Beyond the Cusp

September 19, 2017

The Grand Healthcare Fiasco


Has anybody honestly thought the concept of “Single Payer Government Healthcare” through completely? Senators Bernie Sanders and Elizabeth Warren claim they have the entire thing sorted out. What is their solution, you ask? They will tell everybody that it is easy-peasy-lemon-squeezy. The answer is to simply give everybody a Medicare Card and presto-chango and you have universal healthcare. Nothing will change other than the government will now pay all your healthcare expenses. You actually do get to keep your doctor. Of course, you do not get to keep your healthcare insurance because the government will become your health insurance provider. Now, what could be any more simple? When you go to your doctor, you just show them your Medicare card, they take down the number, you sign that you received the care listed and the government pays your doctor. Well, you will need to press down when signing the paperwork because there are tons of copies being produced, at least five with an unknown upper end. Well, there will be a little more to your doctor getting his money, but your work will be finished. Your physician will then be required to also complete some additional forms further describing the services delivered and the resources used and any testing which was required and any other incidentals which might be required to satisfy the government regulations and specific other essential requirements to complete and satisfy every criteria which the government and Medicare requires. Then the entire package is wrapped-up and mailed using Fed Ex, UPS, DHL, USPS or other mode of delivery of your physician’s choice and after the government Medicare workers complete processing and approving the claim, then the check is in the mail. Well, actually, not necessarily.


Medicare requirements are very particular and it will probably take some adjustment in meeting their standards and style requirements as well as quantitative and qualitative requirements as well as making sure that you utilize the perfect and correct forms for each specific set of procedures as well as the right entries for items utilized and which form for each procedure and a million other vitally important minutia; all of which will take a little period for adjustments. Then, and only then, things will move along smoothly for you, your physician and everyone involved. Of course, there is a faster means your physician might consider in order to make their reimbursement less painful and less time consuming, they might actually consider trying hiring somebody with experience in government forms and government lingo with a specialty in Medicare forms and formulations. Once the wrinkles have been ironed out, then will come the initial shock for your physician, the fact that he will be receiving less for each visit and delivered medical services than he may have become accustomed. With some fine-tuning of how he represents each service rendered and supplemental services required and other technicalities, your physician will be able to rectify some of the deficit he first encountered. The one thing he should be forewarned is that the government may decide to audit his practice if they suspect they might be cheating the government to increase his profit margin by cheating the government by charging for things either he did not provide or for items he did not use. What adds to the overall confusion is that government processing of claims and auditing of these same claims are actually somewhat subjective just as much as objective. That leaves some wiggle room, often some very noticeable wiggle room. Much of that is due to regulations written in order to protect, favor or punish specific items, procedures and a variety of other items and even people which often lead to regulations which are all too often contradictory with all too often vague wording such that things depend upon the person reviewing the same procedural sequence coming out with very different results. This also means that what applied one time might not be acceptable the next which makes for some difficulty complying with every regulation and requirement.


Senators Bernie Sanders and Elizabeth Warren

Senators Bernie Sanders and Elizabeth Warren


But let us leave all this aside and pretend that every provider is fully capable of meeting every wrinkle and requirement in the paper jungle which is government forms and requirements and understand and interpret every regulation with the greatest of ability. So, your physician is now a professional at all things government requirements, what could be the problem now? But what about these HMO, PPO and the rest of the alphabet soup of group coverage? Well, their problem will be to completely standardize treatments for every scenario and also make sure that the physicians itemize and document with great accuracy such that their administrative professionals can accurately file with the government. Our bet is that very quickly the idea of having your own private physician will very quickly become a thing of the past and most physicians will run and hide behind the bureaucracy of some group healthcare facility be it a hospital, clinic or HMO, PPO styled health provider. Yes, there will always be the pay for service providers who will be required to at the least file the Medicare paperwork despite taking an additional fee from their patients. Whether such will be theoretically permissible under the single payer government Medicare for all healthcare packages which the law suggested by Senators Saunders and Warren are suggesting is debatable because, as we all know, the government hates competition when taking over an industry. But there is another item which might allow for such care to exist, the wealthy are unlikely to be kind to having to accept the same level of care as the average person. As the wealthy are the meat behind campaign financing, our government representatives are extremely sensitive to their desires, wishes and comfort, and that means that the wealthy will be permitted their own better healthcare, thus, paying an additional fee to your personal physician will very likely be permitted or opting to go your own way and paying your physician as long as you also pay for government healthcare despite not taking full advantage of their wonderful services. But even all of this is not going to be the biggest problem because to assure that the majority of people end up in the government healthcare system, private health insurance will need to be made illegal across the board, which is why the wealthy will be paying directly to the physician for services and not purchasing an insurance plan. Further, the government will very likely allow membership hospitals charge their flat entrance fee either monthly or annually and any additional fees per service as required to continue to provide their services as long, again, as their members pay their Medicare fees to the government plan.


