A ‘Civil’ War

My fellow Americans, we are at war.

No, I’m not talking about the ‘War on Drugs’ or the ‘War on Terrorism.’ I’m not talking about another ‘Cold War’ or a war using all the latest technological horrors our ingenuity can devise. What I’m talking about is something far more insidious that is potentially more destructive to our society than all the car bombs in the Middle East. I’m talking about a war on Civility.

As the Baby Boom Generation's Beat Culture slid into the Hippie Culture and the Age of Aquarius, America’s youth began to openly shrug off the cultural trappings of their parents and grandparents. They dismissed the formalities of interaction used by the previous generations as “hollow”, “meaningless”, and even “dishonest”. They believed that ‘finishing school’ etiquette helped prop up a class system that was designed to make the rich richer and keep the poor under heel. Therefore, they embraced a rebellious culture of brutally frank honesty with no regard for the effects of their words.

To this day, many of the self-proclaimed ‘intelligentsia’ wrap themselves in a cloak made from the words of the First Amendment and practice this crassly insensitive form of communication. In daily conversation, they use language so scurrilous it would blister the ears of a merchant marine, no matter the setting or the age of casual bystanders. In many businesses, not only is it acceptable to use language that would have gotten you fired as recently as the 1980s, but often individuals who try to maintain a polite and respectful vocabulary are either viewed as ‘soft’, or are assumed to be mocking the listener. Often, if someone tries to express discomfort with the abusive language used by someone around them, the person using the vulgarities starts screaming “censorship” and that the person complaining is trying to deprive them of their Right to Free Speech.

It gets even worse if a discussion or debate is underway. When the members of this literati caste find themselves hearing views opposing their own, they often launch immediately into a verbal personal attack on that speaker, especially when said speaker has disproved the literati's position. In most cases, they will either attack with outrageous accusations and offensive name-calling, or they simply spew forth a stream of invectives as loud as they can in an attempt to ‘shout down’ the opposition. Often, they use both tactics together. In any case, at no time do these ‘enlightened’ members of the ‘tolerant’ ranks afford the speaker with the courtesy of allowing her or him to present their case, then rebutting it logically with facts and observations.

When their beliefs are questioned, the intelligentsia usually follows up by 'gaslighting' the speaker, loudly and publicly accusing them of doing what they themselves were doing all along. They play an intellectually dishonest game of political brinkmanship in an attempt to gain as much sympathy from the general public as they can, while demonizing the person who had the audacity to disagree with them.

When these bastions of the social conscience try to hide behind their Unalienable Right to Free Speech, they fail to acknowledge the flip side of that coin. For every Right granted by the Creator and enumerated in the Constitution and its Amendments, there are implied Responsibilities and Consequences. The most commonly used example of a limitation to the Free Speech clause in the First Amendment is that one can’t stand up in a crowded theater and shout, “Fire!” if there is no fire. That isn’t exactly true. We actually do have the Right to do so, but we also have the Responsibility to consider the Consequences of our actions and not casually do something that may cause injury to others. If we choose to ignore that responsibility, then we must accept the consequences of our actions, which in this case could mean a fine, jail time, or even civil penalties sought by those injured by the irresponsible act. Basically, it comes down to an old adage I like to use: “Just because you can do something doesn’t mean you should do it.”

When the late George Carlin came out with his routine, “Seven Words You Can Never Say on Television,” he created an iconic comedy performance…as well as the basis for the Supreme Court ruling that established that the FCC did have the authority to prohibit the broadcast of ‘indecent’ material over the public airwaves during the hours when children were likely to be in the audience. However, his views of profanity totally dismissed the value of what I like to call, “Civilization Lubrication.” As Robert Heinlein once wrote,

“Moving parts in rubbing contact require lubrication to avoid excessive wear. Honorifics and formal politeness provide lubrication where people rub together. Often the very young, the untraveled, the naïve, the unsophisticated deplore these formalities as ‘empty,’ ‘meaningless,’ or ‘dishonest,’ and scorn the use of them. No matter how ‘pure’ their motives, they thereby throw sand into machinery that does not work too well at best.” (1)

Of course, considering that Carlin also once stated in one of his routines,

“I have absolutely no sympathy for human beings whatsoever. None. And no matter what kind of problem humans are facing, whether it’s natural or man-made, I always hope it gets worse.” (2)

it’s very possible he was intentionally ‘throwing sand into the machinery.’ This has been going on for several decades, but there are two very good examples of this rampant incivility that occurred in 2009.

The first example happened on Wednesday, 20 May 2009. Political pundit and commentator Glenn Beck was invited to appear on a segment of the daytime television chat show, The View. On his radio program on Tuesday, Mr. Beck related a personal anecdote of a chance encounter with two of The View’s stars that happened on an Amtrak train about two weeks earlier under unusual circumstances. When Mr. Beck appeared on the show, he was suffering from a stomach flu and was trying to remain polite and respectful since he was in, as he put it, ‘their house.’ As soon as the segment began, the two individuals he encountered on the train attacked him…obsessing for over seven minutes about who addressed who first on the train. They demanded explanations and apologies for some imagined sleight, then refused to let him reply. They both called him a ‘liar’ multiple times with one of them going so far as to refer to him as, “…a lying sack of dog mess.” The other went so far as to upbraid him for failing to check his facts before reporting a story, even though he had simply been relating a personal anecdote as he remembered it and not reporting a news story, and he has stated numerous times over the years that he is a commentator, not a reporter. All through this baseless attack, Mr. Beck reacted with civility and dignity, refusing to lower himself to the level of his attackers.

The second example happened on Thursday, 21 May 2009. President Barack Obama delivered an address at the National Archives defending his recent decisions on national security. The speaker who immediately followed The President was former Vice-President Dick Cheney who delivered an address that supported the national security policies implemented by the Bush Administration, and criticizing the Obama Administration's reduction of the security measures implemented by his predecessor. Unfortunately, instead of using this as a wonderful opportunity to open up a discussion on the merits of both speeches, a user of the online social network, Facebook, decided to create a page in support of, “Telling Dick Cheney to shut the hell up.” In other words, those Oh So Tolerant individuals who scream ‘censorship’ every time someone asks them to stop using profanity around children have decided that the former Vice-President of the United States no longer has a Right to Free Speech just because he disagrees with the current President.

In fact, my previous post in this blog contains another perfect example of this behavior. In it, I shared an article by respected historian, Victor Davis Hanson, that illustrates just how the the Progressive apologists for the terrorist organization, Hamas, are using these tactics to blame Israel for the atrocities Hamas perpetrated upon them and to convince the public that Israel is the villain, not Hamas. They are going out of their way to project Hamas' inhuman behavior onto Israel and accuse them of doing to Arabs and Muslims what Hamas has in fact been doing to Jews since their inception. Simply stated, the truth doesn't support their political narrative so they have to destroy it.

