Below is an article that is the best news those in favor of free market health care reform could hope for.

Depsite the move being retaliation against the insurance industry's recent report on the potential impact of the Senate Finance Committee's bill on health care costs, the move is welcome. Creating an environment where insurance companies compete is the the first step toward better coverage, and lower proces. Other important changes need to be made, but none would work without this one. Here is the article:

From the Associated Press

WASHINGTON – A House committee has voted to strip the health insurance industry of its exemption from federal antitrust laws as senators announced plans to take the same step.

The moves Wednesday signaled a growing determination by Democrats to punish the insurance industry for its criticism of President Barack Obama's health care overhaul agenda. The House Judiciary Committee voted 20 to 9 to repeal a 1940s law that exempted the health insurance industry from federal controls over certain antitrust violations including price-fixing.

Lawmakers said they wanted to include the legislation in a larger health care overhaul bill taking shape in the House. In the Senate, Majority Leader Harry Reid announced plans to repeal the antitrust exemption as part of its health care legislation.

Accessed at http://news.yahoo.com/s/ap/20091021/ap_on_go_co/us_health_care_overhaul on October 21, 2009 at 12:15 PM.

I have written substantially regarding the true kinds of reform that is needed in our health care industry as well as the forces at work in Washington that are bringing about the current kind of reform bills. Below is a link to a very informative video regarding the health insurance industry's recent ad campaign against the Baucus Bill. I think you will find it fascinating.

Michael F. Cannon on the insurance industry study on the Baucus Bill on FOX

When we finally begin to see through the press releases and media coverage for what this really is, and not the victory that it purports to be, we will be that much closer to being able to advance true reform.

Very inspiring. I hope you enjoy these as much as I do.

Over the past several months I have taken you on a journey of education by which we have explored the root causes of the problems we are facing, philosophical arguments for freedom in health care, possible free market reforms, the financial costs involved with passing and not passing reform, the powers at work in health care reform, and the compromises shaping up in Washington.

The perspective I have offered to you is one not based on self interest, party, or politician – which always leads to perpetual blindness. The perspective I have offered is based on free thinking, information, and independent principles.

However, I have not pretended to be without an opinion. I only hope I supported it with fact, sound theory, and convincing argument. If I was a bit zealous at times, I hope it was never in bad taste. The powerful forces at work are certainly zealous in their causes. Those who believe that Mankind was endowed by their Creator with certain unalienable rights should be even more so; for we are not fighting to take anything – not money, life, or liberty – from anyone or any institution. On the contrary, those who espouse True Reform are those who fight for Equality for all, Justice for those who have been the recipients of Injustice and Life for all Americans – at the expense of none and for the benefit all. This is the kind of reform that has the greatest chance of delivering better health care for Americans, delivering on the American dream, and of getting us closer to a better society.

We now finally reach the end and conclusion of this exhaustive inquiry. Thank you for reading along. Now write to Your Representatives and stand up for what you believe to be the right path forward.

Please Click Here to Write Your Representatives

Now that you have seen some of the possible reforms that should be taken to bring about true change in health care and foreseen the likely benefits derived there from, and seen the powers that are at work in Washington, it is good to give a quick examination to the President's plan and what it actually proposes. The following is the exact text of the President’s plan taken from the White House website (footnote 1) as posted on September 9th. I have taken each point and given a brief opinion for the benefit of the reader in italics.

While you read along, see if you can see what lobbyist each point appeases or makes a compromise with.

Here is the President's Plan:

If You Have Health Insurance
More Stability and Security

· Ends discrimination against people with pre-existing conditions. Over the last three years, 12 million people were denied coverage directly or indirectly through high premiums due to a pre-existing condition. Under the President’s plan, it will be against the law for insurance companies to deny coverage for health reasons or risks.

Translation: Everyone is going to have to pay a lot more for their health care. Rather than make a blanket regulation that all plans must have this waived, products need to be developed based on cost and underwriting, as well as plans where there are no pre-existing conditions, to ensure that each American can receive the kind of health care that best fits their needs.

· Limits premium discrimination based on gender and age. The President’s plan will end insurers’ practice of charging different premiums or denying coverage based on gender, and will limit premium variation based on age.

Translation: Although I agree that premiums should not change based on gender, I disagree that premiums should not be adjusted based on age. The affect of this is that it would push up prices for every other insured individual. Although there should be products in the marketplace that offer this type of coverage, it should not be the only product. This kind of mandate severely limits the marketplace's ability to provide individual coverage for the low income and unemployed as the prices would be unbearable.

· Prevents insurance companies from dropping coverage when people are sick and need it most. The President’s plan prohibits insurance companies from rescinding coverage that has already been purchased except in cases of fraud. In most states, insurance companies can cancel a policy if any medical condition was not listed on the application – even one not related to a current illness or one the patient didn’t even know about. A recent Congressional investigation found that over five years, three large insurance companies cancelled coverage for 20,000 people, saving them from paying $300 million in medical claims - $300 million that became either an obligation for the patient’s family or bad debt for doctors and hospitals.

Translation: This is a very good change that should be implemented.

· Caps out-of pocket expenses so people don’t go broke when they get sick. The President’s plan will cap out-of-pocket expenses and will prohibit insurance companies from imposing annual or lifetime caps on benefit payments. A middle-class family purchasing health insurance directly from the individual insurance market today could spend up to 50 percent of household income on health care costs because there is no limit on out-of-pocket expenses.

Translation: This provision places an ever larger cost on the insured and does nothing to lower costs. This kind of provision will actually increase costs across the board. Insurance is meant to minimize risk. A person should be able to purchase a plan based on the amount of risk they are willing and able to assume. Some product innovations that carry the spirit of this provision could be plans that state that out-of-pocket maximums will not exceed a percentage of a person's annual income. However, mandating that there will be no lifetime maximums and set out-of-pocket maximums for all insurance products will reduce choice in the marketplace and increase costs for all Americans.

· Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money. The President’s plan ensures that all Americans have access to free preventive services under their health insurance plans. Too many Americans forgo needed preventive care, in part because of the cost of check-ups and screenings that can identify health problems early when they can be most effectively treated. For example, 24 percent of women age 40 and over have not received a mammogram in the past two years, and 38 percent of adults age 50 and over have never had a colon cancer screening.

Translation: It is important to remember that nothing is free – especially not in health care. It must be paid for – either in a low co-pay or in an increased monthly premium. It has to be paid for. With that said, I do believe that there should be some basic standards to qualified health plans – preventative care being one of them.

· Protects Medicare for seniors. The President’s plan will extend new protections for Medicare beneficiaries that improve quality, coordinate care and reduce beneficiary and program costs. These protections will extend the life of the Medicare Trust Fund to pay for care for future generations.

Translation: The true reason the government is heading to a financial mess is because of Medicare and the likely costs the taxpayer must assume. Although it is impossible to truly forecast what those unfunded liabilities are, it is safe to assume that it will be expensive. One should no more wish to extend Medicare than they should wish for a beating. Medicare must be secured for those who have it and other options must be given to those who would otherwise qualify for it. This, and the other free market reforms, is the best course for solving our looming financial crisis and for providing care to our seniors.

· Eliminates the "donut-hole" gap in coverage for prescription drugs. The President’s plan begins immediately to close the Medicare "donut hole" - a current gap in its drug benefit - by providing a 50 percent discount on brand-name prescription drugs for seniors who fall into it. In 2007, over 8 million seniors hit this coverage gap in the standard Medicare drug benefit. By 2019, the President’s plan will completely close the "donut hole". The average out-of-pocket spending for such beneficiaries who lack another source of insurance is $4,080.

Translation: Because the People of the United States are insuring the elderly we should provide them with the care they deserve. However, with America's aging population, Medicare in all its parts is an unsustainable program that does nothing for the free market. It may provide a service to the elderly, but certainly not the best one nor the one they deserve. No amount of government improvements in this program will ever change that. The people and their creative forces through the marketplace is the best and surest way to provide quality, value and Justice in health care. This is also an obvious win for the pharmaceutical companies.

If You Don't Have Insurance

Quality, Affordable Choices for All Americans

· Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices. The President’s plan allows Americans who have health insurance and like it to keep it. But for those who lose their jobs, change jobs or move, new high quality, affordable options will be available in the exchange. Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality.

Translation: The health insurance exchange is an excellent idea that must be included in reform. However, the President’s version of the exchange excludes everyone that has or is eligible for group or government insurance. It protects insurance companies, does nothing to improve competition and solidifies the employer and government sponsored health plans. It keeps the status quo for those with insurance.

· Provides new tax credits to help people buy insurance. The President’s plan will provide new tax credits on a sliding scale to individuals and families that will limit how much of their income can be spent on premiums. There will also be greater protection for cost-sharing for out-of-pocket expenses.

Translation: Rather than encourage health insurance which furthers the monopoly of the insurance industry over health care, the government should ensure equal tax treatment for all health care costs – be it insurance, co-ops, health shares or out-of-pocket expenses.

· Provides small businesses tax credits and affordable options for covering employees. The President’s plan will also provide small businesses with tax credits to offset costs of providing coverage for their workers. Small businesses who for too long have faced higher prices than larger businesses, will now be eligible to enter the exchange so that they have lower costs and more choices for covering their workers.

Translation: Rather than deepen the hold of employer sponsored health plans, the President and Congress should seek to open up the health care marketplace and end the complete hegemony of employer sponsored health plans over American health care.

· Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice. The President believes this option will promote competition, hold insurance companies accountable and assure affordable choices. It is completely voluntary. The President believes the public option must operate like any private insurance company – it must be self-sufficient and rely on the premiums it collects.

Translation: Reasons enough have already been given that demonstrate this proposal to be unjust, costly, destructive to the marketplace, inefficient and unsustainable. Rather than seek to reduce the marketplace, the president should seek to build the marketplace.

· Immediately offers new, low-cost coverage through a national "high risk" pool to protect people with preexisting conditions from financial ruin until the new Exchange is created. For those Americans who cannot get insurance coverage today because of a pre-existing condition, the President’s plan will immediately make available coverage without a mark-up due to their health condition. This policy will offer protection against financial ruin until a wider array of choices become available in the new exchange in 2013.

Translation: The high risk pool is an excellent recommendation and should be included in the health care reform plan. However, this should not be part of a National Health Plan and should be state specific.

For All Americans
Reins In the Cost of Health Care for Our Families, Our Businesses, and Our Government

· Won’t add a dime to the deficit and is paid for upfront. The President’s plan will not add one dime to the deficit today or in the future and is paid for in a fiscally responsible way. It begins the process of reforming the health care system so that we can further curb health care cost growth over the long term, and invests in quality improvements, consumer protections, prevention, and premium assistance. The plan fully pays for this investment through health system savings and new revenue including a fee on insurance companies that sell very expensive plans.

Translation: I agree with the principle whole heartedly. Today's generation should be responsible for today's expenses. However, setting a fee on “very expensive plans” ultimately means setting a new tax on plans that employ elderly and unhealthy individuals. Plan design is only one factor in health care costs. The largest factor is the utilization of the plan. The more people use it the more it will cost them. Accordingly, the most expensive plans are the ones that are the most used. And presumably they are the most used because of the unhealthy or older workforce. Furthermore, the real translation is: your taxes are guaranteed to go up. If it’s not going to add to the deficit it is because it will be paid for which means that the taxes will have to be increased. I have already shown that based on the House version of the bill, the wealthy alone will not be able to pay for this legislation – despite what they may say. The numbers don’t add up.

· Requires additional cuts if savings are not realized. Under the plan, if the savings promised at the time of enactment don’t materialize, the President will be required to put forth additional savings to ensure that the plan does not add to the deficit.

Translation: Although this language is nebulous, it is impossible to disagree with the concept. However, what will be cut? Will the government actually cut spending on health care? Will it be politically feasible to begin cutting a certain kind of cancer drug, therapy or technique because it costs too much? It is unlikely. The concept is noble. Putting it into practice however will be very difficult. The government has only increased spending over time. History shows that cutting spending won’t happen.

· Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality. The President’s plan includes proposals that will improve the way care is delivered to emphasize quality over quantity, including: incentives for hospitals to prevent avoidable readmissions, pilots for new "bundled" payments in Medicare, and support for new models of delivering care through medical homes and accountable care organizations that focus on a coordinated approach to care and outcomes.

Translation: Quality over quantity is a concept that must be included in the reform.

· Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system. The President’s plan will create an independent Commission, made up of doctors and medical experts, to make recommendations to Congress each year on how to promote greater efficiency and higher quality in Medicare. The Commission will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care. It will ensure that your tax dollars go directly to caring for seniors.

Translation: Any measure that can improve the value of the service and lower the cost is one that seems to need no defense.

· Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine. The President’s plan instructs the Secretary of Health and Human Services to move forward on awarding medical malpractice demonstration grants to states funded by the Agency for Healthcare Research and Quality as soon as possible.

Translation: Although medical malpractice is a factor in the rising health care costs, it is small. This is a complicated problem and one that is included because the Republicans have been calling for this kind of reform for years. It is tangential to true health care reform.

· Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform. Under the President’s plan, large businesses – those with more than 50 workers – will be required to offer their workers coverage or pay a fee to help cover the cost of making coverage affordable in the exchange. This will ensure that workers in firms not offering coverage will have affordable coverage options for themselves and their families. Individuals who can afford it will have a responsibility to purchase coverage – but there will be a "hardship exemption" for those who cannot.

Translation: Again, if the President wants to reduce health care costs and ensure that all Americans have coverage, he must move away from this kind of model. This goes in the exact opposite direction than the end we desire: quality health care for each American. The president’s direction keeps the monopoly of the insurance industry and maintains the dominion of the employer sponsored health plan. Furthermore, fining Americans for not purchasing insurance should never be considered a crime worthy of a fine.

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Now that you know the forces at work, it is easier to see who is really benefiting from this plan. If you go bullet by bullet you will be able to see which lobbyist was at work. Take those same tools and look at the HELP or Baucus bills. It is most revealing.

In sum, the president's plan contains many important provisions that should be included in the final reform bill. However, it is important to realize that it does nothing to fundamentally improve the American health care system. Even the health care exchange in this system would be a lost reform because, with the exception of the public health care plan, it would offer exactly what we have which is exactly the problem we are dealing with. The government plan would only worsen the situation. If anything, the majority of the President’s proposals would weaken the already dying marketplace that does exist and increase costs and taxes for all Americans.

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Footnotes

1. http://www.whitehouse.gov/issues/health_care/plan/

We just summarized the likely outcomes of Free Market reforms. The blessings of such reforms need not be debated as they are obvious to any reader. True free market reform brings about the desired outcome and blesses everyone. If the blessings are so obvious, why then is this not the direction our government is taking us in?

The answer? Because of politics, self interest, a fear of losing power and a belief that the status quo will continue to work in the future as it has “worked” in the past. The answer lies in a compromise among all of these forces represented by the different lobbying bodies in Washington. I am well acquainted with many of them.

These lobbying forces are many and strong. To name a few, they are:

1. The Insurance Industry
2. The Corporate Lobby
3. The Insurance Broker Lobby
4. The Media
5. Politicians
6. Unions
7. The Socialist Movement
8. Doctors & Providers
9. Individual Citizens

By looking at each one of these players you will get a sense for the reforms that will actually come out of Washington and why. I will briefly touch on each one of these.

The Insurance Industry

The insurance industry will obviously fight against several things:

1. Ending their exemption from the Sherman Anti-Trust Act
2. A Public option that would compete with them
3. Opening up competition against co-ops & health shares
4. Opening up competition of insurance companies across state lines
5. The end of the employer sponsored health plan
6. Opening up the exchange to those who already have insurance
7. Cap out-of-pocket maximums
8. Pre-existing condition reform

They will fight for:

1. A mandate that says everyone should have insurance – even at the expense of businesses
2. Tools that allow them to negotiate down prices
3. An exchange that makes it easier for people to buy their insurance who didn’t already have it

The Corporate Lobby

The Corporate Lobby will obviously fight against several things:

1. A mandate requiring them to “pay or play”
2. Repealing the tax deduction on contributions to employer sponsored health plans
3. Not allowing them to participate in the health care exchange
4. Taxation on “Cadillac Plans”

They will fight for the following:

1. Small business exemption to any mandates
2. Credits that make it easier for them to provide health care
3. An open health care exchange

The Insurance Broker Lobby

This lobby will fight against:

1. The end of the employer sponsored health plan
2. Any kind of tax increase on employers
3. Anything that damages the insurance industry

Reforms they will fight for:

1. Reform that would bring more people onto employer sponsored health plans

The Media

I don’t believe they will “fight” against anything. Although they may not cover, or give air time to important reforms such as:

1. Elimination of the anti-trust exemption for insurance companies (they support the media through advertising)
2. In depth coverage of free-market reform

Reforms that most of the media will fight for:

1. A Public Option – within 45 minutes the other day I saw “How American Healthcare killed my Grandfather” and Bill Maher accusing America as being the only developed nation that “get’s rich on people’s misfortunes.”
2. Coverage for everyone

Politicians

Reforms they will fight against:

1. The overt end of the employer sponsored health plan

· Why would they not fight for this? It is because it goes hand in hand with Medicare and Medicaid. Medicare exists only because of the dominance of employer sponsored health plans because most employers don’t insure people after they retire. Therefore, the government can do that instead. Furthermore, Medicaid also exists primarily because of the employer sponsored health plan because employers don’t insure the unemployed or non-working class. Therefore, the government has a program to take care of them too. These are two programs built around employer sponsored health care. By eliminating the employer sponsored health plan and creating a free market, the need for Medicaid and Medicare diminishes and eventually goes away.

2. Direct taxes on the middle or lower class as they are the bulk of the voters
3. Anything that reduces government income (i.e., HSAs, Vouchers, leveling of tax treatment for all health care expenditures)
4. Increasing the deficit as a result of health care – it is politically unpopular and destructive

Reforms politicians will fight for:

1. The increase of Medicaid
2. Stability and continuity for Medicare
3. A public option (for several reasons, including that this is the surest way to raise enough money without making it look like they are raising taxes)
4. Additional tax revenues
5. Pre-existing condition reform
6. Cap out-of-pocket maximums

Unions

Reforms they will fight against:

1. Reforms that limit an employer’s ability to limit retiree medical any time in the future

Reforms they will fight for:

1. A mandate that makes employers cover 100% of their workforce
2. Securing retiree medical insurance

The Socialist Movement

Reforms they will fight against:

1. The repeal of the anti-trust exemption on insurance companies. (The socialist cause is one for more government programs – not open or free markets.)
2. Free market health care reforms

The reforms they will seek for are:

1. A single payer health care system
2. Taxes on the wealthy to pay for it

Doctors & Providers

Reforms they will fight against:

1. A public option that reimburses at the same level as Medicare or lower
2. Pay-for-performance
3. Allowing the government to negotiate directly with drug companies.

Reforms that Doctors & Providers will work for:

1. Employer Mandate
2. Health Care exchange
3. Pre-existing condition reform
4. Reforms that help them earn more money
5. Pharmaceutical companies will try and expand their drug penetration (i.e., end the ‘doughnut hole’ in Medicare)

Individual Citizens

Reforms citizens will fight against:

1. Raising taxes on the majority of Americans
2. Reforms that appear to be un-American

Reforms we will fight for:

1. Better care for all Americans
2. Lower costs

You probably noticed that most of these players don’t represent groups that are trying to open up markets, create competition, end the status quo or truly lower costs. That is the reason why we are not going in direction that would truly benefit America.

There is of course the CATO Institute and other free-market Washington think-tanks that will try to urge Congress in a free market direction. However, they are not supported by the other players – or even a majority of the people. Sadly, freedom doesn’t have a strong lobbyist because most people receive their information from the media, support politicians rather than policies, work for employers, go to doctors, and belong to unions.

Which of these lobbying forces is the most powerful? It is hard to say as each of them carries a tremendous amount of force with them. Because of this, the reform that will ultimately happen will be a compromise between all of these different sources. You can guarantee that it will include “wins” for all of these players.

Freedom, justice and the proper exercise of agency, is predicated upon education and understanding. We can never hope for that from these major players. Being aware of the largest players and the kinds of reforms they desire will enable you to more properly perceive the kinds of reforms being discussed – where they originated and who they benefit. Only then will we be able to accurately recognize the kind of reform being debated in Washington.

Over the past several weeks I have introduced to you various new options and choices that are necessary for creating a vibrant, free market system in health care – some of which are non-negotiable for creating a better America. To summarize what those recommendations are, they are as follows:

1. End the government sponsorship and protection of the insurance industry by removing the anti-trust exemption on the insurance industry forcing them to compete based on products, prices and services

2. Encourage and bring to an equal level Health Shares and non-profit Co-ops to provide additional options and alternatives for Americans to choose from

3. End the dominance of the employer sponsored health care plan which would promote private health insurance for all – the unemployed, the employed but with no insurance, the employed, and the retired

4. Introduce health care vouchers for employees rather than health care plans

5. Reform tax treatment of health care related expenses so they are all treated equally and do not favor one type of plan over another or one type of provider over another

6. Reform and increase the use of HSAs

7. Create a maximum on the amount the uninsured can be charged relative to the insured

8. Freeze Medicare & Medicaid at their current levels

9. Have the government provide vouchers for the low income and retired to purchase private health coverage that fits their needs

10. Introduce an increased tax deduction or credit for assisting family members with their health care expenses

11. Introduce a truly free and open health insurance exchange for all people and all health care related products

12. Pre-existing condition reform

13. Allow insurance plans written in one state to be sold in another state

14. Pay doctors for results and not only for services including the amount charged and warranties

These proposed reforms are not all inclusive. Some others that I have not focused on include:

1. Encouraging wider user of Health Savings Accounts for retirement health care. Health Savings Account contributions by any source would be tax deductible and never taxed upon withdrawal ensuring that health care expenses come first. If each American put aside between 2-4% of their income annually into an interest bearing account, they would be able to pay for most, if not all, of their health care related expenses after retirement (Footnote 1).

2. Freeing up doctors to be able to dictate their prices rather than the insurance companies. This would obviously create a market that truly competes based on price (Footnote 1).
Requiring, similar to our regulations on public companies, that doctors and hospitals disclose their success and failure rate. Patients have a right to know the quality of care they will be receiving. Furthermore, this reform, combined with #2 above, would truly help to create a marketplace that competes on value – quality and price (Footnote 1).

3. Encouraging more direct interaction between doctors and patients through phone and e-mail consultations. Because insurance companies don’t reimburse for this kind of care, doctors don’t provide it. If doctors are freed in their ability to determine prices and services, the market can better take care of the needs of the people in it (Footnote 1).

4. Electronic Record Keeping to build an infrastructure wherein information is more easily passed, efficiently maintained and more productively used for the care of the patient
A free market agency that rates providers based on quality of care and value of services. Such an agency would be similar to the “Energy Star” rating on electronic products. The value of this is obvious.

To sum up the whole of this kind of reform, if all of these reforms were enacted, American health care would be entirely different. All citizens would be able to have health care tailored to their needs and desires – the young invincibles to the aged and infirm, the employed and unemployed or retired. Insurance companies would not only be forced to compete with each other for the first time in modern history, but they would also have to compete for customers with health shares, co-ops, and self insurance. Small businesses are able to help provide care to their staff through vouchers. There are incentives for private plans to emerge. Employers would still be able to compete for top talent by the amount they contribute to private plans through vouchers. The government’s funding crisis becomes minimized by freezing the number of enrolled members in Medicare and Medicaid and simultaneously stimulates the free market by providing vouchers for eligible Americans to purchase private health care based on their needs. Americans have sufficient funds at retirement to pay for their health care and the costs for everyone have been lowered by competition, electronic records, diverse products and options, individual policies written to their needs, public disclosures of performance levels, and “Energy Star” type ratings.

Essentially, the rich and poor, healthy and infirm, employed and unemployed, could all be provided for. Not only that, they would be more effectively and efficiently provided for than had the government done it. Future generations are not taxed to provide for our care today, our reforms bless untold millions of unborn and future generations, government credit is increased and the National character becomes a light of what free will, Justice and the American spirit intended. True reform would bring about true blessings that could benefit everyone.

Compare this kind of reform to that being debated in Congress. Insurance Companies keep their anti-trust exemption, Medicare, Medicaid and the employer sponsored health plan are further entrenched, choice and freedom is not expanded - on the contrary, it is contracted - government growth goes up, quality eventually goes down, government is forced into an unethical situation of injustice and inequity, certain levels and powers to ration care, ourselves and the future are burdened with an unbearable level of greater and greater debt, the family is weakened, the health care industry is crippled by certain elements of central planning, costs for everyone with insurance go up, and the people in the long run are the ones who are hurt. The future is not all dark with the government health care reform, however. There are still some bright spots such as greater access to health care, some insurance reform, and some efficiency and cost improvements which would be blessings for many. However, it isn’t as bright as they would like us to believe it is either.

In essence, the government would not be able to fulfill its role to promote and protect the unalienable rights it was chartered with protecting: Life, Liberty and the Pursuit of Happiness through the protection of Property. Its good intentions would cripple its abilities to deliver the expected outcomes on every front - not just health care.

