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This Is What Democracy Looks Like

Today's Note From a Madman

February 24, 2008


A Presidential Library

(Comic Books Permitted)


It's fitting that George W. Bush decided to put his Presidential Library on the campus of Southern Methodist University, a.k.a. SMU. In 1987, the athletic department of SMU had been convicted of being so corrupt that they were given the NCAA's version of the death penalty. It seems they were paying their players. The penalty which, at its worst, removed SMU from college athletics for a few years, was applied and the Dallas, Texas school became the poster child of corruption on college sports.

I can find no better place for George Bush to put his favorite book, My pet Goat, into its place on the shelf.

-Noah Greenberg

Senator Obama and Health Care

On health care, Senator Barack Obama is just wrong. When Senator Obama states that the problem with health care isn't that people don't want it - it's that they can't afford it, he's missing the point. Allowing anyone to opt-out of health care, whether it be by a system of private insurance and government-funded programs or a true Single Payer Health Care Plan assumes that all of our people know what's best for them all of the time. We don't.

The fact that Americans without health care insurance clog up our emergency rooms will not go away with Senator Obama's plan, even though it might be eased. The assumption that, for example, young adults who feel almost invincible will take health care over a nice trip to Cancun is dangerous.

Senator Obama wants to provide those who opt-out of his health care plan with catastrophic coverage, in case they get sick (or really, really sick). Those who get to the point when they need catastrophic care, much of the time, are getting the care too late. In addition to its being too late, it would increase the cost of health care to the American middle class who are the ones who are going to have to foot the bill for those who do opt-out.

No one should be able to opt-out or fined, as Senator Obama predicts Hillary Clinton's plan would require. The only requirement should be that all Americans have health care coverage with the ability to walk away from a job and keep their health care. Health care needs to be required of the unemployed as well, even if they can't afford it. And health insurance costs need to be reduced. Too many of us are paying too much of our incomes toward our health care insurance bills. Any health care plan should be based on some sort of equation that takes into consideration earned income, profits made in our stock markets; wealth over a certain total amount of net worth and other factors that make health care costs fair to all Americans.

Taking it a step further, as I have already pointed out in previous Note From a Madman issues, all employers should be forced to give all employees a mandatory day off to see their doctor for a checkup. The doctor would fill out a form merely stating that the employee came and was examined - nothing more - as proof.

Senator Obama needs to re-think his health care plan and make it not only available to everyone, but required of everyone.

-Noah Greenberg

An Examination of the Obama Health Care Plan

Just a surface examination of Senator Obama's health care plan shows the holes, which all could be easily filled.

THE PLAN: Too many Americans go without high-value preventive services, such as cancer screening and immunizations to protect against flu or pneumonia.

Barack Obama's plan would certainly reduce the number of Americans who don't see a doctor because they don't have health care insurance. But there would still be way too many Americans left out in the cold.

Under the Obama plan, the typical family will save up to $2,500 every year through:
Health IT investment, which will reduce unnecessary spending in the system that results from preventable errors and inefficient paper billing systems;
Improving prevention and management of chronic conditions;
Increasing insurance industry competition and reducing underwriting costs and profits, which will reduce insurance overhead;
Providing reinsurance for catastrophic coverage, which will reduce insurance premiums; and
Making health insurance universal, which will reduce spending on uncompensated care.

Now $2,500 is a nice amount of change, and had this been ten- or twelve years ago, it would have been a substantial percentage of what the average American pays towards their health care premiums and bills. For example: The $452 and $192 per month premiums I paid for my employees (married and single employee, respectively) in 1994 for their heath care insurance today is up to over $1,500 and $550 pre month for the same plan (in name only). That plan today covers less and has many more co-pays, higher deductibles and other extras such as a greater difference in the "usual and customary" fees charged by doctors and hospitals versus what the insurance company actually pays. In 1994 that $2,500 would have represented nearly forty percent of my family's monthly premium. Today, and for less coverage, it would represent less than fourteen percent.

