Saturday, June 30, 2012

What Health Care Reform Should Have Looked Like

I have said this before, and I am sticking to my guns.  Healthcare reform is needed.  I began with 7 points, it grew to 8.  Now, after discussions with the healthcare professionals in my family, I add a 9th and a 10th.

1.  Insurance should be for catastrophic losses only, not for every-day run-of-the-mill healthcare expenses.  Let's say I have a cold that has been hanging on for more than two weeks.  My boss says, "hey Ben, do not come back to work until you have seen a doctor."  I go see the doctor, he says I have a sinus infection and gives me an antibiotic.  If I make an average wage/salary, there is no reason to bill my insurance for any of it. I should be able to pay for both the doctor visit and the prescription out of my own pocket with my own money.

Sure, doctors may make less money from our little visit, but they will have more freedom and more satisfaction in their jobs.

With Obamacare, there is an individual mandate, meaning that each person is required to purchase insurance, but there is not a mandate for a doctor to take you as a patient.  That is a key point.  If my company pushes me to an exchange, will I be able to find a doctor who will treat me?  Obamacare does not answer that question.  If the costs are low enough for me to pay for it out of my own pocket, will that question matter?

To accomplish this, costs for doctors to do business will have to be lower.  Medical equipment and malpractice insurance are some of the bigger costs that doctors face.  There are many other unneeded day to day expenses for doctors as well.

2.  You have to entice lower-risk people, meaning the young, into insurance plans.  You also have to find a way to include immigrants and non-citizens, who are usually younger, into the insurance pool to help diffuse the cost.  Obamacare, in part, does this, but not completely.  Some even say that that there are incentives to for younger people to pay the penalty rather than to pay for insurance.

3.  Tort reform is needed to end defensive medicine.

4.  Realistic care for the elderly to improve the quality of life, not just delay the inevitability of death.

5.  Train more providers who are not doctors to assist in medical care, this include hiring more Physician Assistants and Nurse Practioners.  Let me just say, you should see how my kid'd orthodontist handles his practice.  He has a staff of around 20 assistants, with around 10 of them working at one time.  He glides around the room on swivel chair from patient to patient, only doing the work that he is required to do and ensuring that his assistants do not do anything wrong.  This man has it down.  Many medical practices would operate with lower costs using this model.

6.  End the use of the emergency room for medical issues that are not a life and death emergency.  This would probably take a marketing/education plan much like the "this is your brain on drugs" campaign, but if effective, could send a strong message.

7.  Alternative payment methods.  No one should get it for free, but if you can not pay the bill, some community service agreement should be worked out.  The doctor/clinic/practice/hospital could write-off the expense.  The community would be served.  People will not be afraid to see the doctor out of the fear of being left with a big bill.

8.  Aggressively prosecute medical fraud.

9.  Require that all doctors have business classes as part of their medical training.  A medical practice is a business after all.

Thursday, June 28, 2012

The Supreme Court Did Obama No Favors.

The Supreme Court upheld the individual mandate in ObamaCare, meaning that the government can force you to purchase insurance.  But that does not mean that conservatives should hang their head in shame or that Nancy Pelosi should be spinning cartwheels.  In reality, the Supreme Court may have handed Mitt Romney a victory in November.

They ruled that the individual mandate in ObamaCare is constitutional because it is technically a tax increase. Which is, in a sense, true.  Anything that the government requires a person to pay is a tax...everything, even if it is not labeled a tax.  All tolls, fees, surcharges, duties, tariffs, levies, charges and evaluations are really taxes.  A tax by any other name is a tax.  Now my medical insurance premiums are a tax.

Conservatives attacked ObamaCare from the wrong angle to begin with.  If the words, "the largest tax increase in history" were used from the beginning, perhaps this bill would have become to unpopular for Congress to swallow, and it would not have become law.  But now, it is fuel for the fire for Mitt Romney and any person running against any one in Congress who voted for the bill.  If we call it what it is, perhaps Congress will be more willing to repeal it.

Every American should look at their latest paycheck and do as I am doing for you now....I do not mind sharing this with you know, because I am getting a raise in July, so I am not really revealing what I am now getting paid.  I am also not revealing whether I get paid weekly, monthly or bi-monthly.

