Wednesday, September 23, 2009

Healthcare Reform v Free Speech

Tuesday Night I heard that Health and Human Services issued a ruling to insurance providers to stop misleading Medicare beneficiaries. The dispute is over the Healthcare Reform act where some companies are saying “Benefits could be cut.” It does not say they will be. Based on the Baucus bill, there is little way for Medicare to stay solvent unless expenses are cut. How do you cut expenses or the growth if you do not cut benefits?

Apparently it is just fine for President Obama and members of congress to say their reform bill does not include tax increases, but is this not misleading the public when you say you are going to levy a fine if you do not have health insurance? The fine has been dropped from $3,800 a family to $1,900.

Political free speech is what made this country great. Now our own government is attempting to squelch free speech. How stupid do they think we are? I find it despicable that a judge issued a temporary injunction to stop the insurance companies from sending information to beneficiaries.

Hey, maybe this is not a bad idea. We could get an injunction on the government from sending us SSA wage and benefit statements stating what our benefits will be in the future. We might even be able to site this in political debates and adds as well. Maybe we can stop politicians from lying?

Monday, September 21, 2009

Automobile v Health Insurance

President Obama is comparing the mandatory requirement for automobile insurance with that of Healthcare insurance. He sees no difference. However, there is a big difference. In many states, such as Indiana, an automobile must be insured with a minimum amount of LIABILITY insurance to be registered. There is no requirement for collision insurance.

Collision insurance insures you against a loss if you are the at fault driver. If you run off the road, rear end another car, you are insured. However, if you wave collision insurance coverage, you are insuring yourself against a loss.

Liability insurance covers the person you injure or the property you damage. Collision insurance which is not mandatory in any state insures you, the driver, against yourself. If you choose to not buy Collision insurance, you hurt no one but yourself if you have a loss. Health insurance is to protect you against a loss. If you choose not to have healthcare you hurt only yourself. However, in our country hospitals and providers treat anyone including those who do not have health insurance or who cannot pay. Maybe providers should carry uninsured coverage to protect themselves from a loss?

Healthcare insurance is no different than collision insurance, but is nothing like liability insurance. To mandate healthcare insurance may seem like a good idea, but you may make more people/families destitute and impoverished by mandating it. Sure they are covered by healthcare for potential sickness, but in the mean time food, shelter and clothing may take second seat and actually cause a worse outcome.

In any survival situation, the first thing you do is seek shelter, then water, then food. Few people will last two weeks without water, shelter or food. However, millions have gone years without ever seeing a doctor. What we need to do is stop allowing providers or the government from mandating treatment for all without regard to paying for. It may sound heartless, but is it the responsibility of the government to take from one to give to another without regard for ability to pay?

Thursday, September 17, 2009

Indiana Court strikres down the Voter ID Law

An Indiana Court struck down the Voter ID Law even after the U.S. Supreme Court had ruled it was constitutional. The problem that I tried to identify years ago when this was being proposed was that it violated some people’s individual rights. I know personally two people who are denied Indiana Driver’s licenses and State ID’s because they do not have a social security number. I also identified to the state of Indiana that the Voter Registration law does not require a Social Security Number and that it could not require it under Federal Statute.

The state attempted to circumvent Federal Statutes concerning the SSN by requiring a State issued ID. A U.S. Passport is a valid photo ID for voting, but it costs over $100 to obtain. The U.S. State Department cannot require the person have a SSN to obtain a U.S. Passport. If the state were to require a SSN they would be imposing a hardship on people who do not have a SSN.

A year later I was told that absentee ballots could be sent without the photo ID to the voter’s address under certain circumstances; health reason, out of the state at the time of the election and military. When I said this did not cover all circumstances I was told the county does not verify the request is valid, but simply sends the absentee ballot out. In other words lie to get an absentee ballot.

William Sherman Smith used valid names and SSN’s to obtain 149 different Indiana Driver’s licenses. The Social Security Online Verification System verified the name and SSN matched, but cannot identify if a driver’s license had already been issued and Indiana’s BMV could only verify if a driver’s license had been issued using that SSN. As long as you had someone’s SSN and name who had not obtained an Indiana ID or driver’s license (use out of state ID’s), the Indiana BMV issued these types of identifications without question.