Finally, the people who will be hurt by any government healthcare system, where all health insurance is replaced by government payment of healthcare fees, is the health insurance company employees and the independent health insurance agents. From what we have read, this would include somewhere from two and a half million to three million people losing their employment. I can hear your claim that most of these people would be required to be hired by the government to do pretty much the same jobs they perform now. Well, that might be true if the only thing that health insurance employees ever did was process insurance claims. But there are also the salespeople, accountants, executives and likely dozens of other positions other than claims processing. Further, as the government will be the sole provider, and there being a number of healthcare insurance providers, the majority of these people employed by these companies will be out of work. There will be some new employees, enforcement investigators who will be sent to investigate fraud, and there will inevitably be fraud just as there is fraud now in Medicare and Medicaid. Then there are the last two and most frightening truths. With time, this care system will run into the same problems the other government healthcare systems already in use in the United States have, namely the “Veterans’’ hospitals and the healthcare system providing care of Native Americans in the various Reservations. This may be the absolutely most frightening reality of the entire healthcare prospects. There has to be a better system than using Medicare for all or any of the other European systems plus Canada, Australia and New Zealand.


We might suggest the Israeli system where everybody is required to have coverage and pay the healthcare tax. Here is where the Israeli system diverts from the others. There are four separate healthcare systems which are required to provide basic services by the government. Each of the four offers this basic set of services plus each choose a few additional services for their basic coverage. They each offer additional levels of service, say bronze, silver, gold and platinum (used for example only) which each provide additional services and prescription and other service coverages each for an additional fee to your provider. Physicians are required to provide a set number of hours of their practice to one of the national providers. They can then offer for fee services outside the system and collect fees as they desire to charge, if they are so motivated. This is most often taken up by specialists and surgeons. This also allows for those who desire to choose their own physicians outside of the basic providers to pay only the basic fee the government requires and then get all of their care privately. The four separate providers each are kept providing their services, including their additional service levels, at a reasonable rate as they are competing against one another. They also each provide separate additional plans leading to people choosing whichever of the four provide the services they are most likely to require. So diverse coverages, competition keeping fees low and physicians providing service to the general good before they can sell their services on the open market to earn additional fees. It provides the most for the least for the people and allows for physicians to make as much salary as they are able to command from an open market system as well. Everybody gets their advantages and all receive basic health coverage. Major Medical where hospitalization is covered for all is part of the system which appears to be much of what the United States is aiming to cover. There is one problem with the Israeli system, it is Israeli and that appears to disqualify it for some idiotic reason.


Beyond the Cusp


August 5, 2017

Hey Bernie Thanks for Your Advice on Healthcare


Senator Bernie Sanders has proposed for President Trump that there is a singular way to repair the broken healthcare system. Berating the President and the Republicans for their failure thus far to repair Obamacare, Sanders offered his suggestion on CNN stating, “Single payer would save the average family significant amounts of money.” True, that might be the case, unless they pay income tax, but then only the wealthy, according to Democrats, pay income taxes. That is because most of the income taxes are paid by those making over $75,000 per year, seemingly what the Democrats quote as the wealthy in their debates on who should be taxed the highest. Forget that such a salary would not support the average family of four in most of the major cities throughout the United States which is why both parents must work in most families. But for those in the bottom 49% who pay no income tax, but do pay Social Security taxes, single payer healthcare is wonderful as when income taxes double, they will not need fear as twice nothing is nothing. But some of them will need fear because to increase revenue the level for paying taxes will drop precipitously. The only income tax free incomes will likely end up being the lowest 25% or 30% with these new taxable paying a fair percentage which they cannot afford. It is even possible that the new rage of a $15/hr. minimum wage will place you into the income tax range; would that not be a hoot? But Bernie loves the socialist idea and wishes the United States could just become part of the failed experiment we call Europe. We understand his viewpoint and hope that he never gets to carry out such plans as President, something Hillary saved the United States from as he might have bested Trump as many polls reported.