My gross pay from my last check was 1632.64.  My medical insurance premium was 193.33.  According to the Supreme court, that is a tax because health insurance is mandatory and considered a tax.  Here is how the rest of it breaks down:  65.86 in Federal Income Taxes, 57.29 in Social Security taxes and 9.78 in Medicare taxes.  That means that I paid 336.26 in taxes on my last paycheck.  That is about 21% of my income directly out of my paycheck in taxes, where it used to only be 132.93 or about 8%.  Because the health care insurance premium is now a tax, my taxes just went up by 144%.  That's right...Barrack Obama, Harry Reid and Nancy Pelosi passed a 144% tax increase to me and the Supreme Court upheld it.

Also, remember that 193.33 is just my share.  I only pay about 40% of the total premium and my company pays the rest.  Do you think that my company, which already pays the highest business taxes in the world appreciates having another big tax increase levied on them?

Every American that pays health insurance premiums should look at their last paycheck and see the same thing.  What was once an employer/employee co-paid benefit is now a tax.

The only good news is that health care premiums can not be taxed because that would amount to double taxation....we tax what we have already taxed.

Do you think that Mitt Romney can get some traction out of those numbers?  If he doesn't, he's a fool.  Think that Obama can keep playing his...the "rich should pay their fare share" card any longer?  That probably wouldn't be a good idea, after the largest tax increase in history.  If the Supreme Court says this is a tax increase, Mitt Romney should run with that, trump it loud and clear and not let America forget it.  America should go to the polls in November with the words, "it was a tax increase" fully on their minds.  Am I happy about my 144% tax increase?  No, I am not.  Am I happy that my taxes will go up even higher in January?  No, I am not.  Do I want to see that change?  Yes, I do!

Obama promised us hope and change, what he meant was, "when I get through with your paycheck, all that you will have left is hope and change."  Let's hope for real change.

But then again, Mitt Romney did the same thing in Massachusetts, so he may not get the traction out of this that someone else would have.  But who else was there?

Sunday, June 10, 2012

Voting against a debt limit increase? Have a plan?

You're in Congress and you just voted down another debt limit increase because more borrowing is morally irresponsible.  Congratulations, you now immediately have to decide how to balance the Federal Budget, or the US goes into default on some of it's debt?  Welcome to Hell, and I hope that you are not planning on another term in office, even though you probably deserve credit if you can pull this off.  But most in Congress will vote down a debt limit increase to make a statement and have no plan to bring the books into balance.

It is irresponsible to vote down a debt limit increase without a plan to immediately balance the budget.  That is just like me, turning to my wife and saying, honey I'm putting the Visa in the Safe Deposit Box and burying the key in the back yard", but not have a family budget.  If I do this, we are bound to not have money for food or will miss some other payments or something like that.  It's a bad plan.  It's a recipe for chaos.

If all temporary tax cuts are allow to expire in FY 2013, you still have to find 910 billion dollars in cuts.  There will be pressure to completely cut some departments and to reform entitlements.  But there is no time for those kinds of debates.  You have to find 910 billion dollars in savings immediately or the government will default on it's debt.  Any ideas?  Here are some of my suggestions.

1.  Every civilian federal employee to take a week of furlough without pay.  There are about 4.5 million federal employees who make an average of 83,000 per year.  (More than what I make).  This will save the government 70 Billion over the year.  The employees effected...the President, every member of Congress, down to every GS-1 in the civil service.

2.  Every civilian employed by the US government gets 12 to 24 days of paid vacation per year depending on how many years that they have worked for the government.  Cut that down to what the average private sector employee has, which is 5 to 14 vacation days per year.  In doing so, you have just made 187,000 federal employees expendable...that is how many Full-Time Equivalents the government must hire in order to cover the extra vacation.  You can now lay them off.  You have just saved another 15 Billion.  You have now saved the government 95 billion and now have 815 Billion left to cut.