Indiana began using photo recognition programs and found numerous people like William Sherman Smith who had obtained multiple ID’s. So how well did asking for a SSN work? It did diddly squat for fighting Identity Theft, while infringing on the RIGHTS of U.S. Citizens.

What is the answer? How many times will a person performing a repetitious task make an error? From my experience and what others have found, people will make an error 5% of the time. Therefore, requiring a SSN and utilizing this one ID, that has no method of being traced to the particular person presenting it as ID, will result in errors of 5%. Now what happens when you ask for more than one ID that must be verified? With each subsequent person looking at the information, there is less chance the error will go unnoticed. We know that photo recognition worked better than using the SSN. However, photo recognition is not fool proof and can be manipulated fairly easily. When you fill out the voter registration card, they should take a photo of you and issue a voter ID card. Every time you move, you need to obtain a new card. Voter registration already assigns a unique number to the individual. How hard is it to track the replacement, issue and movement of a person if a unique secure number is used?

We are chasing a ghost. With each advance in technology, the identity thieves or voter fraudsters will use future technology to continue to steal and violate laws. Criminals have been around since day one. We are treating everyone now as a potential criminal instead of a citizen.

Wednesday, September 16, 2009

Whe cares enough?

I had a call from a person who reads the Fort Wayne Politics blog. He wanted to know if I was the William Larsen who posts there. We have a lot in common and agree on many things. He asked if I knew of a federal law, statue or prohibition that prevented the U.S. Government from competing with private enterprise. For example, could the government open gas stations and sell gas to the public for a profit? Could they open up grocery stores to compete with Kroger?

I was taught in my class on U.S. Government that they could not compete with private companies. It was prohibited from owning equities/companies and competing with private busniess. The question then arose, how could government offer public insurance if it was prohibited from owning and competing against companies? This is an excellent question. I like to think that I question the validity of many things government does. It is my right and civil responsibility to question the Government. It is the only way we keep tabs on what they do and to expose wrongs.

In the past year the government has bailed out banks taken ownership in banks, insurance companies, mortgage companies and even two of the big three automobile companies. I would think everyone of these actions would violate some law, statute or regulations. However, I like many others have taken for granted they could not do so, but I have never actually verified the existence of this. My question is who cares enough to challenge this? We are beginning down a slippery slope. Is there a means to stop this before it is too late?

After a quick search on the subject I found 20 §437.32 Equipment

(3) Notwithstanding the encouragement in §437.25(a) to earn program income, the grantee or subgrantee may not use equipment acquired with grant funds to provide services for a fee to compete unfairly with private companies that provide equivalent services, unless specifically permitted or contemplated by Federal statute.

Though this does not deal with subject directly, it would lead me to believe that there is in fact some statute that prevents government ownership from competing with private companies. I did find a Supreme Court Case that leads me to believe the court would not strike down Public supported Health Insurance.


“Flow control” ordinances require trash haulers to deliver solid waste to a particular waste processing facility. In C & A Carbone, Inc. v. Clarkstown (1994) , this Court struck down under the Commerce Clause a flow control ordinance that forced haulers to deliver waste to a particular private processing facility. In this case, we face flow control ordinances quite similar to the one invalidated in Carbone. The only salient difference is that the laws at issue here require haulers to bring waste to facilities owned and operated by a state-created public benefit corporation. We find this difference constitutionally significant. Disposing of trash has been a traditional government activity for years, and laws that favor the government in such areas—but treat every private business, whether in-state or out-of-state, exactly the same—do not discriminate against interstate commerce for purposes of the Commerce Clause. Applying the Commerce Clause test reserved for regulations that do not discriminate against interstate commerce, we uphold these ordinances because any incidental burden they may have on interstate commerce does not outweigh the benefits they confer on the citizens of Oneida and Herkimer Counties."

A - The Commerce Clause provides that “Congress shall have Power … [t]o regulate Commerce with foreign Nations, and among the several States.” Although the Constitution does not in terms limit the power of States to regulate commerce, we have long interpreted the Commerce Clause as an implicit restraint on state authority, even in the absence of a conflicting federal statute.