So, what makes this incivility “potentially more destructive to our society than all the car bombs in the Middle East” you ask? It’s this: the incivility into which American culture has been plunged is a wedge that has divided the country into ‘Us’ and ‘Them,’ ‘Left’ and ‘Right,’ ‘Red States’ and ‘Blue States,’ ‘Originalists’ and ‘Progressives.’ As long as feelings and opinions are regarded as legitimate rebuttle to hard facts and figures; as long as any voices are silenced and prevented from presenting their arguments reasonably, logically, and courteously; we will never be able to span the chasm between us and reunite as One Nation. If we do not heal this divide, the United States will be finished. As the old adage says, "United we stand, Divided we fall."

It is time to heal this country, not separate it further. Put down the donkey and elephant banners; put away your copy of, “Snappy Comebacks to Stupid Questions”; take a deep breath and let the person across from you finish his or her thought before you reply…and occasionally pause to let that other person either ask questions or rebut your points. The important thing is to stop the shouting and name-calling and begin to dialogue with one another. There is nothing wrong with being passionate about your beliefs, just keep in mind that the person on the other side of the argument also has the right to be passionate about their beliefs. Remember that there is a difference between being passionate and being emotional, so leave emotions out of the discussion. Also remember that one can be passionate and still present a logical argument supported by facts. And finally, before you come to the table, triple check your facts to make certain you are not basing your arguments on hearsay, innuendo, opinion, or urban myth. I’m always open to other points of view, but you’d better be able to support your position with cold, hard facts or I reserve the right to point out your errors!

Now, go out there and discuss, debate, and decide. Keep an open mind and end the War on Civility. Just stop all the bickering, gaslighting, name-calling, and shouting!

Until next time, be well, Dear Ones!

(1) Time Enough for Love by Robert A. Heinlein © 1973 Robert A. Heinlein

(2) Life Is Worth Losing by George Carlin © 2005 George Carlin

© 2009, 2023 James P. Rice

Healthcare in America: The Fix, pt. 6

Good day, family and friends!

Today, we're going to look at that evil competition thing.  I use the word "evil" because that's how the progressive socialists view competition, and that is how competition is being taught to our children in many public schools these days.  Okay, maybe they don't call it "evil," but they do constantly disparage competition through both word and example.  But I will go into that in more detail in a future post.  Right now, I want to focus on how competition can make our current healthcare system better.

The first way would be to restore what our Founders believed to be one of the most fundamental aspects of the USA: that our Republic is a union of (currently 50) individual states, not a nation-state divided into administrative regions.  The Xth Amendment to the Constitution states, "The powers not delegated to the United States by the Constitution, nor prohibited to it by the States, are reserved to the States respectively, or to the people."  In simple terms, it says that, if the Constitution doesn't specifically say the Federal Government has jurisdiction over something, then the citizens of each State can make their own decisions about how to handle a particular subject.  In other words, the States were to be allowed to have their own community standards, their own 'flavor,' as long as what they did did not violate the Constitution.  The Liberty of American citizens allowed them to 'vote with their feet' on the environments of the individual States; i.e. they were free to up and move themselves and their businesses out of States with oppressive or untenable environments and go to States that have a more favorable environment without having to apply for permission or visas.  The only requirement was that they were expected to follow the local laws of their new home.

Over the last 40 years, however, there have been incremental steps toward marginalizing the Xth Amendment and homogenizing the States until they are indistinguishable, one from the other.  As our country has been slowly marched toward an all-powerful central national government, the States have been forced into a 'one size fits all' mentality in many issues.  Every time one of our 'political heroes' calls for us to 'level the playing field' or 'lower the bar' to correct some perceived inequity, it ends up as a lowering of standards and an attempt to bring everyone down to the lowest common denominator.

You are probably asking, "What does this Civics lesson have to do with Healthcare?"  Well, over the last 75 - 80 years, the professional political class that has arisen in our Republic has stifled competition in both healthcare coverage and delivery in pretty much every State.  Lobbyists have managed to get laws passed in each State that favors only a handful of the hundreds of insurance companies. (Look back at my analysis of the Affordability of Healthcare.)  And remember what the State of New York did to Dr. Muney when he tried to offer his patients a low-cost subscription service?  What We the People need to do is make it clear to our representatives in government that we are tired of them pandering to special interest groups and that they need to start representing the People and upholding the Constitution.  What this means to Healthcare is an end to special-interest set-asides and corporate welfare that stifles competition.  The extent of government interference in any commerce venture should be limited to these questions:

1. "Do any of the tenets of the contract or business agreement put public safety or health in jeopardy?"
2. "Do the contractual obligations defined in the contract or business agreement violate the Constitution or any Laws?"
3. "Have any of the parties in this contract violated the terms of the contract?"

Beyond that, the various levels of government have no business interfering in what is essentially a matter of Commerce; i.e. the relationship between a citizen, their insurance company, and the healthcare providers.  If this were the environment in which the healthcare industry were allowed to reside, it would thrive and we would probably see healthcare costs drop by at least 17%, possibly as much as 27%.  Getting rid of special-interest set-asides would permit competition amongst all of the medical insurance providers in every State.

When this sort of open competition is in place, the Citizens would once again be able to "vote with their feet" and the State with the best, most cost-effective offerings would be the winner.

Next time, more on Competition.

Until then, best regards...



© James P. Rice 2011, 2014

Healthcare in America: The Fix, pt. 5

Good day, family and friends!

Let's plow right ahead...

Once again, depending on whose data you choose to use, Insurance Fraud perpetrated by both patients and physicians account for between 3% and 10% of the cost of healthcare every year. This has resulted in insurance companies creating "Benefits Coverage Panels" made up of non-medical personnel making medical decisions which, in turn, often result in patients being denied treatment based solely on cost and "likelihood of fraud" statistical models and not on the medical data.

I propose two different options for putting medical decisions back into the hands of those most concerned with the results of the decision...the patient and the patient's physician:

1) While I do believe that private insurance companies do have the right and the fiduciary duty to take every legal, ethical, and moral action they can to minimize costs and protect their bottom line, I do not believe that accountants and lawyers are qualified to make decisions as to whether or not a medical procedure is necessary. Therefore, I suggest that medical professionals from all specialties, as part of their professional licensing, be required to serve a minimal amount of time every year on a regional independent board that reviews case histories for the insurance companies and determine whether or not a procedure is medically necessary and should be covered. This would allow medical decisions to be made by qualified medical professionals. It would also allow for insurance companies to reduce their costs by not maintaining the permanent staffing necessary for the "Benefits Coverage Panels", even allowing for the contribution to a central funding pool that would be used to compensate the medical professionals for their time.

2) Periodic review of cases denied by the insurance companies to make certain there is a legitimate medical reason for denying the coverage, as long as the patient met all the other requirements for coverage in their policy. These reviews could be handled by the same regional boards proposed in Option 1.

