Stark Contrast: How the Democrats are missing again on healthcare

Recently Pete Stark told a group that the Republicans were trying to shove a massive bill to repeal the Obamacare Bill down the throats of the Democrats.

The Republicans two-page bill stands in sharp contrast to the 2000-plus page bill pushed through by the Democrats last spring. So Mr. Stark, what's different now?

I had the pleasure of spending an hour with Congressman Stark last March right before the historic vote that changed the way healthcare is financed and delivered in this country. He was adamant at that time that he would never "support" the Senate version of the healthcare bill.

Well he did.

Now this isn't the first time or probably the last that a member of Congress has changed their mind.

But fundamentally the reason he voted for the bill as did most of the Democrats was political: legislation had to be passed regardless if it was good or not. Nancy Pelosi's health care chief told me in a meeting the same day that "we know its not a good bill but we can always fix it later."

The Republicans have taken the position that repeal is the best choice, followed by not funding key elements of the legislation, and probably hoping that the Supreme Court will rule that the Democrats overstepped their interpretation of the commerce clause. The latter is the ruse that allowed them to pass the bill in the first place.

So now the Democrats believe they have to defend the bill they created. And reforming the legislation would be tantamount to failure.

The American Medical Association adopted a recent slogan from their Texan brethren when they started preaching the "Keep what's good. Fix what's broken" mantra. But this lobby tactic would assume that either side would want to fix anything in the first place.

Neither the Democrats nor the Republicans are really motivated to reform the legislation. These polar opposite positions place American patients right in the middle of a stand off -- most likely to be killed by "friendly" fire.

Democrats are missing the boat here by not learning from prior mistakes and following the advice that we talked with Pete Stark about a year ago. Give patients some protections from preexisting illness and right of recision rules from the insurance companies and allow them to keep their doctor.

That's really what patients and taxpayers want.

And, tank the rest of the 2000 pages of the bill.

The 18 thousand new IRS agents, the Independent Medicare Advisory Panel, the criminalization of billing issues, the mandate on individual coverage, the expansion of a broken Medicaid system -- all of this needs to go away. None of it will improve the health of America.

But sadly it is doubtful that anything good will happen in Congress this term related to healthcare.

Yes, the House can refuse to fund key elements of the legislation...they can vote to repeal the bill. But the Democratically controlled Senate and the sitting President will not allow the bill go away.

In the meantime Washington bureaucrats will be turning out millions of pages of rules and regulations that will immortalize Obamacare for millions of patients.




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So what is an accountable care organization?

Mortgage meltdown or medicine meltdown?

As we enter the final phases of the election cycle you can get a good idea of the spoils of big government just by looking at the rhetoric in the campaign.

Clearly, one issue is dominating the election this fall: the economy, and more specifically the lack of jobs.

So I would like to pose a few questions and ideas on just how government actually performs in creating economic growth and in kick starting job growth. I don't necessarily have the answers, but I'm real good at asking questions.

Did government assisted mortgages help the economy? Certainly by artificially lowering mortgage rates and the creation of investor owned, government back sub-prime mortgage equities, the federal system of assistance in home buying has become the norm.

But given the meltdown in the mortgage industry, did we do a service to Americans by putting people in homes they couldn't afford? Flipping houses became the source for a evening cable television show and the folly of many particularly young home buyers.

As liquidity in the mortgage market disappeared so did the dreams and savings of many Americans -- including those that had invested in the "government" back equities of Fannie Mae and Freddie Mac.

Is government funded healthcare going to be beneficial for our country in the long term? Just like mortgages, are we going to put our country into a health system they can't afford?

Out current federal health legislation creates "coverage" for 85% of our citizens, but does nothing to promote access to care or an improvement in health care choices.

The latter is particularly concerning.

Regardless of the life style choices one makes, there is a guarantee of coverage. There certainly needed to be an improvement in health care services for the uninsured, and there needed to be some limitations on the growth in spending, but wouldn't it have been better to put incentives on the user?

The real question becomes: will we be facing a health care meltdown just like the mortgage industry? As the requirements for health care services rise, there being no limitations on cost, and no impediments to limiting health care decisions, can the system continue to function?

The biggest concern here is whether physicians and other health care industry providers (pharmaceutical companies, insurance companies, hospitals) can continue to function in an economic environment of continued declining reimbursement for services.

This is especially true given the proposed 23%+ cut in Medicare rates next month with more to follow in January.

Will there be a decline in health care liquidity?

Physicians and other health care providers may find themselves in a situation much like the mortgage industry: servicing consumers with health care services they and the government really can't afford.

I guess the real question is will there be a foreclosure on your new sub-prime health coverage?



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Obamacare - You want fries with that?

A recent article in the Wall Street Journal and the followup editorial concerning McDonald's decision to consider ending health care coverage for its work force has sparked controversy.

But it is a very compelling message.

Obamacare, or more correctly, the new federal health legislation passed in the spring by the Democratic Congress, promised to "keep your current health coverage intact."

But as the law goes into effect, it is confirming what we pundits have been screaming from the beginning: it will impact everyone in America.

Read: everyone. From the uninsured (which hopefully will see expanded coverage but still be challenged with with limited access) to tax payers to small business and yes, to physicians, everyone will see an impact.

And it will vary from the potential double digit increases on private indemnity insurance for those 25 year old new entrepreneurs to the seemingly bizarre requirement that small business owners will now have to issue thousands of additional 1099 forms to virtually every vendor they purchase products or services from.

So for McDonald's to be considering eliminating health care coverage may not come as a surprise. Now before my faithful readers start sending me emails about "how these were minimum benefit plans" and "these workers deserve better care," let me preempt you.

McDonald's offers ground level employment for thousands of young people -- and many part time workers. So for them to be offering any health care benefits to begin with was extraordinary.

And now to have them being forced to either enrich the plan with added benefits and cost, or abandon their current entry level health benefit structure is an example of how they too will be impacted by the legislation.

But for all the bad that has been said about the federal health regulations, the most chilling concern that I have is that at the end of the day despite the super-sized money and new statues that have been created -- we may not see an improvement in the access and quality of care.

There is no value meal here.