“I totally disagree with # 2. There is no way to control the quality of medical education in every country around the world. This would also completely flood the market with medical practitioners and drastically reduce doctors salaries which I am totally against. I don’t think reducing medical practitioners salaries is the right way to go. Why would anyone do 9 years of med school and residency and be on call all hours of the night if they were making less than they are now?? And on that note, would you want a surgeon trained somewhere you’ve never heard of in Tanzania cutting into you.. even if he charges 1/5 the price of an American?”

Here is my response:

John,

Thanks for the comment.

There is a very simple way to “control [for] the quality of medical education in every country around the world.”  This plan is completely workable if you force foreign doctors to take the same medical licensing exams that American doctors have to take.  This way, whether the doctor was from Canada, Tanzania, or somewhere Ive never heard of, he or she would have to be held to the same standards that all American doctors would.

As far as “drastically reduc[ing] doctors salaries,”  that wouldnt be the case either.  Remember, that part one of my plan would end all income taxes on doctors.  Given that the average doctor finds himself in the highest tax bracket, this would actually result in a massive increase in pay.  [Furthermore, it would save the doctor time, allowing him or her to relax or work more instead of having to figure out their taxes.]  When talking about reducing doctors’ pay, I think you are also forgetting the demand side of this equation.  The simple fact is that demand for medical care is rapidly rising.  A big part of this is because baby boomers are getting older and are requiring more care.  Allowing more doctors into America will result in better care for more Americans at a lower rate.  Yet, ending income taxes for doctors allows them to keep more money while charging less for services–a win-win situation.

Additionally, if we could ensure that doctors from foreign countries were held to the same standards as American trained doctors the cost of medical school might actually decrease.  Think about it–if you knew for a fact that medical schools in Asia, Europe, South America, or elsewhere were significantly cheaper, and you were able to go online and find the pass rates for student from these schools, you as an American might be more willing to attend one of these less expensive schools.

To sum up:  the goal is to increase supply without decreasing pay or quality.  That is why allowing foreign doctors into the country must be done while holding them accountable to the same medical standards as American trained doctors.  That is also why this must be accompanied by an end to taxes for doctors.

Americanly Yours,

Phred Barnet

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This cry is sounded repeatedly by those who are demanding some type of health care reform from President Obama.

Its hard to argue with their logic.  After all, health care costs are soaring and [according to some] there are nearly 50 million Americans lacking health insurance (although they are not without health care itself). Insurance premiums are rising faster than income, and Medicare will run out of money in 2019, potentially leaving millions of retirees without coverage, or causing taxes or government borrowing to rise rapidly.

I agree that something needs to be done.  However, I disagree about what exactly should be done.  Even the proponents of the Congressional plan agree that it is far from perfect, but they continue to repeat the mantra that “we have to do something.”

Well, we do have to do something, right?

The American people arent so sure.  According to a new Rasmussen poll, 54% of American voters–a larger majority than the percentage of Americans who voted for President Obama–believe that passing no health care reform would be a better option than passing the plan currently before Congress.  Only 35% say that the current bill would be better than “doing nothing.”

And it is now being reported that the President has dropped his demand for a “public option.”  If this is true, it could leave behind an expensive bill that does little to change the current system.

This plan is being pushed through Congress at a rapid pace.  President Obama has set artificial deadlines for when he wants legislation on his desk, yet health care reform is a massively complex issue that a new administration shouldnt reasonably expect to tackle in such a short time.  How this Nation to decide on a complex long term health care reform plan in only a matter of weeks?

I am one of the 54% of American voters who prefers “doing nothing” over passing the current plan.  However, that doesnt mean I favor doing nothing in general.  Here are some of my ideas for health care reform:

1)  End (or significantly reduce) income taxes for individuals working as medical doctors, nurses, medical practitioners, etc.

Doing this could dramatically lower the costs of medical care.  Ending or cutting income taxes for medical workers will essentially allow them to earn the same amount of money for charging less for their services.  This would also encourage those considering becoming nurses or medical staff to return to school and become certified in their fields, as well as encourage older medical workers to work for several more years (if they are able to keep more of their earnings, they could be more willing to work longer).  While this could add to the National debt if spending is not cut, the Nation would save a considerable amount of money in added health care costs.  And of course, I would support this plan only if it included spending cuts to balance out the lost revenues.