These independent regional review boards would serve to reduce fraud on both sides of the fence. By not having a vested interest in the case, they can objectively look at each case and determine: whether or not it is a legitimate medical procedure, based on the patient's medical history and current medical status; whether or not the physician prescribing the procedure is merely feeding a hypochondriac's condition to fatten their bank account; whether or not the doctor and patient are working together to out and out defraud the insurance company; or even whether or not the insurance company is attempting to defraud the patient by selling them a policy, then issuing 'rubber stamp' denials in order to avoid paying out on claims. The boards will also reduce the operational costs of the insurance companies...part of which the companies would most likely pass on to their consumers in a competitive market, reducing the cost of healthcare coverage for consumers.

Next time: Competition...it does a body good!

Until then, best regards...



© James P. Rice 2011

Healthcare in America: The Fix, pt. 4

Good day, family and friends!

As I mentioned last May, "identifying a problem without offering solutions is just bellyaching." So, with that in mind, let me begin to lay out my suggestions for addressing the issues facing the best healthcare system in the history of mankind...

The first place we have to start is with Tort Reform. As previously noted, out of control litigation in this country accounts for between 19% and 27% (depending on which study you choose to believe) of healthcare costs every year. Getting the ambulance-chasing shyster weasels and the morally-deficit shiftless scammers under control will knock off a fifth of the cost of providing healthcare and healthcare coverage to physicians, clinics, hospitals, and insurance companies.

The first step to this end is to restore Personal Responsibility to the basic tenets of our legal system:

Allow judges and juries to consider "reasonable expectations" when deliberating on the merits and evidence of a case. (id est: if one orders hot coffee and it arrives steaming, there is a reasonable expectation that spilling it on one's self may result in one's flesh being scalded);

If an attorney or law firm accepts a case that is tenuous at best, and brings it before the courts, and that case is deemed by the presiding judge to be without merit and is dismissed, and that there was no intent to defraud on the part of the plaintiff, then the attorney or law firm (and not the plaintiff) will be required to reimburse the defendants all legal expenses, including lost wages and travel expenses, that they incurred;

If an attorney or law firm knowingly accepts a case that is bogus or outright fraudulent and brings it before the courts, then the attorney or law firm will be subject to the same criminal penalties as the plaitiffs, and, along with the plaintiff, will be required to reimburse the defendants all legal expenses, including lost wages and travel expenses, that they incurred;

I believe that human life is sacred and priceless and that a dollar amount cannot be attached to it. I also believe that the tragic loss of a family member should never be viewed as a bonanza by their survivors. Having stated this, however, I do believe that families should be reimbursed for the loss of a loved one due to negligence or criminal activity. To this end I believe that an equitable way to determine this reimbursement should be as follows:

If the victim is under 68 years of age (10 years shy of the average life span of a citizen of the United States): The age of the victim subtracted from 68 times the average annual total compensation (including value of benefits) someone of the same age/career/educational level in the same federal congressional district can expect to make before retirement times 133% plus any rescue/medical expenses incurred by the family as a result of the event that led to their loved one's death plus legal costs.

Or, as a formula: [(68-A)x1.33W]+MEDX+LEGX = Compensation

(for example: A 42 year old man with a Bachelor's degree who has been working as a Customer Service manager in the computer industry in federal Congressional District Texas-31 dies through the negligence or outright incompetence of a surgeon. To determine the compensation his family should receive, the formula would be: [(68-42)x($46,280x1.33)]+MEDX+LEGX or $1,600,362.40 plus any medical/rescue and legal expenses the family incurred from this tragedy.)

If the victim is 68 years of age or older (10 years shy of the average life span of a citizen of the United States): The average annual total compensation/retirement income for someone of the same age/career/educational level in the same federal congressional district times 3 plus any rescue/medical expenses incurred by the family as a result of the event that led to their loved one's death plus legal costs.

Or, as a formula: 3W+MEDX+LEGX = Compensation

(for example: A 72 year old retired Mechanical Engineer who, thanks to diligently saving money and contributing to a retirement fund, has an annual retirement income of $75,000, dies through the negligence or outright incompetence of a surgeon. To determine the compensation his family should receive, the formula would be: 3x$75,000+MEDX+LEGX or $225,000 plus any medical/rescue and legal expenses the family incurred from this tragedy.)

It may seem as if these formulas place a greater value on the younger person than on the older. Quite the contrary; these formulas are designed to be completely neutral and not attempt to establish any sort of relative value on the lives of these two individuals. Instead, the formulas are merely designed to compensate the survivors for potential loss of family income due to the negligence or incompetence of the surgeons in question. The survivors of the younger victim would have lost 20 - 25 years of his contributions to the family income while the survivors of the older victim would still have the retirement savings he (or she) had established and worked to create, so they would not be facing a financial crisis as a result of the tragedy.

Next time, keeping bureaucrats out of medical decisions.

Until then, best regards...



© James P. Rice 2011

Healthcare in America: The Fix, pt. 3

Good day, family and friends!

Let's get right to it...

Amendment XIV, Section 1 of the Constitution states, "All persons born or naturalized in the United States and subject to the jurisdiction thereof, are citizens of the United States and of the State in which they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws."

In the simplest terms, this means that, if you are born in the US, or have gone through the naturalization process and are no longer subject to a foreign government, then no one can make any sort of law or regulation requiring you to pay a fee, purchase a commodity, or take any sort of test to maintain your citizenship status or to exercise your rights as a citizen. The only exception to this is in cases where a person has been convicted of a crime and either fine or imprisonment has been imposed as their punishment, or if they have had a civil penalty rendered against them.

Basically, this clause states that it is unconstitutional to require law-abiding citizens who have neither been accused of a crime, nor received a judgment against them in a civil proceeding, to purchase health insurance in order to maintain their status as a law-abiding citizen.

I know, I know. I can hear some of you out there decrying, "but what about auto insurance?!? The government dictates that we must have auto insurance in order to legally drive a car. Isn't this the same thing??"

No, it isn't. This argument is nothing but a spurious attempt to compare apples to eggplant. Here is the difference: the Right to Life is one of the unalienable Rights bestowed upon humanity by The Creator (also known as one of Nature's Laws); while driving an automobile is a privilege granted by society. The Constitution was created and designed to protect those unalienable Rights that are an inherent part of our humanity by limiting the ability of government to encroach upon and violate them. Forcing citizens to pay in any form in order to exercise one of our unalienable Rights is in direct conflict with this protection.

On the other hand, automobile insurance was created in order to help citizens more readily comply with the regulation that, before they operate any motorized vehicle on a public thoroughfare, they prove that they can and will be financially able to pay for any damage to another person, vehicle, or other property if they are found to be the cause of an accident. But it is also a misunderstanding that the government forces drivers to purchase auto insurance. Citizens actually have the options of either establishing an escrow account with the minimum balance dictated by law (I believe that, at this time in Texas, it is $100,000), or they can simply not operate a motorized vehicle.