Freedom and Justice as the means leads to Freedom and Justice as the destination. Free market reform isn’t perfect but it is the only way for us to get as close to perfection as we can. The People can do that. The government can’t.

The possibilities of free market reform are as numerous as are individuals. That is the beauty of the market – we all work together, as free Americans, to fill and meet the various needs of every individual in the manner that is best - providing the best service at the best price. It is the invisible hand that moves to fill needs, provides opportunities, sparks ideas, enhances quality, removes barriers, and, where coupled with proper oversight, blesses the whole society. Some would say it is even guided by Providence – after all, free will was given by Him. The proper exercise of agency is a blessing to us all.

This is the best way for America to proceed. If we had no alternative then I would not be nearly so adamant about this kind of True Reform. However, we have an alternative to the status quo that works better than direction we are going in. Why then is it not going in this direction?

To answer that question, we will next briefly address the various forces and players influencing the health care reform debate.


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Footnotes

1. John C Goodman, “A Prescription for Americans Health Care” Imprimis, March 2009, Volume 38, Number 3

One additional major reform that should take place is regarding reimbursement methods. One of the important issues being discussed in the current health care reform debate is how physicians should be paid. Presently, the reimbursement model of both the government and private insurers is based on a negotiated fixed fee schedule for billed services. For example, if a doctor performs a CAT scan, the doctor will be reimbursed $x. If they perform a natural birth, they are reimbursed $x. It is a set fee negotiated with the insurance provider.

The discussion underway looks at this from a new point of view: pay doctors based on their performance – or rather, the results of their work. For example, if a doctor performs a CAT scan that leads to solving a person's particular issue, they are reimbursed at $A. If the doctor performs a CAT scan that does not lead to solving a person's medical need, they are reimbursed at some amount below $A.

Part of paying doctors for results is also setting up a type of warranty system as proposed by John C. Goodman of the National Center for Policy Analysis.

He stated, “In terms of quality, another obvious free market idea is to have warranties for surgery such as we have on cars, houses, and appliances. Many are surprised to learn that about 17 percent of Medicare patients who enter a hospital re-enter within 30 days – usually because of a problem connected with the initial surgery – with the result that they typical hospital makes money on its mistakes. In order for a hospital to make money in a system based on warranties, it must lower its mistake rate. Again, the goal of our policy should be to generate a market in which doctors and hospitals compete with each other to improve quality of care and cut costs (footnote 1).”

Surely this will be an important discussion but is one that far exceeds my comprehension of billing or the scope of this work. The factors involved are complicated.

However, this is an option that has great merit. In approaching this topic, it is important to remember that it does not have to be one way OR the other. Insurers can offer different plans that use these different models. Those plans who use the pay for performance model would be purchased at a lower price because it could be assumed that this system would reduce waste and increase results. However, the other option could still be available for the consumer who desired a more secure system. The cost would reflect that decreased risk. Over time the better product would survive.

No method should be mandated as the sole product or offering. The marketplace is about choice and freedom. This payment option should be widely introduced into the market as an option for the consumer and, whereas this part of the market doesn’t exist, it should be incentivized for a short period of time in order to provide the necessary capital, direction and incentive.

By providing alternatives in the marketplace, competition is increased, prices are lowered and individual's needs are met. By paying for performance, waste is eliminated, prices are reduced, and people’s health is more rapidly improved. This is an easy reform to recommend.

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Footnotes

1. John C Goodman, “A Prescription for Americans Health Care” Imprimis, March 2009, Volume 38, Number 3

People with pre-existing conditions should be able to get health insurance. Pre-existing condition clauses exclude people from receiving care or insurance if they have had a history of disease, ailments, or health risks while they were not insured by a qualified insurance plan. There need to be health care options for these people. That is not negotiable. Leaving them out of the only safety net available is not an option we should accept. However, is the only alternative eliminating all pre-existing condition clauses? No, it isn’t.

The plan proposed by the President, and both the Senate & House bills, require that all pre-existing condition provisions be stricken from every single health care plan. What does this translate into for you and me? It translates into everyone having to pay a lot more for their health coverage because of the automatic risk assumption the insurance carriers will have to assume and the lack of products competing in the market. If we are trying to lower costs in health care, creating one product for all is not the direction to go in. One product means no competition, guaranteed price increases, and no market forces in this area to bring additional value.

What are the alternatives? As with most things, the alternatives lie in widening the field of options.

As with any insurance, there must be an underwriting process to determine if the insurance provider will assume the liability of insuring any particular person. The insurer deserves to know what kind of health the person is in they are being asked to insure. It is only right and fair to do so.

Option 1

With life insurance, as opposed to personal health insurance, there is often a guaranteed issue amount. A guarantee issue is an amount of life insurance a person is guaranteed to be approved for – regardless of any other factor. The amount beyond that is dependent on underwriting approval. Could health insurance not do the same thing? Could an insurer offer certain kinds of coverage (e.g., physicals, primary care doctor visits, emergency room care, certain kinds of treatments, etc.) as a guaranteed issue and offer additional levels of coverage pending underwriting? Even if denied additional levels of coverage, a person could still receive a majority of their needed care through this kind of process.

Option 2

Another kind of health care product could be a plan that does eliminate all pre-existing conditions with no underwriting. Surely the cost of this product would be higher than had they undergone the underwriting process. Nevertheless, this would allow those who need or desire to bypass underwriting to receive all the care they need.

Option 3

A final kind of health care option would be where underwriting is involved but if an individual does have a history of certain kinds of disease or ailment, their private plan is approved at the higher coverage but at a rate that factors in the person's history and likely needs.

For options one and two, there could be an increased tax deduction based on health care premiums for those who would have these kinds of plans. This additional tax relief would help offset for the increased premium.

Are there other alternatives to these three options? Of course there are. This is just the beginning. However, these three options provide for all, both those with pre-existing conditions and those without, to receive the kind of medical care they need and at prices that reflect the level of service they are likely to use. This kind of adjustment would greatly expand coverage options for those in our country who need it most.

This approach also preserves the market’s ability to provide alternatives and a variety of different products. This is a fundamental element to expanding coverage and lowering cost. A one-size-fits-all approach could never do that. Freedom and Justice in health care is the answer to true health care reform.

Imagine what the health care industry would look like if the reforms I have proposed so far were all enacted. Although not yet complete, here is a snapshot of what it is shaping up to be:

Because of the birth of a free market system based on options, variety of products, and competition, all Americans would have access to affordable, private health insurance that is tailored to their needs and is not tied to an employer or government program. The uninsured are able to safely choose and assume the risk of going without insurance and have the risk minimized by equal tax treatment and a percentage cap on the amount charged. If worse came to worst, the family supports the needs of the individual and receives the tax credit from the government to pitch in. The poor and elderly who qualify for Medicare or Medicaid after the reforms are enacted, are given vouchers to private insurance and are empowered to pick a qualified option that is best suited for their needs. Employers are still able to attract and retain top talent through health care as a form of compensation by providing competitive vouchers to private health plans – insurance, co-ops and health shares. This new and vibrant market, invigorated by new players, customers and forces, innovates product solutions for the poor, the rich, the healthy and infirm.

Part of this new structure and environment facilitating this competition is the health care exchange proposed by the president with four adjustments:

1. No Government health plan

2. The exchange includes national health care plans – not just state plans. Opening up the market to our-of-state plans opens the doors to so many more options that are essential to creating choice in health care. The CATO institute reports that “One study estimated that that adjustment alone could cover 17 million uninsured Americans without costing taxpayers a dime (Footnote 1).” The barrier on out-of-state written plans needs to be lifted. It is the equivalent of an iron curtain on health care on a state-by-state basis. This iron curtain protects the insurance companies – not the consumer.

3. Include non-insurance options such as co-ops and health shares

4. Not limit who can participate. Currently, both the house and senate bills on health care limit the participants within the exchange to those who are not eligible for employer or government health care. Accordingly, the exchange in these plans is of benefit to only those without insurance. In effect, the exchange in the current bills does nothing to create a marketplace for health care. These limitations further entrench the employer sponsored health plan and the government’s health care programs. People need to have options and freedom to choose among them.

With these adjustments, the health care exchange proposed by the President and Congress is perfect.

An open and free health care exchange would create the marketplace where individuals could find a health care option that fits their health status, income, and health care goals. Without the kinds of reforms I have discussed in the preceding articles, the health care exchange would be like an out-dated mini-mall on the outskirts of town that no one voluntarily stops by to shop in. Yah, there might be something there but it sure doesn't look promising. In the kind of marketplace I described above, there would be a myriad of options, products and companies to choose from – similar to your favorite shopping mall – where there is something for everyone – all within the reach of the consumer through the exchange.

A free market health care exchange is the perfect vehicle to facilitate the kind of marketplace that will be created as a result of true reform in the health care industry.

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Footnotes

1. http://healthcare.cato.org/free-market-approach-health-care-reform

We have already discussed two modifications that are needed to address the tax treatment of health care costs:

1. Expand the Role of HSAs
2. End the Preferred Tax Treatment to Employer Sponsored Health Care Plans

We will now discuss two more:

1. Equal Tax Treatment for Individual Health Care Costs
2. Tax Credit for Assuming the Health Care Costs of Family Members

Equal Tax Treatment for Individual Health Care Costs

First, the government should treat all individual health care costs the same – health insurance premiums, co-op premiums, health share premiums, out-of-pocket expenses, etc. Presently, Americans can only deduct health care expenditures that are greater than 7.5% of their adjusted gross income. The average gross income in the US is around $55,000 (Footnote 1). That means the average American has to spend $4,125 before they can deduct any of it from their income taxes. How is that right? We allow every dollar for employer sponsored health care to be tax free but yet the uninsured cannot deduct their own out of pocket expenses if below this level.

There are Medical 529 Flexible Spending Accounts that allow for employees to pay for health care related expenditures with pre-tax dollars. However, these again are employer sponsored plans. The unemployed cannot take advantage of this tax treatment. It also further entrenches the employer as the provider of health care and not the market.

Tax Credit for Assuming the Health Care Costs of Family Members

Second, those who do pay for the medical expenditures of a family member can deduct these costs from their taxes as well. However, what is needed is not just a deduction, but a temporary tax credit to encourage families to take care of one other. This credit would be enacted at the same time Medicare & Medicaid levels are frozen and vouchers provided to those who would otherwise qualify for these programs. This credit is needed as an encouragement to help restore the family as the basic unit of society and can be of great aid as the government reduces its own involvement in the insurance business and manipulation of the private industry.

Taxes do change behavior and they create, alter or destroy markets. Justice in health care requires Justice in tax treatment.

These are two other examples of changes that seem very logical to make when trying to save Americans from the burden of health care costs. These are not complicated changes. They simplify the tax code, end government manipulation over health care, free up creative forces, lift burdens, and promote the family. They are simply the right way to go.

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Footnotes:

1. http://www.irs.gov/taxstats/indtaxstats/article/0,,id=96981,00.html

As mentioned in an earlier post, employer sponsored health plans dominate the health care market. As already stated, this poses a problem on at least five levels:

1. It reduces the incentives private health insurers have to create a variety of products that could be used by those who do not have group coverage through their employer.
2. It creates a dependence of employees on the employer for health care.
3. It creates a one-size fits all approach for the employees of the company.
4. It creates an ethical problem where an employee’s health is a form of compensation.
5. It means if you lose your job, you lose your health insurance.

This has to change - and that is coming from a Benefits Manager at a Pharmaceutical Company.

One Size Fits All

Employer sponsored health plans usually provide extreme levels of coverage. They can be so rich that they provide many more benefits than 95% of employees need. These plans are of little use but of high cost to everyone enrolled. It could also be the exact opposite – providing little more than the basics and at high costs. The ability to find a plan based on an individual’s needs doesn’t exist in our current system because employer sponsored health plans are not designed with the individual, bur rather recruiting and the masses, in mind. An individual focused plan also won’t exist in a government system. It will only exist in a free market system.

This reality is one of the other major reasons for the rise in health care costs - plans designed with the masses in mind. The customer in our industry is the masses - not the individual. It is the employer and not the employee.

If we are to create a free market where companies compete for people as customers, then you have to create a market of customers. One of the easiest ways of doing that is by ending the employer monopoly over health care.

In the book, “The World is Flat,” Friedman argues for health care reform that ends the dependence of the employee on the employer. Some would argue that this eliminates a very important part of an employer’s ability to recruit and retain top talent. However, this change can be done in two ways:

1. National Health Care Plan
2. Employer Vouchers for Health Care

I have already proven through logic and reason that the first option is too costly, inefficient and unjust for us to adopt. If faced with the facts and a choice between free market reform and government reform, the answer for most becomes obvious. Furthermore, National Health Care would also truly eliminate an important part of an employer's ability to attract and retain top talent.

