in their personal situation. 

It will take years to “reform” the health care system once some reforms are passed.  That may not sit too well with the millions of insured Americans who are unlikely to see anything other than “more of the same” problems after reform.

I hope the above analysis does not come true but I fear that it will. 

East Carolina – the Jarrett Brown show

I was at the game.  The coverage in the Charleston press on Sunday I think failed to properly emphasize the “big league” job done by QB Jarrett Brown.  It has not been since Marc Bulger that West Virginia has had a legitimate long pass threat.  Let me tell you Jarrett AND his receivers are the real deal.  Throwing it over the heads of the defenders is what we need to win big games. We even threw a pass across the middle – something I have not seen from WVU in years.  Several blogs ago, I remarked that Jarrett is the Tim Tebow of the Big East and I think that was proven on Saturday.  With the long ball threat Noel Devine is going to get some nice runs.  If we win decisively at Auburn I am going to feel very, very good about this season.  I still think we are looking at a 9 and 3 season but if Jarrett brings his A game every week….well who knows.  Go Mountaineers!!!

Journalists Are Not Professionals Anymore

When you go to anyone of the following professionals, you receive their opinion whether you like it or not – doctors, lawyers, certified public accountants and priests.  If you don’t like the number, the CPA is not going to change it.  If you don’t like the advice and analysis the lawyer gives you, he or she can’t change the law so that you “like it.”  If a doctor tells you have a disease, he or she won’t change the diagnosis just because you don’t “like” being sick.  When a priest tells you what is wrong and what is right, he or she won’t change the message so that you “like” it.

Unfortunately, today’s journalists clearly spin the news to please their audience.  This is not necessarily anything new, yellow journalism has been around forever.  However, in an age when more and more people are exposed to news (TV, radio, Internet, newspapers, magazines) it is sad that journalists present themselves like entertainers.  Give them what they want is the driving factor.  Liberal journalists make fun of conservative people in the news, and conservative journalists lambast actions by liberal actors.  Why?  Because they know who their audience is and they know these people won’t tune it unless they get the “spin” they want.  This is of course driven by the ratings and the need to make a profit.

I miss the “good old days” when the big networks (CBS, NBC, ABC) freely admitted that they lost money subsidizing their news departments.  Journalism was considered to be a profession and it was felt that for the good of the country, the networks had to provide this service even if they didn’t make a profit.  Think about it.  Back when Walter Cronkite was at CBS and Huntley/Brinkley were at NBC did anyone “spin” the news?  Did Republicans watch one newscaster over another?  Was one anchor liberal and the other conservative?  No, that did not exist.  The news was the news.  Opinion was presented separately and identified as such.  Remember Eric Severaid on CBS?  Now opinion was infected the news, and we have what we have.  A Fourth Estate with about as much moral underpinning as a pack of wild dogs.

The Republic will survive, of course, but it is still sad to see.

Nashville

Just got back from Nashville.  I was there for the Music City Bowl, Coach Nehlen’s last game.  Very interesting place.  4% unemployment.  Diverse economy …. publishing (75% of all Gideon Bibles are printed there, health care and, of course, entertainment).  No income tax.  A 9% sales tax.  Many religions are headquartered there.  Vanderbilt University (tuition $50,000 per year) is in downtown Nashville.

I visited the Country Music Hall of Fame twice.  It seems after World War II what had been “country music” noticed that singing cowboys like Gene Autry and Roy Rodgers were popular.  There was also a negative connotation to country music, namely, the hillbilly perception.  So country stars started wearing cowboy hats and dressing like cowboys to “borrow” the respectibility of the great America hero from post-war Hollywood, namely the cowboy.  Thus was born country western music.

I stood in RCA Studio B where Elvis recorded over 200 of his songs.  An amazing place.  I also visited The Hermitage where President/General Andrew Jackson (founder of the Democratic Party) lived.  Also went to the Legends on Second Avenue.  This bar is covered with record album covers going back well into the fifties.  Amazing.

Stayed at Opryland which is a easy place to get lost in.  The biosphere, however, is a sight to see. 

We went to the Grand Ole Opry.  Little Jimmy Dickens (West Virginian), Charlie Daniels, Bill Anderson, Trace Atkins and others performed.  Saw the Ryman as well, the original home of the GOO.  Hank Williams is all over that town.  He died (or was determined to be dead) in Oak Hill, West Virginia at the gas station just across from Herbert Jones’ Lundale Farm.  My father was his West Virginia executor.

Nice vacation.

Shelia Blair – Who is She?

Just the most impressive voice around when it comes to regulatory reform in the financial area – that’s who.  Shelia Blair is the head of the FDIC, the government agency which insures deposits in banks.  She was appointed by George Bush and retained by BHO.

This lady spotted the subprime problem years ago before anyone on main street or in Congress had even heard of the phrase.  She raised the alarm and was ignored – basically by everybody who mattered.  She also believes as do I that financial institutions cannot ever again be allowed to grow “to big to fail.”  I have read articles about her and seen her on Sixty Minutes.  And in this age of government taxpayer funded bailouts, let’s remember one thing.  When a bank fails, the FDIC steps in, takes over the non-performing loans, puts in enough money to cover the deposits and either shuts in the bank down or sells what is left at auction to a healthy bank.  Who pays for this bailout?  The banks do.  Not the taxpayer.  Banks are assessed insurance premiums each year by the FDIC. Sound like a solution that could be expanded beyond banks to investment banks and brokerage houses.  Yep. 