2)  End (or significantly reduce) immigration restrictions for individuals working as medical doctors, nurses, medical practitioners, etc.

Ultimately, costs in any industry, including health care, are dependent on supply and demand.  Any doctor, nurse, x-ray technician, etc. who is able to speak English should be offered instant American citizenship.  There are large numbers of such people all over the world who are interested in becoming American citizens, but who are unable to do so because of current immigration laws.

3)  Allow insurance companies to sell plans across State lines.

Federal law currently prevents insurance companies from selling plans across State lines.  This is just plain illogical.  This leads to inefficiencies and increased costs for both the business and the consumer.  Imagine if cell phone companies had to comply with similar restrictions–a company like Verizon would be prevented from having a National plan, they would have to have a different plan and pricing scheme for each State and D.C, and the cell phone user’s costs would be higher as a result.  The same is true for health insurance.  Allowing insurance companies to sell plans across State lines would essentially create a National insurance market where customers could go online to a site like e-healthinsurance.com and select a plan from companies headquartered anywhere in the Nation.  Taking this step would also allow insurance companies to cut unnecessary staff–potentially passing savings on to consumers.  There is no reason for a company like Blue Cross to have to have 51 different organizations to create and price different insurance plans.

Remember that just because we “have to do something” does not mean that we should have to do “anything.”  There are good as well as bad reforms, just as there are good and bad treatments for any disease.  A doctor with a seriously ill patient should look at all the options and diagnose the patient carefully and as accurately as possible before treating the patient.  Treating the patient before diagnosing him and reviewing all of the options could be catastrophic.

Americanly Yours,

Phred Barnet

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Tomorrow morning we will all wake up in a world where everyone is covered with some form of medical insurance, including the approximately 50 million Americans currently without health coverage. Yet, the number of doctors, nurses, and medical staff will be the same tomorrow as it is today. Likewise, there will be the same number of hospitals, doctors’ offices, and medical care facilities as there is today.

It is worth remembering that our medical professionals are already strained, waiting rooms are crowded, emergency rooms are already plagued by long waiting times, and it often takes days to get an appointment to see a doctor.

Giving an additional 50 million Americans immediate access to the same number of medical professionals and facilities will flood our health care facilities and doctors with new patients, putting further strain on an already strained system. The result will be longer waits, more crowded doctors’ offices and hospitals, and a general decrease in the level of care.

Increasing the number of Americans with health care is a noble goal and is being pursued with the greatest of intentions. But as it is said, the road to hell is often paved with good intentions. There is no way around the fact that adding an additional 50 million people to the health care system will decrease the level of service being offered.

The current health care bill will succeed in giving more people health care, however it will result in much worse care for the over 80% of Americans who are currently covered.

This is an excellent example of the law of supply and demand. No matter what is done about health care, tomorrow’s supply of health care –the number of doctors, medical facilities, etc. – will be the same as today. Yet, implementing a nationalized health care system requires that tomorrow’s demand for health care increases dramatically. A sudden increase in demand without an increase in supply always leads to a shortage of the product in question.

In the free market, a shortage of goods causes prices for that good to increase to a level where those who cannot afford them are ‘crowded out’ of the market. The profit earned by the producers of the good encourages additional producers to enter the market. This creates an increase in supply and drops the price of the goods for all consumers. Under the President’s plan, however, demand will be raised without an increase in supply, whereby the government will be forced to allocate health care. When government bureaucrats make decisions on how goods and services should be allocated, rationing occurs.

Under the new government run health care system, the government will need to take measures to “keep costs low” in an effort to save American citizens money and prevent negative political fallout. While this also seems like a noble goal, the consequences will be devastating. Government mandated cost cutting measures also necessarily mean less profit for those who operate medical facilities.

Taking away the profit motive, will result in fewer people being willing to take risks and opening new medical facilities. Medical supply companies will be less willing to produce life saving medical devices, and the benefits of taking a medical education will diminish. The loss of profit motive will result in fewer services being shared among more consumers. This will lead to further rationing, rather than allowing market forces to make corrections.

Even the best of intentions can’t change facts. If Americans want to continue to have a decent health care system without government rationing, they must oppose universal health care coverage.

