I recommend you to read Dr. Elizabeth Warren’s blog “America Without a Middle Class” at Huffington Post.
http://www.huffingtonpost.com/elizabeth-warren/america-without-a-middle_b_377829.html
This is a respectable article that tells us the big picture of where this country is standing in “its passage from a land of dream to a land of harsh, unsustainable life and social economic systems” for the majority of people. In this country, working hard has been increasingly dissociated with having financially manageable, good life and securing financially relaxed retirement. manageable, good life and securing financially relaxed retirement.
Read More of Mikyung's blog at:
http://mikyunglim.wordpress.com/2009/12/05/america-is-it-in-the-passage-from-a-land-of-dream-to-a-land-of-harsh-unsustainable-life/
"Concerning Senator Sherrod Brown’s (D-Ohio) remark that “the president and vice president are focused on Main Street, but some of the president’s economic consultants were too focused on Wall Street at the cost of small business.
It’s good to hear that the blame of current negative or not-yet-visible outcomes of bailouts and recovery plan has not yet fallen onto President but onto his advisors/consultants.
But, if the outcome of financial sector overhaul, one of President’s Pillar policies, goes bad while the other pillar policy, health care overhaul, is struggling to be passed with or without waterdowned contents, it may eventually, possibly cost the credibility, achievement of President great deal for not delivering his promises...."
Full Text at:
http://mikyunglim.wordpress.com/
" Former Secretary of Labor, Prof. Robert Reich discussed the limitation of China as a source of boosting US economy and jobs in his blog, “Obama, China, and Wishful Thinking About American Jobs,” at Huffington Post. He points out the limitation of China in boosting US economy and jobs as China’s high savings and investments rates and low consumption rates. These characteristics have been the typical profile of developing countries in the stage of high economic growth before reaching the stage of becoming advanced industrialized countries like US and Western European countries.
Here is one irony that I cannot avoid but noticing. Americans here expect Chinese people to help, save US economy and job conditions while they themselves (or we ourselves) keep damaging our own economy and jobs by scheming / manipulating domestic policies for political advantages or profit reasons that end up providing excessive profits to a few wealth group of people at the costs of screwing up the rest of people and the whole economy. And we look for the solution of our problem from a foreign country which also struggles with its own sets of problems including starving people and high unemployment in parts of the country? Does this make sense?
Regarding Prof. Reich’s blog, I wondered about other reasons of China being a limited source of US export market and boosting US economy: (a) the huge gap between the riches and the poors in that country; (b) the limitation of US international marketing / business....."
Read the Full Text at: http://mikyunglim.wordpress.com/2009/11/21/regarding-robert-reichs-obama-china-and-wishful-thinking-about-american-jobs/
Ms. Huffington cited two such cases. The first case was JPMorgan’s scheme on bribing the officials of Alabama’s Jefferson County to obtain billion dollar contract and then persuading them to switch from fixed rate bonds to bonds hedged with risky derivatives, which drove the County on the verge of bankruptcy. Another case was Merrill Lynch’s..............
The problem with people who opposed government intervention and bailouts, insisted on small government, and only worried about the high costs of economic recovery plan, bailouts, and health insurance reform is, they completely omit / ignore the real problem itself, the big picture of currently failing US economy. Instead, they just focus on a side, secondary issue of cost problem. It’s like cancer patients who refuse to take the necessary medical treatments, chemotherapy and choose to die in order to avoid the high costs of medical treatments. The mind setting of these people can be compared to that of conservative voters who voted for ex-president. Many conservative Christian voters’ single-minded choice of presidential candidate only based on abortion issue...........”
Read more at:
http://www.everydaycitizen.com/2009/11/bailouts_economic_recovery_pla.html
In the morning of hearing Ms. Palin’s coin conspiracy, my 5 yrs old Kindergartner and I practiced “Kindergarten Math” using coins. The kind of addition and deduction thingy. We called it “Penny Conspiracy.”
I read that Ms. Sarah Palin is going to wage a “War against “New Class” of intellectuals, government bureaucrats…and parasitic elites.” My first response was......(Read the rest of the post at below website.)
http://mikyunglim.wordpress.com/2009/11/16/coin-conspiracy-penny-conspiracy-and-ms-palin/
Politics seems to be hard guessing work based on trials and errors. An example may be seen in today’s news (November 12, 2009) by Huffington Post reporter, Shahien Nasiripour. Mr. Nasiripour reported that when the administration decided on spending the tax payer fund of $75 billion on a plan to reduce troubled-homeowners’ monthly mortgage payments and, therefore, housing foreclosures earlier this year, Pres. Obama should have listened to economists, John D. Geanakoplos and Susan P. Koniak’s suggestion that the administration should reduce the principals that troubled homeowners owed to banks and mortgage servicers instead of trying to reducing their interest rates... Read the remaining part at below website.
http://mikyunglim.wordpress.com/2009/11/13/housing-foreclosures-still-not-decreasing-my-response-to-huffington-post%e2%80%99s-%e2%80%9cthe-economist-the-obama-administration-should-have-listened-to-%e2%80%9d/
As one of many people who strongly believe that the Noble Peace Prize is awarded to the right person for the sake of global peace talk, and feeling uncomfortable at strong criticism against it, I posted the below blog at Everyday Citizen.
http://www.everydaycitizen.com/2009/10/obamas_nobel_peace_prize_anyth.html
I wish people to set the right priority in this issue. And why many Americans cannot be happy with the fact that their leader is honored with this award?
I only wish that these people atainst the award are not the same people who voted for the ex-leader, just because he looked like, talked like their beer-dringking-body with slur pronunciation, and helped him disassemble this country's economy and international affair into total disarray for eight years.
Aren’t we supposed to be happy that the rest of world still believes the President of United States as the leader of global communities?
And what is the quality of global leader? Eagle.
According to a news report, in a town hall meeting, Mr. McCain said as below.
“McCain urged them he would fight for health care reform but reiterated his opposition to President Barack Obama's plan to create a government option to compete with private insurers, arguing that it would be the eventual end of private insurers in the U.S.
Obama and most Democrats say a government option would serve to balance the power of private insurers. But insurance companies see it as a step toward a government takeover, and many business groups agree.” -AP-
Here is my question to Mr. McCain is. Is he saying that he is OK with the fact that private insurance firms had not minded to abuse their unlimited, unregulated power on consumers in the disguised name of free market system? Is he OK with the fact that these firms’ business practices to squeeze out any possible drop of money from consumer’s pockets ended up contributing to endless number of medical patients’ bankruptcies and nation / worldwide recession? (Especially, when these firms have sustained their market power not by performing well and being competitive, but by constantly lobbying, bribing Washington folks over decades.) But Mr. McCain is not OK with the government’s efforts of preventing the future possible occurrence of the same thing?
What is Mr. McCain’s reason to protect insurance firms? Whom was he elected to represent?: (a) people’s interests or (b) those of insurance firms? Does he protect insurance firms’ interests over publics’ just out of pure consciousness despite the fact that the almost-Great Depression occurred less than a year ago and still going on?
