If you like your health care plan you can keep it and if you like your doctor you can continue to see him. This is the BO mantra. He starts out every health care speech with this statement as he thinks the more he says it the more it will be believed as the truth. But let me tell you the real deal. BO is absolutely telling the truth, however, he is leaving out a critical part and only revealing half the statement. He is right in that in Obamacare you can keep your health paln/doctor but what he fails to mention is that is going to cost you more and possibly a lot more to do so. You see, these lawyers such as BO are trained to use the English language to deceive. They purposely make comments that are half truths and incomplete so that they cannot be accused of lying in the future. They are experts in the field of verbal deception. He purposely leaves out the second sentence that the cost to keep your plan/doctor may be prohibitively expensive because he knows this would be unpopular and kill the plan. By creating a system of government health care, private care would be comparatively more expensive and this will de facto force more people into the public plan on an economic basis. BO can later claim he was telling the truth, that you can keep your plan. Bur he fails to mention only if you can afford it.
As an employee either your employer will provide health care or he will have to pay a penalty to the government so the government can supply you with health care. Lets take the first situation. Your employer give you an amount of money to spend on health care. You go the market place and find that your employer has given you enough money to pay for the public plan (what incentive is there for him to provide more?). In order to keep your existing plan you will have to pay the difference which may be thousands of dollars. So you will have to decide whether you want to spend the difference to stay in your existing plan or opt for the public plan.
The second situation is very similar but instead of getting the subsidy from the employer, it is coming from the government, The subsidy from the government will also likely cover the public plan and you will have to decide whether you want to pay the difference to stay in your existing plan. Again, BO says you can keep your plan but what he fails to mention is that it’s going to cost you.
The other factor is how the cost of the public plan will be determined. The politicians can easily keep it artificially low which will make private health insurance comparatively more expensive requiring greater out of pocket expense to pay the difference. This will make private insurance more out of reach for most people dumping more of the population into the public system.
Truthfully, I have no problem with a competing public plan that is accurately priced. The private health insurance is also broken as too much money goes towards overhead ( CEO salary, advertising, stockholder profits) and too little for medical care. The public plan would force private companies to compete by lowering overhead and premiums. The only caveats are that the public plan must be priced at an accurate level base on its payment of services and overhead. It cannot be subsidized with taxpayer dollars. It must allow providers to participate and drop from the plan based on their reimbursements.
People in their gut know the future of their health care lies in the balance and that is why we are seeing such an enormous backlash. Do not believe you will be able to keep your own plan without great expense. If it sound too good to be true it likely is. Beware the experts of verbal deception.
Saturday, August 29, 2009
Tuesday, August 18, 2009
End of Days
Of the several venues that I frequent in my practice I began to consider a nursing home that I visit on occasion. On this unit the residents are all hooked up to ventilators or breathing machines. They are all incapable of breathing on their own so a trachesotomy is placed which is a hole in the front of the neck and a tube is placed into their windpipe which then gets attached to a breathing machine. Periodically the tube wears down and that is where I come in to change it. These patients are fed through a tube that goes through their abdomen into their stomachs, are completely unaware of their surroundings and are essentially kept alive through artificial means. They have absolutely no quality of live and in fact are likely suffering. I suspect if they had the chance to express their views they would elect to have the machines removed and allowed to pass.
The problem is that the majority of these patients experienced a sudden, unexpected and significant brain injury. Whether a large stroke, traumatic brain injury or an aneurysm that ruptured they succumbed to an event that placed them in this unit without the ability to have planned for their desires. Some live for years in this situation with absolutely no chance of recovery and the costs to maintain these individuals is enormous. Only the families can elect to withdraw treatment and their families for whatever reason demand that they be kept alive on machines. I cannot understand why the families cannot make the most humane decision for their loved ones which is to allow them to pass. Maybe there are religious reasons or feeling of guilt, and I am not saying these are easy decisions, but to maintain a body with no cognition for years and years is wrong. Unfortunately for these patients, they did not have an advanced directive which would have expressed their desires prior to their injuries.