Vouchers

The second option preserves this ability, takes health care out of the hands of the employer, places health care decisions in the hands of those who need that freedom, and is an easy reform towards Freedom and Justice in Health Care.

Rather than an employer paying directly for an employee's health care in an employer sponsored health plan, an employer can provider a voucher the employee could use in choosing their own insurance, co-op or health share plan - tailored to their own medical needs - that they can take with them to whatever employer they choose to work for (footnote 1). The voucher becomes the competitive piece an employer can use in attracting and retaining their talent – not the plan.

Furthermore, the employer can still receive a tax deduction for a voucher they provide for a private health plan – but not for contributions to an employer sponsored plan – that tax treatment goes away.

The end of the employer sponsored health plan greatly opens up the market to innovate in its product offerings and prices and allows all citizens of every level, employed or unemployed, rich or poor, young or retired, to receive the benefits of the increased competition that will result in the end of the employer sponsored health plan and increase of millions of individual customers. It would figuratively open up the flood gates into an area all but dead by decades of drought. It would bring life to our health care system and all would benefit.

This change should make every heart leap for joy in the true opportunities and blessings that await our Nation after true reform that restores Freedom and Justice to the health care industry.

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Footnotes

1. http://healthcare.cato.org/free-market-approach-health-care-reform

One of the largest issues in our health care market today is the complete dominance of employer based health care plans. This poses a problem on at least five levels:

1. It reduces the incentives private health insurers have to create a variety of products that could be used by those who do not have group coverage through their employer
2. It creates a dependence of employees on the employer for health care. In the 21st century we want employers to be able to retain top talent but not manipulate them through certain programs that should be transferable regardless of the employer.
3. It creates a one-size fits all approach for the employees of the company.
4. It creates an ethical problem where an employee’s health is a form of compensation.
5. It means if you lose your job, you lose your health insurance.

Some of these points are so obviously wrong that they merit no more discussion than proving that matter exists. Although more on this topic will be discussed at a later time, it is important to note that this dominance of employer based health care has been created, in part, by the tax treatment employers receive for offering health care. This has to end.

Employers receive a tax deduction for every dollar they spend on contributions made toward health care. It also reduces the amount of payroll taxes as employee contributions are all pre-tax. For employers looking for a break from the nearly 40% corporate tax rate, this deduction appears to be a win-win. However, it is only a win in the short term. The long term consequences are those we are now experiencing: a dearth of options for those who are employed without employer based health care, almost no private market for the low-income or retired, no options for the unemployed, and large business plans at large business prices forced into small business operations. The model is unsustainable.

A model encouraged by the Government now becomes criticized by them. Regardless of where the blame lies, reform must be enacted to establish Justice in our health care system by ending the dominance of employer sponsored health plans.

To do this, the first thing that is needed is to end the tax deduction for employer contributions to an employer sponsored health plan. If an employer wishes to contribute to a private health plan, this is another topic that will be discussed at a later time.

The second thing that needs to take place is end the special pre-tax contribution an employee makes to their employer sponsored health insurance. This special type of tax treatment is only for employer sponsored plans – it discriminates against all other kinds of health insurance type products. Let all health insurance type products be tax deductible – no matter where they come from (footnote 1). The type of tax treatment I already discussed should be favored rather than the current exemptions.

Certainly this change would have to be implemented over time and would have to include other reform in the US Corporate Income Tax code to allow private industry a chance to adjust to a truly free market system. Nevertheless, this should be a welcome change for all - corporations and individuals.

Government manipulation in the private market has in part created the problem we are now facing. Ending this preferential tax treatment on employer sponsored health plans will help place the government in its proper role, end an employee’s health as part of their compensation, reform health care in America, create an incentive for the industry to begin furnishing competitive health care products to individuals based on their needs and health care goals, and allow individuals to no longer be completely dependent to an employer for something so important. This must be an integral part in any change that is to lead to a better America.

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Footnotes

1. http://healthcare.cato.org/free-market-approach-health-care-reform

As has been shown, government involvement in health care is the true crisis at hand. The Federal Government is forced to find an additional source of funding for its tremendous unfunded liabilities. The most likely source for this new funding is through expanding its insurance jurisdiction. Amazingly, the government's involvement in health care is one of the major sources in the rise in health care costs throughout the industry. Its involvement has also completely removed any market for private insurers to offer products for the uninsured low income and elderly.

What incentive does a Blue Cross or CIGNA have to offer a low cost insurance product for the low income or elderly? They have none and there is no market. The government fully dominates these areas.

If we wish for the private industry to provide health care for all Americans, then the government must eventually get out of the insurance business. It is a fallacy to blame the industry and at the same moment keep the industry out of those markets. If we want the marketplace to work, the government will slowly have to step back. It is that simple.

How then do you open up these areas to the private market? The answer lies in limiting over time the role of Medicare and Medicaid. This doesn't mean take away these programs from those who already have them. The reform that is needed is in their future expansion and availability. If you want to help those with a low income be able to obtain affordable health coverage, you have to open up these markets. Here is how you do it:

1. Freeze the number of enrolled Medicare & Medicaid members at their current levels. As members fall off the rolls, do not replace them with new enrollees.

   
   

2. For a fixed period of time, such as five years, provide vouchers for those new applicants who would otherwise qualify for Medicare of Medicaid to purchase a type of coverage created from the newly established free market (Footnote 1). The vouchers could only be used to purchase a qualified plan that adequately meets their needs. This provides a “stimulus” into an emerging market and ensures that those who would have qualified for these government programs would still receive the benefits of insurance.

   
   

These adjustments would still provide coverage for those who presently can't afford it and provides a safety net during the transition.

Reducing the government involvement in health care on the side of insuring individuals is paramount to creating a fair and competitive market. This marketplace includes all options and the freedom to choose the type and level of coverage they feel is best for them.

This influx in members into privately ran options will further increase competition and lower prices. With more customers wanting private insurance (and not employer based plans), an opportunity would arise for the marketplace to provide various kinds of insurance plans and other health care options such co-ops and health shares. Through this kind of market creativity, people are better served. This is the direction we as Nation should be racing to go in.

Furthermore, by limiting the expansion of Medicare & Medicaid, you greatly reduce the burgeoning federal deficit. Five years from now the government can actually begin to reduce spending and use those tax dollars in other needed areas such as education, infrastructure and the national defense.

By creating a market that takes care of the needs the government has been dominating for the past 40 years, we not only are able to better provide for those in need but we are also able to help restore the government to a sustainable level.

Responsible health care reform, such as this, will still take care of those on government health care but will also provide a way to create a marketplace for the low income and the elderly.

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Footnotes

1. http://healthcare.cato.org/free-market-approach-health-care-reform

As was just discussed, there need to be options for the American consumer to choose in health care.

In the reformed world of free market forces, those options so far include:

1. Health insurance purchased in a market that truly competes
2. Health security through a co-op or HealthShare
3. Remain uninsured by using the formula discussed in my past post

There is another product that exists that could become 3a: Health Savings Accounts.

Currently, health savings accounts are attached to a high deductible health insurance plan. This is further evidence of the entire monopoly that insurance companies enjoy over our health care market. There are tremendous benefits to HSAs and those benefits need to passed onto more than just the insured.

Michael Cannon of the CATO Institute, in his paper, "Large Health Savings Accounts: A Step toward Tax Neutrality for Health Care," proposed making some changes to HSA's which would encourage more competition and therefore drive prices down to a competitive level. His proposals are as follows:

1. Increase HSA contribution limits dramatically. For illustrative purposes, assume the maximum annual contribution limits would be roughly tripled, from $2,850 to $8,000 for individuals and from $5,500 to $16,000 for families.

2. Remove the requirement that HSA holders be covered by a qualified high-deductible health plan. HSAs would be open to those covered by any type of insurance, as well as the uninsured.

3. Allow HSA holders to purchase health insurance, of any type and from any source, tax-free with HSA funds.

Cannon writes, "Restructuring the exclusion for employer-sponsored health benefits in this way would enable more individuals to obtain health insurance that matches their preferences, would increase efficiency in the health care sector, and could reduce inequities created by the exclusion. These changes also offer a means of limiting the currently unlimited tax exclusion for employer-sponsored health benefits that may be more politically feasible than past proposals. " He concludes: "Large HSAs could serve as a step toward a tax system that offers no preferred treatment to health expenditures, and thereby forces the health care sector to accomplish more with the resources devoted to it (Footnote 1)."

This option, tied to the one previously discussed, would create a truly viable option for the uninsured. Such an expansion of the HSA could be an additional product that would bring more competition, and therefore greater options at lower prices, to the consumer.

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Footnotes

1. http://www.bepress.com/fhep/11/2/3/

As discussed in my previous post, the market has failed to deliver options that create competition, add value and drive down prices. Reform is badly needed to restore Justice to our health care system. One reform that must be looked at is decreasing the amount of risk the uninsured have to bear.

One of the major advantages the insured have over the uninsured is that, although their premiums are astronomically high, the cost is not nearly as high as the actual cost of major health care services. Because the actual cost is so high, people purchase insurance to keep themselves financially safe in case the need arises.

Insurance companies are able to pay out billions of dollars in bonuses and profits because they are able to leverage their huge population of insured individuals against hospitals and doctors and demand, or rather force, them to accept less for the services than they would have otherwise billed.

The government with its even larger population of insured is able to do this even “better” than insurance companies. This creates some unintended consequences within the whole system. For example, a typical profit margin is 30%. If Medicare reimburses you at 60% of billed charges, you have actually lost money. The provider has to make it up somewhere. Who do they pass it on to? The insurance companies and the uninsured. This pushes up premiums and costs at an alarming rate and financially devastates those without insurance. Because of the fear of the financial loss that comes from being uninsured, people will eventually do all they can to get insurance.

Increased competition will lower costs. In addition to the other recommendations I have made, one more reform that needs to take place is a measure that places a maximum amount the uninsured can be charged for medical services. This would increase competition and provide a level of security. For example, if the original price of a service is $1,000 and the insurance company reimburses the provider $500 for the service, the uninsured should not be stuck with the full bill of $1,000. That however is exactly what is happening in most cases.

There certainly should be some advantages for having insurance. However, one of them should not an exclusive window to discounted prices.

There is no easy way to solve this problem. If you lower prices on some customers it has to be raised on others. The problem is that the uninsured are always the ones who get the worst end of the equation. It is not Just that a system which presently forbids competition and forces prices up leaves those who cannot afford insurance left in the most vulnerable situation.

So, what is the solution?

The most logical solution is that the uninsured will not pay more than 1xx% of the average reimbursement amount (or the advantage the insured enjoy) the Insurance Provider pays for a given procedure, test, or visit. It seems right to me, that the percentage should be about 120%. The exact science of this formula would have to be determined. When using this formula in the situation above, the uninsured consumer would have paid $600 instead of the full $1,000. Through health reform legislation, the differential, or $400, could become a tax deduction for the provider or even a temporary tax credit.

Even without the extra protection from the tax code change, this could still be a viable option. However, without the tax benefit, this push prices up in other areas. Nevertheless, the insured still would enjoy the advantage they expect by being insured and the market would find the appropriate balance with these safeguards in place.

With or without the tax code change, being uninsured becomes its own product. It comes with a risk but it also comes with a safeguard – or type of insurance - and possible reward based on the health of the individual. More on this topic will be discussed in my next post.

This is not the perfect solution. However, it is one solution among many that must be considered. Bringing the insured vs. the uninsured costs to a similar level creates options for the American consumer. With this kind of safeguard, the consumer has options: remain self insured or purchase health insurance. Whereas presently, the consumer doesn't truly have a choice. They are forced into one situation or another. Furthermore, this kind of provision could be one for a temporary duration of time, for example of five years, while the health care market begins to grow and take hold on free market principles. As it does, other options will be created that will provide the insurance and protection needed. For the time being however, this is a necessary change to provide justice in an unjust and perhaps even predatory system.

Choice lowers costs through increased competition and options. If we believe in health care for all and in prices that all can afford, this is something that must be debated and considered.

As shown in my last post, monopolies in health care are at the core of the problem we all must deal with. To break up monopolies, there need to be other options in health care for people to choose besides health insurance. Options create competition and competition drives down prices.

Presently, if you do not have insurance you are left incredibly vulnerable. Health care expenses can be astronomical. Health care needs can be detrimental. When combined together, the sum often is unbearable suffering of both body, mind and pocket book. The lack of options puts all of us at a disadvantage.

