GOP ticket 2012

There has been recent talk about the lack of leaders amongst the republican party. But I think there are extraordinary people who would make terrific candidates to campaign against an Obama-Biden ticket in 2012. I do not want a woman just because she is a woman and I do not want an African- American just because he/she is an African-American. I want the person who espouses the views that I believe in and can enunciate and debate them successfully.
I have nothing against Sarah Palin, she is a bright woman, but she is not presidential material. I probably agree with her politically but she does not have the capacity to debate those views against extremely bright challengers. To choose her again because she is an attractive female would be a mistake. We should not be the party that puts style over substance. We should put the best man/woman forward. We are the party that looks past the superficial. We don't judge a book by its cover, we believe in the power of the individual regardless of his race or sex. If that person is an older white male then we should go with that. We have to trust that the American people can look past the sex/color of the candidate and can look at the substance behind the shell. I know that's a leap of faith but its our only chance. The republicans will never win playing the celebrity game against the democrats. The republicans will win because their ideas are better.
Having said that, I think Newt Gingrich is the person who elaborates the position of the republicans eloquently and confidently. He can clearly state the positions of the republicans and how they contrast with the government centric democrats. He can debate the fiercest challenger with facility and can connect with the common man detailing the advantages of the conservative/republican values. There is no doubt he has negatives and he is a polarizing figure. That is only because he sticks to his positions and doesn't change with the most recent poll figures. But this is what we need at this time, a grown-up with real experience.
As far as the the vice presidential candidate, I think Charles Krauthammer would be a great choice. Yes, another old white male, but a great candidate. He is a terrific communicator both with the written and oral word. He portrays calmness and confidence and has a way of explaining complicated issues in a very simple to understand manner. I think he would be great in a national ticket.
So lets believe in the capacity of the American people to select a candidate based on their ideas and not by their exterior. A Gingrich-Krauthammer ticket in 2012 would truly put the decision to the American people. Do we want a country with larger government, more government power, higher taxation, and more government intrusion in our lives similar to a European model. Or do we want a country where we believe in the power of the individual to excel with minimal government interference. A place where race, sex and sexual preference are not factors in determining a person's ability to succeed, only his own talents and abilities. Lets have this debate as a country on these issues and not about personalities and lets decide in which direction we want to go.

doctors and antitrust laws

Would it be fair to plumbers if everybody got together in a state and said to the plumbers this is a schedule of what we are paying for your services, for instance, unclogging a drain. Take it or leave it. The plumber could either accept the rate dictated by the population or be excluded from the base of customers. He could elect not to accept that schedule of fees but he would likely have no customers as the population would elect to go with the plumber who accepts the reduced "negotiated" fee.
It is likely in such a scenario that incomes of plumbers would decrease and thus people would be less likely to enter the profession of plumbing. This would result in smart people going into other professions that are not forced into fixed fees. The outcome is fewer and less desirable people entering the field and ultimately poor service to the population.
You may ask why don't the plumbers get together and say none of us will work for the reduced fee schedule. Therefore, forcing everybody to negotiate individually with the plumber. In fact, this violates anti-trust laws and is prohibited. The plumbers cannot get together and discuss and/or set their fees. The spirit of this law makes sense as it would be unfair for all the plumbers to decide on a fee together which limits competition and forces a specific fee for a service. By competing with each other, the plumber will try to get a price lower than his competitor to get the business.
It is unfair that the population can get together to negotiate fees but the plumber cannot. It seems to me that their should be an even playing floor. If the population can negotiate as one (collectively bargain) then the providers of the service can do this as well and bargain as a collective group. On the other hand, if the population cannot or does not have the structure to collectively bargain then the provider cannot as well.
So where am I going with this?
This is analagous to the situation currently in place for the doctors. The fees are set by the insurance companies. The doctor can take it or leave it. The insurance companies are effectively collectively bargaining for the population but the doctors are unable to assemble to bargain as one entity due to anti-trust violations. A single doctor cannot take on an insurance company to effectively negotiate fees.His only options are either to accept the fees and see patients or reject the fees and see minimal or no patients. This is price fixing and needs to be changed.
As usual it will be the public that loses. Ultimately, the fees forced upon doctors will be so ratcheted down that the doctor will be losing money resulting in him dropping the insurance companies (this is currently underway). This will lead to less access to doctors under people's insurance and the doctors that do accept the insurance will likely be of poorer quality. That is because the only way the bad doctors would be able to attract patients is to remain on the list with the insurance companies, otherwise nobody would go to them. Additionally,when a patient wants to see a doctor outside the insurance company, he will likely incur significant fees which he/she would be responsible for. Again, the public loses.
Another outcome is fewer young people will enter a field where the value of their services are determined by a beurocrat or politician.
The fair resolution to this problem is easy. If insurance companies collectively bargain for their population then the physicians can collectively bargain for their services. Seems only fair.