I agree with the Obama administration that end of life planning should be a critical part of the reformation of healthcare. Everyone should be required to have an advanced directive to clearly state what their wishes are. The document should express the desires of the individual not to be maintained indefinitely by artificial means and to be allowed to die. It is clear that many families cannot make the appropriate decision and that is why the document lets the family off the hook, so to speak. Not only will this allow for the more humane treatment of these patients but another benefit is the savings of an enormous quantity of money that is currently being wasted.
The attack by the right on this part of the health care reform is not fair. People have the option of expressing their desires precisely on the advance directive and the government cannot mandate specific language. It is very important for everyone as part of their individual and civic responsibility to have these forms completed. There should be no barrier for individuals to fill out these forms and there should be no cost to the individuals. This will ultimately save a tremendous amount of money in health care costs. But more importantly, it will allow all of us to express our desires to die in a dignified manner with minimal suffering and with the least burden to our families and to our country. It will release our families from the responsibility of making end of life decisions for us that seem so difficult.
The problem is that the majority of these patients experienced a sudden, unexpected and significant brain injury. Whether a large stroke, traumatic brain injury or an aneurysm that ruptured they succumbed to an event that placed them in this unit without the ability to have planned for their desires. Some live for years in this situation with absolutely no chance of recovery and the costs to maintain these individuals is enormous. Only the families can elect to withdraw treatment and their families for whatever reason demand that they be kept alive on machines. I cannot understand why the families cannot make the most humane decision for their loved ones which is to allow them to pass. Maybe there are religious reasons or feeling of guilt, and I am not saying these are easy decisions, but to maintain a body with no cognition for years and years is wrong. Unfortunately for these patients, they did not have an advanced directive which would have expressed their desires prior to their injuries.
I agree with the Obama administration that end of life planning should be a critical part of the reformation of healthcare. Everyone should be required to have an advanced directive to clearly state what their wishes are. The document should express the desires of the individual not to be maintained indefinitely by artificial means and to be allowed to die. It is clear that many families cannot make the appropriate decision and that is why the document lets the family off the hook, so to speak. Not only will this allow for the more humane treatment of these patients but another benefit is the savings of an enormous quantity of money that is currently being wasted.
The attack by the right on this part of the health care reform is not fair. People have the option of expressing their desires precisely on the advance directive and the government cannot mandate specific language. It is very important for everyone as part of their individual and civic responsibility to have these forms completed. There should be no barrier for individuals to fill out these forms and there should be no cost to the individuals. This will ultimately save a tremendous amount of money in health care costs. But more importantly, it will allow all of us to express our desires to die in a dignified manner with minimal suffering and with the least burden to our families and to our country. It will release our families from the responsibility of making end of life decisions for us that seem so difficult.
Wednesday, August 12, 2009
Dustin the River Guide
I was on vacation this past week so I missed an entry on to the blog. Anyway, I went to Idaho for a week where I spent four days on the Salmon and Snake Rivers white water rafting and camping on the banks of the river. I must say this was an extraordinary experience. The natural beauty of this country is beyond what words can describe. Experiencing man-made beauty such as art, architecture, theater and cuisine can be impressive but they don't nearly approach the majesty of the natural world.
On the river we had guides who led our party. One of them was a twenty something guy from Montana named Dustin. A very bright young man who was planning to attend law school in the fall. Obviously he was a democrat (young, prelaw, tree hugger) and me being on the opposite side of the political spectrum led to several contentious conversations. I asked him if it was possible to be conservative politically as well as pro-environment to which he responded no. Naturally, I asked to explain why and he could not come up with a reasonable answer. It is unfortunate for the right/conservative/republican side to be associated with an anti-environmental position. I cannot reconcile the fact that views of less government, more individual responsibility, and greater emphasis on religion is somehow connected with being less environmentally friendly. And contrarily, more government involvement in our lives, less stress on religion, and more reliance on the state are positions that somehow are connected with the pro-environmentalist position. The left should not have exclusivity when it comes to being pro-environmental.