See? Not the same thing.

Okay, I went a bit long this time. Next time, I really will start laying out my suggestions for repairing and improving the best healthcare system in the world.

Until then, best regards...



© James P. Rice 2011

Healthcare in America: The Fix, pt. 2

Good day, family and friends!

Well, now! It seems Real Life reared its ugly head. This is my first post since 30 July 2010. For those of you new to my blog, I started this series of articles in August 2009. If you want to bring yourselves up to speed, I suggest you start with my first post on Healthcare in America located at http://smellthetruth.blogspot.com/2009/08/healthcare-in-america-just-how-sick-is.html.

Now, let's continue the discussion...

Amendment X of the Constitution states, "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." In other words, if the Constitution does not specifically say the Federal Government can do something, then it is automatically prohibited from doing it. Not only that, but anything the Constitution does not specifically permit the Federal Government to do is the jurisdiction of the individual States, or the individual citizens themselves and can't even be touched by the Federal Government. Once again, the Founders were brilliant when they created the Constitution. They knew that it was inevitable that like-minded individuals would try to band together, gain control of the nation, and impose their personal opinions and philosophies on this country. To prevent this from happening, they created a series of checks and balances in an attempt to make certain the United States was under the Rule of Law and not the Rule of Man.

"What does this have with Public Law No. 111-148," you ask? A better question to ask is this: Where in the Constitution does it grant the Federal Government the power to...

1) ...take over (not just impose and enforce safety regulations that span all the States) an entire industry and its corollary industries?

2) ...dictate that private, law-abiding citizens must purchase a commodity in order to remain a citizen in good standing?

3) ...confiscate legally-gained income from one group of citizens and redistribute it to and supplement the lifestyles of a different group of citizens who have chosen to be less productive and focus more on personal gratification?

4) ...establish that the worth of one citizen is greater than another based on the citizen's age and ability to contribute to society?

The answer to those questions is, "No where." The Constitution does not grant any of those powers or abilities to the federal government. There are some who have tried to stretch and twist the sentence in Article I, Section 8 that grants Congress the power "to regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes"...what is commonly referred to as the "Interstate Commerce Clause"...to apply to these four areas. Only the most twisted, creative mis-interpretation of a clause written to be straight forward and self-explanatory can be used to justify such unconstitutional actions.

Next time, I finish up with the violation of Amendment XIV and start laying out my own suggestions to fix Healthcare in America.

Until then, best regards...



© James P. Rice 2011

Healthcare in America: The Fix, pt. 1

Good day, family and friends!

This time, I am going to begin looking at the cure for the issues facing healthcare in our nation. As I have stipulated all along, while we may have the best healthcare system in the world, it does have some serious problems that need to be addressed. Because of this assertion of mine, I've been asked by numerous people (including one of my daughters), "if you acknowledge that the current system is broken, why do you oppose the Healthcare Reform Act that Congress passed this spring to fix it?" The short answer is this; because it's unconstitutional.

Public Law No. 111-148, formerly known as H.R.3590 - The Patient Protection and Affordable Care Act, signed into Law by President Barack Obama on 23 March 2010, violates the Article I, Section 8; Amendment IX; Amendment X; and Amendment XIV. Further, this Law dictates that, for the first time in the history of our great Republic, ordinary law-abiding citizens automatically become criminals unless they purchase a government-sanctioned commodity.

In Article I, Section 8 of the Constitution of the United States of America, it is clearly stated that, "...all Duties, Imposts, and Excises shall be uniform throughout the United States." In Part I: Subpart I: Section 2701, entitled "Fair health insurance premiums", the Law establishes variable premiums based on age and annual income. This is in addition to Subtitle E: Subpart B: Sections 1411 - 1415, which provides special tax credits and 'cost-sharing' for citizens below the government-defined 'wealth' threshold. In other words, if you choose to work hard to earn a good education, apply yourself to your career and become successful, this Law forces you to not only pay more for your healthcare coverage, but you will be subsidizing the lifestyle choices of pot-smoking, minimum-wage slackers (like the characters of Dante and Randall from the "Clerks" movies) who have chosen to never apply themselves and perpetually exist on the fringe of society.

Amendment IX of the Constitution states, "The enumeration in the Constitution of certain Rights shall not be construed to deny or disparage others retained by the people." In other words, the Constitution and the Bill of Rights highlight select Natural Rights, but by no means lists them all. One of the Natural Rights the authors of the Constitution believed we posses by virtue of our very Humanity is the Right of Property. In other words, I, and only I, am entitled to the fruits of my labors and I am the final authority on how best to enjoy those fruits, as long as it does not infringe on the Rights of another. The Founders believed that only a despot would attempt to confiscate the property of one law-abiding citizen and deliver it to another all in the name of some nebulous 'greater good.' They intentionally crafted the Constitution as they did in an attempt to prevent the sort of draconian actions by the Federal government we've seen for nearly two decades. Whether you call it "Leveling the Playing Field" or "Social Justice", the redistribution of wealth prevalent throughout Public Law No. 111-148 is a clear violation of the Right of each and every American citizen to legally strive, legally succeed, and enjoy the legal results of that legal success.

Next time, we look at where this new Healthcare Reform Act runs afoul of Amendments X and XIV



Until next time, best regards...



© James P. Rice 2010

Healthcare in America: Affordability, the Summary

Good day, family and friends!

In my past six Healthcare posts, I have been looking at the costs associated with the best healthcare system in the world. Here's what I've discovered:

> It is very expensive to get the best medical training in the world and to develop, learn, acquire, and maintain modern state-of-the-art medical technologies. Doctors start their careers as much as $800K in debt before they ever see a patient;

> While there are clear-cut cases of greed in the insurance industry and instances where profit is placed ahead of the needs of the customers (patients), these cases are in the minority and most insurance providers are struggling to stay afloat. The average profit of the 1300+ insurance providers in 2008 was only 2.2%;

> The abrogation of the Principle of Personal Responsibility from our legal system and the accompanying environment of rampant litigation account for between 19% and 27% of the cost of healthcare every year through increased malpractice insurance premiums;

> The cost of the bureaucracy created to monitor the rules and manage the paperwork of the various healthcare insurance offerings account for between 14% and 32% of the cost of healthcare every year;

> Insurance Fraud perpetrated by both patients and physicians account for between 3% and 10% of the cost of healthcare every year. This has resulted in insurance companies creating "Benefits Coverage Panels" made up of non-medical personnel making medical decisions;

> And the betrayal of trust perpetrated by our elected officials who bow to special interest pressure to create laws and regulations designed to block the normal competition of the free market economy.