Americanly Yours,

Phred Barnet

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You may recall that the health care plans being pushed by the Administration and Democrats in Congress are very similar to the provisions passed in Massachusetts’ 2006 health care reform bill.

While it may sound good to pass a bill that will subsidize a scarce resource (in this case health care), doing so always has consequences.  In this case, dropping the price of health care has led to an increase in the number of people taking advantage of these services, resulting in a massive shortage in services.  This in turn results in an increase in the price of services for those who are notable to take advantage of the government subsidy.  Watch:

What a great video!  Please pass that along to your friends.

Americanly Yours,

Phred Barnet

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According to the AP:  “Americans who refuse to buy affordable medical coverage could be hit with fines of more than $1,000 under a health care overhaul bill unveiled Thursday by key Senate Democrats looking to fulfill President Barack Obama’s top domestic priority.”

I thought this was America.  I thought this was the land of the free.  I thought that people in this Nation were allowed to live their personal lives as they choose.

Apparently I thought wrong.

Who do these Senators and this President think they are?

Congress and President Obama have no right to fine people for choosing not to purchase health coverage.

If the President and others can justify abortion by citing privacy rights and the right to choose, cant the same rights be applied to those who privately choose not to purchase health insurance?

And what will happen if you dont purchase health insurance and then you refuse to pay the fines?  Will the government have you thrown in prison?

In lingo straight out of the socialist phrase book, these fines will be called “shared responsibility payments!”

Shared responsibility payments?  Are you kidding me?  I share absolutely NO responsibility for the health and well being of others. The punishment for not purchasing health care coverage should come in the form of denied or increased cost for services rendered, not a government imposed fine.

Americanly Yours,

Phred Barnet

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Senators Dodd and Kennedy are either lying or are unbelievably stupid.

In fact, this bill only encourages employers to drop coverage for their employees.  According to the National Coalition on Health Care, “The annual premium for  single coverage [employer health plans] averaged over $4,700.^“

Under this plan, employers can drop their employees coverage, knowing that the government will pick up the tab.  Doing so will result in a “fine” of $750 per full time worker, but will actually result in cost savings around $4000 per employee!  This is a massive subsidy for corporations who choose not to insure their employees.

This plan will encourage employers to abandon their private insurance plans knowing that their employees will still be covered.  This will lead to a “race to the bottom” among companies because dropping coverage will lead to massive cost savings.

For example, at the end of last year Microsoft employed around 56,000 workers in America.  If they were to drop all of their employees’ health care plans, they would be subjected to fines of around $42 million  However, considering that the average health care plan costs employers around $4,700 per person, Microsoft would actually save around $221.2 million per year–after paying the “fines” by dropping coverage.

This new bill is a rotten one that will destroy private health insurance.  It will cause employers to drop coverage for their employees and will result in more Americans using the government “option.”

This bill will cost Americans a lot of money, will subsidize corporations who drop employee coverage, and will destroy the private insurance industry.  This bill will be ironically called the “Affordable Health Choices Act.”  Please call your Senator at 1-800-833-6354 and voice your opposition to this bill.  It will only take you two minutes.

Americanly Yours,

Phred Barnet

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But, there is something that they arent telling you:  many (if not most) of those without health care in this country choose to not have health care.

Yes, at least 45 million Americans are not currently insured (according to most studies, but Ill get back to that later), but a closer look at the numbers tells a different story than the one that you have probably been told in the past.

I recently read John C. Goodman’s paper titled “Solving the Problem of the Uninsured,” and although I do not support the same solution that he does, I found his paper to be quite interesting.

Dr. Goodman took a hard look at the numbers and facts about the uninsured in this country and found some surprising information.

He wrote that the lack of health insurance can be compared to an experience like unemployment–many people experience it at one time or another, but it rarely is a long term problem.  For example, “75% of uninsured spells are over within 12 months.  Less than 10% last longer than 2 years.”

Many of the uninsured are actually eligible for government or job related health care, but chose not to that advantage of it: “there are between 10 and 14 million people who are theoretically eligible for Medicaid and SCHIP (for low income families who do not qualify for Medicaid) but do not bother to sign up.  This is almost one in every four uninsured persons in the country.”