B - To determine whether a law violates this so-called “dormant” aspect of the Commerce Clause, we first ask whether it discriminates on its face against interstate commerce. In this context, “ ‘discrimination’ simply means differential treatment of in-state and out-of-state economic interests that benefits the former and burdens the latter.” Discriminatory laws motivated by “simple economic protectionism” are subject to a “virtually per se rule of invalidity,” which can only be overcome by a showing that the State has no other means to advance a legitimate local purpose....

C - The flow control ordinances in this case benefit a clearly public facility, while treating all private companies exactly the same. Because the question is now squarely presented on the facts of the case before us, we decide that such flow control ordinances do not discriminate against interstate commerce for purposes of the dormant Commerce Clause.

Compelling reasons justify treating these laws differently from laws favoring particular private businesses over their competitors. “Conceptually, of course, any notion of discrimination assumes a comparison of substantially similar entities.” But States and municipalities are not private businesses—far from it. Unlike private enterprise, government is vested with the responsibility of protecting the health, safety, and welfare of its citizens. These important responsibilities set state and local government apart from a typical private business.

Given these differences, it does not make sense to regard laws favoring local government and laws favoring private industry with equal skepticism. As our local processing cases demonstrate, when a law favors in-state business over out-of-state competition, rigorous scrutiny is appropriate because the law is often the product of “simple economic protectionism.” Laws favoring local government, by contrast, may be directed toward any number of legitimate goals unrelated to protectionism. Here the flow control ordinances enable the Counties to pursue particular policies with respect to the handling and treatment of waste generated in the Counties, while allocating the costs of those policies on citizens and businesses according to the volume of waste they generate.

Finally, it bears mentioning that the most palpable harm imposed by the ordinances—more expensive trash removal—is likely to fall upon the very people who voted for the laws. Our dormant Commerce Clause cases often find discrimination when a State shifts the costs of regulation to other States, because when “the burden of state regulation falls on interests outside the state, it is unlikely to be alleviated by the operation of those political restraints normally exerted when interests within the state are affected.” Here, the citizens and businesses of the Counties bear the costs of the ordinances. There is no reason to step in and hand local businesses a victory they could not obtain through the political process.

Finally, it bears mentioning that the most palpable harm imposed by the ordinances—more expensive trash removal—is likely to fall upon the very people who voted for the laws. Our dormant Commerce Clause cases often find discrimination when a State shifts the costs of regulation to other States, because when “the burden of state regulation falls on interests outside the state, it is unlikely to be alleviated by the operation of those political restraints normally exerted when interests within the state are affected.” Here, the citizens and businesses of the Counties bear the costs of the ordinances. There is no reason to step in and hand local businesses a victory they could not obtain through the political process.

Justice Alito, with whom Justice Stevens and Justice Kennedy join, dissenting.

This Court long ago recognized that the Commerce Clause can be violated by a law that discriminates in favor of a state-owned monopoly. In the 1890’s, South Carolina enacted laws giving a state agency the exclusive right to operate facilities selling alcoholic beverages within that State, and these laws were challenged under the Commerce Clause in Scott v. Donald (1897)....

Thus, were it not for the Twenty-first Amendment, laws creating state-owned liquor monopolies—which many States maintain today—would be deemed discriminatory under the dormant Commerce Clause. There is, of course, no comparable provision in the Constitution authorizing States to discriminate against out-of-state providers of waste processing and disposal services, either by means of a government-owned monopoly or otherwise.

Nor has this Court ever suggested that discriminatory legislation favoring a state-owned enterprise is entitled to favorable treatment. To be sure, state-owned entities are accorded special status under the market-participant doctrine. But that doctrine is not applicable here.

Under the market-participant doctrine, a State is permitted to exercise “ ‘independent discretion as to parties with whom [it] will deal.’ ” The doctrine thus allows States to engage in certain otherwise-discriminatory practices (e.g., selling exclusively to, or buying exclusively from, the State’s own residents), so long as the State is “acting as a market participant, rather than as a market regulator.”