The only connection I can see is that the right has historically placed greater emphasis on business and profits and sometimes this may have come at the expense of the environment. The extreme environmentalists would have us sacrifice any profit generated at the expense of the environment regardless of its benefit to humanity. Obviously, a middle ground has to be reached that is sensitive to both the preservation of the environment and the use of its abundant natural resources for commerce.
The environmental issue should not be a right/left issue at all. There is no reason why the right cannot be as green or more green than the left. In fact, I can make the argument that one's heightened sense of individual responsibility and liberty would lead to a greater feeling of one's responsibility to the land. Much more so than can be controlled or legislated by the government. Yes, it is important for the government to set aside land for preservation but who is going to pick up the wrapper, clean the campsite as if no one had been there or be obsessively careful with campfires? the government? Only the individual can micromanage his actions.
The democrats use environmental issues for political gain They create or exaggerate environmental issues to polarize the electorate and claim they are the only truly green party. It's time for a conservatives to boldly claim that they will not concede this issue to the left. Their slogan should be "conservatives for conservation" and should claim to advance the position of using the environment in a responsible manner.
The platform of the right should include limited government, greater personal responsibility for their lives and their land, and the preservation and care of the environment. Natural resources must be used in the most efficient and minimally destructive manner. So to my friend Dustin, the river guide, I hope you can reconsider your political affiliation and feel comfortable being green in the red party. The right needs young people such as yourself to lead us into the future.
On the river we had guides who led our party. One of them was a twenty something guy from Montana named Dustin. A very bright young man who was planning to attend law school in the fall. Obviously he was a democrat (young, prelaw, tree hugger) and me being on the opposite side of the political spectrum led to several contentious conversations. I asked him if it was possible to be conservative politically as well as pro-environment to which he responded no. Naturally, I asked to explain why and he could not come up with a reasonable answer. It is unfortunate for the right/conservative/republican side to be associated with an anti-environmental position. I cannot reconcile the fact that views of less government, more individual responsibility, and greater emphasis on religion is somehow connected with being less environmentally friendly. And contrarily, more government involvement in our lives, less stress on religion, and more reliance on the state are positions that somehow are connected with the pro-environmentalist position. The left should not have exclusivity when it comes to being pro-environmental.
The only connection I can see is that the right has historically placed greater emphasis on business and profits and sometimes this may have come at the expense of the environment. The extreme environmentalists would have us sacrifice any profit generated at the expense of the environment regardless of its benefit to humanity. Obviously, a middle ground has to be reached that is sensitive to both the preservation of the environment and the use of its abundant natural resources for commerce.
The environmental issue should not be a right/left issue at all. There is no reason why the right cannot be as green or more green than the left. In fact, I can make the argument that one's heightened sense of individual responsibility and liberty would lead to a greater feeling of one's responsibility to the land. Much more so than can be controlled or legislated by the government. Yes, it is important for the government to set aside land for preservation but who is going to pick up the wrapper, clean the campsite as if no one had been there or be obsessively careful with campfires? the government? Only the individual can micromanage his actions.
The democrats use environmental issues for political gain They create or exaggerate environmental issues to polarize the electorate and claim they are the only truly green party. It's time for a conservatives to boldly claim that they will not concede this issue to the left. Their slogan should be "conservatives for conservation" and should claim to advance the position of using the environment in a responsible manner.
The platform of the right should include limited government, greater personal responsibility for their lives and their land, and the preservation and care of the environment. Natural resources must be used in the most efficient and minimally destructive manner. So to my friend Dustin, the river guide, I hope you can reconsider your political affiliation and feel comfortable being green in the red party. The right needs young people such as yourself to lead us into the future.
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