These six bullet points pretty much summarize the economic challenges to making healthcare in America more affordable. Just addressing real tort reform, policy and document simplification, and seriously hammering those who intentionally commit insurance fraud could reduce healthcare costs by close to half.

Next time, I'll start in on why the Obama/Pelosi/Reid Healthcare Reform Act is most definitely NOT the answer, then I will propose my own solutions. After all, identifying a problem without offering solutions is just bellyaching.


Until then, best regards...



© James P. Rice 2010

Healthcare in America: Affordability, pt 6

Good day, family and friends!

Today, we look at the ugliest of the three Cost Sisters...special interest legislation.

I call special interest legislation the ugliest of the three sisters because it is rooted in one of the most morally repugnant actions known to man...betrayal of trust. We the People elect individuals to represent us at all levels of government with the hope that they will do the right thing, protect our God-given Rights, and uphold the law of the land. Yet, time and time again, once they are in office they bend (if not break) the truth, sacrifice their principles, and sell out to the various lobbyists and special interest groups; all the while justifying their actions by declaring, "that's just the way the business of government works. You have to compromise in order to get things done down the road." I believe this to be a contemptible lie.

What does this have to do with the affordability of healthcare? Ask yourself these questions: if there are over 1300 insurance companies and underwriters in the United States offering healthcare coverage, then why in some states are the citizens' choices limited to as few as 4 of those companies? Why are corporations forced to offer different insurance options to their employees, based on the state in which they work? Why is it that a self-employed individual in Texas can get medical insurance for a family of 4 for less than $400 per month, while the same coverage in South Carolina costs over $1400? The answer...special interest groups and lobbyists.

Unfortunately, many of the states' legislatures have given in to the seduction of easy campaign donations and feel-good photo ops. They create laws and regulations that severely limit competition and provide a protected market to a handful of insurance companies. Because of this, the insurance companies in those states have no incentive to streamline their operations and improve their efficiency in order to reduce prices. Not only that, but in many of those cases, requests for rate hikes by the protected companies are given 'rubber stamp approval' by the very officials tasked with protecting the public from inequitable business practices.

One of the most egregious examples of this problem is the state of California. The citizens of California have been saddled with the highest medical insurance premiums in the United States, yet they are only allowed to choose from 4 carriers. At every opportunity, California's state legislature has overwhelmingly blocked attempts to introduce competition into the medical insurance industry.

Another blatant example of special interest protectionism and governmental control happened in New York. In 2008, Dr. John Muney started offering a new program to his patients: $79 per month for unlimited doctor's appointments. He believed that if he could reduce the mounds of paperwork created by health insurance, he could cut his costs and ensure that healthcare was within reach for everyone. It wasn't long before the New York State Insurance Department swooped down and told Dr. Muney that he had to stop offering his low-cost flat-fee program because it was a form of insurance and he was not licensed to sell insurance in the state of New York. It seems that, at least in the state of New York, the only way for a doctor to avoid the hassles of insurance is for that doctor to start his or her own insurance company.

Basically, while your political heroes line their pockets and solidify their power base, you end up paying more every year for medical insurance. They have betrayed the trust their constituents placed in them in favor of catering to special interest for their own personal benefit.

Next time, I summarize the problems I've identified in this series and start looking at the solution.

Until then, best regards...



© James P. Rice 2010

Healthcare in America: Affordability, pt 5

Good day, family and friends!

Sorry about the delay in posting this installment. Real Life can be a real grizzly bear.

Now, let's continue our look at the costs associated with litigation, insurance fraud, and special interest legislation....

Ambulance-chasing weasels aren't the only thing negatively impacting healthcare costs. Insurance fraud being perpetrated by both, larcenous patients and unscrupulous doctors, is a major problem in the 21st Century. The FBI estimates that fraudulent billings make up between 3% and 10% of total healthcare expenditures every year. In 2007, for example, total healthcare expenditures in the U.S. were $2.26 trillion. If the FBI's best case is true, that means that in 2007, U.S. healthcare insurance providers were ripped off for nearly $68 billion. At worst, it was $226 billion. This loss is automatically passed on to the consumer in the form of higher premiums.

But the problem is only growing. Last year, the Government Accountability Office (formerly known as the General Accounting Office) stated that they have been unable to definitively identify the scope of the fraud and systemic abuse being perpetrated within the Medicaid/Medicare system. Their best case guess is that, in 2008 alone, taxpayers were robbed of a minimum of $69 billion by people intentionally defrauding the system. This is an increase of over 200% from only the year before. The FBI estimates that this will only get worse as people live longer and make more demands on the Medicare system. And this doesn't include the honest mistakes made every year by tens of thousands of Medicaid/Medicare recipients overwhelmed by the complexity of the bureaucratic maze they have to negotiate just to see a primary care physician.

These increasingly sophisticated ways of 'gaming the system' have created a layer of bureaucracy within many insurance companies that have evolved into something resembling systemic abuse in its own right. I'm speaking of what are sometimes called 'Benefits Coverage Panels'. These are the panels or committees employed by the insurance companies to review the diagnoses and treatments doctors propose for their patients covered by that insurer. In order to protect their slim profit margins, some insurance companies now have accountants and bureaucrats (who were never physicians themselves) reviewing medical cases and second-guessing experienced physicians, often denying treatment because, in their humble opinion as a bean-counter or paper-pusher, the treatment wasn't necessary. These coverage panels are just another unnecessary expense adding to the cost of healthcare insurance.

Next time, the impact your political heroes have on the cost of your healthcare coverage.

Until then, best regards...



© James P. Rice 2010

Healthcare in America: Affordability, pt 4

Good day, family and friends!

Today, we start looking at litigation, insurance fraud, and special interest legislation.

Another component that has caused the cost of doing business for both physicians and insurance providers to skyrocket is runaway litigation. Over the last 30 - 35 years, the concepts of 'Personal Responsibility' and 'Reasonable Expectation' have been either perverted or completely discarded by personal injury attorneys. People who are grieving over a personal tragedy are being convinced by these ambulance-chasers that it will make them feel better to lash out at the deepest pockets they can find. Here are two recent examples of such spurious abuse of litigation:

1) Earlier this year, a grieving family in Montana filed suit against the parent company of Louisville Slugger because their son was killed by a line drive hit by a batter using one of their aluminum bats. The jury awarded the family $850,000.

2) A woman in Oklahoma has filed suit against Samsung and Sprint Nextel because a man who was distracted by a cellphone call ran a red light and broad-sided a car in the intersection, killing the woman's mother. This suit is pending.