Because of the lack of options and sadly for the American consumer, it is difficult for a person to get medical insurance at an affordable rate. Here is why:

1. Monopolies in health insurance have allowed prices to climb un-challenged by the market because no true free-market exists
2. Pre-existing condition clauses increase premiums for all and often eliminate badly needed care for those who need it most
3. Price are so high for medical insurance that people cannot afford it if their employer is not subsidizing it
4. There are so few insurance companies to be able to choose from that the lack of competition reduces the need these few companies have to compete for customers. This dearth of choices eliminates all competition for better service at lower prices

In this setup, the consumer has only three choices if they don't have a job or have one that doesn't offer health insurance: pay an incredible amount for an individual insurance policy, purchase a high deductible health plan, or risk going uninsured. Many people take the risk of going uninsured because they simply cannot financially afford their own policy.

This is a failure of the market. We already discussed one change that has to be made. Here are two others:

· Privately Ran Health Care Cooperatives or HealthShares
· The establishment of standards for rates billed to the uninsured vs. the insured

The latter will be discussed in a later post.

What are Health Care Cooperatives or HealthShares?

A health care cooperative is a group of individuals who join together to insure each other's health needs. The cooperative is owned by the members of it. It is similar to that of the Credit Union model. I am not referring to a managed care health care cooperative where the Co-op provides the medical services in addition to the coverage. I am only referring to a cooperative that acts as the insurer. This kind of cooperative would allow for competition in the health care reimbursement market.

One such HealthShare is Altrua (http://www.altruahealthshare.com/)

Here is an introduction to Altrua from their homepage:

“You're probably here because you're looking for affordable health insurance. Would it surprise you to learn the answer to affordable medical benefits may not be health insurance at all?!“Altrua HealthShare is not health insurance. Altrua HealthShare is a nationwide faith based membership of individuals who share in each other's medical needs by bearing the burdens of others.“Because we're not health insurance we can offer our members lower monthly costs than they were paying for health insurance AND provide MORE options and service than they were receiving.“Health sharing began over 30 years ago as a non-profit medical need sharing concept of members caring for one another. And it's becoming more popular every day as a trusted alternative to health insurance.”

You can probably get a feel for the advantages of such a product. Our health care market needs more of these types of options for the American consumer to choose from.

However, through tax code treatment, co-ops are discouraged over health insurance. This discouragement further entrenches the insurance & government monopoly over health care. This entrenchment is what has brought us to the current crossroads.

If we wish to increase competition in health care, we would be wise to learn from some of the things said by the The Heritage foundation:

“If Congress wants to provide Americans access to health co-ops, it would need to make it possible for an institution to combine tax-exempt (non-profit) status with mutual insurance status, something health plans cannot do today. Congress should allow mutual health insurance companies to form based on the credit union model. Under this model, Congress would simply grant non-profit status to mutual insurance companies, justified by the "member benefit" they provide.

“Very likely, with this form of health care arrangement possible, various non-profit memberships and other organizations might link with a health co-op to make coverage available. State farm bureaus or consortia of churches, for instance, could establish such co-op health insurance.

“In addition to these steps, addressing the tax treatment of health plan benefits in the individual tax code would help spur co-ops. If families could receive the same tax relief for joining a co-op--or any other free-standing health plan--as for enrolling in an employer-sponsored plan, there would be new options for the uninsured or underinsured (Footnote 1).”

Further options equals additional competition. Additional competition, as long as the Antitrust exemption has been removed, means additional benefits to the consumer through increased services at lower costs. This will lower health care costs and increase options for the uninsured.

In short, it will help to bring about Freedom and Justice in health care.

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Footnotes

1. http://www.heritage.org/research/healthcare/wm2493.cfm

What is the end or purpose of Government? According to the first draftsman of our Constitution, “Justice is the end of government. It is the end of civil society. It ever has been and ever will be pursued until it be obtained, or until liberty be lost in the pursuit (Footnote 1).”

We need government and we need it to administer justice for all. Therefore, government has a place in health care. As has been plainly illustrated to a point beyond reasonable argument, that place is not in the further entrenchment of the government in taking over private industries but is rather in regulating them and seeing that the principles of Justice and Liberty are protected and strengthened – not lessoned or altogether destroyed.

An over zealous government, however, is not the only way to lose Justice and Liberty. Unfair and unbridled capitalism can be just as dangerous to justice and the liberty of the People. To protect the citizens of a Free country against the usurpation of power and undue influence by others, including corporations, government serves as the arbitrator and administrator of supposedly blind justice. These just laws bring all mankind to the level and force us to operate as equals – each having their fair chance to succeed or fail based on their own efforts, or lack thereof, and not by the unfair forces of others.

One such just law is the the Antitrust law.

In 1993, the Supreme Court ruled that the purpose of this laws is:

"not to protect businesses from the working of the market; it is to protect the public from the failure of the market. The law directs itself not against conduct which is competitive, even severely so, but against conduct which unfairly tends to destroy competition itself (Footnote 2)."

If, from this statement, Antitrust laws are instituted to protect the public from the failure of the market, can we not infer that one of the major causes of market failures is a lack of competition itself – hence the need to create and enforce such laws? Indeed we can.

And, who will not agree with the fact that the health care market has failed the consumer by not providing them with quality services at affordable prices? So, if the health care market has indeed failed us, can we not conclude that part of its failure is based on the injustice of trusts or monopolies which altogether eliminate competition and free market forces? Again, indeed we can.

The failure that has lead us to this issue has arisen from a suppression of the Free Market – not the result of a free market - and an unjust protection by government on the insurance industry.

I will explain.

As much as some would like us to believe that reforming health care is a complicated issue, the truth of the matter is that making some very basic and essential adjustments would do more for American health care than most of the changes being debated. The most basic and immediate of changes that is needed is reforming the insurance industry to increase competition. One major obstacle toward creating a competitive market in health insurance is that the insurance industry, by law, doesn't have to compete.

The Insurance Industry is one of only two that are exempt from Federal Antitrust laws. The other industry is that of Major League Baseball (how did that happen?). Again, by law, insurance companies do not actually have to compete on a fair and level ground with each other. On the contrary, they are free to fix prices, collaborate on product offerings and gather information together. How is that a free market? It isn't. Also, in such an environment how can prices be driven lower through market forces if free market forces don't even exist? The answer is they won't ever go down. On the contrary, because of the ambition and self interest of man, they will only go up.

If we want the market to succeed as it does in every other well established industry, wouldn't we want “to protect the public from the failure of the market” and institute a law against health insurance monopolies “which unfairly tends to destroy competition itself”?

We would – absolutely.

Accordingly, that is why the first, and most basic reform in creating a free market health care system that works for America, is that of repealing the Antitrust exemption health insurance companies enjoy. It is necessary. It is absolute. It is non-negotiable if we are to truly create an environment where Justice is administered and society is blessed. Only by creating an environment where companies compete for business will better service at lower costs be offered. This is the first step to that.

Both an over zealous government and unfair and unbridled capitalism are detrimental to justice and the liberty of the People. To restore Justice and Freedom to the health care industry, this is a recommendation that must be enacted.

______________________________


1.Federalist #51, James Madison
2.Spectrum Sports, Inc. v. McQuillan, 506 U.S. 447, 458 (Supreme Court 1993)

Even though the current plan being debated in the halls of congress will expand coverage for more individuals, it does nothing to improve health care in the United States over the long run. It will actually deteriorate its quality as has been seen recently in Canada and Norway. In Canada their health care system was found nearly unconstitutional because the level of service was so poor and sub-standard that it was not meeting their constitutional requirement for health care (Footnote 1). The supreme court of Norway recently found the incredibly long waiting line to see a doctor illegal and mandated that the government actually transport its citizens to foreign countries to receive their needed health care (Footnote 2). The deteriorating level of care is a result of the government's monopoly on health care and the lack of a free market at work – the very system being devised for us.

Despite the American health care system being the best in the world, we should in means be pleased with how it works or fail to make major reforms to our ailing and inequitable system.

Currently, our health care system is one of government manipulation in the marketplace, monopolies in the insurance industry, and a dearth of options for the individual when it comes to their own insurance options at a price that is unaffordable for almost everyone. It has to change. I am, and think the American public should also be, for Freedom when it comes to health care.

I have said much about the President's plan and have shown how, despite its best intentions, it is destructive of individual freedoms and is the wrong direction for America in the present and future at the individual, national, and family level. The case I have presented is strong in its opposition to the current plan. However, reform is very badly needed or else the status quo, which is also wrong for America, will continue.

Necessarily then, I will now proceed to show the type of reform that is needed to bring about sustainable and improved health care for all desiring citizens.

Health Care Reform must include health insurance reform. The kinds of reform that are needed are as follows:

1. End the exemption to the federal anti-trust laws that the insurance companies enjoy

2. End the monopoly insurance companies have over health care reimbursements through:

   • Privately Ran Health Care Cooperatives
   • The establishment of standards for rates billed to the uninsured vs. the insured

3. Freeze Medicaid & Medicare at their current levels

4. End the Federal Government's manipulations on the health insurance market by eliminating the payroll tax deduction on employer contributions made to health insurance

5. Reform tax treatment for health care costs

6. End the employer based health care plan monopoly over health insurance

7. Increase competition within the insurance industry by creating a health insurance exchange that includes insurance plans across state lines

8. Eliminate the pre-existing condition clauses for most plans

9. Change the way health care is paid for: results vs. procedures (which is a valuable part of the current plan under debate)

Over the next several weeks I will expound upon each one of these and the potential impact they would have on the insured, the uninsured, and the American tax payer. These concluding pieces will show how the principles of Freedom and Justice are the most effective, principled, and correct rules to guide our actions in bringing affordable health care to Americans and supplying them with the best quality and level possible. Freedom, together with the government in its proper role, can truly create a more perfect Union, ensure domestic tranquility, and promote the general welfare of the the Citizens of the United States of America. Freedom truly is the last best hope of man.

________________________________________

Footnotes

1. http://www.opinionjournal.com/editorial/feature.html?id=110006813

2. http://www.cato.org/mediahighlights/index.php?highlight_id=731

I got the following directly from http://www.barackobama.com/. It explains better than anything the health insurance exchange:

“The Obama-Biden plan will create a National Health Insurance Exchange to help individuals purchase new affordable health care options if they are uninsured or want new health insurance. Through the Exchange, any American will have the opportunity to enroll in the new public plan or an approved private plan, and income-based sliding scale tax credits will be provided for people and families who need it. Insurers would have to issue every applicant a policy and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and meet the same standards for quality and efficiency.

Insurers would be required to justify an above-average premium increase to the Exchange. The Exchange would evaluate plans and make the differences among the plans, including cost of services, transparent. The Exchange will have the following features:

Comprehensive benefits. The benefit package will be similar to that offered through the Federal Employees Health Benefits Program (FEHBP), the program through which Members of Congress get their own health care. Plans will include coverage of all essential medical services, including preventive, maternity and mental health care.

Affordable premiums, co-pays and deductibles. Participants will be charged fair premiums and minimal co-pays for deductibles for preventive services.

Simplified paperwork. The plan will simplify paperwork for providers and will increase savings to the system overall.

Easy enrollment. All Exchange health insurance plans will be simple to enroll in and provide ready access to coverage.

Portability and choice. Participants will be able to move from job to job without changing or jeopardizing their health care coverage.

Quality and efficiency. Participating hospitals and providers that participate in the new public plan will be required to collect and report data to ensure that standards for health care quality, health information technology and administration are being met.”

I love this concept except for two very important points:

For the health care exchange to truly increase competition, it needs to extend beyond state boundaries. To have two to four companies competing against each other isn’t competition. In most states that is what it will be (Aetna, Blue Cross, CIGNA and some other provider). Health Insurance reform must change the way insurance is written in the states and begin to allow plans to extend beyond single states. If you want to see competition, try 10-20 plans that offer comprehensive in-state and out-of-state benefits competing for your business – that is when you will really see the benefits of this kind of exchange.

The public option will drastically reduce the private insurance industry. The Free Market is the best road for reform and the Public Option will forever close it. You cannot just rebuild an entire industry once it has been destroyed. Rather than destroy it we must seek to make it better.

The health care exchange with the public option is just a mechanism to get people onto the public option quicker than they otherwise would be and therefore would lead to a decline in the free market even faster. The attached video shows the intent of the exchange and public option.



The exchange could be a wonderful tool if used to truly increase free market forces and did so with the modifications listed above. Otherwise, it is a wolf in sheep’s clothing as shown in the video. Free market reform must include the Health Insurance Exchange as tailored above. A modified exchange is an excellent idea that we must push forward. If not modified, it will become a political tool and the consumer will lose.

