If You Like Your Health Plan You Can Keep It But....

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.

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.

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.

A Great Press Conference

I can't believe I ever thought i would have a difficult time coming up with material to write on this blog. I contemplated several topics this week but I felt I had to write about the most successful press conference I have ever seen. By that I mean, what is the purpose of a press conference? To inform the press and public as to what is going on in the administration and what the president is thinking and planning. Well BO certainly informed the public on two issues that are very enlightening. Unfortunately for him, these two topics were not in his planned comments but he brought them up anyway in an unscripted manner. It certainly demonstrated his true feelings as to where the problem lies both in the escalation of health care costs as well as in race relations. A disaster for BO but a truly informative and eye opening conference.

I also felt obligated to write about this press conference since I learned during this conference that I am personally responsible for the dramatic escalation of health care costs in the United States. Not only that, but I am unethical, I decide treatment based on reimbursement, and I border on criminal activity by performing unnecessary surgery on children. Yes, I admit it, I perform tonsillectomies. Just put the handcuffs on me already and ship me off to Alcatraz. BO is really smarter than I thought. He is fully knowledgeable in the field of Otolaryngology and understands all the criteria that go into the decision as to when a tonsillectomy is appropriate. He knows exactly what goes through my mind when I decide to operate and he has determined that I am performing unnecessary surgery on children just for the money.

This knucklehead with a law degree doesn't consider the amount of training I went through to be qualified to perform tonsillectomies and to understand when it is indicated and when it is not. He doesn't consider the thousands of children that benefit from the surgery as many studies have concluded and he has no clue as to the indications to perform such surgery. He has concluded that the parents of the children undergoing tonsillectomies are complicit with the surgeon and are not smart enough to ask the doctor whether the surgery would help their child so they allow their children to undergo unnecessary surgery (don't you worry the government will come to your rescue). He hasn't considered that the risk of doing unnecessary surgery carries with it the risk a lawsuit which is always in the back of any surgeon's mind. He also hasn't considered that in cases where the indication for tonsillectomy is recurrent tonsillitis that in fact health care costs are reduced by the surgery as the patient's need for doctor visits and antibiotics are greatly reduced.

It is sobering to know that BO considers the doctors as the source for the nation's healthcare problem. He clearly said as much at the news conference and he will likely bring this opinion to the restructuring of our healthcare system. Doctor beware, you are the problem. The only doctor that is safe in the restructuring is the abortionist. The only surgery that BO approves of and promotes is an abortion. I, who try to improve the lives of children through medical and surgical treatment, am the problem but the doctor who destroys life is revered. Truly a bizzaro world.

Briefly, the other revelation during the press conference was his determination that it was the fault of the police officer in the Gates arrest. BO is a genius. He admits he doesn't know the details but is smart enough to know that it was the police officer who acted stupidly, according to BO, who was at fault. In fact, this clearly demonstrates his view that police officer, you are the problem. The facts do not matter, your training doesn't matter, your years on the job do not matter, and your previous behavior regarding race relations do not matter. The knucklehead with a law degree (BO) has predetermined that you are a racist just like he has determined that I am a unethical, money hungry, deceiving physician.

So lets add two more sets of people to the list of groups who should definitely regret their votes for BO (See entry 5/25/09). Doctors and the law enforcement community. The fact is any doctor that voted for BO should have his head examined. There were plenty of indications during the campaign he was going to reform health care on the backs of doctors since it is them who are problem. Now we know the full extent of his feelings towards doctors. And anybody who makes their living in law enforcement you should know you will never get the benefit of the doubt. You are predetermined to be racist and will be judged as such.

I would like to thank BO for expressing his heart felt opinions on these matters and really detailing his true beliefs. We need to have more press conferences with BO so we can learn more about his honest opinions in all matters. Biden has got nothing on BO when it comes to public missteps.

Job Creation (?Job Saving) Obama Style

It has certainly become a lot more clear what Obama meant when he said he was going to create or save thousands of jobs. It turns out the jobs he is saving are jobs that are funded by the taxpayer and not private sector jobs. With his massive "stimulus" bill he is pumping money into state and municipal governments to help balance their budgets without any conditions. Instead of these local governments making the hard and necessary choices of cutting back their payroll and unsustainable benefits they are just continuing to suck the taxpayer dry by taking federal funds which will be payed for by higher federal taxes as well as by repaying debt by our children and grandchildren.

The other job that Obama has decreed as worth saving is the union employee. He is bailing out the car companies which are clearly not based on a profitable business model. But nevertheless the taxpayer will be burdened by the perpetuation of these union jobs. Instead of the car companies making the tough choices and the government forcing the companies to make those choices the union is able to protect their jobs at the expense of the taxpayer. It is unfair that with unemployment at 9.5% and with millions of people having lost their jobs that these auto workers are supported by tax dollars and artificially maintained in their positions. The administration is bought and paid for by the unions. Of course this is a payback by Obama for the union support during the campaign.