But the most famous case of abusive litigation that really opened the flood gates is the case of Liebeck v. McDonald's Restaurants from 1994. In case you don't remember, this is the case where a 79-year-old woman who, due to her own actions, spilled hot McDonald's coffee in her lap. Thanks to her weasel of an attorney and the twelve idiots on the jury she received a judgment of $2.86 million dollars for 'comparative negligence'. To add insult to injury, her husband filed a separate suit against McDonald's for "loss of spousal duties" because his wife couldn't have sex while she recovered. McDonald's settled his suit out of court for another $150,000.

What do these cases have to do with the cost of healthcare? They are some of the most egregious examples of the courts throwing personal responsibility out the window. This attitude that people are no longer responsible for their own actions has spilled over into every aspect of our society...including healthcare. Because of this 'victim mentality', the cost of medical malpractice insurance coverage has gone crazy. Paying the out of control punitive damages being awarded in malpractice cases have severely increased the operating expenses of the malpractice insurance carriers. They pass this cost along to the physicians in the form of a six-fold increase in malpractice insurance premiums. In turn, this increase in the operating costs of a physician's practice results in higher overall costs to the consumer for every visit to a doctor's office. As with just about every other cost in this debate, there is a wide disparity in just how much of a physician's cost is malpractice insurance...between 19% and 27%, depending on which report you read.

Next time, we continue looking at the impact of litigation, insurance fraud, and special interest legislation on healthcare costs.

Until then, best regards...



© James P. Rice 2009

Intermezzo - Copenhagen Climate Conference

WARNING! Today's post is a bit longer than usual.

Good day, family and friends.

Recently, when I asked a number of my friends and family to join a social group regarding the UN Climate Change Conference that begins today in Copenhagen, I received a terse chastisement from one of my friends accusing me of ignoring the facts and blindly supporting a conspiracy theorist. I replied to this friend with a summary of the facts I have uncovered in my own research and my own reasons for my position on this conference. When I re-read it, I thought it sounded pretty darn good (if I do say so myself!) and decided I would share it with the world through this blog. The only changes I've made is to change the voice from responding to specific allegation to being a narrative. So, here we go. Enjoy!

First, I have always believed as part of my Core Principles that it is humanity’s responsibility to be good stewards of the Earth. I believe we have a duty to ourselves to continue to advance our knowledge and exploit the resources of the Earth for that advancement, but that it must be done in such a way as to impact the ecology as minimally as possible so we can leave a planet for our children and grandchildren that is better than the one into which we were born. I believe that we are overdue for a technology upgrade in how we power our society and that it will take us completely away from fossil fuels, but I also believe that forcing our society into new energy sources before they are proven efficient, reliable, and cost-effective will prove disastrous.

Second, before you conclude that I am doing nothing but parroting the paranoid rhetoric of Alex Jones, you should know I have listened to him exactly once over the last ten years. It was late at night several months ago when I was driving back from San Antonio and needed to listen to something annoying to keep myself awake. Quite frankly, Alex Jones’ position on a particular topic never enters my mind one way or another when I am researching it.

Third, do I believe the climate of the Earth is changing? Yes I do. Is this climate change man-made? No. Even the most pessimistic climate reports (e.g. the UN’s IPCC and former VP Al Gore) have humanity contributing only 11% of the ‘greenhouse gases’ that are being blamed for the change in the planetary climate over the last 150 years. A look at the meteorological records going back to the early 19th century shows that, over the hundred years between 1900 and 2000, the average planetary temperature has risen 0.74 degrees Celsius (approximately 1.33 degrees Fahrenheit). That’s not 0.74 degrees every decade…that’s 0.74 degrees for the entire Century as opposed to the one degree per decade some climate change pundits claim. Not only that, but since the year 2000, the average planetary temperature has actually dropped by 0.11 degrees Celsius.

If humanity did not cause even this minimal increase in the Earth’s average temperature, then what did? Well, to counter the 2,000 scientific experts listed in the UN’s IPCC Report, there are nearly 30,000 experts from many different disciplines (meteorology, climatology, planetology, paleoclimatology, astronomy, and physics just to name a few) who have identified two primary causes:

1) the Earth is at the tail end of the warming period that followed the last ice age. This ‘mini ice age’ ran from the mid-15th century to the mid-19th century and has been identified as one of the principle catalysts for historic events such as the winter-related failure of Napoleon’s invasion of Russia and the Irish potato famine. In fact, archeologists and paleoclimatologists have determined that the average global temperature for 2000 was still cooler that the average global temperature of the year 1000; and

2) Over the last 60 years, solar activity has reached an 8,000 year high. In fact, it can now be demonstrated that the temperature increase in the last century has a more direct correlation with the sun’s irradiant output than with the level of CO2.

To be fair, I will concede that a handful (possibly a couple hundred) of the nearly 30,000 scientists are probably in the employ of ‘Big Oil’. But if you are going to dismiss their findings because of a small sub-group, then, to be intellectually honest, you must dismiss the results of the other side as well since 186 of the 2,000+ scientists listed as contributors of the IPCC report had to threaten to sue the UN to have their names removed because they disagreed with both the methods the IPCC used and the conclusions the IPCC published as ‘settled science’.

Fourth, while the concerns over the state of America’s sovereignty is usually the first concern listed by opponents of the Copenhagen conference, it is actually a summary of all the issues many people have with the draft of the proposed agreement that has been made public.

I have to concede here that I did make a mistake…one that many people have been making. The draft of what President Obama will be asked to sign at Copenhagen next week is not a treaty. Rather, it is a proposed global Accord. The UN committee that authored the accord stated they intentionally did it this way “to avoid the issues that prevented the Kyoto Treaty from being universally implemented.” The reason this distinction is important is that, as what happened with the Kyoto Treaty, Congress would have to ratify any treaty the President signed before it would be implemented by the U.S. With an accord, however, the President can implement it without ever consulting Congress through cabinet-level policy changes and Executive Orders. President Obama (as did the previous two administrations) has clearly demonstrated that he is more than willing to use these tools to get around that pesky Constitution thing.

It has been stated that, “anyone following the debate over signing this treaty should be following the issues of who is required to participate, what sanctions should be imposed, what levels of compliance are practical and attainable and other realistic concerns, not whether we are signing over our government to a world power.” With the exception of fringe elements such as Alex Jones’ followers, that is what most people opposing the accord are doing. These concerns were first brought to my attention when I saw an interview with Lord Christopher Monckton. Lord Monckton is a respected member of the British House of Lords and a self-educated expert on global climate change. As a member of Parliament, he received an advance copy of the accord and proceeded to go through it with a fine-toothed comb. Here are some of the highlights:

• The accord establishes a redistribution of wealth from industrial nations to third-world nations in the name of ‘Reparations of Climate Debt’;
• It establishes an “internationally interlocking bureaucratic entity for the purpose of governing the terms of the accord, collecting up to 2% of the GDP of industrial nations to be redistributed to un- and underdeveloped nations, and to enforce the terms of the accord by whatever means necessary”;
• It establishes a interlocking infrastructure of technical panels with the right to intervene in the economy of any nation, in spite of the laws or government of that nation;
• Defines industrially-generated CO2 as the main cause of Global Climate Change;
• Sets CO2 reduction standards for industrial nations that can only result in the reduction in the standard of living for that nation while having absolutely no effect on Global Climate Change. (When the numbers are crunched, it shows that the standards set by this accord will result in only a 1% reduction in CO2 in approximately 175 years!);

Basically, this accord will have absolutely no impact on the global climate, punishes developed nations for daring to have the audacity to advance humanity, will only serve to establish the framework for a fledgling global bureaucracy structured under Marxist principles, and will waste billions (if not trillions) of dollars that could be better used by the private sector to research, perfect, and implement the new forms of clean energy we desperately need. Remember, most of the scientists the UN are leaning on for the 'settled science' of global warming were screaming that we were about to enter a new ice age only 33 years ago!