Respondents are doing exactly what the market-participant doctrine says they cannot: While acting as market participants by operating a fee-for-service business enterprise in an area in which there is an established interstate market, respondents are also regulating that market in a discriminatory manner and claiming that their special governmental status somehow insulates them from a dormant Commerce Clause challenge....

The dormant Commerce Clause has long been understood to prohibit the kind of discriminatory legislation upheld by the Court in this case....

It seems to me the U.S. Supreme Court would be divided on whether U.S. Government could compete with private insurance companies in providing healthcare to the public. On one hand the Court says the "state" can regulate as long as they are equitable upon all private parties (treat them the same). On the other hand it implies it would not be acceptable saying the "state" would not be insulated from a dormant Commerce Clause challenge.

My take is as long as the "federal" government discriminates equally and causes all insurance companies and employers equal harm, the "federal" government can survive a challenge to the Healthcare Reform proposed by Obama. The way the court sees it, is we as a people get what we vote for. We have the power to stop this with our RIGHT TO VOTE.

Can anyone provide information on the subject?

Monday, September 14, 2009

Social Security – Who would have guessed?

The Social Security Administration has finally placed on their website information on multiple different “fixes” for Social Security’s solvency over the next 75 years.

They look at seven different areas:

  • COLA - Cost of living adjustment
  • Taxation of Benefits
  • Payroll Tax
  • New Enrollies
  • New Investment Vehicles for Trust fund
  • Change the full retirement age
  • Change the Benefit Formula
Each one of these catagories have multiple variations. There are both charts and tables identifying a year by year projection. The tables I believe are more useful since they provide an actual value. There are two values to pay particular attention to:
  • Annual Balance (revenues minus expenses)
  • Trust Fund Ratio
SSA looks at a solvency period over 75 years. Doing this has several flaws:
  • It includes all revenues from all cohorts Those who turn 65 after the 75 year solvency period have their contributions consumed by those who receive benefits during the 75 yea period. The solvency period ends in 2084. With a full retirement age now at 67 for those born after 1970, this means any person who is born after 2017 will pay into Social Security, have their contributions used to pay current beneficiaries only to relive the same problem we have today.
  • It only includes those liabilities that must be paid within the 75 year period. Those born after 2017 earn credits yearly toward Social Security Benefits, but they do not accrue a liability and is therefore not included in the evaluation. In simple terms those who retire prior 2063 are fully evaluated (though they may not be able to pay benefits). Those who retire between 2063 and 2084 are evaluated partially. For example; for those born in 2016, they represent just one full year of liabilities instead of 21 to 22 years.
What is very obvious is that no matter how many different ways SSA looks at the problem, there is not one solution that makes Social Security Solvent. The trust fund ratio decreases quickly and goes to zero in all cases. A zero trust fund ratio means the trust fund is exhausted. In addition the annual social security balance goes negative in all situations. This means expenses exceed revenues.

What the different scenarios point out vividly is the magnitude of the problem. Even raising the pay roll tax in two increments over a decades does not solve the problem long term. This is referred to the cliff effect. The 75 solvency period is a moving target. If today we look at 75 years into the future, then we are looking out till 2084. In 2010 they are looking at 2085 and in 2011 they are looking at 2086. This means if we decide to do anything, we fall off the cliff the year after the solvency period ends. It is like starting a whole new social security program with a full compliment of beneficiaries and no trust fund.

Is there a way to get a truer idea of the problem, yes? The SSA has done the difficult task of creating the algorithum and collecting the data needed for the calculation. However, they have failed to exclude the revenues from those who are working, but who are too young to receive benefits during the 75 year evaluation period. If they did this, you could calculate the unfunded liability very closely. In addition, you would not have too look out 75 years, but simply 25 years.

They have the data, they simply need to refine the parameters of who is included. They know by SSN applications who was born when. They get yearly information on wages earned subjected to the SS-OASI tax. This is not rocket science, just plain simple high school math.

Why won't they do this? IF they did this, the payroll tax would have to go to over 18.5% from 10.6% today. This is a very signficant hike and would most likely meet more challenge than Healthcare Reform. Therefore, it is better for them (worse for the worker) to take baby steps and bait us into paying a little bit more, cutting benefits, raising retirement age and changing the benefit formula. In this way they lead us to the ulimate outcome where we pay 4 times more for a benefit than it is worth and they (politicians) never have to face the public.