And why Mr. McCain and insurance firms insist that the government will drive them out of business even if they do perform well in future, become competitive and don’t drive people into bankruptcies? Do they really believe that the government would intentionally harm its efficient, good domestic industries out of malicious intention instead of keep them alive for the sake of economy?
What should have happened is, they should have gotten into bankruptcies if they haven’t been functional, instead of their patients, public going into bankruptcies to cover the costs of their greed and inefficiencies. US auto companies got bankrupts or fell near bankrupcies because they had not been competitive to survive. Then why inefficient insurance firms deserve to stay profitably afloat and instead send people into bankruptcies? What’s the difference between auto makers and insurance firms?
Mr. McCain brought Ms. Palin into the Center of US politics and protects insurance firms against US public interest. Does he sleep well during nights?
It is unfortunate that Ms. Sarah Palin had handled the issue of Health Insurance Reform in ungraceful manner, such as calling it “Death Panel.” As she is likely to run for 2012 Presidential Election, the way she handled the public issue in this thoughtless way puzzles me. Public should expect far more from her than the way she handled this issue. She should have made public statements in far more mature, responsible, well informed, thoughtful, and honest ways, using proper, decent language, with her heart rooted on improving public wellbeing. This attitude is what public must expect to see from a potential presidential candidate of this country.
Another disappointment is, some public actually buying, believing this kind of silly statement, and media creating some kind of shock effect out of it and stirring public opinion. Despite numerous corrections of this false statement via media over time, it is absurd that this kind of statement still grabs public attention, seemingly giving her some political gaining.
It would have been great if she had done her best to understand issues and try to make public statements from her heartful consciousness of trying to identify the best for US public, instead of promoting public sensation with words that are wrong.
I do not know whether what I am going to write may sound joking or reasonable to readers. If I were in shoe of President, I may have thought about creating the corresponding, public sensation-provoking Ads in response to Ms. Palin’s case, in order to grab the attention of the very same public that paid attention to Ms. Palin’s back to the stance of “Pro-health care reform”.
If I were President (in dream), I may think about ordering my staffs, pro-healthcare-nonprofit organizations, Hollywood producers, or other supportive entities to make the counteracting, sensation-provoking Ads in response to Ms. Palin’s statement. The Ads may feature several housewives of Ms. Palin-look-alikes, who are perky, spunky, passionate, active, energetic, in Ms. Palin-image-suggesting-outfits of various occasions (e.g., hunting / fishing outfits, hockey/soccer mom, formal office outfit, housewife outfit, gym/workout outfit, etc) in various scenes of moose hunting, fishing, cheering up at children’s sports events, cooking, doing house chores, working at offices, etc.
Then producers of Ads may make these Ms. Palin-look-alikes to make statements similar to below:
“I do (moose) hunting. I love fishing.
I am a busy hockey/soccer mom. I love my kids.
I am a busy housewife. I am a hard working mom.
I am perky, spunky, passionate, active, energetic……
I am honest.
I love, deeply care for my country and people.
I care for truth.”
“What I don’t do” are:
“I don’t lie.
I don’t falsify, distort truth.
I would never harm my country, my people for my personal gains, interests.
I strongly believe that “Health Insurance Reform” is designed for my wellbeing, wellbeing of my family, and wellbeing of all of you.”
“Calling it as “Death Panel” is a complete lie; it is aimed at personal, political gains at the costs of harming public interests. As an honorable citizen of this country, I would never do this kind of thing to my country. Because I dearly love my country, etc……..” And will add more statement of supporting the Reform, such as “Public Health Care Plan is designed to stop the draining of your money into the pockets of the health care industry riches by increasing competition in the industry, improving industry efficiencies, eliminating industry wastes,.….save your money, give better access to better quality health service to all of us, and protect our financial security. Health care reform is about protecting us from “Harms’ Way” !
(There could be various versions of this kind of Ad; housewives’ version, male version, grandpas and grandmas’ versions, and kids versions, depending on the preference / target viewers of entities/organizations that produce this kind of Ads).
What I would really like to see in this kind of Ads are to clarify the fundamental relationship between (a) the healthcare / insurance industry’s misconduct in their business, (b) their cover-ups, their decades-long lobby activities in Washington to protect Govt laws and rules that have allowed their business practices, and (c) how “Public all together” have been massively losing to the industry’s scheme over decades. As the industry has assigned roughly six lobbyists to each one of over 500 congressmen to continuously garner their usual business, this nature of the industry should be well communicated to general public to make them understand what’s is the fundamental nature of all these mumble and bumble.
Does this sound silly ???? Or reasonable ????
I thought for a few days about creating “Public Clinics” as a way of reducing the heavy costs of health care reform, before listing the short draft at this website. Interestingly, I learned that, hours earlier before I posted it, First Lady delivered a speech in Washington D.C. that $850 million Recovery Act grants will be given to community health centers across the country. (Considering this interesting timing, there may be a good chance that I caught her telepathic message, which must have echoed nationwide for several days before the event, to come to think of the possibility of “Public Clinics,” the enlarged, systemized version of community health centers.)
Despite the recent, abrupt stumbling of the progression of health care reform debates in Congress, upon the release of CBO report of too high expected costs and limited coverage of the reform, public support for the reform still remained strong and increasing number of ways to reduce the costs of reform have been identified. The current events, such as President Obama sets his ambitious strides on overhauling US foreign policies/relations and repositioning U.S. in international political map, along with our newly emerged Senator Al Franken, give me the impression that the crisis in health care reform is getting fainted away. Nonetherless, I would like to add “Public Clinics” to the list of ways to reduce the costs of and finance the reform as identified below:
1. Creation of “Public Insurance Plan” to compete with private insurance options.
2. Creation of Public Clinic.
3. Streamlining the linkage within the health care industry’s supply chain to increase efficiency and productivity.
4. Proposed tax increases including “income tax surcharge, a tax on employers based on size of their payroll, a value-added tax in a form of a national sales tax” of the House version.
5. Spending cuts: reduction of Medicare overpayments to hospitals, prescription drugs, private insurers and elimination of wastes in Medicare and Medicaid.
6. Disease Prevention, promotion of public health, good nutrition, fitness, and public health (as addressed by Sen. Tom Harkin)
7. (new Senate healthcare plan) the mandatory acquirement of health insurance (shared responsibility payments) and financial penalty to people who refuse to carry it, which is expected to raise money to partially finance the health care reform.
8. Stricter restriction on food industry
9. Changes in public culture and infrastructure (more sidewalks, parks, recreation areas, more active lifestyles (more exercise, fitness, sports), perceptions.
If President Obama’s statement, “The public plan, I think, is an important tool to discipline insurance companies," can be true, I believe, “Public Clinics” can be a (partial, depending on the function they take) tool to discipline hospitals or other health care providers to be efficient and to decrease the costs of current health care reform proposal. Of course, there are community health care centers across the country. But considering the scale of their operation, funding system, and the composition of board members (half of them being their patients), the capacity / function of community health care centers seem to be far short of what “Public Clinics” could offer to the society.