About that single payer plan that Bernie thinks would be the salvation for healthcare in the United States. It would save the United States and her people from the slow disintegration of the health insurance industry simply by eliminating it overnight. Bernie would say that this was wonderful because these blood-sucking insurance companies are horribly evil as they actually are in business making a profit. That is horrible unless you have stock from your 401K plan or personal stock holdings or if you happen to work for one of these health insurance companies which Bernie wants to put out of business. You see, Bernie believes that any company which makes a profit is making that profit because it overcharges the people using their product, be it clothing at WalMart or health insurance from an insurance company. Bernie would tell you the government could do the same job of providing the payments for your health better than the existing systems which need to make profits. Profits, according to Bernie, never come from efficiency and prices are not lowered by competition, everything is out to steal your money by ripping you off. That is why Bernie believes the government should run every industry. He would likely tell you that the government should run the grocery stores such that you would never have to pay for groceries. All you would do is receive your government food card which would have a color code and when you get to the store, the shelves would tell you how much of any item your color permits you to buy and whether or not you are permitted to buy some things at all. You have the purple card, no candy or sweets for you; the government has you on a low carb, high fiber diet, so enjoy the yummy, government produced granola and soy wafers. You see, if the government is paying for your healthcare, the government will need to control what you eat. Expect certain items to become illegal if the government pays for your healthcare such as alcohol, cigarettes, whole milk and many high fat products or anything else the government deems is not good for you, unless you have that special card which allows you to shop at the primo store where they even sell ice cream. The government would be permitted to enroll you in a mandatory exercise class and if you do not measure up to the fitness reports, expect a fine, it is not a fat tax, it is an under fitness fine.


We all got a fine example of where government provided single payer healthcare results in the sad saga of Charlie Gard who was sentenced to have life support removed from his one-year-old body because the costs of treatment were too high for his likely lifetime earnings. Oh, of course they did not put it that way, and it only took this long because his parents had been fighting to be allowed to take him to the United States, where the government does not determine who is worth saving and everybody is worth saving, for treatment which was even offered free for over nine months, or Charlie would have died before his four month birthday because he was too expensive and his earnings would not have repaid the government. Oh yea, that is the criteria that the health boards use, potential earnings against initial costs. That is why once you reach seventy they do not even pay over a minimal amount for prescriptions. At that age, you are really done earning and nobody cares if you live or die any longer anyway, and that includes family. That is what the government has decided and is also kind of what the children are taught to believe as well. Socialized medicine, it is just wonderful as long as you are healthy.


Helicopter landing at MedStar Washington Hospital Center

Helicopter landing at MedStar Washington Hospital Center


There are all the stories about the wonderful care in Canada. Well, I worked at one of the finest heart hospitals in the world located in Washington D.C. and of our heart patients needing life saving surgeries, there were two main countries from which they came; Saudi Arabia and Canada. We also got a decent number from Europe though most of the Europeans with that kind of money belong to private care groups which are actually membership hospitals or clinics. That is how the really wealthy get around national healthcare. They either belong to a private health provider or go to the United States or, oddly enough, Israel and India. But the rest of us in the regular person on the street category, we are rated by our earning potential in Europe and Canada. Part of the reason the system in Canada works is that the United States is rather close to Canada and all too many Canadians simply slip across into the United States, rent a place and head to the hospital with their driver’s license and get their care and pay for it, often arranging payments with the hospital. Why wait in Canada for two years for a new hip when you can get one in the United States in ten days?


There is a reason that the United States has about the best healthcare system in the world and definitely the largest which performs the most procedures. There is no healthcare system in the world which places a higher priority on the lives of their patients than the United States spare one, and that is the nation which values the lives of every human being so highly that even their enemies enter their hospitals for treatment knowing that everything possible will be done to preserve their lives.