“Furthermore, in most places people are able to enroll in Medicaid up to 3 months after they receive medical treatment.  Because these people can enroll at the drop of a hat, even after they have incurred medical expenses, are they not de facto insured even without the necessity of formal enrollment?”

“A lot of other people are also voluntarily uninsured.  For example, about 9 million people (more than one in five of the uninsured) are eligible for employer insurance and decline to enroll even though the employer share of the premium is usually nominal.”

Many of the uninsured in America actually have the money to purchase insurance, but for one reason or another chose not to:

“The largest increase in the number of uninsured in recent years has occurred among higher-income families.”

“Further, over the past decade, the number of uninsured increased by 54% in households earning between $50,000 and $75,000 and by 130% among households earning $75,000 or more.  By contrast, in households earning less than $50,000 the number of uninsured decreased approximately 3%.”

“Some information about middle-class families who are voluntarily uninsured is provided by a California survey of uninsured with incomes of more than 200% of poverty.  Forty percent owned their own homes and more than half owned a personal computer.  Twenty percent worked for an employer that offered health benefits, but half of those declined coverage for which they were eligible.  This group was not opposed to insurance in general, however, because 90% had purchased auto, home, or life insurance in the past.”

Now, lets add all of this up:  we have 10-14 million who are eligible for Medicaid or SCHIP, but do not enroll, and an additional 9 million that are eligible for benefits at work but do not sign up and we have between 19 and 23 million people in these two situations alone who are eligible for health insurance, but decline (or choose not to sign up for) it.

This takes a huge chunk out of the original 45 million number, bringing it down to a range between 22 and 26 million people who are uninsured and do not have the option to become insured.  This is a much smaller number, especially when you remember the above statistics that the vast majority of people who are uninsured are uninsured for less than a year.

But, there are also several reasons to doubt the 45 million number itself.  Dr. Goodman’s study cites a study by the CBO which “estimated the actual number of uninsured may be as low as 21 million.“  He also cites “another report [which] finds that, even using Census Bureau methods, the 45 million number is about 25% too high, or off by 9 million people.“  So, if those studies are correct, we have reduced the number of uninsured to 21-36 million.

And, if (and this is THE BIG IF) those two studies that he cited are correct and the number of uninsured is actually between 21-36 million, then it is safe to say that there is no major “insurance crisis” going on in this country.

Why?  Well, at least 19-23 million Americans are eligible for health insurance or coverage but do not take advantage of it.  Combining these numbers and the above numbers from the two studies (one of which came from the CBO), we are left with a range of anywhere from -2 million to 13 million uninsured.  13 million might seem like a huge number, but it is only around 4% of our population (and remember 13 million was the maximum).  There has got to be a way to take care of this small percentage of Americans that will cost less than President Obama’s $1,000,000,000,000 [$1 trillion] health care initiative.

Americanly Yours,

Phred Barnet

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In other words, this plan is extremely expensive and will only accomplish around 1/3 of its goal.

$1,000,000,000,000 [$1 trillion] over 10 years comes out to $100,000,000,000 [$100 billion] in new debt per year from this program.  If you divide that up amongst the $304 million people living in this country, the cost of this program in new debt per person per year is $328.95… BUT…

Not everyone pays (ie, the poor) or even files for taxes (ie, children) .  According to the IRS, 132,276,000 individual tax returns were filed in 2006.  Of these returns, 43,400,000 had no tax liability (and many actually had a negative tax liability).  This means that taxes were paid on 88,876,000 tax returns. [Note:  i used the 2006 IRS numbers because I was unable to find a percentage of returns that didnt pay taxes in 2007]

Now, if we take the $100,000,000,000 [$100 billion] and divide it up among the 88,876,000 income tax returns that paid taxes, we find that those Americans who do pay taxes will be forced to pay an average of $1125.16 per person per year to finance President Obama’s healthcare plan. Remember, this is an average–many Americans will be forced to pay much more than this.

And remember, this $1125.16 per taxpayer will only cover about 1/3 of those Americans who do not currently have health insurance.  Covering the other 2/3 will undoubtedly be much more expensive.

As a taxpayer, are you OK with the government telling you that you HAVE TO pay $1125.16 per year to pay for someone else’s healthcare?  If not, you need to call or email your representative and tell them that you oppose this plan–before it is too late.

Americanly Yours,

Phred Barnet

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