Especially, if there had been the consideration of government imposing employers (that currently deal with 160 million workers) to adopt “Public Health Insurance Option” and if the government incorporates “Public Clinics” to treat patients under Public Health Insurance Option as well as those of private health insurances (if they choose), the expected benefits will be:
1. Huge savings on health care costs by taking care of patients under both of public or private health insurance options within the government-owned “Public Clinic” facilities, instead of sending out them to more costly private health care providers.
2. Improving consumer welfare as reduced costs will allow to cover larger number of uninsured people than before.
3. Enhancing the security of US industrial competitiveness, manufacturing base, jobs.
4. Improving the efficiencies of health care providers such as hospitals, doctors' offices, and other health care providers by reducing their operating costs.
5. The initial role of Public Clinics may begin with specializing in the areas such as primary care, vaccination, disease prevention, and dealing with major national illness such as obesity, diabetes, heart diseases, high blood pressure, prostate / breast cancers, which are the significant sources of high health care costs. Over time, their function, capacities can be adjusted to changing market demand patterns or need of national health care policies.
6. Public Clinics can be geographically located in areas such as poor rural or urban areas where the majority of low-income, minority, uninsured population reside; strategically locating “Public Clinics” in specific geographic areas may make them best serve rural and urban poors and uninsured people.
Thanks Ed, again, for sending this article.
In relation to my prebious blog post, Health Care VI: Regarding Impending Congressional Decision on Health Care Reform, Economist Reinhardt's NY Times article below very well depicts the problems regarding "employment-based health care system" in this country. Although he supports free market-based health care system, rather than the government-run public health care system.
MAY 22, 2009, 6:05 AMIs Employer-Based Health Insurance Worth Saving?By UWE E. REINHARDTUwe E. Reinhardt is an economics professor at Princeton.Ask any group of health policy experts whether they would have put in place our employment-based health insurance system, had they had the luxury of designing our health system from scratch, the resounding answer most likely would be “No.” In fact, no other industrialized country has quite this arrangement. It is uniquely American in origin and in modus operandi.Our employment-based system was not the product of a carefully designed health policy. It was a byproduct of evading wage controls during World War II.At the time it was thought that, as the nation’s drafted military personnel risked their limbs and life on foreign battlefields at low, tightly controlled pay, those who stayed behind should have their wages controlled as well.But with the wink of the eye with which Congress routinely puts loopholes into the tax laws or regulations it imposes, the wage controls imposed in World War II did not extend to fringe benefits. And thus, employer-paid fringe benefits, including employment-based health insurance, were born.As was noted in last week’s post, Congress further encouraged the growth of employment-based health insurance by treating the employers’ contribution to their employees’ health insurance as a tax-deductible business expense. On the other hand, it was also not viewed as taxable compensation of the employee.Remarkably, and quite unfairly, that tax preference was not granted to families forced to purchase health insurance on their own. They had to buy it with after-tax dollars.From the perspective of employed Americans and their families, this model appears to have served them reasonably well. In opinion surveys, over 80 percent of the respondents typically declare themselves satisfied with that coverage. It can explain why Americans have grown so attached to that system and why so many politicians are keen to shore it up.From the perspective of health policy experts, however, that approach has serious shortcomings.First, it keeps opaque who actually pays for the health care used by employees.Both employers and employees seem to believe that the “company” absorbs the cost of the employer’s contributions to the group health insurance premiums for their employees — typically 80 percent of the premium.Employers believe that these costs must either be recovered through the prices of the goods or services they sell (i.e., passing along the rising costs of health care to their customers in the form of higher prices), or taken out of the return to the company’s owners. On that belief, American executives now complain pitiably that the high cost of American health care makes their enterprises uncompetitive in the global marketplace.For their part, employees tend to view employer-paid health insurance as a gift, on top of their pay. Therefore they see little personal gain in attempts to control the cost of their care.Most economists are persuaded by theory and evidence that, over the longer run, the contributions employers make toward the fringe benefits of their employees come out of the employees’ take-home pay. Economists think of employers as pickpockets, so to speak, who take a chunk of the employee’s total compensation and buy with it whatever fringe benefits they “give” their employees. That process blinds employees to the inroads that their health care makes into their families’ livelihood.A second major shortcoming of employment-based health insurance is that it is only temporary. It is tied to a particular job in a particular company, and it is lost with that job. Nowhere else in the industrialized world does a family, already down on its luck over a job loss, also suffer the loss of its health insurance. It happens only in America, under employment-based insurance.Finally, the group health-insurance premiums employers pay to private insurers are “experience rated” over that employer’s group of employees. This means that the group premium is based on the claims experience – that is, the health history — of just that small group of employees.For small employers, it can mean that if serious illness befalls one or several employees in the group, it can drastically and unpredictably drive up the premium for every employee in the group. Not surprisingly, only 49 percent of employers with three to nine employees sponsored health insurance for their employees in 2008, as did only 62 percent of employers with three to 199 workers (Exhibit 10 here).The objective of current health reform efforts should not be to abolish the employment-based system to which so many Americans feel attached, brittle and expensive as that system may be. Instead, the aim should be to develop a robust, parallel system of fully portable insurance that individuals or families can purchase on their own, in a properly regulated and organized market, with public subsidies where deemed necessary. As my earlier posts to this blog sought to explain, this can be done in a variety of ways.The success or failure of the current efforts by President Obama and Congress to reform the American health system can be gauged by the degree to which that goal has been accomplished a year from now. If success in this regard serves to shrink the traditional employment-based insurance system, so be it.
I would like present this discussion on U.S. health care reform in the order listed below.I wish that this discussion does not come out too late as the debate in Congress has been ongoing for long time.
The Structure of Health Care Industry
Balancing Act: Regarding the impending congressional decision on the options of
health care system
Selecting the Option of Medicare-like Plan run by HHS
Conclusion
U.S. health care system has been controlled by a supplier-driven industry / market structure, rather than consumer / demand - driven one that is the pre-requisite for free, efficient market competition to provide the lowest product prices at possible highest quality. This supplier-driven industry / market structure of health care, I believe, is the main cause of current highly inefficient, excessive profit-seeking industry structure that has become heavy burden to individuals, society, and manufacturing industries.
The core problems of current U.S. health care system, I believe, arose from the fact that health care deals with (a) precious human lives (that make patients difficult refuse or delay the treatment or medical services offered by health care providers), (b) invisibility of pricing system of medical treatments and services before receiving them and the fact that the providers of health care services and insurance companies determine them and consumers are simply notified to take them and pay during the post-treatments/service period, (c) complexities of medical treatments and terms that general public often don’t understand fully, (d) the deregulation of health care industry based on wrong economic assumption that “wrongly defines humans as rational decision makers”; the deregulation gave the industry opportunities to do whatever to maximize profits; and (e) the health insurance companies’ operating, network system determine the choices of patients’ medical service providers, treatments, locations, and whether they can receive them or not. These factors gave health care providers (f) strong authoritative power. In this industry conditions / structure, healthcare providers have been able to abuse their authoritative power without constraints that led to high inefficiency, heavy financial burden from health care costs to individual, other industries and the whole society. The dire consequences of this supplier-driven U.S. healthcare industry / market structure are well epitomized by the fact that “the U.S. spent approximately $2.2 trillion on health care in 2007, or $7,421 per person, which accounts for 16.2% of GDP, nearly twice the average of other developed nations.”