Finally, even if this is a treaty and not an accord, President Obama needs to make a statement to the world that he is not a ‘sheeple’ willing to go along with anything just so the World will think nice things about him. He needs to send a clear message that he will only sign on with a plan that will have a positive impact on all the people of the World, and that he honors and respects the Constitution…the document that has brought freedom, opportunity, and prosperity to more people than anything else in the history of the world…and is truly the First Defender of the Constitution. This is why he must not sign the Copenhagen Accord.

While I do believe we need to continue to monitor and study the climate of the Earth, I firmly believe that the minor warming trend we experienced over the last century is part of a natural cycle. I believe that climatology is part of a greater need to study, understand, and protect the entire ecosphere of our planet, and that money currently being wasted on ‘snake oil’ schemes to ‘fix the climate’ would better serve humanity and the Earth by being applied to research in alternative energy, alternative agricultural methods, oceanic research, extra-planetary exploration, and in encouraging ‘positive’ land stewardship habits in people instead of trying to legislate them into submission.

I encourage everyone of you to call the White House switchboard at (202) 456-1414 and politely let President Obama know what we expect of him when he joins the other heads of state in Copenhagen next week.

Best regards....




© James P. Rice 2009

Healthcare in America: Affordability, pt 3

Good day, family and friends!

Lets continue our look at the costs associated with healthcare insurance...

Thanks to knee-jerk reactions by both the courts and the insurance companies to the actions of a handful of miscreants, modern healthcare insurance policies are engorged with fine print designed to severely limit what the policy covers while balancing the need to provide a value to the customer with that of making a profit for the company's shareholders. Unfortunately, all this fine print creates a burden on everyone...from the customers who have to track what is and isn't covered, to the medical providers who have the additional cost of hiring dedicated specialists to handle the jungle (excuse me...'rain forest') of policies and paperwork created by the fine print, to the insurance companies themselves who are also saddled with the costs of having entire departments dedicated to handling the paperwork and interpreting the policies created by the fine print. Depending on which study you read, between 14% and 32% of the cost of healthcare are the administrative costs associated with the fine print.

Believe me, if the insurance companies thought it would be safe to operate without the fine print and its concomitant costs, they would scrap it in a heartbeat. After all, as with any publicly-traded company, they have a duty to those investors who hold shares of the company's stock to be as efficient and profitable as possible. And do you honestly believe that doctors enjoy spending any part of the capital of their practice on the clerical necessities of insurance claims?

It will probably surprise most of you that the premiums paid for insurance policies make up only a portion of an insurance company's capital. The rest of it comes from the sale of stock in the company and from investments the company makes with its capital on hand. This is why making certain the shareholders get some sort of return on their investment is so important. If the company makes no profit, there are no dividends for the stockholders. If there are no dividends, there will be no new stockholders and existing ones will begin to divest themselves of their shares. The end result is that, without the working capital provided by investors, the insurance companies will go out of business.

This is the point where I expect to hear politicians and progressives start whining about "the obscene profits insurance companies make on the suffering of the American public." How does one define "obscene profit"? Currently, there are just over 1,300 insurance companies operating in the United States that offer some sort of healthcare policy. The average profit for all of these companies in 2008 was 2.2%.

*GASP!* How obscene!

It gets even worse. The 16 largest insurance companies that account for right at 80% of the net worth of the insurance industry averaged a whopping 3.4% profit, with the single highest profit in the healthcare insurance industry for 2009 being (drumroll, please) 4.6%.

O! The Humanity! Say it isn't so!

Let's compare that to the average profit margin of...oooh, let's say...professional politicians. These fine, upstanding, selfless individuals make a profit of 100%. Or how about that planetary champion of the climate, Al Gore. His projected profit for 2009 for his 'humanitarian' efforts to fight 'global climate change' is 290%. If the 'Cap and Trade' Bill is signed and put into effect in the next 6 months, then Vice President Gore stands to make a profit of nearly 500% in 2010.

So, which profits are the most obscene?

Next time: Insurance Fraud and special interest legislation...litigation's ugly stepsisters.

Until then, best regards...



© James P. Rice 2009

Healthcare in America: Affordability, pt. 2

Good day, family and friends!

Last time, we established that most medical professionals are working hard to earn a living in what they believe to be their true vocation. Quite frankly, anyone who chooses to pursue a medical career in our overly-litigious society deserves a warm round of applause and a hearty pat on the back.

Now, to continue with the analysis...

The second component we have to look at when asking why healthcare costs what it costs is insurance. Thanks to a concerted effort by certain politicians, a growing entitlement mentality spreading through our society, and a very few bad apples in the insurance industry, healthcare insurers have been painted as demons in the healthcare debate. The biggest reason for this is that most modern Americans have a skewed vision of exactly what insurance is.

As a result of the creeping efforts of the Progressive movement over the last 75 to 80 years, most Americans now view their insurance premiums as payments for entitlements. They believe that, as long a their monthly payment is made, they are entitled to access to any healthcare they desire, no matter the cost or availability, as long as they also pay their token co-payment and a small deductible. This warped view of insurance is why many people are unhappy with their healthcare coverage.

The truth of the matter is that insurance is nothing more than a legal form of gambling. When your premium is paid, whether by your employer or out of your own pocket, a wager is placed with the insurance company (the House) that you are going to need medical assistance and that they, within the 'rules' of the wager, will pay for all or part of it. When they accept your wager (premium), the House (insurance company) is betting that you will remain healthy and hale and won't need said medical services. Unfortunately, most bettors (you the customer) let themselves be distracted by the bright shiny lights that is the marketing campaign for the insurance policy and fail to actually read and understand the rules of the wager (i.e. the fine print). Additionally, most bettors also forget the first rule of gambling: "The odds are always in favor of the House."