Our warning to the wonderful (and the less than wonderful) people of the United States is, please keep your wonderful, privately-run healthcare system as is because once you lose it to the government you will never be able to extract the same system. By the time you manage to extricate yourselves from the horrors to come, the system will be as broken as your streets, bridges and highways have become. Would you trust your life to the snow removal in most cities where it is run by the city or the state, and those levels of government are more efficient than the federal government, except maybe for the city government in Washington D.C. due to the horrible example they have right there to emulate. Yes, many times people complain about how long they waited in an emergency room just to get five stitches in their child’s lip after a slight altercation on the playground. Keep in mind that an emergency room is not first-come-first-served basis but on a most serious first basis as somebody with a broken leg or sucking chest wound comes in after you, they will be treated before you and your five stitches is about the lowest form of injury once the bleeding has been treated which often requires a cold cloth to stop the bleeding. Heart attacks usually take first priority, which we can attest to by personal experience. We will grant you that emergency rooms could use larger staff but then somehow whenever we end up in one, it is always when they are bust with seeming thousands arriving by the hour; and we never see them on a Wednesday morning at 10:00AM and there were no major car accidents and everybody is watching “The Price is Right” or doing crossword puzzles. If the United States ends up with universal healthcare run by the government, then the emergency room might become the most efficient place even time-wise in the entire hospital. Honestly, after the debacle with the Veterans Administrations Hospital System and them even using two lists, one for their reports which showed how promptly they dealt with caring for the veterans and the real list which had vets dropping dead in the hallways waiting for a bed or even to see a physician for an initial diagnosis, let alone treating their problem; and this is the kind of system people honestly desire? Ask the Native Americans about their government run healthcare. After checking out those two disaster cases, then tell me that is the healthcare you want for you and your family. Sometimes you want the different choices competing for your business, because it makes them try harder. Public run healthcare means every choice is run by the same administrators and could not care about your business as they get paid no matter how poorly they treat you, or even if they refuse to treat you.


Beyond the Cusp


August 4, 2017

If You Hate Your Obamacare, You Must Keep Your Obamacare


America was promised that first thing out of the box, given the power, Obamacare would be repealed and some things improved if they were to be kept. Well, that did not happen, did it. They have tried at least twice to repeal and replace it with what they said would be a system based more on competition and less on government. The first was rejected by many conservative commentators and healthcare specialists. That was probably predictable as they are politicians, not geniuses. Well, the House went back and presumably asked for advice from physicians and insurance executives as well as heads of healthcare facilities of every level and type and came up with a Plan II. The Senate spent a fair amount of time in debate and made alterations amending parts, adding and cutting until they felt they had molded something worthy of sending back to the House of Representatives and presenting to the people. The Republican leadership requested the party come together and send the legislation back and advised that after the House of Representatives had their shot at altering, adding and cutting the Senate would have another go at what they received. The Republicans were likely guaranteed that unlike Obamacare, which was passed in haste and fearing the replacement for Senator Kennedy would topple their chance to pass anything different, they passed the legislation as it stood in a state of sheer panic, unfinished and knowing it would fail. This was acceptable as they defined the plan to murder the insurance leg of the healthcare support system. That would place healthcare at the precipice and without the financial support of the insurance leg, soon the entirety of the healthcare system would be pushed beyond the cusp and the American people would demand that they be saved from the collapsing healthcare system. They would demand from the very people who allowed the crisis, actually enacted the necessary infection of the system forcing its collapse, the authors of the problem to save them and repair the problem.


The repair was going to be single payer government healthcare, the British styled system just like the system which just allowed Charlie Gard to die. The single payer style British, or Canadian, French, Swiss, German or any other European styled healthcare or similar to any socialist system’s healthcare system and then the government would control life itself. Many are probably wondering why the British Courts decided that Charlie Gard, Charlie the Innocent, had to have his life support terminated and thus making Charlie terminated. There will be reports that he was unsavable, but not all treatments had been tried and New York – Presbyterian Hospital/Columbia University Medical Center was willing to try an experimental treatment free of any cost if the British courts would permit them the opportunity to attempt and save his life. The parents through a funding site had raised more than sufficient money to pay for any incidentals to allow them to accompany their newborn son. But the problem was simple for the courts, could the government allow their citizens to chase treatments which might actually save their lives outside the British system. Allowing Charlie Gard to be treated, even for free, could set a dangerous precedent and if such became anything approaching normal, then their entire system would be called into question. They could not allow for the British government single provider system to be questioned and called into doubt. The risk that the people in Britain might come to doubt whether they were really receiving the best conceivable healthcare from their government could not be risked and Charlie Gard had become the test case before the world. Charlie against the British government healthcare system, Charlie had to lose, Charlie had to be allowed to die with dignity because that was the British way, or at least it is now. Charlie had to be denied any chance to live outside the British healthcare system.