Balancing Act: Regarding the impending congressional decision on the options of health care system
The key issue in restructuring the U.S. health care industry, or system, I believe, is “how to shift the system from the current supplier-driven industry / market structure to the more efficient, consumer demand-driven industry / market structure. To achieve this goal, the reform should be able to weaken the authoritative power of the health care service providers and insurance companies while empowering individual consumer of those service with the freedom of choosing service providers, treatments, locations that offer lowest prices with possible highest quality at that prices, while they are constrained not to abuse their freedom.
By now, most of possible ideas on how to reform health care system are probably out on the table and have been debated in Congress. A friend, Ed, forwarded me a news article a few days ago that reports three different designs for a new government health insurance plan that are debated in Senate during this week. They are:
(a) Create a plan that resembles Medicare, administered by the Health and Human Services department.
(b) Adopt a Medicare-like plan, but pick an outside party to run it. That way government officials would not directly control the day-to-day operations.
(c) Leave it up to individual states to set up a public insurance plan for their residents. (NY Times, May8, 09)
However, the government currently has federal budget constraints regarding overhauling health care system as listed below:
(1) Administration’s need to balance current excessive budget deficits in order not to repeat the case of Regan era,
(2) Expected crisis of Social Security and Medicare programs in future that should be taken care of sometime.
(3) Overwhelming weight of current and future Medicare costs in federal budgets, which indicates the heavier weight of “Medicare-like plan for All” in federal budget.
“The proportion of spending attributable to Medicare and Medicaid in the health system is expected to rise from 4 percent of GDP in 2007 to 19 percent of GDP in 2018, making it the principle driving force behind rising federal spending in the decades to come.”
“Health care costs doubled from 1996 to 2006, and are projected to rise to 25% of GDP in 2025 and 49% in 2082.” (The Costs of Inaction: The Urgent Need for Health Reform)
(4) The fundamental problems of Employer-based Health care system including its heavy burden on U.S. industrial competitiveness, enslaving employees, and large and constantly increasing employees’ portions in health insurance costs and employees’ decreasing take home wages. 1
(5) Current health care system is tough for small businesses and rural populations.
In my view, the Option (a), medicare-like plan run by HHS seems to be more desirable than other options to take the market controlling power away from the suppliers of health care services to consumers. Between the Options (a) and (b), the difference in their effects may only depend on the quality of jobs (reform operation) done by either HHS or an outside party. Leaving control to an outside party, however, may leave room in health care reform to egress from the direction that the government intended. The potential operation by HHS would also need sufficient supervision, disciplines, and incentive systems to prevent the chance of operation falling into “red tape.”
After considering the federal government’s fiscal constraints as mentioned earlier and other aspects of the current health care system, I would like to suggest one possible version of Medicare-like Public Plan run by HHS. There may be a chance that the Congress already discussed the type of policy I would like to discuss here and decided that it is not practical, though. In this version, the government provides Medicare-like “Health Care for All”, acts as a single payer, and becomes the intermediate agent between the healthcare industries and individuals, and companies. The government will have collective bargaining power with health care and pharmaceutical companies that will keep the costs of their services and products down at bulk-rates and push them to improve efficiencies and reduce costs. This will enable all individuals to take the benefits of government’s bargaining power no matter whether they work for big companies or are self-employed.
At the same time, to finance the government-run health care system, the government collects the premiums of healthcare benefits from business entities (for employed people) and individuals (for unemployed, small businesses, rural population, or self-employed people) in forms of health care benefit taxes, or in other forms, based on their income levels. The amounts of healthcare benefit taxes / premiums would be determined at progressive rates in proportion to subjects’ income levels. In case of companies, the government may determine the share of companies in total health care costs of their employees (for example, companies pay 45% - 60% of the total health care costs of their employees to HHS) in a way that their healthcare costs are comparable to those of their foreign competitors in developing countries and don’t become burdens in their international competition.
Regarding determining tax / premium rates of healthcare benefits, the government may start from the income level of poverty (e.g., $25,000), impose the minimum tax rates (e.g., 0.3%-0.5% on this income group, and increase tax / premium rates at progressive rates as income level increases. For example, the healthcare benefit tax / premium rates may be set at higher rates (for artificial example, 5%, 4%, 3.5% etc) for income groups with annual earnings higher than $250, 000 or $500,000 (artificially set numbers) than those (e.g., 0.5%-1.5% or so) for income groups with annual earnings below $80,000, or $50,000. As high income groups have received exponential rates of rewards and compensations to their work and investments from the society, they should contribute the corresponding amount of maintenance / nurishment fees to the society in order to maintain the conditions of society and labor forces reasonably good so that they can continue to receive the monetary benefits of others’ work for them. The tax / premium rates may be adjusted to the several family constraints such as the number of children / dependents and/or the ratios of income to debts, etc. On the other hand, as income level goes down close to poverty level or below, the government’s healthcare benefit taxation / premium may turn into subsidies or other forms of supports for low income groups.
Personally I believe that, in conjunction with Pres. Obama’s plan with a mix of tax increases and spending cuts, and other supportive related policies, this suggested alternative may give more leg room on the federal government’s maneuvering of healthcare reform as well as other impending major policy issues financially. Though nothing would be clear until punching actual numbers into spread sheets and do through budget analyses for the feasibility of various plans. For now, in my view, this alternative seems to give better chances of achieving the following goals of health care reform:
(a) the fundamental agenda of providing better access and affordability to all;
(b) reduction in U.S. business / manufacturing’s healthcare-related-cost burdens as part of their operation / production costs that significantly affect their global competitiveness; depending on the government’s maneuvering of tax / premium rates to impose on corporations, the government may be able to reduce companies’ shares in the total healthcare costs of employees, for example, from 100% of them to 45%-60%, so their health cost burdens can be comparable / competitive with those of other developing countries; the remaining of these healthcare costs may be passed onto high income groups and other social entities through the government’s diverse taxations; this system also eliminates the problem that the employer-based health insurance system have increasingly passed employers’ costs onto employees and decreased workers’ earnings;
(c) inclusiveness of every individuals and various social entities in sharing the benefits of government’s collective bargaining power against healthcare providers and pharmaceutical companies; the benefits of government’s collective bargaining power (in forms of lower costs and better access) can be offered to individuals (who were previously excluded from receiving the benefits of (companies’) group bargaining power against insurance companies);
in this alternative policy, there is no need to set up “insurance purchasing pool” or "exchange" to help make private coverage more affordable for individuals and small businesses.