It is the frog who jumps into a pot of cold water that is slowly heating up.

I used the word fix because that is what it is. It is like any addict. Social Security needs a fix and takes what it needs without asking, thinking or realizing the consequences. Can you stop your craving for Social Security? Who can you just say no to Social Security?

Thursday, September 10, 2009

National Healthcare: The chains that will bind all

What is the definition of a RIGHT? A right is anything that does not require a sacrifice from another person or places a burden on another person to fulfill. Is Healthcare a right, no? It requires sacrifice by others and places a burden on others for it to take place.

Is healthcare a moral obligation? If it is a moral obligation, then what are food, shelter and water? Are these moral obligations and if so are they more important or imminent than healthcare? What we have never created as a nation is a set of priorities. We have many programs that are failures such as Medicaid, Medicare, Fannie May, Freddie Mac, the U.S. Treasury, Federal Pension Guaranty program, Social Security and more.

Now the nation is debating healthcare, another program. The first question that should be asked is, is this a function of government? If it is, then we should look at Medicare, Medicaid and Veterans Healthcare as teachable lessons. Both Medicare and Medicaid have shifted trillions of dollars of costs from a few to everyone else. The payroll tax of Medicare is inadequate and the trust fund will be exhausted in 2017, then what? What about those born after 1952? Do we raise the payroll tax even more; do we charge those born prior to 1952 a higher premium to recoup what congress failed to charge them?

As a parent I am responsible for my families well being FIRST! My first priority is to take care and provide for my family FIRST. However, the government believes my first priority is to support Medicare and Medicaid and takes without asking dollars out of my paycheck. I then compete against those on Medicare and Medicaid for healthcare using my own dollars! Because Medicare and Medicaid cost shift, I pay more for my healthcare. In addition I compete against employer subsidized healthcare insurance when they negotiate rates nearly as low as Medicare again shifting cost to all others.

Government has artificially stimulated the healthcare industry: pharmaceuticals, medical implants, technology, procedures, diagnostics and more. Individuals who work in the healthcare industry are engineers, janitors, maintenance, data processors, nurses, doctors, specialists and more. They are neighbors, parents, brothers and sisters. They all provide labor and as such want raises like everyone else. Healthcare is labor intensive and there is no force multiplier, a doctor treats one person at a time. This makes healthcare costs rise at wage rates, not inflation. In addition the US has primarily private hospital rooms instead of four to a room increasing costs by 300% and decreasing efficiency. The US has the highest ratio of MRI, CT, diagnostic equipment, hospital rooms than any other country. The US System is based on “waiting for a patient to arrive” rather than other countries based on “patients waiting to be treated.” The US has lower utilization rates, yet this technology must be paid for, resulting in higher per service costs.

Medicare began with good intentions. Medicaid began with good intentions. Social Security was begun with good intentions, yet good intentions have never produced a single government program that did not become costly.

The U.S. has not had budget surplus since 1957. Every single stimulus package, tax reduction or fix to government programs that borrowed money to do so has never been repaid. In fact the interest paid on these borrowed funds was in fact borrowed, compounding the problem.

Employers are allowed to provide health insurance to employees in lieu of paying higher wages. This is nothing more than a tax subsidy. The government does this with IRA’s, education credits, charitable deductions, child tax credits, mortgage interest and 401-k’s. The government has been so good at doling out special tax breaks to groups that everyone has a hand out. Who is paying the cost of all these hand outs, the economy? We all want lower taxes and more benefits. The only question is how much are you willing to pay for a new program, or should I say how much are you willing to saddle your children with?

The solution is simple. No healthcare provider can charge different entities, that it sees, different prices for the exact same service (CPT code). This would eliminate the cost shifting of Medicare, Medicaid and insurance (both private and company sponsored) to all others.