The jobs that BO has decided are okay to lose are those of small businesses, the true generator of the majority of jobs in this country. In fact he is contributing to the loss of jobs by small business. By increasing taxes and mandating employee health care coverage or a fine, any bozo can see this will lead to further unemployment. He fails to appreciate the critical role small business plays in the economy. What small business owner will hire in this environment? The small business owner will cut back on payroll to maintain profitability.

So union jobs and municipal jobs are in and small business jobs are out. BO has decided that preserving these jobs are more important than stealing from future generations. And on the flip side losing the small business jobs is okay even if it tanks the economy. This is a very bad trend for our economic future. Although we are seeing a slight bounce back from the lows in the economy I cannot see a scenario that would lead to a significant expansion of the economy. We will likely see a jobless recovery and a protracted period of economic stagnation.

Where's Hillary?

I don't know if you've noticed but Hillary is nowhere to be found. I haven't seen her on the news, on any news shows, or quoted in the newspaper as far back as I can remember. One would expect in light of the recent uprising in Iran, a major and historic moment, the secretary of state would have weighed in with her opinion on the matter. There are two possibilities, either the administration is controlling the situation and limiting her exposure so she doesn't outshine Obama. I think this is unlikely as I doubt she would be quieted by her previous foe. More likely she is purposely remaining under the radar screen. But why?

I have no doubt that Hillary is still seething from the primary battle and feels she should have been the nominee. She must be second guessing her campaign constantly since she knows she was the more qualified candidate. She was given the position of secretary of state but then all these special envoys were appointed to deal with specific regions. An envoy to the middle east (Mitchell), an envoy to Pakistan and Afghanistan (Holbrooke), an envoy to Sudan (Gration), an envoy to Iraq (Hill), etc. All the hot spots were taken by appointed envoys. So what's left for Hill? Not much, just a very sore, frustrated, vengeful woman.

I think she has every intention to run against Obama in the 2012 primary. If she appeared on the news she would have to follow the party line and back up all of Obama's decisions and policies. She doesn't want to be seen doing this as this would negate her ability to criticize his policies in the next primary. She is waiting for the perfect time to resign her position and this will likely be in some response to an Obama position that she will say she cannot support. This recent episode was perfect since Obama did not immediately support the uprising in Iran. Hillary could have stepped in and said I support the freedom fighters and stood against Obama. This makes her look to be the candidate who supports democracy in a theocratic regime while Obama looks to be the guy who wants to schmooze with the Mullahs and Ahmadinejad.

The problem was it was too early. She has to wait for about another year until she makes her move. His approval numbers will continue to deteriorate over the next year while she is in the background with a low profile quietly building support. As his numbers go down there will be splintering within the democratic party. He will be on the liberal side and she will dominate the moderate wing. The liberal agenda will be seen as an absolute failure both domestically and with regards to foreign policy. There will be major defections from Obama supporters to the moderate wing of the party ie. Hillary. Her approval numbers will soar as the dems look for a less liberal representative. She is a very intelligent, calculating woman. I have no doubt we have not seen the end of the Clinton machine.

Lessons From MJ

The king of pop, Michael Jackson, was a highly talented entertainer who was blessed with many skills that propelled him into an extremely privileged life. He attained worldwide fame, his music was recognized around the globe, he earned a large fortune but despite all that, the evidence points to the fact that he was an extremely unhappy individual. It seems clear that he was conflicted about his heritage, his blackness. His desire was to reject being black. By reshaping his nose through repeated surgeries, chemically altering the color of his skin, and straightening his hair it appears his goal was to remove his negroid features. It seems unusual that the black community has embraced MJ to such a great extent posthumously even as he appeared to reject that community during his life.

This is no way a slight on people of color but rather a manifestation of someone who is unhappy with who he or she is and is searching for a path to happiness. He likely thought if he could just lose certain ethnic features he would achieve fulfillment through a new appearance. He bought into the notion that it was his blackness that was preventing his ultimate desire of self-fulfillment.

He also demonstrates that regardless of endless possessions it was not enough or able to satiate his quest for self fulfillment. Regardless of an enormous mansion, endless furnishings and anything that his heart desired he remained unfulfilled.

Finally, he demonstrated that a life of fame does not necessarily correlate with a life of happiness. I recently heard a survey conducted amongst college aged kids as to what is there greatest desire. It wasn't wealth or health but the desire to become famous. As demonstrated by MJ and numerous other celebrities, fame is no guaranteed pathway to a content life. We live in a society where celebrities are placed on a pedestal and are adored, and kids want to attain that adoration to the exclusion of everything. Maybe that is why we have so much depression in this country as people buy into the idea that if they were better looking or richer or had more stuff or famous then only then would they be happy. And since this not attainable to most it becomes a source of dissatisfaction that leads to depression.

So MJ has shown us that fame, wealth and appearance are not necessarily a pathway to a fulfilled life. Despite his many gifts he lacked the one gift that would allow him to be content. The greatest gift one can receive is to be happy with what one has, what one looks like, and with one's lot in life. This is not to say that one should not strive for greater things but to be content with one's station in life is truly the greatest gift.