Health Care: Mongering All Around, When Money is the Issue

Sarah Palin did fiscal conservatives a disservice by focusing on "death panels" and mongering fear to build opposition to the Obama - Pelosi -Reid health care initiative. Although the left wing has used intimidation and outrage consistently since Gore lost the Presidency in Florida and the courts, outrage did not prevent or end the Iraq War. When your outrage exceeds your argument, you lose the vast center of the population.

Democrats, who are rightly upset about the worst of the behavior of the opposition to their health initiative have set themselves up to look like hypocrites because they often encouraged (Speaker Pelosi) and mostly looked the other way when their political allies practiced the same tactics on a seemingly inept George Bush and a war-mongering Dick Cheney.

So while the far right mongers fear to get citizens to act out and the left wing fights back, we need to get the politicians to discuss the real issue here, which is money and the economy. An expansion of health care services has to be paid for. Since a solution that can not be payed for is not a solution, what do the current federal health care service programs teach us?

Medicare although providing needed services to retired Americans is not a solution because it is not fundable in the future. In order for the economics of Medicare to work, we need both a perpetual baby boom and less services consumed on a per senior lifetime basis. Neither scenario is going to happen.

Both the Democrats who created the Medicare system and the Republicans who added services to it are responsible for the system in its current state. While waste and fraud are huge issues within Medicare (>10% of its cost) the "sword of Damocles" which hangs over all of our heads is the "criminal" funding model. I call it criminal because it is a Ponzi scheme and in any private endeavor it would be a crime.

Unlike individuals and the private sector, Congress writes rules that allow it to make material promises to the public which it can not keep under any reasonable scenario. When asked a health care funding question on Meet the Press today, Rep. Charles Rangel, Chairman of the Ways and Means Committee refused to answer the question and instead expressed his outrage about the expression of right wing outrage. He chairs the singular committee for the levying of federal taxes and raising revenue but does not want to discuss how we fund a future multi-trillion dollar obligation.

The other major federal health care service program is Medicaid. While Medicaid is not subject to the same demographic issues as Medicare, it is underfunded in just as onerous a way. Medicaid reimburses hospitals for services, which they are by law required to provide, at less than the cost of delivering those services. The difference between the cost of consumed services and reimbursement is simply added to the overhead cost of operating a hospital and redistributed to anyone who is paying for services. It is cost shifting and therefore a hidden tax on anyone receiving health care through private means.

Now the same federal government that is running a huge operating deficit and already is committing legal "fraud and theft" with the funding of Medicare and Medicaid wants to expand its role and control of health care service delivery. The Federal government needs to reform itself before it expands services.

The Democrats, who either see their sweeping November election victories as a mandate or "once in a generation" opportunity have approached this issue with too much focus on expediency rather than an open discussion with the American public. Are we going to relive 1993 and 1994, where the Clintons squandered their first administration and empowered a Republican minority?

The independents and moderates who supported President Obama in the election did not vote for a boundless expansion of debt and a take over of health care (the universal payer option). The popularity and goodwill extended to the President has never been extended to Speaker Pelosi or Senate Majority Leader Reid.

The Democrats need to limit their initiatives to reform and regulation in the health insurance industry and providing modest financial assistance for health care to the poor and working poor.