(d) socially inclusive sharing of financial responsibility of healthcare reform: the responsibility of financing healthcare reform are shared, spread over different income groups and social entities with some adjustments and flexibilities;
(e) eliminate some of negative aspects of “employer-based-health insurance system;
(f) depending on how to execute this policy alternative, the government may be able to create more breathing room or space in federal budgets in preparation of dealing with other impending public policies and balancing out federal budgets;
Healthcare system can be considered as “soft-infrastructure” in comparison to hard (physical) infrastructure such as roads, bridges, water / energy supply, telecommunication, and others. Both of hard and soft-infrastructure are the backbone of a nation’s economy and industrial system and the current economic crisis is one indication that one of soft-infrastructure hasn’t functioned properly. To make sure that a society and industries function well, we need to properly develop and maintain our infrastructure in efficient ways. Maintaining healthy, productive labor forces at lowest costs and in efficient ways is one of essential to operate this economic system smoothly.
The core of the suggested health care reform plan may be reducing financial burdens of maintaining healthcare system from middle, low-income individuals and American corporations and transfer those burdens to rich income groups. In this system, the government is set to be an intermediate agent to finance the system through taxation and spending cuts as President Obama suggested, exert collective bargaining power against healthcare service providers and pharmaceutical companies to put the prices of their services and products at the lowest levels, provide healthcare coverage to all individuals, and maintain US industries globally competitive by reducing their healthcare cost burdens. Personally, I believe that this alternative policy suggestion has a potential to shift U.S. helath care system from the current one based on supplier-driven industry / market structure to the one based on more efficient, consumer demand-driven industry / market structure.
This alternative may require deeper restructuring than the versions, which are currently discussed in the House and Senate, in terms of the industry structure and human and financial resources, and require deeper commitments from the government, industries, and individuals, especially from those in higher income groups. Deeper restructuring may bring deeper, more meaningful changes and outcomes, along with potentially deeper pains in the transition process. I wish President Obama’s success in healthcare reform and other policies that will make people remember his legacy not only during his terms but also in years after he leaves his post.
-Picture from National Geography
There has been news about Republicans and some Democrats’ skepticism about current Energy Proposal that emphasizes the increasing supply of renewable energy and “cap-and-trade” measure to control CO2 emission. Their claim of opposition is that these measures “increase costs for consumers, send jobs overseas, and hurt businesses.”
I also read, the administration reportedly intends that the energy bill does not conflict with international trade rules to prevent any disruption on US exports. And there has been the suggestion of negotiating a new “international climate change agreement” to obtain nations’ long term commitment to control emission. As President is scheduled to meet the world leaders of major economies to discuss the energy crisis, “EU calls on US to help lead global fight for climate change”, and small nations ask for more drastic measure from industrialized economies to control extreme weather changes including flood, rising sea levels, and extreme weather changes, there seems to be a increasingly better chance to get international agreements and support on energy and climate issues.
As I observe the changing international and domestic politics, and as the current opposition to the energy legislation is labeling this bill as a potential source of increasing energy costs and taxes, and weakening US industrial and trade competitiveness of, I would say, “tradable goods” in both world and domestic markets along with domestic jobs, I would like to discuss the alternative ways of dealing with these problems.
I am not certain about the practicability of this suggestion, and I don’t have specific information on how costly or cheap these new energy sources from wind, sun, waves or other renewable sources can be, especially in the beginning stages of their industrial or commercial applications. Common knowledge has been that new technologies, inventions, developments, and prototypes of newly developed products usually tend to be relatively expensive in their initial stages of development and introduction to market / commercial usages. It usually takes time for industries and markets to get accustomed to new types of technologies and products and refine / reshape their production methods / technologies into commercially cheaper and cost efficient mass production system.
Assuming that these renewable energy sources and technologies may need a bit of transitional period to mature and become mass, standardized, cost-effective energy sources to consumers and industries, and to reduce the possible disadvantage of US manufacturing of tradable goods in the initial stages of switching to these new energy sources if the administration governmental consumption of renewable energy sources, the administration may continues to pursue US consumer, industries, and government to switch to renewable energy sources, I would like to suggest the followings:
1. In the beginning stage of pushing the consumption of renewable energy to consumer, industrial, and federal and state governments, it may be useful to differentiate and wisely choose the proper target groups with different time schedule of adopting renewable energy sources. In the beginning stage of implementing this energy legislation, the administration may choose individual consumer, industries of non-tradable-goods (such as retailing, medical industry, tourism, other service industries), and federate and state governments as the primary target groups to switch from traditional energy sources to renewable energies. And it would be less hurtful for US manufacturing if the administration provides longer, gradual, flexible time schedules for US industries of tradable goods to switch to renewable energy sources so that they gradually adapt to new energy sources. This flexible adjustment period will reduce the chance that the shift to renewable energy sources partially contributes to deteriorating weakening the global and domestic competitiveness of industries of tradable goods.
2. During the process of implementing (1) as mentioned above, it would be productive to seek international agreements on harmonizing, equalizing global industrial and trade competitive conditions. This effort may include the phased time schedule of incorporating renewable energy sources and emission control worldwide. Requiring these conditions as the prerequisites or fair conditions for global industrial and trade competitions, negotiating memberships, rules, or terms of World Trade Organization (WTO), regional / multilateral trade agreements, foreign market access / investments / bidding for foreign government contracts or procurements, and serving global common cause of fighting climate crisis could prevent from penalizing the manufacturing competitiveness of countries, who actively pursue the fight for global climate crises, because they adopt these measures to protect environments. It is critical to make nations face the same sets of underlying rules and conditions of international industrial and trade competition including energy and pollution issues, and to prevent from disadvantaging, penalizing specific nations’ manufacturing that adopt climate-friendly production methods are critical.
According to political history of negating regional and/or multilateral trade agreements, dealing with labor or environmental standards have proven to be difficult issues as imposing these standards to economies of different GDP sizes have been tough challenges. And multilateral negotiations have been inefficient, time consuming, and often difficult to reach resolutions / agreements. However, recent international political scenes have shown some positive signs regarding climate issues. For example, there have been news reports such as
“European Union environment ministers called on the United States to help the EU lead and finance the battle against climate change.”
"The EU has been the leader of the international debate. We want to keep on and to offer a co-leadership to the US."
"We need to build a coalition. It cannot be done unilaterally on the EU side," "It is not only an obligation of the EU to come with fundings and figures... the United States, Japan and all the developed countries should contribute."
Although EU showed passive attitude toward the “Global Fight with Terrorism” at NATO meeting, the bloc is showing a positive attitude toward dealing with Global Climate Crisis. When both the US and EU, the largest world markets and have strong leverages in world politics and commerce, are so enthusiastic on working together on climate issues, and many small nations are anxious about taking drastic measures to tame climate crisis as natural disasters such as flood, rising sea level, and drought are threatening their nations’ survival, I believe there is better than ever favorable chance of getting international cooperation on adopting renewable energies and emission issues, along with other environmental issues, to their economies and manufacturing.
