CONVENTION REPORT                              

HEALTH CARE REFORM:  THE TRUTH

The Baucus Plan

The Baucus Plan is the main plan out there as of now.  It would cost $900 trillion over the next ten years, or $100-$150 billion in new federal spending, and it would be everyone’s responsibility to obtain health care coverage; it would be mandated. The goal is a national health plan that allows all inhabitants of the U. S. to receive high-quality , affordable care regardless of age, race, ethnicity or income; in other words if you find yourself in the U. S. you will benefit from health care regardless of who you are, how you got here or your ability to pay.  An IHCC would be established, a board of governors, that would be appointed by the president and approved by the senate and would be responsible for defining cost and coverage, setting quality standards and cost effectiveness requirements and mandating the type and quality of care delivered.  This plane would prohibit insurance companies from denying coverage for people with preexisting conditions.

There was a concentrated effort on the part of the Senator to avoid participation by the AMA, the NMA and the AHA.  The assumptions regarding flaws of health care delivery are based on academic studies think-tank philosophies, lawyers and public administrators; not by health care providers,  

Financing of Plan

Competitive bidding programs would be instituted with vigilant government oversight, strong punishments for those who try to defraud the system, increased reporting of costs and detailed quality of the health care provided.  Physician self –referral would be resisted and prosecuted, hospital ownership would be prohibited, medical malpractice laws would be revised and overpayment to private Medicare providers would be eliminated.  New models would be developed to help lower the cost of long term care and tax reforms would be explored with aim of reducing health care spending.  The Baucus Plan would aim to pervade every element of the health care system;  the driving force would be seeking methods that benefit government and society, not necessarily the individual patient.

Misconceptions

Proponents claim there are 46 million uninsured; however this includes 11.3 million illegally living here and most American oppose health care for illegals, and  17.6 million who can afford insurance and opt not to purchase it.  

The U. S. is the only developed country that does not provide health care for all it’s citizens; absolutely not true; South Africa and Bermuda  do not provide health care; if one is a citizen of a European country, proof of citizenship is required and non citizens are required to obtain a health card for non-emergent services.

The U.S. system is not the best in the world: highly disputable. WHO ranked the U.S., with a population of 303,824,640, as  37th  in the world because there is no universal health system and France with a population of 64,057,792 as 1st

High IMR is certainly not highest in the world. Factors not related to health care are mother’s prenatal care, quality of baby’ care during first year, maternal behavior and lifestyle decisions such as smoking, substance abuse and nutritional problems. Premature babies in this country, who have some sign of life,  there will be an attempt at resuscitation, that at first is successful and then the baby dies, this is listed as “infant death”.  If that baby was born in some countries, the delivery team will not attempt resuscitation and would be listed as “stillborn”, not infant death. Babies with  low birth weight of have a much higher death rate during the first year of life; yet each of these babies are cared for in the U.S., one of a few countries that even make an attempt, and their deaths are counted as “infant death” against the U.S. only to be used by individuals, many of them politicians, who want to discredit our health care system. 

The government can deliver health care at a significantly lower cost than the private sector. With the countless examples of government inefficiency and waste, this claim can hardly be promoted as accurate.  According to NHE , administrative costs for Medicare is 3.1%, for Medicaid, 7.1% and for private insurance 14.1%.  These figures are deficient as a review of the data not included in the private sector but not included in Medicare such as cost of tax collection. marketing, outreach and education costs, customer service costs, program auditing costs done by the Office of the Inspector General, contract negotiation building costs and staff salaries.  Once these hidden costs are noted, the government was found to spend 66% more to provide health care than private insurance.

Manipulation of the Market

Modern health care reform is based on the notion that the market is inept at ensuring health care delivery, cannot control the opportunistic forces that drive its players and propensity for abuse.  Only the government, with its sage and learned members, is able to place a calming effect on the market and be thoroughly regulated.  This is contrary to the mercantilistic   forces that help build this country, but pervade every aspect of health care reform.