The two most troubling aspects Obama's plan mentions above are these:
(1) Increasing insurance industry competition and reducing underwriting costs and profits, which will reduce insurance overhead;

The problem I see here is the ongoing battle between the insurance industry their lobbyists, and a new president who will most likely be governing without filibuster-free Senate. There are enough health care insurance companies already. It isn't that there is no competition, the problem is that they don't want to compete. As it stands now, corporations which provide health care coverage for their employees shop more for price than coverage. Most executives in charge of their company's health care plans look at their health care needs without taking into account the lowest common denominator - the employee with the sick family member. The competition can't come from the insurance companies as they fight against each other for one corporation's business, it has to come from the competition which only comes when addressing the American public directly. No one makes you purchase the car your company decides you should buy; no one forces you to purchase food from only one supermarket because your company made a deal with that supermarket. Each and every one of us would receive a pre-tax stipend and be allowed to purchase health care that is best for us.

And this leads me to the obvious: There needs to be real regulations governing the health care industry, and I don't see that word, "regulation", being used by Senator Obama. The insurance industry and their CEO's are not going to give up their $5,000 golden umbrella stands and multi-million dollar retirement packages without a fight, and the only way to get them to do so is to regulate them.

(2) Providing reinsurance for catastrophic coverage, which will reduce insurance premiums...

Just who is going to pay for this catastrophic insurance anyway? By not forcing - yes, forcing - the American people to purchase health insurance for themselves and their children, we are setting up a system which will cost Americans their lives and the send the bill to the middle class for treatments that came too late for that uninsured individual. It's a hole which needs to be filled.

Another Obama point which needs to be addressed is, the "mandate (that) all children have health care coverage." Under today's health care plans and how they're set up, children can only be covered if their parent(s) have health care coverage. Corporate health care plans are arranged in either two-tier or four-tier manners, which look like this (prices low- to high): Two-Tier price charges the subscriber as a single or as a family; Four-Tier charges the subscriber as single, husband and wife; parent and child (children); or family. There is no price plan for "children only", other than the very limited SCHIP initiative. The presumption that Obama's plan makes, and we have heard him say, is that "Children don't have a choice." Well, sometimes, adults don't know what's good for them either.

The part of Obama's plan which I believe is a good start is his "NATIONAL HEALTH INSURANCE EXCHANGE."

It states: "To provide Americans with additional options, the Obama plan will make available a National Health Insurance Exchange to help individuals who wish to purchase a private insurance plan. The Exchange will act as a watchdog and help reform the private insurance market by creating rules and standards for participating insurance plans to ensure fairness and to make individual coverage more affordable and accessible. Through the Exchange, any American will have the opportunity to enroll in the new public plan or purchase an approved private plan, and income-based sliding scale subsidies will be provided for people and families who need it. Insurers would have to issue every applicant a policy, and charge fair and stable premiums that will not depend upon health status. The Exchange will require that all the plans offered are at least as generous as the new public plan and meet the same standards for quality and efficiency. Insurers would be required to justify an above-average premium increase to the Exchange. The Exchange would evaluate plans and make the differences among the plans, including cost of services, transparent."

It, however, doesn't go far enough. "Watchdogs" are a great idea unless they remain chained up. A "Watchdog" without teeth is all bark and no bite. The only true way of having this exchange truly make a difference is to make it a regulatory agency, much like to FAA, FDA and the SEC. And it has to be performed on a federal basis, not on a state-wide basis.

Another question I have relates to the employer contribution area of the Obama plan. It reads: "Employers that do not offer meaningful coverage or make a meaningful contribution to the cost of quality health coverage for their employees will be required to contribute a percentage of payroll toward the costs of the national plan."

Although I agree with this provision, I wonder if it will end up costing some Americans their jobs, and how many Americans will be affected. When you increase the tax burden - and it is a tax burden - to a small business, those dollars have to come from somewhere. True regulation of the health care industry will help ease that burden.