The definition of insurance is where a group of people pool resources together where the risk of occurrence is low, yet the loss could be great if it occurred. Insurance does not work when the risk of a loss is great. The risk that people go to the doctors for flue, vaccinations, broken bones and other ailments are frequent. Do you really want to pay an extra fee to cover the cost of administration in paying for these? The simple truth is healthcare costs money and each of us needs to face the fact we are responsible for the basic costs. With that said, the deductible should be about $2,000 per person. This provides incentive not to over use the system, reduced processing and puts controlling cost in the hands of the consumer. It would also provide catastrophic coverage for the low risk occurrences that if they did happen could bankrupt you.

Who Caused the Healthcare Crisis?

Who caused the Healthcare Crisis? If we go back to the days before insurance, who paid for Healthcare? Prior to the 50’s few had Health insurance. Wage freezes were enacted by congress and signed into law by the president. This was done to curtail inflation. This was an artificial means of controlling inflation. Employers were allowed to offer Health insurance to employee’s tax free as an inducement to work for a company. Pre tax Health insurance is much better than after tax Health insurance.

This caused a decrease in Federal Tax Revenues as taxable income became pre tax benefits. In 1965 Medicare came along and placed a burden on workers. Though small at the time, Medicare could only grow in size and cost. During the 70’s Medicare’s growth was no fast that to save this “efficient” and “great” program from bankruptcy, congress passed legislation that defined Medicare reimbursement rates. These rates have gone from 100% in 1965 to a low of 70% today.

The reduction in reimbursement had to be paid by someone; otherwise the provider would go out of business. The provider than created two tiered pricing: Medicare and private. When Medicaid was passed, a third tier pricing was added. The result was escalating costs. Employers were paying more and so a new market was created, Health Plan Administration. These plans allowed companies to pull their collective size and negotiate with providers for lower rates. This created another pricing level within our healthcare system.

Is it appropriate for a provider to have different pricing levels based on quantity? Yes, when they can save money, increase efficiency and quality based on economy of size. However, when it comes to healthcare, economy of size is a very small component of the cost. A provider sees and treats one patient at a time. Though the more patients he sees increases utilization of staff, material purchases and consumable, it does little for overall efficiency of providing healthcare.

The cause of our healthcare problem is congress. They created the different pricing tiers, removed consumers from evaluating and choosing providers and now want the American people to let them do the same across the nation.

They tax 100% of our economy today. What happens when they are allowed to run 16% of economy?

What happens when they are allowed to run 16% of economy? Can anyone name one government agency that works?

  • Social Security
  • Medicare
  • Post Office
  • Security and Exchange Commission
  • U.S. House of Representatives
  • U.S. Senate

President Obama’s speech

President Obama’s speech last night highlighted many different things.

The United States is one of the wealthiest countries in the world.
If this is true, why do we have deficits? Why do we have an $11.7 Trillion debt? Why can’t people pay for their own Healthcare?

If Medicare spending is not slowed, then it will consume the entire federal budget.
If Medicare is such a well run program with lower administration rates, then why do studies identify fraud in the hundreds of billions a year? Do they not add fraud to the administration costs? Maybe if they added more oversight (higher administration costs) they would have less fraud, comparable to private insurance.

The U.S. is the only industrialized country without national Health coverage.
This sounds like a lemie statement or keeping up with the Jones’s. Should we copy what others do? Should we give into peer pressure?

Medicare is a success.
If it is such a success, why is it devouring the Federal Budget?

Pre- existing conditions are not covered by private insurance because of higher risk.
Insurance is based on risk. The higher the risk potential, the higher the premium. Oil tankers pay a high premium traveling through the Hormuze Strait. Insurance can be obtained for just about any type of loss. The problem is the cost will be appropriate for the risk. A national Healthcare program that covers all without regard for risk must cover this increased cost. Obama has not said what the premium will be. He has failed to identify the cost to each person and using spin leaves it up to the individual to interpret. Each individual's interpretation will be different. Does your interpretation match with President Obama's?

What is a RIGHT?

What is the definition of a RIGHT? A right is anything that does not require a sacrifice from another person or places a burden on another person to fulfill. Is Healthcare a right, no? It requires sacrifice by others and places a burden on others for it to take place.

NBC-33 Debate poll results from 2002