The Insurance Exchange is a network of insurance plans and companies administered and mandated by the government to task the employer of funding and maintaining the health care system for non-elderly living in the U.S.  Under this strategy, there is no individual responsibility because health care coverage is legally required and provided to everyone whether they choose to contribute or not; therefore there is one legal meaning, the individual will be prosecuted and punished for not procuring some form of health coverage.

The most revolting and threatening example of government-intervention on health care is the proposed Independent Health Coverage Council, a federal agency designed to regulate every aspect of the health care industry.  It would define “coverage”, “affordability”, “high-quality” and “cost effective care”.  Any insurance company IE must subject itself to the scrutiny of government price regulation.

Effects on the Work Force

The compendium and conditions that would lead to a mass exodus of actively practicing physicians in this country is rapidly materializing; the key is issues of reimbursement, excessive administrative oversight and litigious risks. The state of Florida Department of Health released its first annual physician workforce report from the results of a mandatory questionnaire linked to physician relicensure: they are 13% said they would reduce or discontinue practice over the next 5 years,  only 31% said they would take emergency room call s. with an additional 11%, that would reduce their involvement with emergency room care.  Others would reduce what they do by different percentages over the next 2 years.  This situation will get worse as many physicians are exiting the field or reducing their involvement; there also seems to be a shortage of young physicians to pick up the slack. 63.85% of Florida physicians cite the top reason for changing, reducing or discontinuing their practice as being under the control of politicians, bureaucrats and administrators.

As this process continues this country will increasing rely on inferior applicants and foreign medical graduates: we already import about 25% +.

Cost of Health Care

The 2006 health care dollar went to: hospital care; 31%; other spending (dentists, home health, durable medical products, over the counter medicines, public health, research and structures and equipment); physicians and clinical services 21%;  prescription drugs 10%; program and administrative costs 7%; and nursing home care, 6%.

It is clear that Americans are paying for and willing to fund is the same thing they pay for in any other industry; whatever the service, they demand quality service.  This then is the underlying conflict between that and the changes lawmakers are trying to forcibly effect and the American public wants.

Conclusions

The Baucus Plan ignores many of the great shortcomings from models from which it seeks to borrow such as health restrictions in health care independence and long waits for treatment; it wrongly assumes would be tolerated in this country. They also know, but ignore, that the vast majority of health care providers will be opposed to the stipulations inherent to the plan.

Recommendations

First and foremost is to allow the health care professional to assume the role of reformers.  It seems audacious for physicians and other health care professional to set out to reform the judicial system and it is equally absurd to have lawyers and foreign policy experts redesign the health care system.  At present there are 12 physicians in congress and it makes no sense not to employ their talents.

It is not sufficient to say there are disparities in health care delivery and the country is spending too much on health care.  The root causes of these shortcomings must be identified and defined and the solutions must address these shortcomings, not take the form of sweeping reforms  We really do not want to weaken the system but preserve what is working and preserve the elements of  free market principles.

We have recurrently established that the most essential fiber of a vibrant health care system is its workforce. As such we must lure the best and most capable minds to this field and encourage these highly valuable, resilient and caring people to persevere as long as possible.  As long as the question of government policy remains toward the illegal population remains unaddressed, any attempt at solving health care needs will be less than effective.

The proponents of reform are convinced that government intervention and regulation is the way to control health care expenditure; this bureaucracy would dwarf Medicare in size.  Health care provider cost should be put out in the open, allowing physicians to know the charges by other physician, a practice that is presently prohibited by federal law.  This is the only way health care providers can compete in a free market system.  Insurance companies should not be able to set prices on health care systems.

Every effort should be made at removing tax incentives that favor employer based plans over individual ones. America’s reliance on the employer to provide health care coverage is outdated, restrictive to the individual and increasingly less effective at capturing the largest segments of  our workforce.  Increasing the fiscal burden on the employer will actually have negative effects on the economy, unemployment levels and mean wages earned.