Combined sacrifice? the exception

We have all been asked to make sacrifices for the sake of the economy. Laborers, manufacturers, health care workers, small business owners, and even some government workers have been asked to make obligatory sacrifices (? isn't sacrifice by definition voluntary?). The only group that I have not heard in connection with sacrifice is the lawyers. Not one time during these difficult times have they been targeted to give at all. I am sick and tired of the lawyers being immune from any government intervention. The reason is obvious since the ones demanding sacrifice are either lawyers themselves ( a large majority of the politicians) and/or are bought off by the legal profession. The conflict of interest exists where many politicians have friends or relatives in the legal profession or plan to rejoin the profession after their political stint. Thus they are loathe to do anything that would reduce their compensation.
It is well known that the cost to the economy by the lawyers is significant. The cost of litigation of class action suits and judgements against large business, the fear of small business getting sued by a litiginous customer or employee, the cost to local governments of ridiculous lawsuits, the cost shouldered by doctors for malpractice insurance are a tremendous burden on the economy.
Ultimately these costs have to be passed on to the consumer/tax payer. If these costs were reigned in, it would have a dramatic effect on all aspects of the economy.
The lawyers will defend that they protect the little guy against the big corporations. In fact, they strive for jackpot juries for the few (mostly themselves) and leave the rest of us paying the tab. Is that where we want to be as a country and society? Do we want the lawyers putting this burden on business which causes a loss of jobs so few can win the lottery? I say now is the time for CHANGE, Mr. Obama. Lets hear ONE TIME you identify the legal profession as a problem that has been going on for too long, is a huge strain on the economy and needs to be reformed for the sake of the future of this country.
If you want to reform health care which you claim is so important to the economy you must reform the malpractice issue simultaneously. As a doctor I routinely order tests to avoid a lawsuit even if the chances of finding an abnormality are miniscule. I cannot take the chance of missing the one in a million abnormality because that might result in a lawsuit. This greatly increases the cost of care.
I am pessimistic that any change will take place that will alter the current legal situation . The structure is stacked in favor of the lawyers and we all pay for that. Now in addition to the congress being mostly lawyers we have the president and vice president both lawyers.
The pharmaceutical industry can no longer give me a pen with their name/logo on it because of a conflict of interest as a pen may distort my ability to prescribe medicine (ridiculous). Isn't it a greater conflict of interest where the legislators (mostly lawyers) have to police and regulate those in their own profession. Lets see if anyone will be brave enough to demand that the lawyer sacrifice.

health care-bottom line

Okay, so let me put in my two cents reagrding health care. The bottom line is the cost to provide prompt quality care to every American is too expensive. Although I believe this would be a reasonable way to spend our national treasure, to extend the lives of the people who generate the treasure, the cost would eat up a major portion of the GDP. To avail everybody of all the technological advances and heroic treatments available would be cost prohibitive. So what is the solution to provide universal care to all Americans? By the way, guaranteeing insurance to people does not guarantee care as there may not be a doctor who accepts your insurance.
The end game has to be a two tier system as exists in other countries. A public and a private system. Everybody will obtain a package of insurance that provides basic care. That insurance may be from an insurance company or more likely from the government. Most likely it will not be profitable enough for an insurance company to participate. The availabilty of that care will be depend on reimbursements to providers. If it acceptable then people will be seen and treated promptly. However, the more likely scenario is if payment to providers is poor then as in other countries access to a doctor, obtaining tests and receiving operations will be delayed and waiting lists will be the norm. Most doctors offices, radiological facilities, hospitals, are for profit businesses. If profit is no longer possible or too low then the availability of those services will decrease. This will generate a second tier of private medicine where a person can see a doctor or get a test promptly for direct payment. This second tier is profitable to the provider/owner and will be provided promptly. There may be an insurance policy for this second tier of healthcare.
I see a system where a doctor spends some time in a public clinic seeing patients in the basic tiered insurance and then has another private office where he sees his private patients. The public clinic could be located in the hospital because the doc will not be able to or want to pay rent to see poorly reimbursable patients. The office hours will be limited and the number of patients limited resulting in waiting lists.
To avoid runaway healthcare costs and keep the expense neutral the solution is either to maintain current reimbursements and volume of patients thus rationing care as more volume comes online (more patients in the system). Alternatively, to increase the volume at lower reimbursements resulting in waiting lists (as described above) which also rations care by default. In either case care will be rationed. By including everybody, by necessity, access will be reduced. Only those that can afford it will obtain immediate access to healthcare. Universal coverage is a noble goal, but don't expect the access to care which that coverage provides to remain what it is today.