BTW, in my current job, which pays better than what the average American earns, I get 0 paid time off.  No vacation time and no holidays.  If I do not work, I do not get paid.  I have to pay for vacation out of my own pocket and I work a flexible schedule the rest of the week when there is a Holiday.  There are many in the new economy that have given up paid time off to maintain health care benefits.  For us, it was one or the other.

3.  Bring the troops home from Afghanistan immediately.  That is another 80.4 Billion.  175.4 Billion down.  734.6 Billion left.  Source

4.  Europe gets along rather nicely, now-a-days.  We aren't really needed there.  Let's bring the troops home from Europe.  That would save us about 287 million, according to Rep. Jared Polis of Colorado.  Let's round that up to 300 million.  Now we have saved 175.7 Billion and have 734.3 billion left.  Mmm...that's not the kind of savings that we need, but we will keep it in there.  It makes a statement that we are serious.

5.  Cut off long term welfare recipients.  Let's have churches and other private groups help them find work.  That could save us another 10 billion, according to the Cato institute.  We have now saved 185.7 Billion and have 724.3 billion left to go.  We have now trimmed 1/5 of the federal deficit.

6.  We have 142 million unemployed.  5.4 million of them have been unemployed for over 6 months.  It used to be that we cut off unemployment benefits after 6 months to get them back to work.  At 330 per week, we could save the government 92 billion.  Now we are at 277.7 billion cut from the budget with only 632 billion left to cut.

7.  ObamaCare is expensive.  Let's repeal it.  That will save the government 340 billion that would have been added to the deficit.  We are now at 617 billion saved.  We are now only 293 billion away from a balanced budget.

8.  One of the problems with the Federal Budget is the huge amount of money that is spent on interest.  Could we do something about that?  There are 268.6 million acres of land out west that is owned by the feds and not doing anything else.  What if we sold it all at the cost of 1000 dollars per acre (30% below the going value for an acre of Utah desert) and apply it toward the national debt.  We have reduced the national debt by 2.6 trillion dollars.  That is about 23% of the debt, reducing interest by 23%.  That saves another 58 billion.  Putting us to a total of  675.  That leaves us with 235 billion.

9.  The total federal expenditures for FY 2013 was expected to be at 3803 Billion.  We have just taken 675 billion off of that total.  We now are down to 3128 and have 235 billion left to cut.  We order every federal department at this juncture to cut their spending by an additional 10%.  They will need to do so without affecting benefits paid to citizens.  That means that an additional 313 billion will be saved.  That leaves us with 78 billion to spare, which should not be spent, but should be used to help us go through the same exercise in FY2014, which is needed because one can only lay off 187,000 Federal employees once.

BTW, remember this is after all temporary tax cuts have expired.  If you want to keeps those, you have to come up with another 300 billion.  It was a lot of work to come up with just this.

A plan will need to be made to keep the US Government in the black permanently and retire some of the national debt.  Of course, the consequences are laying off 187,000 federal government employees will be devastating.  Hopefully, it is done proportionally across all 50 states.  This means that 187,000 people have joined the 14 million people already out of work.  This is why I say to any congress bold enough to pass it, they probably deserve to keep their jobs, but will likely lose them.

A sensible congress, even a conservative one, will likely save a plan like this for better times when the displaced federal employees can easily find private-sector jobs, like in the 1990s.  That will soften the blow to the economy.  But I suspect that Tea Party Republicans will forget all about this when the economy improves and let the government grow even larger, just like the former presidential candidate named after a cookie did.

I put this list together with resorting to...this program is unconstitutional, therefore let's get rid of it.  I tried not to put an additional burden upon the already overburdened state governments.  In better economic times, states may be able to shoulder more responsibilities.  I was also able to leave Social Security Benefits, Medicare and Medicaid untouched.  It is a common belief that for a long-term solution to the Government's debt problems, that Social Security, Medicare and Medicaid will need to be examined.

My challenge is for anyone who is running for Congress and says that they will not vote for another debt limit increase is to come up with a better plan.  This plan stinks and will have serious consequences, but I am not running for Congress.  I asked Dan Liljenquist's team, for example, if they had one.  But they did not offer any specifics, just generalities.  Certainly anyone serious about no more debt limit increases in Congress has given this some serious thought.  If not, they do not deserve your vote.