Young people who are vibrant, working for a living, short on money, long on good health and are not insured by their employer, forego insurance to cut expenses.  When a devastating illness or injury happens they are unable to work.  One solution is to create a public assistance fund so that any acutely ill or injured person becomes immediately eligible for health care.  The public fund assumes responsibility for payment of medicals bills, and once the patient returns to work, he is the responsible for repayment of bills at a pace that is adjusted for his income; under no circumstance would it be zero.  The plan will work retroactively so that the health care providers would be reimbursed and no longer be burdened with paying for the uninsured’s health care.

Preventative medicine is an invaluable tool for the public health care expert and the individual. It plays a very small role for the economist and should not play a major role if cutting health care costs.  There is a large amount of room for improvement in the medical malpractice arena, no bill should be passed without tort reform. Legislation protecting physicians from unsubstantiated lawsuits will go a long way toward lowing costs of health care.  Another reform is the establishment of health court, specific to the practice of medicine; these courts would review medical cases and whose juries are composed of well versed health care providers

 

The above was taken from the book written by one of the speakers at the health care workshop at the NFRW convention. Dr. Julio Gonzalez is an orthopedic surgeon who lives in Venice, FL.

CMS      Centers for Medicare & Medicaid Services                CPT Code current procedural terminology  
 E & M codes   evaluation & management                                IHCC   independent health coverage council
SGR   sustainable growth rate                                                    IMR     infant mortality rate 
 NHE   national health expenditures

 

Other thoughts from health care work shop 

AMA and Nurses’ Association not supporting health care bill as it is.  Public option is very bad, free market system for insurance is much better. 

(For those of you who weren’t at Tuesday’s meeting this is from Barbara Stables report: “ if nothing else, please have a will or trust, living will, durable power of attorney and medical surrogate.  Discuss funereal plans with your family.  This will give you peace of mind and will less traumatic for those you leave behind.  Have these documents notarized!!”

FROM MICHAEL STEEL, RNC

He was at the Mall on 9/12 and there were 2 million people there; that is was a very orderly crowd and people were making their own signs.  Their slogan was “Mr. President, do you hear us now; this is your only “public option”. He wants to see a new direction for Republican Women.  We need to groom and elect women and advance young Republican Women and keep them involved; we must be proactive need a “ 21st Century Women’s Contract for America”.    Republican core value , protect our God given rights and then no man can take them away. “A good party is a terrible thing to waste”.

Col. Alan West

The government is getting into every aspect of our lives; so much of the country’s leadership is inept, unintelligent and corrupt. Washington doesn’t what leadership is; we need leaders, not political correct people running our government.  We need to build on principles of values.   Some of his suggestions to return to basics and be proactive: 1) need to reduce corporate tax, 2) give tax credit to small businesses, 3) demolish capital gain tax, 4) create job training program and new jobs, not quotas, 5) welfare reform, 6) abolish death tax.

Frances Rice

We need to work on swelling our base; recruit blacks, Asians and Hispanics.  (You may not know that most Asians are Republicans; I intend to go speak with their club and the Black Republicans).  We need to be in close touch with the TARS (high school students) and college Republicans.  The TARS need  community service to graduate.  We can check with school board on this.

If you ask a black what they believe in, most say their values are  the same as Republican; so ask them why they vote for Democrats.  It was the Democrats that repelled the Civil Right Act of 1851; JFK was anti civil rights and it was the Republicans that passed the Civil Right Act.

Ladies, 

There was a lot more said but all the speakers talked faster than I could write.  I realize this is very long because of the book report; as I hadn’t done a book report in many years, it took me four hours;  but I did think the health care issues was one of the most important issue we are facing.

The FFRW’s new motto:

“For Republican Women, there’s no such thing as an off year election”.  We need to get to work electing conservative Republicans; write letters to the editor (maybe the PNJ will actually print a few) call talk radio and talk to your friends and neighbors.