Some may think we are close to time travel but we can be assured that the masses don't have power to use it within the next generation or two. For if they could, they would comeback in droves and wage a revolution of their own with an all too familiar battle cry: “No taxation without Representation!”

Surprising to us however, we are the tyrants and they are ones we have put in chains. How? Deficit spending and our national debt are exactly that – taxing those without a voice in our political process, the unborn that is, and laying the burden upon their shoulders.

Chief Justice John Marshall wrote in 1819, “The power to tax is the power to destroy (Footnote 1).” It certainly is a power that, when misused, can lead to a destruction of economy, prosperity, growth, and liberty. It is also a power that when properly wielded provides for efficient government, enforcement of the law, protection of our citizens, and support for the prosperity of the people.

Because it is a double edged sword, and because it is the people's money that must be collected, the power of taxation can only be justly employed when it is by representation of the people who must be taxed.

If you and I are represented by our Congressmen who serve us for the duration of their term, who is it that represents those who are not yet even alive? By the law of representation, no one can.

If we believe that representation is the only just way to regulate taxation, burdening the unborn and unrepresented with the expenses of today is unjust and immoral.

Debt is bondage. Anyone who has had debt knows the truth of this saying. To be in bondage as a result of our own choice is one thing. To be in bondage for the choices of the dead is entirely different and infinitely more cruel. It is a form of slavery, taxation and redistribution of wealth to which they will see and receive almost no benefit (Footnote 2).

It is simply wrong to ask future generations to pay for our education, our wars, our freedom, our cash for clunkers, and our welfare entitlements. There is no way around it. It is simply wrong and unjust. The unborn are not the recipients of the benefits of these policies, entitlements, programs and wars. Alonzo Fyfe put it this way:

“The National Deficit is the redistribution of wealth – the value of the slave labor – that is to be taken from those who have no political voice to be handed out to those whose votes the politician wants to buy.

It is no different than imposing a tax that is imposed only on those who are black, then using that money to write checks that are distributed to white people (Footnote 3).”

Certainly there are some rare exceptions to when this would be just. However, those exceptions are rare and involve in no way entitlements for the living today.

As has been shown in several of these short essays, the true costs of health care reform placed on the American taxpayer are not even fully known but surely far exceed those being projected. Current unfunded liabilities for Medicare are already $74 trillion (footnote 4). Currently, the house version of the health care reform bill has over $13 trillion of unfunded liabilities (footnote 5). As much as I agree with the President that health care reform should be deficit neutral, the fact of the matter is, it won't be. Among so many other things, the government's management of Medicare is proof of this.

Paying for our health care is our responsibility. We cannot argue with this. We cannot put our children and grandchildren in bondage for our benefit today.

If we create a bondage for those who cannot be represented in the process, and redistribute their wealth even before they are born and have a chance to acquire it, it is the truest form of taxation without representation and the greatest form of tyranny and oppression.

If We the People, through our representatives desire this kind of health care reform, then so be it as long as we, and only we, are the ones who pay for it. If we make this choice, then we must live with the consequences – not the unborn and those who have no voice in our system, those whose futures should be their own, and not ours, to decide.

Our beautiful National Anthem contains these solemn words:

“Oh, say does that star-spangled banner yet wave

O'er the land of the free and the home of the brave?”

It may yet wave, but for the unborn they are not free. And for us, if we fail to do the right thing and not take responsibility for our freedoms and privileges by paying for them in our own time, then no longer can America be called the home of the brave - as Bravery is to do the right thing in the face of difficulty and opposition. Bravery is to sacrifice. Bravery is to seek the truth and to live by it. Let us be Brave and keep ourselves, our children and our grandchildren Free.

___________________________________

Footnotes

1. http://www.bartleby.com/73/1798.html

2. http://chestofbooks.com/finance/Amasa-Walker/The-Science-of-Wealth/Fallacies-Respecting-A-National-Debt-Part-3.html

3. http://atheistethicist.blogspot.com/2009/06/sad-fate-of-future-generations.html

4. http://online.wsj.com/article/SB120373015283387491.html

5. http://www.cato.org/pub_display.php?pub_id=10422

“I've also pledged that health insurance reform will not add to our deficit over the next decade, and I mean it...

President Obama July 22, 2009 (Footnote 1)

I believe this is a laudable and praiseworthy goal and I hope it is true. However, in what reasons, assurances and truth do I have to hope?

The American people have no basis upon which to believe anything from Washington D.C. when spending money is concerned. If you need proof of that, as of the moment this post was being written, our National Debt was $11,889,652,785. What does that look like? According to CNBC.com, “If denominated in $1 bills, the cash would stack as high as the tallest building in the world, the 2,683.7 foot Burj Dubai skyscraper… 1,474,918 times. At this height, it would create a block of bills with a base approximately twice the size of the Empire State Building's, which is just under the size of three American football fields.

If consolidated into a single stack of $1 bills, it would measure about 749,666 miles, which is enough to reach from the earth to the moon twice (at perigee), with a few billion dollars left to spare... It is also interesting to note that this number is approximately 13 times the amount of US currency in circulation, according to the Treasury bulletin, which lists the amount at $853.6 billion as of December 31, 2008 (Footnote 2).”

If you need further proof, think of the Iraq War, Medicare, Medicare Part D, and the War in Afghanistan. Almost all of this debt is from former administrations and we cannot blame the current president for past errors. Our national debt and recent events however show a long train of abuses when it comes to the public purse. Even now, President Obama continues to fund our wars in Afghanistan and Iraq through supplemental bills just as President Bush did so he can say how his budget cuts the deficit when it really doesn't. Four weeks ago he touted on Prime Time TV how he had cut the deficit by $2,200,000,000,000 (Footnote 1). Yesterday the White House announced that they had reduced it by only $200,000,000,000 (Footnote 3). That is a two trillion dollar error in a matter of weeks.

The President said, “I'm not going to sign a bill that, for example, adds to our deficit.” However, this year the Federal Government has spent $1,580,000,000 that it didn't have (Footnote 3). Granted, a lot of that was emergency spending for things that many believe may help our economy in the short term. However, not all of it has been helpful and some would argue that none of it was necessary or helpful - including the non-partisan congressional budget office (Footnote 4).

So, on what grounds do we have to believe the current President's projections for how much health care reform will cost? We have no such grounds. Those who do believe the government's projections are disregarding not just history, but the present reality.

If we can't trust the cost projections, how can we trust the President when he says “health care reform is not going to add to that deficit”?

Reality has proven to us that costs are always higher than they tell us. The president tells us that health care reform will cost $1,000,000,000,000 over the next 10 years (Footnote 5). Is that all? Some project health care reform to be $8 trillion over 10 years…60% as large as our current national debt (Footnote 6). Even the current house bill has a projected budget shortfall of $13,600,000,000,000 (Footnote 7) – far more than the $1 Trillion being discussed. According a Walt Street Journal article last year, Medicare alone has an unfunded liability of $74,000,000,000,000 (Footnote 8). How will all of this be paid for? It will be paid for by deficit spending – that is, taxing the unborn to pay for expenses today.

The fact of the matter is, they are not being honest with us regarding the costs of the bill in an effort to pass it. This will cost much, much more then they are telling us because a) it always does, and b) government programs always expand over time. We have to account for this.

To not be honest about the costs and what this means for us in the near and long term is irresponsible and misleading at best, reckless and dishonest at worst. In either case, it is a far cry from good government and representative democracy.

The right way to do this would be to be open and honest about the costs and the reality of what it will take to pay for it. But we're dreaming if we think that will happen...

The president and those who are pushing for this change and trying to sell it with these cost projections are peddling dreams – not reality. And even worse, their dreams will become our financial and economic nightmare in the not too distant future as the public becomes straddled with the true costs of government health care reform and are forced at all levels and in more than one way to pay for it.

__________________________________________

Footnotes

1. http://voices.washingtonpost.com/44/2009/07/22/transcript_of_obama_prime-time.html

2. http://www.cnbc.com/id/30108264/?slide=12

3. http://www.reuters.com/article/newsOne/idUSTRE57K4XE20090821

4. http://www.washingtontimes.com/news/2009/feb/04/cbo-obama-stimulus-harmful-over-long-haul/

5. http://moneywatch.bnet.com/economic-news/article/health-care-reform-what-it-will-cost-you/330206/

6. Health Reform 2009: Watershed or Waterloo? A Lockton Benefit Group Webcast

7. http://www.cato.org/pub_display.php?pub_id=10422

8. http://online.wsj.com/article/SB120373015283387491.html

For those who have read any of my recent articles, it is no mystery what my views are regarding most of the parts of the proposed health care overhaul bill. I want reform just as badly as the President but I want a different kind of reform and, throughout these posts, have been making part of that case. However, before proceeding, I must first declare how utterly wrong and contemptible many of the techniques are that are being used either to sell or thwart the proposed legislation.

I do not support the derogatory label of “Obamacare” or the likening of this legislation to that of the Nazis. I am disappointed in those who would attend a public forum and use it to turn it into a shouting match. I am disappointed at those who would deface property, resort to calling names and make crazy accusations about our government with such things as death squads and fascism. They have deceived themselves into thinking that the desired end justifies the means. And importantly, it seems as though they have failed to remember that Americans are generally good people and that our Representatives generally try to do good and to help our country – in both Parties.

Conversely, the techniques of not being honest about the reasons, alternative solutions, true costs, and possible outcomes of this proposed legislation is dishonest, sinister and wrong. They too have fooled themselves into thinking that the desired end justifies the means.

They both err in that you cannot separate the end from the means – the means become the end. The means being used on both sides will not lead us any closer to a society of peace, unity and brotherly love. In fact, they lead us further away from the very thing we seek to create.

This is still America and we all still love our Country – no matter what side of the isle we are on. The primary difference is not in what we want to accomplish but in how we wish to accomplish it. Just as you cannot separate the means from the end in the legislation being discussed, you cannot separate the means from the ends in the techniques that are being used to thwart or pass it.

Respect, honesty, reason and building on common ground must be the means as it is the only end we truly desire. The current tactics will only further divide the ground we are on and cause us to no longer be One and Indivisible.

Those exalted and noble means are what we must expect from ourselves and one another – on all sides of this argument. That is the only way we will actually become anything better as a result of this debate. We want to build a better society; the place that begins is within each one of us and in the choice of means we use to get there. In this debate and all others, let us all make the choice to take the road less traveled – that of respect, honesty, reason and building on common ground – as that is the one that makes the difference.

Discovering the true cost of Health Care Reform is paramount to finding the proper way to fund it. To do that, we have to look at many different sources, including the White House and the press. I found this article provided an important perspective on the debate. I hope you enjoy.

by Jagadeesh Gokhale and Kent Smetters

This article appeared in National Review (Online) on August 6, 2009.

Even a popular president like Barack Obama cannot win arguments against two forces: God and mathematics. While the president has openly shared his reverence for the former, he has decided to take on the latter. It's a fight that he will lose.

Upon taking office, President Obama decided to postpone his campaign promise to implement a true cost-saving reform of Social Security and Medicare. Instead, he's trying to expand the nation's entitlement offerings with massive new government spending on health care.

The Congressional Budget Office's mid-July "score" of the main House health-care bill puts the price tag at about $1 trillion over the next decade; the Blue Dog Democrats managed to shave off only about $100 billion. But ten-year budgets, as even the CBO has warned in the past, are not reliable for assessing entitlement programs. Most of the spending in the House plan is phased in over several years, making the ten-year cost look deceptively small. Extending the budget window by just three years doubles the program's cost to over $2 trillion.

This enormous shortfall is equal to about 1.6 percent of all future projected GDP, or 3.5 percent of all future payrolls subject to Social Security taxes. From those numbers, this additional burden might actually seem manageable. But President Obama promised that he would raise taxes only on those in "rich" households.

That's where the arithmetic gets especially interesting. Funding the new health-care plan on the backs of households making $200,000 or more per year would require permanently increasing their annual total tax payments by about 50 percent. So, for example, a household that currently pays $50,000 in federal income taxes would need to pay another $25,000. Remember, however, that Social Security and Medicare already face enormous shortfalls. Shoring up these programs — another Obama campaign promise — would require collecting 328 percent more tax revenue from the rich. No, we didn't forget a decimal point: That is three hundred and twenty-eight percent.

Most households making between $200,000 and $500,000 per year would not have enough money to pay their federal, state, and local tax bills, much less eat. Rich households in California or New York would not be able to pay their tax bills regardless of their incomes. And a family of four living in a low-tax state (South Dakota) would need to gross almost $900,000 per year to have enough income left over to reach the poverty line. In fact, there is no mathematical configuration of taxes on the current rich alone — including additional levies on the "super-rich" making more than $1 million per year — that is compatible with putting the nation's entitlement programs and the new health-care plan on a sustainable course.