And in relation to what I mentioned above (the burden of taking care of those who aren't covered due to a lack of a mandate), Obama's plan mentions the following: "Catastrophic health expenditures account for a high percentage of medical expenses for private insurers.22 In fact, the most recent data available reveals that the top five percent of people with the greatest health care expenses in the U.S. spent 49 percent of the overall health care dollar.23 For small businesses, having a single employee with catastrophic expenditures can make insurance unaffordable to all of the workers in the firm. The Obama plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers' premiums. Offsetting some of the catastrophic costs would make health care more affordable for employers, workers and their families."

The problem with this part of the Obama plan is that it puts the financial burden of taking care of the now-ill individual (who opted-out of the health care plan) on the shoulders of his fellow taxpayer. Take, for example, two young people fresh out of college, who appear to be in good health. Let's call them Bob an Boob. Bob purchases health care, sees a doctor and finds out that he has a suspicious growth on his back. The doctor removes it, monitors Bob regularly and makes sure that Bob stays in good health for the foreseeable future.

Boob, on the other hand, takes that extra cash and goes to Cancun in April where he hopes to pick up and fondle a college co-ed on the beach. As she's putting sun tan lotion on his back, she says, "What's this?" Boob responds, Aw, that's nuthin'," and goes about his fun in the sun. A couple of years later, that "Nuthin'" turns into "sunmthin'" and it's too late to help Boob.

So while Boob is being made comfortable in the hospital as he awaits his end, and the American people pick up the tab, Bob is now vacationing with his new wife and first child on that very same beach where Boob ignored his burgeoning problem.

Obama's plan needs to include everybody in a mandate and needs to include a provision where all Americans are given a day off to visit a doctor each year.

And, finally, I want to know what happens to those who now have heath care insurance through their employer, but are paying way too much as a part of their employee participation fee. I happen to be in that particular group as I pay over $1,000 per month in addition to my employer's contribution. That $1,000 represents the single greatest monthly expense I have, even greater than my mortgage payment, real estate taxes and the lone car payment I make each month combined. If I decide that I no longer wish to pay into my employer's plan, will I be allowed to purchase the government plan? And if I purchase that plan, will my family's doctors be forced to accept it?

Senator Obama's plan, although leaps and bounds above anything which Senator John McCain offers (a continuation of the George W. Bush Plan: Plan to Stay Healthy), is still not good enough. He needs to re-think his ideas and make a mandate because one is necessary.

-Noah Greenberg

"I am ready to be your Commander-In-Chief"

Hillary is going around saying "I am ready to be your Commander-In-Chief." What does she think she's doing? Who is she trying to win? Do Progressives say "Command-In-Chief" when asked what comes to mind when they think of the Office of the President?

Isn't that a militaristic reactionary neo-con frame?

She shouldn't be going around saying 'I'll bake cookies for Achmadinejad' but she should talk about energy policy, security by building the economy and developing clean energy and an educated citizenry.

-Larry Furman

The White House Comments About McCain and the New York Times

What a hilarious headline! "White House Accuses NYT of Anti-GOP Bias". So what's new already? "Anti GOP Bias" is anything that exposes the corruption, dirty tricks, avoidance of the law, anti-American treason and bad morals of any Republican, including John McCain.

I don't give a toot in hell if McCain was sleeping with some woman not his wife, or if he was back in the early 1990s. Why should anyone care about someone else's personal life? That's their personal business.

The facts are a whole lot more sordid. They impinge upon McCain PUBLIC life, and then they become PUBLIC business. Those two claimed to be friends. Maybe that's all they ever were, but. . . THEY MET FREQUENTLY, SHE GAVE HIM MONEY, SHE IS A LOBBYIST, HE IS AN ELECTED SENATOR, and HE WENT TO BAT FOR HER COMPANIES.

That, folks, is illegal, indictable corruption. It's called being "on the take". In recent years many other arrogant GOP Congressmen, and a couple of equally arrogant Dems, have gone to jail for less.

-Jenny Hanniver

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-Noah Greenberg