A quote from Glen Beck (he was not at the convention) but a good quote; “The government cannot solve the problem, the government IS THE PROBLEM”.                                                                                                   

 

Submitted by Kay Addison, former President of EFRWC, now President of Santa Rosa Federated Republican Women

CONVENTION REPORT                              

HEALTH CARE REFORM:  THE TRUTH

The Baucus Plan

The Baucus Plan is the main plan out there as of now.  It would cost $900 trillion over the next ten years, or $100-$150 billion in new federal spending, and it would be everyone’s responsibility to obtain health care coverage; it would be mandated. The goal is a national health plan that allows all inhabitants of the U. S. to receive high-quality , affordable care regardless of age, race, ethnicity or income; in other words if you find yourself in the U. S. you will benefit from health care regardless of who you are, how you got here or your ability to pay.  An IHCC would be established, a board of governors, that would be appointed by the president and approved by the senate and would be responsible for defining cost and coverage, setting quality standards and cost effectiveness requirements and mandating the type and quality of care delivered.  This plane would prohibit insurance companies from denying coverage for people with preexisting conditions.

There was a concentrated effort on the part of the Senator to avoid participation by the AMA, the NMA and the AHA.  The assumptions regarding flaws of health care delivery are based on academic studies think-tank philosophies, lawyers and public administrators; not by health care providers,  

Financing of Plan

Competitive bidding programs would be instituted with vigilant government oversight, strong punishments for those who try to defraud the system, increased reporting of costs and detailed quality of the health care provided.  Physician self –referral would be resisted and prosecuted, hospital ownership would be prohibited, medical malpractice laws would be revised and overpayment to private Medicare providers would be eliminated.  New models would be developed to help lower the cost of long term care and tax reforms would be explored with aim of reducing health care spending.  The Baucus Plan would aim to pervade every element of the health care system;  the driving force would be seeking methods that benefit government and society, not necessarily the individual patient.

Misconceptions

Proponents claim there are 46 million uninsured; however this includes 11.3 million illegally living here and most American oppose health care for illegals, and  17.6 million who can afford insurance and opt not to purchase it.  

The U. S. is the only developed country that does not provide health care for all it’s citizens; absolutely not true; South Africa and Bermuda  do not provide health care; if one is a citizen of a European country, proof of citizenship is required and non citizens are required to obtain a health card for non-emergent services.

The U.S. system is not the best in the world: highly disputable. WHO ranked the U.S., with a population of 303,824,640, as  37th  in the world because there is no universal health system and France with a population of 64,057,792 as 1st

High IMR is certainly not highest in the world. Factors not related to health care are mother’s prenatal care, quality of baby’ care during first year, maternal behavior and lifestyle decisions such as smoking, substance abuse and nutritional problems. Premature babies in this country, who have some sign of life,  there will be an attempt at resuscitation, that at first is successful and then the baby dies, this is listed as “infant death”.  If that baby was born in some countries, the delivery team will not attempt resuscitation and would be listed as “stillborn”, not infant death. Babies with  low birth weight of have a much higher death rate during the first year of life; yet each of these babies are cared for in the U.S., one of a few countries that even make an attempt, and their deaths are counted as “infant death” against the U.S. only to be used by individuals, many of them politicians, who want to discredit our health care system. 

The government can deliver health care at a significantly lower cost than the private sector. With the countless examples of government inefficiency and waste, this claim can hardly be promoted as accurate.  According to NHE , administrative costs for Medicare is 3.1%, for Medicaid, 7.1% and for private insurance 14.1%.  These figures are deficient as a review of the data not included in the private sector but not included in Medicare such as cost of tax collection. marketing, outreach and education costs, customer service costs, program auditing costs done by the Office of the Inspector General, contract negotiation building costs and staff salaries.  Once these hidden costs are noted, the government was found to spend 66% more to provide health care than private insurance.

Manipulation of the Market

Modern health care reform is based on the notion that the market is inept at ensuring health care delivery, cannot control the opportunistic forces that drive its players and propensity for abuse.  Only the government, with its sage and learned members, is able to place a calming effect on the market and be thoroughly regulated.  This is contrary to the mercantilistic   forces that help build this country, but pervade every aspect of health care reform.