I also believe, it would be more effective to get international agreements on climate issues if these issues are negotiated along with commercial / trade issues, later of which have been regulated by WTO and regional trade negotiations and have been major economic concerns to both developed and developing countries. I expect that this combination of issues is more likely to motivate both developed and developing countries whose economies are keenly related to exports. Although current global economic downturn may have negative effects on this endeavor and consensus is often tough to reach, the timing and international political environments for negotiating energy / climate issue are more favorable than before.
Thesedays, reading news on President Obama’s speeches and European tour made me somewhat emotional. It was because of his speeches. I started reading “Strategies on Afghanistan” and “Prague Speech” with certain excitement, expectation of reading something great. I finished those with tears, almost felt like crying…….I bowed my head down to him out of respect.
A few times in my life, I fell on the verge of tears when I saw almost perfect, spectacular performance of athletes, artists, or scenes of natural wonders or disasters like hurricanes or storms. I haven't imagined that politics could give me the similar kind of fulfilling, sensational completeness. I almost doubted my becoming emotional on those speeches to be partially due to my political naivety or hormonic imbalance from possibly still on-going trace of postpartum things…..
Those “Speeches” were speeches that made me feel like, they must have been there all through the time. It felt familiar. natural with such full of vision, inspiration, eloquence, and simplicity, written with the exact kind of righteousness, vision, correcting all wrongs and making things right to serve justice. Just didn’t imagine that there would be actually a real human being to deliver them.
Although the initial visions shown in those speeches have been compromised with the reality to make progress to certain level, the initial inspiration that those speeches brought is not forgettable. It’s like, his words were pounding on readers’ brain cells and nerves, like a pianist pounding on piano keyboard.
Long time ago, I heard that “Behind the Rise of King, there is the Divine Providence.” As he unfolds his policies more and more, these words come to mind more real, stronger.
I bet, its not just First lady, Michell Obama, who feels like Mr. Obama is her soul mate. I believe there are millions of men and women in this country who feel same way. And more worldwide.
As the new administration and economic crises are gradually settling down with progress, we, average people's mind also gradually, guiltyfully, drifts away from the big issues of the society and world and return to our often-harsh reality, immediate problems of life; how to live, how to survive. Reality reminds me that politics may be luxury to many people, the regret that I have heard from several males who once did and had to give up.
This morning, I read that Arctic sea ice is melting so fast that they wouldn’t be around in the Earth in next 30 years. And the disappearing Arctic ice means that the sunlight-reflecting, Earth-cooling effect of its white surface will disappear and sunlight will be all absorbed through the newly exposed dark ocean, increasing the temperature of Earth further. Disappearing Arctic ice, along with fossil fuels, are the major causes of global warming, according to the report.
All of us, all societies, and all nations have our, their own individual universes with different orders of priorities, what’s the most or least important. In mothers’ universes, what their kids ate this morning, whether they are sick or play with which toys or books, that kind of things are the most important things above anything elses. Anybody who don't agree with them are strangers. For teenage girls, makeup, clothes, boys, parties, drinking, and going wild come first before anything else in their universes. For business men, drug dealers, or any kind of entrepreneurs, money, profits, promotion come first before anything else at any costs. For hungry people, food comes first. For sick people, medical service comes first. For artists, art comes first. During good times, whether we are richer, thinner, have bigger cars or houses, have more fun and entertainment of life than others come first. During recession, economy comes first. To terrorists’ world, attacking their enemy nations comes before their own lives and peace. For nations, which countries have the strongest military or economic power, or how to put pressure or threaten other countries to get what they want come first before anything else, etc.
While all of our universes are colliding with each other without finding common grounds, consensus, and concessions, the world have become a chaotic, uncontrollable place. In the process, our only common home, the Earth, have taken the backseat all the way, while we have been consciously and/or unconsciously trashing it close to the point of no-return, it increasingly becoming inhabitable for us anymore. But still it doesn’t seem to be important enough to get proper amount of our attention and to do something about it. We are in life-threatening crisis. Just we don’t think so.
It is absurd to hear the news of AIG's impending $165 Million dollar bonus to its top executives while having received billions of govenment bailout money under current severe recession and skyrocketing unemployment.
Greed seems to be addictive, obsessive, like drugs. It must make the infected people lose their senses. It is amazing to see these company executives' dareness, boldness to attempt this profit scheme despte the expected national rage over their decision. This must be the dire negative symptom of Corporate America.
It is further surprising that there seem to be few supreme laws which can override any lesser degree laws that allow small number of malicious people to viciously attempt to rob money from their country in open, seeminly legal way. This is believed to be one of the obvious loopholes in U.S. legal system after undergoing the decades of interest group-driven US politics.
President Obama's determination to block this behavior is one, single choice he has. What other choices does he have, in face to this unbelivable "Corporate Financial Terrorism"?
As President Obama and his administration have believed that the overhaul of health care system is one of the policy pillars in rebuilding the shaken US economy, I would like to share the outcome of our Health Care Meeting in Wichita, KS. I hosted this meeting on last December. When I submitted our group report, I wondered whether this report may be perceived as out of touch. Now, as I have seen the President’s continuing efforts of developing functioning health care policy for US individuals, businesses, and fiscal safety, I would like to share the outcomes of our group report in the following order.
The Health Care System We Prefer
Ways of reducing health care costs.
Identified Problems with Current Health Care System
Future Suggestions
Moderator’s View
Extremely profit-oriented US health care system has deeply jeopardized people’s financial security and US industrial competitiveness. Heavy medical bills have caused almost 50% of massive foreclosures of US housing market, and personal bankruptcies, and suppressed US industrial competitiveness in domestic and world markets. Highly inflated healthcare costs have increased employers’ burden of paying for their employees’ health care costs, which, in turn, have increased their business/production costs far higher than their foreign competitors.
What our group unanimously agreed upon was to have a “Nationalized Health Care system,” coupled with continued optional private medical practices. In this system, the government is a Single Payer and pays for everybody. Corporations do not bear any health care costs of their employees. It is because “employer-based-health care system“ has yielded many problems for both employers and employees. Some of these problems are:
a. This system often forces employees to stay on bad jobs that treat employees horrible, oppressive, and abusive. In this way, this system often enslaves employees to their employers.
b. Employers often negotiate the benefits that employees can receive, not the other way around.
c. Whenever employees change their jobs, they have to change doctors and start over again. This starting-over process interrupts consistency in treatment and preventive care, preventing patients from receiving consistent quality medical services; Making a mistake at work can cost employees more than just their jobs; it can cost them their lives.
d. Most jobs have a (sometimes very significant) waiting-period before employees are eligible for health insurance.
e. Employees have to pay for a large portion of health insurance costs (employees’ portions in health insurance costs are constantly increasing) under this system. In this way, this system depresses employees’ take-home wages while health insurance under this system often does not really work for them.
f. For most small businesses, providing health insurance for employees is prohibitive; it stifles the start-up of small businesses and independent ownerships; it further fuels our society’s dependence on huge, bloated, chain companies owned by billionaires.