U.S. federal income taxes are already very progressive. The top 10 percent of income earners pay the majority of federal income taxes. The top 1 percent of income earners pay a quarter of all taxes.

But can't we expect the rich to pay even more? Maybe for a few years — but not without disastrous consequences to America's future.

A major tax increase causes the tax capacity of the rich to shrink gradually as two factors kick in. First, many of the households falling into Obama's "rich" definition are married couples in which both partners are working professionals. When tax rates rise, the lower-earning spouses in these couples tend to work less. Often, they quit work entirely. Second, many of the "rich" are budding entrepreneurs and small-business owners. They finance their operations using their own after-tax income, or with after-tax resources from family and friends. Small-business innovation is the fuel for long-term economic growth. In fact, many of the largest companies in the United States today were either small or nonexistent just 25 years ago. Killing small business kills the American economy.

We cannot allow federal health-care subsidies — mainly Medicare and Medicaid — to continue to grow faster than inflation indefinitely. The challenge is to find ways to make the nation's commitments to retirees and others sustainable without harming economic growth prospects. In this regard, the Obama administration is charting a course in the wrong direction — expanding entitlements on the backs of our nation's job creators. The math will work against the Obama administration and, eventually, against us all.

Jagadeesh Gokhale is a senior fellow at the Cato Institute and Kent Smetters is a professor at the Wharton School and a visiting scholar at the American Enterprise Institute.

More by Jagadeesh Gokhale

Accessed at http://www.cato.org/pub_display.php?pub_id=10422 on August 16, 2009

In my last post I showed how the government has usurped, in many ways, the role of the family in providing certain kinds of care that Nature intended the family to provide for one another. Today I will show how the government weakens the family by providing that care.

If a Nation is to become stronger, its families must become stronger. And, as with exercise where weight must be added for the muscle to grow, families must lift together the burdens placed on their shoulders.

State Welfare & the Metaphorical Arch

When the government steps in and takes upon it the responsibility of providing shelter, loans, certain kinds of education, medical care, food, utilities, and personal income to name a few, it usurps the role of family and removes the “weight” off the family’s shoulders. As with exercise, by lessoning this burden, the family is prevented from growing at best, or weakened at worst. It eliminates the struggle and the tension necessary for growth and the gaining of strength.

The hard and difficult experiences of life that force us to grow, necessarily create a type of tension within us and the family unit. However, that tension is not destructive and shouldn’t be removed at all costs. What should happen is that by the individual and family growing as a result of the tension, those burdens which once were hard to bear become bearable. By becoming stronger ourselves we are then able to bear one another’s burdens. By the family becoming stronger, we can bear the burdens of those not part of our own immediate family, but reach out to the broader family of neighbor, community and world. However, without first becoming strong ourselves we have no strength to offer to those in need.

With the tension gone because of the lack of sacrifice, it weakens the individual and family unit. When we become weaker as individuals, our families become proportionally weaker. When our families become weaker, the Nation likewise weakens. What we need is not an elimination of tension and opportunities to bear our burdens; what we need is to bear them together. This is illustrated by the following quote.

Victor Frankl, a Holocaust survivor, wrote in his moving memoir Man’s Search for Meaning:

“I consider it a dangerous misconception of mental hygiene to assume that what man needs in the first place is equilibrium or, as it is called in biology, “homeostasis,” i.e., a tensionless state. What man actually needs is not a tensionless state but rather the striving and struggling for some goal worthy of him… If architects want to strengthen a decrepit arch, they increase the load that is laid upon it, for thereby the parts are joined more firmly together.”

The family is the arch. The responsibilities of life are the load. When the government decreases the load upon individuals and families by supplying out of its seemingly boundless resources the necessities Nature intended the family to supply for each other, it succeeds most often in this one thing: keeping this metaphorical arch – the individual and the family – from rising to their potential. Furthermore, their help is, often times, actually not help at all and can be detrimental. For me to say otherwise would be to deny my years of personal experience and observations.

Human Potential

Is humanity not the crowing creation of Nature? Indeed we are. We are not here because we are lacking in capacity or natural endowments. We are in the position we are because we are strong and endowed with gifts that must be used for the benefit of ourselves and each other. The mind, imagination, moral perception, imagination, industry and science placed in the being of Mankind is awakened, instructed, strengthened and refined through the experiences nature provides us in supporting ourselves, supporting others, and, at times, allowing ourselves to be served by those around us.

A baby chick hatching from its egg struggles to make its way through. If aided, it will die as it didn’t gain the strength necessary to survive upon its arrival into the world. So too has Nature deemed that through struggle and sacrifice we should live as well as grow in strength and capacity. Through these experiences we can become refined as polished stones – both as individuals and families – and thus become more fit to help and serve one another. We learn that we are entitled to nothing but our own freedom but instead are indebted for everything we have and are. We learn that through love we become One.

Conclusion

I believe in a society where love and peace prevail and where we are all our brother’s keeper. To do this, we must be the keeper – not the government. The government weakens us and our families by taking away the opportunities for struggle, service and sacrifice. If we can no longer bear our burdens by having been weakened through inaction, how can we expect to bear one another’s burdens that theirs may be light? Is not that our divine responsibility? A welfare state weakens our ability to fulfill that.

The families of America are in trouble. There is no disputing this fact. Again, we turn to Confucius, “To put the world right in order, we must first put the nation in order; to put the nation in order, we must first put the family in order.” Just as architects who desire to strengthen a decrepit arch increase the load that is laid upon it, so should we allow families to work together to carry the burden life has entrusted them to carry, and thus they, like the arch, will be more firmly joined together.

No one likes to struggle. No decent person likes to see another person struggle. However, as much as we hate to see people struggle, the government should not be the hand that reaches out to help. It should be the hand of Mother, Father, brother, sister, son, daughter, Grandmother, Grandfather, aunt, uncle, cousin – it should be yours. Strengthen those hands – the hands of Family – and you will strengthen the Nation that we all might bear one another’s burdens that they may be light.

In this post and the next I will briefly illustrate how government welfare weakens the family unit in two ways:

Just governments institute laws to protect, among other things, life, liberty and property. As with all laws, there are consequences for breaking those laws.

What happens when the government institutes laws that directly oppress the rights that governments were instituted to protect, and then punish the people for not obeying or complying with those unjust laws?

That is the very situation the government is creating with the current versions of the health care reform legislation. As shown in one of the last essays, the government does not have the right, even when a majority wills it, to take away the property from one group and give it to another.

Recently the President held a press conference on health care reform. In that conference he said that Health Insurance would be mandated for all (Footnote 1). All able (able as defined by the government) Americans will be forced to participate or be fined. The fine as written into the bills at the moment is an additional 2.5% of your income (Footnote 2). Additionally, all wealthy Americans will be forced to have more of their income taxed to pay for the insurance of those who cannot afford it (Footnote 1). As written in an earlier post, forced “charity” and government intervention where it has no moral authority to act is tyranny and injustice.

Laws are instituted to primarily protect Natural Rights. When those laws are broken, there are consequences. So I ask of you, what natural right is a person transgressing when they, of their own free will and accord, choose not to purchase health insurance? Are they stealing another person’s property when they choose not to purchase a service – for themselves (Footnote 3)? Are they taking another individual’s life when they choose not to purchase a service – for themselves? Are they taking away another person’s liberty when they choose not to purchase a service – for themselves?

Indeed not!

Then what punishment that is just can possibly be levied upon a person who is not trampling upon the rights of another? No such just punishment can exist.

On the contrary, it is the Government that is taking away the Liberty of its people when it forces them to purchase a service when it may be against their will and it is the government who is taking away property when it takes it from one group to give to another.

Rather than protect rights, government has sought to re-define rights and thereby re-define what it can punish. It wants the people to believe that they have the right to demand that the rich pay for the poor’s health care. It wants the people to believe that if one citizen doesn’t participate in the system that they are actually taking away health care from another. It wants the people to believe that Government was instituted to create a more glorious outcome rather than administer Justice and ensure Liberty. It wants the people to believe that the ends justify the means. It wants the people to forget that there is no way to separate the ends from the means. Tyranny to get there will mean tyranny when we get there. Injustice as a path means injustice as a destination.

Can we not see how backwards things have become?

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Footnotes

1. http://voices.washingtonpost.com/44/2009/07/22/transcript_of_obama_prime-time.html Accessed on August 6, 2009
2. http://keithhennessey.com/2009/07/14/house-taxes-the-uninsured/ Accessed on August 6, 2009
3. Additional Information for the Interested Reader:

Is someone stealing another person’s property when they choose not to purchase insurance for themselves? No. When someone does not pay for a service then it can constitute stealing or theft. For most people though who get a bill that is $5,000 or more and who are required to pay it within a few short months, it is almost certain they will not pay. This is not because they don’t want to, but because the terms don’t allow them to.

If a person who is without health insurance receives a service and is left with a bill in the tens of thousands of dollars, there needs to be a way prepared for such a person to pay their bill. This is one of the areas in which reform is needed but is being neglected. Ways to reform this area include:

1. Reduce the gap between the rate the uninsured pay verses the rate the insurance companies reimburse providers. For many services this gap is enormous. This could be adjusted by a regulation that says the difference should be no greater than X %.

2. Change the way bills are collected from the uninsured. To have 100% of a $5,000 bill due in 120 days is not feasible for most Americans. Allowing individuals to pay off providers for health care bills at a pace they are capable of would help ensure that the bills are paid. Such a schedule could be based on the individual’s income, debts, and family resources.

3. Reduce taxes or increase the deduction allowed for charitable giving. This would help more non-profit organizations to have the resources needed to support those in need.

Amazingly, one of the factors that contributes to the exorbitant amount the uninsured have to pay is the low reimbursement levels from the government and insurance companies. Providers then pass on the loss to other customers paying out of pocket. When those customers don’t pay, they pass them off to the insurance companies. And, at the moment, the health care industry has no incentive to change the way they bill the uninsured because they can quickly pass off those unpaid expenses back onto the insurance companies through higher costs. They cannot, however, pass off those costs at the same rate to the government which in turn forces private insurance rates to increase at an even higher rate.

The reason why the insured often pick up the tab for the uninsured is because of the way the uninsured are billed and of their forced payment arrangement. Change the way the uninsured are billed and the way they are able to pay and you will see them more able to pay their own expenses. This is the kind of reform that is needed. When the government forces compliance with an immoral law it is oppression. When the government punishes the People through fines for non-compliance it is tyranny. When the government takes, by force, the fruits of other people’s labors it is stealing. Reform must align itself with Natural Rights and the protection of them. There is a way to do that and I believe it is the only just and right way that will lead to a better America and a better outcome. Again, tyranny to get there will mean tyranny when we get there. Injustice as a path means injustice as a destination.

In a book I recently started, I was impressed by John H. Groberg’s stories from his time serving in Mongolia. The people there were so humble, so simple, so kind and so close to God. They lived in a desert but yet they experienced no violence over scarce resources. The desert people lived in a state of community and oneness that many philosophers only dream of.

In that desert community, families leave their tent doors open for any traveler, known or unknown, who happens to need food or drink. They live after the manner of happiness because they love and respect one another. There also is an understanding about what you could take in another’s home and what you couldn’t. Respect for those unwritten laws created a peaceful society. Sadly, most of the western world, while being a place of great plenty, is fraught with much violence. We have not yet learned to live as One. The difference between Mongolia and the West is that Mongolians freely and willingly give of their substance, not just their excess, to their fellowman. What we consider “mine” in many cases they might consider “ours.”

Nevertheless, in both societies there is a respect for the property of others. There are boundaries. Wherever you are, if a person takes something that is yours without your permission, we call it stealing. If a person takes your wallet or purse we call this stealing. If a person in Mongolia were to enter the tent of another, which is opened to him for food and water, and takes the person’s clothes, bed, or money, it is clearly stealing. In these cases the person would have a right to call the police and report a crime. Stealing is an evil act.
As shared in my previous post, for evil to succeed most it must appear normal – and the best way to make it seem normal is to legitimize and legalize it. It is important to realize that just because something is legal, it does not mean it is right. For example, prostitution, non-medical Marijuana use, pornography, abortion, gambling and other sins and vices are legal in many parts of the country or world. Again, just because it is legal it does not mean it is right. The government’s redistribution of wealth is one such immoral, but legal, activity.