Charlie Gard with Tweets of Pope Francis and President Donald Trump

Charlie Gard
with Tweets of Pope Francis
and President Donald Trump


This is the eventuality which Obamacare was and will bring about. Should the number of insurance companies dwindle until there were only a few, possibly just one, and the government’s job would be made that much easier. Part of Obamacare was the government covering the losses of health insurance companies and using bureaucratic delays, they could starve the weaker insurance companies into folding leaving fewer providing coverage until the government could simply absorb the remaining companies and merge it all into government single payer healthcare. Presto Change-o and the government would respond to the cries of the sheeple who would not know where to turn and would be willing to accept anything because they were scared. That plan is still working, and working right as planned and the system to give the government control over life and death is still working because there are those who desire the government to absorb this power. These are the government lifers who have been in Washington D.C. so long that they have come to believe their own propaganda. They believe that government will be exactly what the people need and if the government just took over all the healthcare, then things would be perfect. When, after taking over healthcare, they still did not have all the power required to control the population, then what, then what would they grab next? What would be next, the food stores?


Who are the people who desire to run everybody’s life from Washington D.C. and are blocking any hope of changing the current Obamacare trap from snapping shut? Well, the Democrat Party leadership is all behind this and were the ones who enacted this to begin with. When the Democrat Party leadership wants something, they get what they want because they appear to have complete control over their members. When the Democrat leadership wants something passed, it passes. When the Democrat Party leadership wants something opposed, it is opposed. Then there are the Republican Party faithful. When the Republican Party needs their votes, they get them. Then there are the government faithful, those for whom the government means everything. They will support government even over the people. These Republicans just shot down the latest Republican healthcare plan. The plan likely was not perfect, but nothing is but it would have given some hope against Obamacare. Who are these Republicans who prefer Obamacare and the government over the people? Well their names are Lamar Alexander, R-Tenn.; Shelley Moore Capito, R-W.Va.; Susan Collins, R-Maine; Dean Heller, R-Nev.; John McCain, R-Ariz.; Lisa Murkowski, R-Alaska; and Rob Portman, R-Ohio. For many these names are not of any surprise and they all live in states where they will very likely be reelected and will die while serving, or is that disserving in the Senate.


Senator John McCain has taken his objection to a whole other level when he stated to the media that the “major failures” of ObamaCare were that it was “rammed through Congress by Democrats on a strict party-line basis without a single Republican vote. We should not make the mistakes of the past that has led to ObamaCare’s collapse, including in my home state of Arizona, where premiums are skyrocketing and health care providers are fleeing the marketplace. We must now return to the correct way of legislating and send the bill back to committee, hold hearings, receive input from both sides of the aisle, heed the recommendations of the nation’s governors, and produce a bill that finally delivers affordable health care for the American people.” That is a mouthful and probably would escape many that what John McCain, Mr. Loyalty when on the campaign trail, what he just stated is that he will join any Democrat effort to oppose any efforts to repeal or replace ObamaCare. He has just joined the Democrat offensive to refuse anything that the Republicans offer unless it is to further fund ObamaCare and continue to inflict its heavy toll on the American people. So, as long as the Democrats continue their rejection, they can count upon Senator John “I’m a loyal and trusted Republican” Sidney “but I am also a ‘Never Trump’ loyalist and with his opposition on anything which makes him look bad or not honor his evil promises” McCain, thus I must join the Democrats once again on this effort to save ObamaCare and “Stump Trump.” So, the Republicans in the Senate can add John McCain to the Democrat Party opponent list for the duration and should put up an honest and valid challenger to his next election or force his retirement. He has joined the left and will not be retrieved; he has gone round the bend.


Beyond the Cusp


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