Thursday, June 7, 2012

Dan Liljenquist...A Puppy in a Dog Fight

Some of you who read through this blog will notice that the original name was "Fire Orrin Hatch."  We would still like to see Hatch take the long ride into the sunset, but a quality candidate has not emerged as our hero, instead we have Dan Liljenquist.  Certainly a random drawing out of the entire delegate pool that emerged out of this spring's caucuses may have had a chance at producing a more qualified candidate.

Liljenquist, as a business leader, might on the outset appear more qualified that Orrin Hatch was when he unseated Frank Moss in 1976.  But the Liljenquist campaign has failed to trump this advantage.  Instead, it has been a constant barrage of anti-Hatch campaigning.  Is the "Elect Dan" campaign is trying to hide something.

You will not find a lot if you try to research Focus Teleservices publicly.  They are still a privately held corporation, and do not have to file records with the SEC.  Perhaps this is the main reason why the Lilgenquist campaign is not talking a lot about their candidate's business record.  It is either this, or it is not all that impressive.  If Dan accomplished something at Focus, we all deserve to hear about it over and over again.

I have personally known Focus employees and can only provide circumstantial anecdotal evidence of what that company is like, and what I can provide is probably not indicative of what Dan Liljenquist did for Focus.  I can provide no evidence that Liljenquist made a difference, good or bad, with that company.  That is a shame.  But that is not my job, that is Dan's job.  This is what disturbs me the most about the Elect Dan movement.  How can you convince me that he can make a difference in Washington if you can not or will not provide evidence that he has made a difference at Focus?  Soundbites like, "Dan is a proven business leader" mean nothing without the evidence to prove it.

Dan's record in the legislature is not all that impressive.  He sponsored some impressive legislation, particularly with pension reform.  But, he did not serve a full term and during his time in the state senate, and he missed a large number of votes.  Perhaps if he was present during those votes, he would have a more conservative rating.

It has always been my fear that Orrin Hatch is so powerful in the Utah Republican Party that no one who believes that he or she has a future in the party would dare to take him on.  This is probably the case.  Tim Bridgewater, who lost in the primary 2 years ago to Mike Lee decided to sit this campaign out.  Cherilyn Eagar, who also ran against Bennett in 2010 decided to run in the 2nd Congressional District, and failed to make the primary ballot in that race.  Some of the other suspects, like Fred Lampropolis and Lane Beattie stayed away from this race as well.  This is my evidence that Hatch is too powerful in this state and probably no longer the best representative of Utah's needs, the people with a real shot a beating him stayed home.  It's would be like the Miami Heat making this year's NBA finals because the Celtics, Hawks, Pacers and Bulls decided to stay home.

I would be happier if Orrin Hatch had decided to hang up his sneakers and believe that a pool of more qualified and better organized candidates would have emerged for us to choose from if Hatch decided to retire.  Instead, we have puppy in a dog fight.  Of course the Democrats could have brought Peter Caroon or Jim Matheson to the fight, but their candidate will probably be just a weak as Liljenquist.  If Dan pulls off a miracle, the General Election in November might be interesting.

Yet, Hatch has accomplished so little during his time in Washington and has offered Utahans nothing but excuses.  When someone runs for office and admits he has accomplished little in 36 years, he probably does not deserve another term, even if he is running against Pee Wee Herman.  If I was in the senate for 36 years and wanted another term, I would provide a long list of accomplishments.  Therefore, I will probably be voting for Liljenquist, anyway.  But I was hoping for someone better.  Dan Liljenquist has yet to prove he is better, but Hatch has not proven he deserves another term in Washington.  I have a hunch that most republicans in Utah do not agree with me.

If you were interviewing for a job, and someone ask the question, "why should I hire you?"  Would you hire the one who only says, "I'm better than the guy I want you to fire?"  Would you renew to the contract of the man who says, "I've been here for 36 years and have yet to accomplish all that I set out to do back then?"  That is exactly the kind of campaign that Dan Liljenquist is running.  This is the kind of campaign that Orrin Hatch is running.  Utah deserves better, but if this is all we can provide, we deserve another six years of Hatch.