To achieve a Nationalized Health Care System, the participants of our group were willing to accept any measures. We came up with our own strategy of finding new governments revenue sources to finance this new Nationalized Health Care System: Increasing Taxes and Reducing highly inflated Inefficiency Costs of Health Care System.
Many of us were willing to pay higher taxes, even higher gas prices as far as they are good for environment (such as reducing gas consumption and carbon dioxide emission), economy, and building infrastructure; we believe that higher taxes would be more healthcare-cost-effective and financially-better-off for consumer than maintaining current Health Care System and paying often outrageously inflated health insurance premiums and medical bills under currently malfunctioning system. There was a suggestion of statewide health insurance system, instead of nationalized health insurance system, but it is expected to have many limitations in high costs of designing individual systems in each state and harmonizing rules and regulations among different states.
Our group identified the ways of reducing inflated health care costs as increasing market competition and efficiency of health care system. For this goal, it is important to have:
a. Visibility of prices and information of medical procedures and services, doctors’ records / history of medical practices, and transparency of medical billings to facilitate patients’ informed, wise decision makings on selecting doctors, hospitals, and medical procedures that will increase market competition and decrease prices of medical services.
b. Reform health care industry’s billing / coding systems that often add high fees, extra charges to medical bills for their services to increase their business profits.
c. Promote primary care and preventative care to decrease the future costs of health care.
For this purpose, (a) increase the number of Centers for Disease Control and Prevention; (b) introduce strong measures to fight obesity and diabetes whose health care costs have imposed huge burden on health care system; (c) school lunches and vending machines must provide balanced, nutritious food; (d) employers should be given incentives to maintain work places free of smoking, alcohol, and drugs; and (e) the benefits of diet and exercise must be addressed to all ages (Dr. Walt Chappell)
d. Changing structure of health care system to reduce health care costs:
d-1. Increase in the numbers of medical schools, training facilities, doctors, and nurses statewide and nationwide will increase market supply of medical professionals.
d-2. Allow ARNPs and PAs to open and operate primary-care clinics in rural and urban settings to treat 80% of the health care needs that reduce costs and overhead (Dr. Walt Chappell).
d-3. Establish public and private 24/7 health-care centers in urban areas to treat minor health needs including primary-care illnesses or injuries.
d-4. Allow lower level medical staffs to handle simple medical procedures or prescriptions will greatly reduce health care costs.
f. The government should more aggressively promote healthy lifestyles.
f-2 There should be public programs that promote healthy life style, smoking ban.
g. Statewide purchases of generic drugs and statewide systems of medical malpractice insurance at one group rate.
h. Lowering the costs of medical education and letting graduates of medical schools to serve for their communities or small rural towns’ medical needs to pay back their education costs will reduce health care costs.
i. Preventing or weakening the influence of money, interest group politics in protecting and maintaining current corrupted business practices of health care industry to increase market efficiency and decrease prices of medical procedures and services.
j. A nationalized malpractice insurance system for health care professionals could dramatically lower the costs of health care, thus allowing many qualified physicians to continue practicing.
1. The major problem of current system is accessibility to health care; it’s not the accessibility to health insurance.
2. There are too many “hidden costs” in current health care.
2-a. A trip to the ER results in a bill that charged not only ER costs but also various physicians’ charges.
2-b. When patients visit doctors or undergo procedure, they are not informed of what procedures and charges they are going to receive prior to going through the procedure.
Even after they receive procedures, they are not given a list of charges. Insurance companies pay charges without consulting whether the patient received the listed services. And often refuse to pay for charges that the patient had no choice but to receive.
These “add on” charges are exacerbated by a very complicated medical billing coding system which necessitates breaking things down in a way that lend additional charges to this service.
3. Inability to access health care or excessive medical billings have often caused many bankruptcies or permanent losses of health.
4. The profit-seeking business practices of healthcare system cause major problems in providing adequate healthcare services and inefficiency of the system. Healthcare service for military is far better functioning because it does not seek profits but caring patients.
Emergence room services are advertised heavily to increase profits; they are being used as major ways of increasing profits rather than being geared toward provide emergency services.
5. A person without health insurance effectively has no access to comprehensive health care of any kind.
5-a. Programs for low-income individuals are virtually inaccessible to people who had not been originally “low-income” group. For example, one million-plus people who have lost their jobs in 2008 but originally not belonged to “low-income” group are not eligible for benefit programs for low-income individuals.
5-b. Social programs for low-income individuals discourage their beneficiaries from learning smart money management such as developing personal savings or getting jobs. It is because if the beneficiaries of these programs start to be able to manage money well and have savings of their own, they become disqualified for these welfare programs for low-income people even before they can financially sustain their lives by themselves.
5-c. These low-income programs disqualify people (although the situations are not due to their faults) who inherit even a small amount of money in a bequest, or receive small settlements from auto insurance companies for “totaled” vehicle (which they will have to replace using that small settlement).
5-d. These log-income programs provide poor health care and often lack consistency in treatments and little preventive care.
6. There are not enough doctors in the United States.
6-a. Rural areas have severe shortages of doctors. Because of no competition, doctors in these areas are not upheld to any standards of quality.
6-b. The wait time to see a specialist is too long, often takes months.
6-c. Because the “best and brightest” are going into specializations, not general medicine, specialized hospitals are often profit-centers rather than service centers.
6-d. The AMA controls the number of students to enter medical school and that of new MD graduates.
6-d-1 The AMA does not want to increase the numbers of MDs, although increasing the supply of MDs is a way of increasing competition among MDs and decreasing the prices of their services.
6-d-2 A large portion of medical schools in the US are from overseas. Upon graduation, they return to their home countries; it means a quarter to a third of graduates of medical schools (as regulated by the AMA) are not practicing in the US.
(Moderator: however, foreign students’ studying in the US has been an important contribution to the US economy because the education industry in this way had ranked as the number 10th (or so) largest industry in this country, years ago).
7. There are not enough nurses in the US.
8. Insurance companies pursuit enormous profits and corrupt their and health care providers’ business conducts. Their financial influence prevents any attempts at reforming the health care system.
They impose ridiculous requirements to health care providers to generate more profits to them: such as complicate medical billing code system that add extra charges for their services.
For example, an MD (and MD-level charges) is not necessary for a child to get a note for his school to prove that the he missed school because of flu; This procedure is also exacerbated by complicated medical billing coding that allows separate charges for every minor, conceivable things.
It is best to keep simple procedures to be handled by lower level medical steps in order to reduce health care costs in general.
Insurance companies should not be allowed to dictate patient’s treatment as they don’t have any medical expertise.
Pharmaceutical companies have too much influence on insurance companies’ business practices; in consequence, insurance companies refuse to pay for most things that involve preventative care (such as mammograms) or non-pharmaceutical care (well-established non-Western alternatives such as acupuncture, herb treatments). Sole dependence on pharmaceutical products is not a wise choice for smart health care.