I sincerely hope that the politicians and US VOTERS will listen to and make efforts to find out the opinions of Shelia Blair.  This lady is the real deal in a time when we desperately need real solutions and real reform not compromise solutions and pandering platitudes.

 

Health Care Reform – the Public Option

Personally, I like BHO’s idea of a publicly run health care insurance company to compete with and make the private insurers honest.  In West Virginia, the lawyer malpractice insurance rates began to rise in the early 1990″s just like the medical malpractice rates.  The  West Virginia State Bar joined a few other small states and formed its own non-profit legal malpractice carrier.  It is still active today.  Oh by the way, legal malpractice premiums in West Virginia stopped rising and have remained reasonable and affordable ever since.

Commentors bemoan the “unfairness” of a public entity competing with a private entity.  How would you like it, they say, if the government opened a hot dog stand right beside your stand?  With public dollars, they can run you out of business!  Hogwash.  Government and the private sector already compete side by side. 

You can ride the subway or pay for a cab.  Your choice.

You can go to a public golf course owned by the city or join a private club.  Your choice.

You can go to a public pool or join a private one.  Your choice.

You can watch public television or the networks.  Your choice.

You can allow the police to protect you or hire a private security guard.  Your choice.

You can go to the county owned hospital or the private one.  Your choice.

You can mail something at the post office or use FedEx, UPS or DHL.  Your choice.

Please don’t argue that the mere idea of a public option is somehow obviously unfair, unworkable and unimaginable.  It is all around us every day.

 

Vice Presidents and VP Wannabees – Oh My

Sarah Palin will resign as governor.  Makes no sense to me.  Her Twitter explanation is also ungrammatical.  Good grief.

And then there’s Joe Biden.  Will someone please tell him to stop answering tough questions by saying “look”?  In his interviews, whenever he gets a question he doesn’t like he goes “look” and then says something.  He also refers to the Obama-Biden administration is his answers.  Joe likes to talk which is fine but lose the attitude, Joe.

 

Health Care Costs

We keep hearing that the cost of health care is going up each year.  I think there are two components in that idea of “cost” and if such is the case I imagine the distinction needs to be considered and understood in any reform efforts.  When someone says, “health care costs rose by six percent over last year” three conclusions can be drawn.

1.  The cost of health care services and goods rose per unit price by 6%.

2.  Patients requested and received 6% more services than last year.

3.  A combination of the two.

What is interesting is number 2.  Suppose the auto industry announced that it had sold six percent more cars this year than last.  Everyone would rejoice.  Good news.  But if because of expanded coverage, new procedures or increased demand the “health care industry” makes six percent more sales than last year, everyone goes “stiff legged” and bemoans the “increasing cost of health care.”

This reaction is, of course, because few if anyone actually pays for their own health care.  The insurance company or the government pays.  So when more sales are made this causes the “price” of health care to rise not because doctors have necessarily raised their fees but perhaps because they saw more patients, ordered more tests and performed more procedures. This is the item 2 component.  In fact, some medical costs have actually fallen.

The conclusion of this analysis would therefore be that Americans (largely defined) are “buying” more health care than they can afford.  Now that is one difficult problem to solve.

The question now becomes this:  How do we create a WalMart model for the delivery of health care services?  At WalMart the quality is good and the prices are low.  But when the customer doesn’t pay the cost, how is the customer attracted to an efficient WalHealthMart?

Wish I had the answer.

 

 

The Credit Crisis

Finally, the saga of what happened and why appears to be complete.  The primary culprits are Wall Street “masters of the universe” investment bankers who created a “monster” called mortgage-backed securities that were not based on sound economics but rather on “sizzle” and flawed assumptions.  The credit bomb eventually exploded because greed by the bankers and borrowing citizens created a “bubble” which burst and froze the credit system.  To a lesser extent the federal regulators and federal politicans are also at fault for not reigning in this abuse but quite frankly it is hard to blame them too much since their culpability arises only with 20/20 hindsight.

The only thing I still don’t understand is why the “toxic assets” as these securities are called apparently still have no value or stated another way can’t be valued.  Certainly all of the mortgages supporting these securities are not bad.  Why can’t someone value the instruments and figure out what the real loss is?  I have not heard a good answer or explanation on that.

I know we are now going to expand the regulatory powers of various agencies and the Federal Reserve to hopefully prevent this from happening again.  For my money (pardon the pun) I think the problem is that banks have been allowed to merge and merge and merge and become far too large.  Too big to fail is what caused this mess.  If we had more but smaller banks and investment houses then it is still possible that all of them will make the same mistakes but I doubt that.  I think we should look at “busting up” these large private institutions and change if need be the anti-trust laws to prevent market concentration in the financial services area.

Mountaineer Football Prediction

There is nobody on the Mountaineers 2009 football schedule that can’t be beaten.  That’s the good news.  The bad news is that there are six teams on that schedule (Pitt, Cincinnati, Louisville, South Florida, UCONN and East Carolina) that also would not be “surprise” winners if they beat WVU. 

Given this seesaw balance, I predict the following:

WVU will beat these teams:

Liberty

Auburn

Colorado

Syracuse

Marshall

UCONN

Cincinnati

Pitt

Rutgers

That means losses to

East Carolina

South Florida

Louisville

Record: 9 and 3