Sunday, June 3, 2012

A Plan to Spur the Economy and Help Balance the Budget

It is not easy to both balance the federal budget and spur the economy.  The Keynesian theory suggest that borrow money is the best way to spur the economy.  But there appears to be a limit to what borrowed money can do, and it appears that all of the money borrowed by Congress since 2008 has done very little to spur the US economy.  The jury is still out on whether or not it even prevented a worse problem.

The US economy does not need more federal spending right now.  One of the problems is that the bold spirit of entrepreneurism that was once a staple of the economy has disappeared.  Do you remember when the American Dream was to be your own boss?  What happened to that spirit?  One of the reasons it has gone it has gone is that Americans have become more risk adverse than they were in the past.

Entreprenuerism should not be looked as as a bad thing.  Almost every big business was once a "ma and pa" shop.  Wal-Mart was once a single store in Feyetteville.  General Motors was once a horse and buggy repair shop.  IBM was once just an innocent idea of statistician Herman Hollerith.  Almost every company on the Fortune 500 list had humble beginnings.  Every forest in the world was once a single tree, and the Government needs to find a way to encourage small companies to start up again to repopulate the depleted forest.  At the same time, the Government needs to find a way to tighten their belt.

One of the ways that Federal Government can do both is to encourage government employees to retire early and to back the risk that they will take to begin their own business.  There will be opposition to this plan because it is risky and it does require spending money to begin with.  But in the long run, the government will gain back more money than is spent and a long-term debt will be reduced.

1.  Step one is to offer a buyout to government employees and military members who are close to retirement.  But it can not be just anyone who is ready to retire, it has to be proven leaders who would be more likely to succeed in business if they strike out on their own.  This will take an honest assessment.  They will have to have enough funds set aside, or in their retirement plans to survive without an income for a couple of years.  But there should be, out of the millions of Federal Employees, a few thousand that can take the risk.

2.  The eligible government employees who chose to retire early will be able to use a percentage of their saved retirement money as seed money for their business and the Government will agree to match they money that they invest in an interest-free or low-interest SBA loan.  Part of this loan will be forgiven for every employee that the new business hires that remains employed with them for 5 years, depending on how much that person is paid. 

It sounds like the government is spending a lot of money that they will never see again.  The fact is that when any business hires a person the government comes out ahead in three ways.  First, that person is no longer eligible for federal programs like unemployment benefits, food stamps and medicaid.  Second, that person is paying taxes on his income.  Third, the employed person is injecting money into the economy because he has to spend money he has earned to live and much of that money is spent on recreation and some of that money is saved and invested.

In this plan, the government will benefit because they no longer have a higher paid employee on their payroll.  The pension amount that this person would have received will be reduced because they retire early.  The employee choosing this option will need understand what they are sacrificing to become their own boss.

In this plan, a new small business will get started.  This can be any type of business.  For example, it could be a military doctor retiring after 15 years in the service to begin his own practice.  That doctor is going to probably hire a PA or a NP to help see patients.  A nurse or two to assist him.  Someone to process the medical records and bill the insurance companies of his patients.  A business manager and a receptionist.  Those people may be young people, but they may not be.

Other types of businesses, for example, a consulting firm, would require more experienced employees.  The older types of employees who simply do not get hired by companies right now.  These people may accept lower pay just to work again.  Of course, I am referring to those over 50.  Many in this age group do not have children at home may not require a higher salary.  They are more likely to remain on board with a small business for the required 5 years.  This could stave off some of the early retirements that are currently draining the Social Security System faster than expected.

Many of the other plans that government has tried during the current recession, such as the Cash for Clunkers program were one and done deals.  They were programs where there was one shot to spur the economy and that was it.  That one shot has been spent, and the money is gone with little economic benefit.  When the government helps a small business to start up and remain viable, there is a lasting effect on the economy.  It is money well spent, and the government will make back more in taxes than they will spend.

The final benefit is that the government is not just letting people go and hoping that they can find work in the private sector.  They government would be giving people an incentive to continue to work and add to the economy.  That is a long-term investment.