The Insurance Exchange is a network of insurance plans and companies administered and mandated by the government to task the employer of funding and maintaining the health care system for non-elderly living in the U.S.  Under this strategy, there is no individual responsibility because health care coverage is legally required and provided to everyone whether they choose to contribute or not; therefore there is one legal meaning, the individual will be prosecuted and punished for not procuring some form of health coverage.

The most revolting and threatening example of government-intervention on health care is the proposed Independent Health Coverage Council, a federal agency designed to regulate every aspect of the health care industry.  It would define “coverage”, “affordability”, “high-quality” and “cost effective care”.  Any insurance company IE must subject itself to the scrutiny of government price regulation.

Effects on the Work Force

The compendium and conditions that would lead to a mass exodus of actively practicing physicians in this country is rapidly materializing; the key is issues of reimbursement, excessive administrative oversight and litigious risks. The state of Florida Department of Health released its first annual physician workforce report from the results of a mandatory questionnaire linked to physician relicensure: they are 13% said they would reduce or discontinue practice over the next 5 years,  only 31% said they would take emergency room call s. with an additional 11%, that would reduce their involvement with emergency room care.  Others would reduce what they do by different percentages over the next 2 years.  This situation will get worse as many physicians are exiting the field or reducing their involvement; there also seems to be a shortage of young physicians to pick up the slack. 63.85% of Florida physicians cite the top reason for changing, reducing or discontinuing their practice as being under the control of politicians, bureaucrats and administrators.

As this process continues this country will increasing rely on inferior applicants and foreign medical graduates: we already import about 25% +.

Cost of Health Care

The 2006 health care dollar went to: hospital care; 31%; other spending (dentists, home health, durable medical products, over the counter medicines, public health, research and structures and equipment); physicians and clinical services 21%;  prescription drugs 10%; program and administrative costs 7%; and nursing home care, 6%.

It is clear that Americans are paying for and willing to fund is the same thing they pay for in any other industry; whatever the service, they demand quality service.  This then is the underlying conflict between that and the changes lawmakers are trying to forcibly effect and the American public wants.

Conclusions

The Baucus Plan ignores many of the great shortcomings from models from which it seeks to borrow such as health restrictions in health care independence and long waits for treatment; it wrongly assumes would be tolerated in this country. They also know, but ignore, that the vast majority of health care providers will be opposed to the stipulations inherent to the plan.

Recommendations

First and foremost is to allow the health care professional to assume the role of reformers.  It seems audacious for physicians and other health care professional to set out to reform the judicial system and it is equally absurd to have lawyers and foreign policy experts redesign the health care system.  At present there are 12 physicians in congress and it makes no sense not to employ their talents.

It is not sufficient to say there are disparities in health care delivery and the country is spending too much on health care.  The root causes of these shortcomings must be identified and defined and the solutions must address these shortcomings, not take the form of sweeping reforms  We really do not want to weaken the system but preserve what is working and preserve the elements of  free market principles.

We have recurrently established that the most essential fiber of a vibrant health care system is its workforce. As such we must lure the best and most capable minds to this field and encourage these highly valuable, resilient and caring people to persevere as long as possible.  As long as the question of government policy remains toward the illegal population remains unaddressed, any attempt at solving health care needs will be less than effective.

The proponents of reform are convinced that government intervention and regulation is the way to control health care expenditure; this bureaucracy would dwarf Medicare in size.  Health care provider cost should be put out in the open, allowing physicians to know the charges by other physician, a practice that is presently prohibited by federal law.  This is the only way health care providers can compete in a free market system.  Insurance companies should not be able to set prices on health care systems.

Every effort should be made at removing tax incentives that favor employer based plans over individual ones. America’s reliance on the employer to provide health care coverage is outdated, restrictive to the individual and increasingly less effective at capturing the largest segments of  our workforce.  Increasing the fiscal burden on the employer will actually have negative effects on the economy, unemployment levels and mean wages earned.