9. The costs of malpractice insurance drive many qualified doctors (especially gynecologists) to leave their profession.
9-a. It is urgent to find the middle ground between allowing people to sue for genuine medical malpractices and money-seeking, not productive lawsuits that penalize every tiny mistakes that medical doctors make by accident.
9-b. It is necessary to set up a Medical Review Panel with experts of significant medical knowledge that review and evaluate the fair, justifiable causes of malpractice suits before they go to courts.
10. “Anti-choice / anati-abortion crusaders of narrow special interests” often influence funding of clinics that provide numerous valuation medical services to their communities.
(Moderator: Often these group of people may believe that they have righteous causes to
block the function of these clinics or even voting patterns of politics, but ended up
harming the society; it’s their blinded belief system often resulting from deadly trust /
following on the Script word by word, without real understanding on what it means, and
without sincere studies and learning of actual social situations; simply ended up in their
ignorance but believe it as their religious conviction)
11. The rejection to cover pre-existing conditions is unacceptable. Under this condition, unemployed person getting a mammogram at a safety-net clinic is useless if unfavorable diagnosis on her condition prevents her from obtaining health insurance and get stuck on Medicaid for the rest of her life (or worse, not being eligible for Medicaid or thrown off Medicaid for various reasons).
12. Lack of regulations and rules on the industry’s business conducts.
13. Misinformed people, interest groups’ political influence on government policies and the health care industry.
14. Support for mental health care in parity with standard medical care is imperative.
a. We need public education and easy accessibility to medical information.
Hold more public forums and educational programs, designate TV/Radio Channels to broadcast educational programs and open discussions on health care issues to promote and circulate correct public information on health care and policy issues and educate general public regarding this issue.
b. Investigate and learn the advantages of heath care systems in US air force, Medicaid, Western European health care systems, and Delaware’s health care system; apply the learnings to new health care system.
c. The design of health care system should be based on improving people’s welfare, not on increasing corporate profits.
1. One major problem of the US health care industry is that this industry does not follow free market system, free market competition which is supposed to reduce the costs of medical services and products down and improve service and product qualities.
A. When information on prices of healthcare services / procedures are hidden and information on the qualities of healthcare services and physicians/hospitals’ previous histories of medical successes and malpractices are not easily accessible to consumers/patients, patients can not base these price and quality information of prospective healthcare providers’ services to make decisions of which hospital/doctors/medical procedures they choose to cure their illness. The current conditions of the health care industry his prevent the market function properly and reach the ideal market equilibrium where prices and demand of healthcare services and products are most efficient (lowest) at the possible best qualities under the given market conditions.
To achieve the competitive market system of the healthcare industry, the foremost thing to do is having the visibility of prices / costs of health care services, individual procedures, what kind of standard procedures/services needed for patients of specific illnesses, qualities/ qualifications / history of doctors/hospitals in medical successes or malpractices,
B. When consumers need to find healthcare services, they have to check with insurance companies’ directory to see which physicians or hospitals in a specific area are affiliated with the insurance company in order to receive the insurance coverage; this selection process first bars the selection of good doctors/ hospitals.
Insurance companies’ network/affiliation with specific doctors/hospitals limits patients’ selection of healthcare providers. In this way, this insurance companies’ network/affiliation system appears to prohibit the functioning of free market system from working efficiently to reduce costs down and increase service quality.
2. The major failure of US market system that has contributed to recent economic downturn is the previous government’s failure to provide proper rules and regulation on business practices that would have promoted the free market system to function effectively and find the lowest prices of goods and services at the demand level of consumer.
The market system has been manipulated by the interest groups or other predatory business practices that increased prices prohibitively high only for the business profit while consumers didn’t have any places/mechanism to resort to (when they are victimized by unfair business practices of big corporations) but just taking /accepting whatever offered by companies.
For example, where there’s wrong business conducts or problems of companies, consumers can report to Better Business Bureau; the agent tries to mediate between the company and victimized consumer; but if the company shows no interest on the mediation by Better Business Bureau, that was the end of the process unless the victim sues the company
Business’s bad conducts can be only noticed and brought to media or public attention only when large number of victims gets lawyers’ attention to file lawsuits; large number of lawsuits brings huge social costs.
Overall, many of us believed that we would pay far more for our health care costs under current inefficient health care system than we would pay for them under a Nationalized Health Care System, even after considering higher taxes to the government to finance for a Nationalized System. Consumer’s financial burden from medical bills under current health care system is perceived to be far higher than the corresponding one under a Nationalized Health Care System even if we pay higher taxes. It is because health care costs under current system have been highly inflated due to its inefficiency costs resulting from the lack of fair market competition, supply shortage of doctors and nurses, costs of bureaucracy, administration costs of medical billings and codings, malpractice lawsuits and insurance costs, and high costs for medical education.
However, general public’s perception of this issue and/ or willingness to pay higher taxes and/or gas prices to finance a Nationalized Health Care System in effect may depend on their level of information and education level of this issue; the more educated, informed we are about above (a), (b), and (c), the more likely we accept the idea of paying higher taxes and gas prices to finance a Nationalized Health Care System instead of current health care system. Especially, people are more like to prefer this system if they are more aware of how much emergency medical bills can jeopardize their livelihoods, such as outrageous medical bills.
Health care issue has undergone dramatic changes. In early January, Mr. Daschel announced that the complete overhaul of health care system is unlikely. A few days later, he announced that the overhaul of this system is under consideration. Recently, we heard the news that our Kansas Govenor Sebelius is chosen to be the Secretary of Health and Human Service (HHS), coupled with President Obama’s pledge to complete the overhaul of health care system by the end of this year and his Health Care forum on March 5, 2009 that invited Congressional members, health care interest groups and interested Americans.
President Obama recently proposed tax increase on wealthy people with annual income higher than 200, 000 (individuals) and 250, 000 (couples) to afford his health care overhaul. Although the idea of increasing tax is expected to face strong opposition in Congress, this plan currently appears to meet political necessities:
A. Financing new health care system:
· To reduce people’s inability to do financial planning due to unpredictable medical billings and avoid risks, personal bankruptcies, and loss of retirement funds.
· To reform inefficient health care system that has been one of the major contributing factors to current massive housing foreclosures, economic recession, and the weakening world competitiveness of U.S. manufacturing over decades.
B. Redistributing national wealth and decreasing the widening gap of wealth between the rich and poor with disappearing middle class.
Widening gap between rich and poor is an indicator of unhealthy society, which is prone to social conflicts and public unrests. It would be better to keep the society balanced and healthy so even the rich can maintain their stable good living conditions by paying back some of their money to nourish the society. Especially when the bulk of their earnings occurred through the wrongly designed, devised social, economic system, the money should be redistributed via righteous ways. For rich, tax increase may mean slight differences in their choices of ski trip to either Switzerland, Montana, or nearby neighborhood ski resorts, or buy one more piece of Gucci dress or brand name shoes. For poor, it’s a matter of having well prepared warm meal on dinner table, or peanut butter jelly sandwich, or no meal at all.