Ezra Taft Benson, former Secretary of Agriculture, explained it this way:

"In a primitive state, there is no doubt that each man would be justified in using force, if necessary, to defend himself against physical harm, against theft of the fruits of his labor, and against enslavement of another. This principle was clearly explained by Bastiat:

'Each of us has a natural right - from God - to defend his person, his liberty, and his property. These are the three basic requirements of life, and the preservation of any one of them is completely dependent upon the preservation of the other two. For what are our faculties but the extension of our individuality? And what is property but and extension of our faculties?' (The Law, p.6)

Indeed, the early pioneers found that a great deal of their time and energy was being spent doing all three - defending themselves, their property and their liberty - in what properly was called the "Lawless West." In order for man to prosper, he cannot afford to spend his time constantly guarding his family, his fields, and his property against attack and theft, so he joins together with his neighbors and hires a sheriff. At this precise moment, government is born. The individual citizens delegate to the sheriff their unquestionable right to protect themselves. The sheriff now does for them only what they had a right to do for themselves - nothing more. Quoting again from Bastiat:

'If every person has the right to defend - even by force - his person, his liberty, and his property, then it follows that a group of men have the right to organize and support a common force to protect these rights constantly. Thus the principle of collective right --its reason for existing, its lawfulness -- is based on individual right.' (The Law, p. 6)

So far so good. But now we come to the moment of truth. Suppose pioneer "A" wants another horse for his wagon, He doesn't have the money to buy one, but since pioneer "B" has an extra horse, he decides that he is entitled to share in his neighbor's good fortune, Is he entitled to take his neighbor's horse? Obviously not! If his neighbor wishes to give it or lend it, that is another question. But so long as pioneer "B" wishes to keep his property, pioneer "A" has no just claim to it.

If "A" has no proper power to take "B's" property, can he delegate any such power to the sheriff? No. Even if everyone in the community desires that "B" give his extra horse to "A", they have no right individually or collectively to force him to do it. They cannot delegate a power they themselves do not have. This important principle was clearly understood and explained by John Locke nearly 300 years ago:

'For nobody can transfer to another more power than he has in himself, and nobody has an absolute arbitrary power over himself, or over any other, to destroy his own life, or take away the life or property of another.' (Two Treatises of Civil Government, II, 135; P.P.N.S. p. 93)

The Proper Function Of Government

This means, then, that the proper function of government is limited only to those spheres of activity within which the individual citizen has the right to act. By deriving its just powers from the governed, government becomes primarily a mechanism for defense against bodily harm, theft and involuntary servitude. It cannot claim the power to redistribute the wealth or force reluctant citizens to perform acts of charity against their will. Government is created by man. No man possesses such power to delegate. The creature cannot exceed the creator.

In general terms, therefore, the proper role of government includes such defensive activities, as maintaining national military and local police forces for protection against loss of life, loss of property, and loss of liberty at the hands of either foreign despots or domestic criminals (Footnote 1).”

Redistribution of wealth by the power of the government is the opposite of the Mongolian approach. There, the people of their own free will invite people in and give of what they have. Their leaders don’t make them open their doors and if a door is shut the travelers cannot open it. Furthermore, the rich don’t open their doors wider than the poor nor do the poor keep their doors shut but all are alike and care for each other. That is the society that I want.

Here, the Government takes by a majority rules vote in congress money from those who have and gives to those who don’t in the form of welfare checks, housing, education, government contracts and free medical care. Such forced “charity” is everything but charity and will further continue to create a divide between to poor and wealthy. It will continue to create a society of selfish and self centered people in all classes. It will continue us down the path we are on, and further from the path we actually think we are on. These policies make us less One Nation, and more divisible.

Although well meaning, such policies are tyrannical, immoral, unjust, and evil. The Government has no authority to do this – even if a majority of citizens through their leaders vote for it. If the majority through their leaders does vote for it and legalize redistribution activities, the majority becomes the mob, the Rights of all are trampled and the minority is villainized, the protector becomes the oppressor and the securer of liberties becomes the destroyer of liberties. The tables turn and, what do you know, everything appears right and perfectly normal.

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Footnotes

http://www.laissez-fairerepublic.com/benson.htm (Accessed on August 4, 2009)

The other evening, my wife and I were discussing the original “Bewitched” series. You know the one, Samantha & Darren? It was a series we both enjoyed when we were kids. With our Netflix membership, we decided to order it so we could watch it again and share it with our children.

We were both surprised at how non-wholesome in many ways that series was. It really epitomized the culture of the era:

1.Wives stayed home, cleaned and cooked. Period.
2.Men worked and did nothing at home.
3.Wives supported their husbands in their ambitions but should have none of their own.

It also showed things such as:

1.It was okay to harass women who worked.
2.Cheating on your wife was easy to do.
3.Women were supposed to dress a certain way for men.
4.Husbands could look at edgy magazines, in front of their wives, without a problem.

Truly many positive changes have been made over time which make the “good old days” not quite so good – just old. During the discussion I stated, “Evil succeeds most when it is made to appear perfectly normal.” That epiphany has been said in other words. Isaiah said it this way, “Men shall call evil good and good evil.”

As you think about those two statements, you will come to realize the truth of them. People generally repulse evil because of their nature. Evil, when put in stark contrast with good, is easily detected and mostly not accepted. It is when that evil is made to appear good that it is chosen.

Think of it this way:

Could slavery have persisted for so long, and a war wherein over half a million people died, had not the institution of slavery been accepted by many as good and normal?

Could there be such a huge drug using community if, to them, it didn’t seem right or normal to do so?

Could women have been denied their equal political rights for so long had it not seemed right and normal to do so?

Could Robin Hood have stolen from the rich to feed the poor had it not seemed right and normal for him to do so?

Could the bigotry against the Jews have been so deadly had it not seemed right to be prejudiced against them?

Could discriminating in employment decisions against people because of their gender, race, religion, age, disability or sexual preference take place if it didn’t seem normal and right?

Could the harassment of women by men have happened on such a regular basis if it wasn’t acceptable?

Could the wars fought by aggressors have happened wherein sovereign peoples were enslaved and oppressed, had it not seemed right and normal on the part of the oppressor nations to do so?

Could immoral laws be signed into law if the majority of people did not find them right?

The answer to all of these questions is a resounding NO. These evils could not have been if the people did not think them right or normal. Because all of these evils have or do now exist, we can see how successful evil has been in the past as it has prevailed many, many times – and will ever try to succeed and oppress the freedoms of mankind. It has cost the lives, dignity, and potential of billions of our brothers and sisters.

All of mankind has a conscience and knows the difference between right and wrong. However, evil will conceal itself under the disguise of good. It makes it easier for people to accept. People also have a remarkable ability to convince themselves that what they do is right – even when it isn't.

To be Free is to know what is Right, Good and True and to live thus circumscribed. It is to be an agent for one's self – free to act, and not to be acted upon. Evil entangles, strangles, and eventually destroys according to the degree it is indulge in; whereas Freedom increases the capacities of those who abide in it to bless, care for, and contribute to the welfare of themselves and those around them. Those who abide in Freedom are never content with blessing themselves only but roam their communities, cities and world to bless all humanity.

Because of this reality, there lies on our shoulders, the shoulders of a Free people, to do all we can to not be deceived by what appears to be right and normal. President Lincoln said that “freedom (is) the last best hope of earth.” It is. Therefore, you and I should do all we can to protect our Freedom – at all costs.

It is up to us to seek truth and live accordingly, and, above all, to beware of those who call evil good, and good evil.

Throughout my life I have been touched by the stories of people who have exercised their individual liberties to become more than they were and to live life as they choose is best. These stories are being written on all scales in all places by the millions. They are trying to be written in Iran even as I write this post. People there are craving for the right to choose for themselves, and not by their government, how to live their lives. The world will also never forget the image of Boris Yeltsin standing on a tank, staring down a military coup at the beginning of a Russian movement for personal and economic freedom. Atop that tank he stated, “The people of Russia are becoming masters of their own fate.” The coup was defeated and the democratically elected Yeltsin returned to office.

The end of the Soviet Union, together with China’s movement towards free-market capitalism, proved to the world that the planned economy of controlling supply and demand had failed. Free market economies are engendered in Liberty.

In any economics class, you learn the law of supply and demand. All other things unchanged (technology, shipping, efficiency, productivity, etc.), as the supply goes up and demand remains constant, prices go down. As the demand goes up, and supply remains unchanged, prices go up. As prices go up and the opportunity for a return is seen, individuals jump into the market and offer new innovations or comparable services, thus bringing the price back down and giving those individuals part of the wealth they created. Naturally, the best way to bring down prices is to increase the supply or decrease the demand.

Businesses come and businesses go according to their ability to meet the demands of the consumers in the marketplace. If the business can supply a service that enough people find value in and are willing to pay an amount that is sufficient for the business owners and operators to continue to work for, it will succeed. If not, it will fail and some other business will generally take its place.

Because the Government can no longer afford to be in the health care market, it is seeking to adjust these laws to their own circumstances. Rather than accept the natural laws of economics, government wishes to change the rules.

If government can become the primary insurer of health care for Americans, it can limit the demand by helping Americans avoid, what it deems to be, unnecessary services. By limiting the number of people who get CAT scans for example, the supply appears to go up because “demand” goes down and thus prices go down. Additionally, we may even see government built and ran hospitals as it attempts to increase the supply of services. By increasing the supply of hospitals and doctors, it would cause prices to go down, all other things unchanged.

“If you like your doctor you can keep your doctor. If you like your plan you can keep your plan.” That is what the President keeps repeating, over and over again. However, let us think through this. If you can get the same, or similar plan, for less money (because it is subsidized by the US taxpayer), and still keep your doctor, why wouldn't you go that route? The truth of the matter is, the government's plan will eventually put your plan out of business.

Because of the taxes that will be laid on what the government is calling “Cadillac plans,” mandates to have health insurance, and the heavy subsidies that will be involved in the “public option,” there will eventually be no viable alternative to government ran health care and private insurers will not be able to compete. It is a simple law of economics; the ignoring of which would set aside ages of experience. Even the health care exchange, although an excellent idea in concept, will bring more and more people and businesses onto the “Public Option.” Thus the government will eventually have a vast monopoly on services and will be able to dictate the price it will pay for them. This will appear to bring down costs. It will - but it won’t be natural – it will be by force, and the industry, and therefore our citizens, will be hurt.

What the government doesn’t take into consideration is the human condition. Within each individual there exists varying degrees of desire for freedom and liberty. Some would rather be told to do what needs to be done, some would rather tell others, while still others would rather just tell themselves, and others would do nothing at all. Those individuals who capture the moment and make things happen are the ones that bring about the greatest innovations, changes and events in families, communities and nations. Those individuals who catch their vision and support them by following their lead make those events or innovations occur. And together, we all have brought the world ahead.

The government monopoly over health care reimbursements, payments and costs will ultimately lead to a decline in the innovations and quality of care that has distinguished American health care worldwide. How will it do so? By reducing, or altogether limiting in some areas, the individual liberty of the citizens who make up the health care industry. When the laws of supply and demand are controlled by government, they can control the prices and therefore how much they may pay for the services, but it also will take the opportunities that the human condition needs, opportunities for gain, risk and reward, out of the equation. The reduction, or elimination of these opportunities, will lead to fewer innovations, poorer quality of care, and fewer of our best and brightest going into the Health Care Industry as has been witnessed in other countries with a government monopoly on health care. I can attest to this from my own experience.

By reducing the liberty available, we will be reducing mankind. If we were created to act, and not to be acted upon, the more we are forced to be acted upon rather than to act for ourselves reduces the very fundamental purpose of our existence.

Interrupting this natural balance and flow of human forces is destructive to both the individual Human and the supply/demand balance for the good or service rendered. This destructive force is called oppression or tyranny.

I remind you of what Adam Smith wrote in his 1775 Lectures on Jurisprudence:

“Little else is requisite to carry a state to the highest degree of opulence from the lowest barbarism, but peace, easy taxes and a tolerable administration of justice; all the rest being brought by the natural course of things. All governments which thwart this natural course, which force things into another channel or which endeavor to arrest the progress of society at a particular point, are unnatural, and to support themselves are obliged to be oppressive and tyrannical.”

There is an option besides the status quo and the President's plan. Essentially, that option is the one that will break up insurance monopolies, cut back the government’s involvement as an insurer, elevate the government to a role of supervision and regulation where they can setup the right structure for free market forces to work, find a way that the uninsured can pay rates comparable to that of the insured, and create a model for affordable, private insurance not obtained through an employer.

That is the best chance for America.

As our founders stated in the Declaration of Independence, “all experience hath shewn that mankind are more disposed to suffer, while evils are sufferable than to right themselves by abolishing the forms to which they are accustomed.” However, let’s not volunteer for more eventual suffering, oppression and tyranny at the hands of government – no matter how subtle it may appear at first. Let the government govern, protect and regulate and let the People remain the masters of their own fate.