Young people who are vibrant, working for a living, short on money, long on good health and are not insured by their employer, forego insurance to cut expenses.  When a devastating illness or injury happens they are unable to work.  One solution is to create a public assistance fund so that any acutely ill or injured person becomes immediately eligible for health care.  The public fund assumes responsibility for payment of medicals bills, and once the patient returns to work, he is the responsible for repayment of bills at a pace that is adjusted for his income; under no circumstance would it be zero.  The plan will work retroactively so that the health care providers would be reimbursed and no longer be burdened with paying for the uninsured’s health care.

Preventative medicine is an invaluable tool for the public health care expert and the individual. It plays a very small role for the economist and should not play a major role if cutting health care costs.  There is a large amount of room for improvement in the medical malpractice arena, no bill should be passed without tort reform. Legislation protecting physicians from unsubstantiated lawsuits will go a long way toward lowing costs of health care.  Another reform is the establishment of health court, specific to the practice of medicine; these courts would review medical cases and whose juries are composed of well versed health care providers

 

The above was taken from the book written by one of the speakers at the health care workshop at the NFRW convention. Dr. Julio Gonzalez is an orthopedic surgeon who lives in Venice, FL.

CMS      Centers for Medicare & Medicaid Services                CPT Code current procedural terminology  
 E & M codes   evaluation & management                                IHCC   independent health coverage council
SGR   sustainable growth rate                                                    IMR     infant mortality rate 
 NHE   national health expenditures

 

Other thoughts from health care work shop 

AMA and Nurses’ Association not supporting health care bill as it is.  Public option is very bad, free market system for insurance is much better. 

(For those of you who weren’t at Tuesday’s meeting this is from Barbara Stables report: “ if nothing else, please have a will or trust, living will, durable power of attorney and medical surrogate.  Discuss funereal plans with your family.  This will give you peace of mind and will less traumatic for those you leave behind.  Have these documents notarized!!”

FROM MICHAEL STEEL, RNC

He was at the Mall on 9/12 and there were 2 million people there; that is was a very orderly crowd and people were making their own signs.  Their slogan was “Mr. President, do you hear us now; this is your only “public option”. He wants to see a new direction for Republican Women.  We need to groom and elect women and advance young Republican Women and keep them involved; we must be proactive need a “ 21st Century Women’s Contract for America”.    Republican core value , protect our God given rights and then no man can take them away. “A good party is a terrible thing to waste”.

Col. Alan West

The government is getting into every aspect of our lives; so much of the country’s leadership is inept, unintelligent and corrupt. Washington doesn’t what leadership is; we need leaders, not political correct people running our government.  We need to build on principles of values.   Some of his suggestions to return to basics and be proactive: 1) need to reduce corporate tax, 2) give tax credit to small businesses, 3) demolish capital gain tax, 4) create job training program and new jobs, not quotas, 5) welfare reform, 6) abolish death tax.

Frances Rice

We need to work on swelling our base; recruit blacks, Asians and Hispanics.  (You may not know that most Asians are Republicans; I intend to go speak with their club and the Black Republicans).  We need to be in close touch with the TARS (high school students) and college Republicans.  The TARS need  community service to graduate.  We can check with school board on this.

If you ask a black what they believe in, most say their values are  the same as Republican; so ask them why they vote for Democrats.  It was the Democrats that repelled the Civil Right Act of 1851; JFK was anti civil rights and it was the Republicans that passed the Civil Right Act.

Ladies, 

There was a lot more said but all the speakers talked faster than I could write.  I realize this is very long because of the book report; as I hadn’t done a book report in many years, it took me four hours;  but I did think the health care issues was one of the most important issue we are facing.

The FFRW’s new motto:

“For Republican Women, there’s no such thing as an off year election”.  We need to get to work electing conservative Republicans; write letters to the editor (maybe the PNJ will actually print a few) call talk radio and talk to your friends and neighbors.

A quote from Glen Beck (he was not at the convention) but a good quote; “The government cannot solve the problem, the government IS THE PROBLEM”.                                                                                                   

 

Submitted by Kay Addison, former President of EFRWC, now President of Santa Rosa Federated Republican Women