Rush

It seems that Obama-Pelosi are implementing the strategy I discussed in a previous entry, although I intended for the republicans to use it. Their strategy is to select the standard bearer for the republicans and portray him as the leader of the party. By selecting Rush Limbaugh they have picked an idealogue who is a very polarizing character. You either love him or hate him, strongly agree or think he is a nut job. He in not a politician trying to be inclusive of as many followers as possible. He believes in a certain ideology and sticks with it. Unfortunately, this is not a recipe for a succesful politician but is for a radio talk show host. His concern is a loyal audience, not necessarily to appeal to the masses. So if he alienates some, that is fine as long as his ratings remain strong. By selecting him, the democrats have elevated Rush, and are thus attempting to distance many moderates from the republican party.
This game is effective and should be played both ways. Nancy Pelosi is an idealogue as well, and is a polarizing figure in her own right. In addition, she is the speaker of the house which makes her more naturally the spokesperson for her party. Alot more reasonable than selecting a nonpolitician, radio talk show host as the spokesperson. The republicans must focus on her and demonstrate how she is shaping the democratic party and the current agenda. This is not a falsehood but actually the truth. The republicans have no shot at this time trying to bring down Obama. He is too smart, charismatic, and loquacious with too much mass appeal. They must portray the dems as a far left party under the leadership of Pelosi, with Obama just following her lead, allowing her to shape policy, and marketing her ideas. The more we see Pelosi the worse it will be for the dems.
I just hope the republicans figure this out before Obama does. If Obama was smart he would distance himself from the far left wing of the party. He should demonstrably go against the policies of Pelosi. This would enable him to capture the moderates of both parties and ensure his popularity as a mainstream politician.

disingenuous

There is no justification for the wreckless fiscal policy of the Bush administration especially since it was done under the banner of conservatism. His policies have given the democrats tremendous power and freedom to enact far reaching legislation under the rationalization that the conservative principles of the Bush administration were a failure. The truth is that on the spending side, the Bush administration was a failure and was far from fiscal conservatism. On the other side, the revenue aspect, the last eight years were a remarkable success. Every year the revenues taken in by the treasury far exceeded the projections and this was due to his tax policy. The tax cuts implemented by Bush strongly stimulated the economy resulting in the strong inflow of taxes.
Having said that, I must say that Obama-Pelosi and the democrats are completely disingenuous. They basically say that the economy is in the current state due to the the policies of Bush and his tax policy. This is a blatant lie and Obama-Pelosi are intentionally, with full knowledge perpetuating a lie in order to advance their agenda and reverse the Bush policies.
The state of the economy has nothing to do with the Bush tax cuts and is purely due to the deleveraging that is occurring as credit is reduced and the housing market corrects. An unfortunate excess of the economic cycle perpetuated by lack of adequate oversight and the credit frenzy perpetuated by both parties.
To lie to the American people and say the economy is in the condition it is in due to Bush's tax policy is misleading and disingenuous. I believe that the proposed tax increases will further handicap the economy as the redistribution of wealth continues. Somehow I think Obama understands this. He is too bright not to see the evidence of the revenue stream brought in by the last administration. He has to be more about Obama and not Obama-Pelosi. I think with time he will move away from the far left Pelosi crowd towards the center and use tax policy to stimulate the economy.