To be fair, most of that fine print is as complex and convoluted as the worst example of an ambulance-chasing shyster could make it, so it does take a considerable investment in time for the average American to read through and understand what they are getting. Unfortunately, all that fine print evolved over time in response to economic pressures placed on the insurance companies by gradual changes in litigation. This is where some of those 'bad apples' come in; unscrupulous men who would describe a policy to a potential customer as being one thing when it was something completely different just so they could make a sale. Thus, the actions of a few resulted in the implementation of policies and procedures within the insurance industry that were designed to minimize the damage caused by future bad apples and protect the interests of their shareholders. In other words, the only people who won at that table were the lawyers.

Next time, we continue to look at the costs involved with healthcare insurance.

Until then, best regards...



© James P. Rice 2009

Healthcare in America: Affordability, pt. 1

Good day, family and friends!

Well, its been over 2 months since my last post. For those of you who have been following this series, I apologize. However, I receive no compensation at all for my blog and activities that pay the bills must come first.

As I started looking into the affordability of healthcare in America, the question I started with was, "why does it cost what it costs?" There are as many different opinions as to 'why' as there are corrupt politicians in government. Some have claimed that costs are set and controlled in secret by a consortium of medical insurance corporations and pharmaceutical companies with a goal of padding the bottom line. Some claim that the healthcare providers themselves are just greedy individuals who are demanding every dime the traffic will bear. President Obama even went so far as to suggest that physicians are performing unnecessary surgeries in order to collect higher fees from MedicAid/MediCare. In fact, the truth is that modern medical technology is simply very expensive to develop, learn, acquire, and maintain, and that rampant insurance fraud and out-of-control litigation makes healthcare coverage prohibitive for the underwriters.

So, let's start with the physicians. Most physicians start their careers at least $200,000 in debt from their education. Additionally, the average start-up cost for a new medical clinic for a General Practitioner is between $300K and $500K. If the clinic is for a medical specialty (e.g.: Endocrinology or Orthopedic Surgery), add another $200K - $300K. This means that a new doctor opening a new clinic incurs between $300K and $800K in additional debt before they ever see a patient. This plus the desire to have access to a pool of experience causes most new physicians fresh out of their residency to become employees of an established clinic.

While it is true that these highly-trained medical employees usually do make a salary in the low six-figures, they earn every penny of it. These men and women are usually the ones pulling the long and undesirable shifts. Most averaging 68 hours of work per week and only 8 days total of vacation in the first five years after they complete their residency. These new members of the clinic are usually the ones on call during the holidays. Basically, they work hard to establish themselves with their patients and the local hospitals at which they have privileges. In other words, they are 'paying their dues.' On top of that, most physicians spend an average of 36 hours per year in additional training on new procedures, equipment, and medications.

In addition to the cost of employing these medical professionals, the clinics themselves also have a staff of highly-trained nurses, physicians' assistants, and medical receptionists/clerks to pay. Their overhead also includes items such as the facilities themselves, routine medical equipment maintenance, cleaning crews that specialize in medical facilities, and medical/laboratory courier services. Finally, they usually have at least two medical billing specialists just to deal with the complexities of the plethora of insurance options available to their patients. After all that, most medical clinics (with the exception of clinics specializing in 'elective' procedures) barely clear a profit of 6% at the end of the year. Not exactly an easy way to get rich quick, is it.

Next time, I'll look at what goes into the cost of healthcare insurance and address the abominable suggestion made by the President.

Until then, best regards...



© James P. Rice 2009

Healthcare in America: Accessibility, pt 2

Good day, family and friends!

When last we met, we established that everyone, from the most indigent to the wealthiest among us, has access to healthcare. I am not yet dealing with physician choice or the cost of private physicians or the number of specialists per capita in a given area of the country or any other questions or issues. All of that comes later. All the last post was meant to do was answer the question, "How accessible is healthcare to the citizens of America?" The answer is, "Anyone within 250 yards of an American emergency room or department, whether or not they are a U.S. citizen, whether or not they are actually within the borders of the U.S., have access to all the medical care necessary to treat and stabilize an emergency condition to the point where they can reasonably be expected to care for themselves, or until they can be discharged into the care of a qualified caregiver, whether or not they are able or are willing to pay for such medical service."

But many people believe that isn't enough...that they shouldn't be 'forced' to go to an emergency room if they want to see a doctor. According to the Bureau of the Census, the American Medical Association, and the Centers for Disease Control, in 2006 (the last year this statistic was available for all three organizations), between 91% and 92% of the population of the U.S. lives less than thirty minutes from either a primary-care physician or a non-emergency clinic that is still accepting new patients. Of the remainder, just under 6% of the population chooses to live in remote areas more than thirty minutes from any sort of population center, no matter how small. This means that only 2% to 3% of the U.S. population lives in what are called 'under-serviced' areas.

While I do acknowledge that there are areas in which the American Healthcare system can be improved, I have to applaud our nation on accessibility to medical care. Of the twenty most populous nations in the world, Japan comes the closest to offering the level of healthcare available to Americans. There are nations that seem to be doing a better job of delivering healthcare to their citizens than America...Cuba and Sweden are the two countries most often used as examples...and for their population, they very well may be doing a good job. But comparing the logistics of delivering medical care in the third most populous nation on Earth to the logistics of delivering it in the seventy-fifth and the eighty-eighth most populace nations is like comparing the logistics of traffic management in Greensboro, NC and Chesapeake, VA to that of Chicago. It isn't even an 'apples-to-apples' comparison; rather, its more like 'apples-to-eggplant'. Basically, such a comparison is spurious and completely without merit. The bottom line is that, of the twenty nations that make up just over 79% of the world's population, none provide better access to healthcare than the United States of America.

Next time, I start looking at the cost and affordability of healthcare in America.

Until then, best regards...



© James P. Rice 2009

Healthcare in America: How Accessible is It?

Good day, family and friends!

I start today with the question, "Does everyone have access to healthcare in America?" The short answer is, "Statistically speaking, yes."

In 1986, the Emergency Medical Treatment and Active Labor Act (42 U.S.C., Chapter 7, Subchapter XVIII, Part E, § 1395dd, EMTALA) was passed as part of the Consolidated Omnibus Budget Reconciliation Act. This act mandates:

"In the case of a hospital that has a hospital emergency department, if any individual (or a person acting on the individual’s behalf, whether or not the individual is eligible for benefits) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists."

It further goes on to define an "emergency medical condition" as either:

"(A) a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in—
(i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
(ii) serious impairment to bodily functions, or
(iii) serious dysfunction of any bodily organ or part; or

(B) with respect to a pregnant woman who is having contractions—
(i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
(ii) that transfer may pose a threat to the health or safety of the woman or the unborn child."

This EMTALA goes on to make it illegal for a hospital to have any sort of financially-based conversation with the individual until such time as the patient's condition has been stabilized and the conversation will not interfere with the diagnosis and treatment of the condition. Later amendments from Congress defined "individual" as "any person within 250 yards of the emergency room/department, regardless of the person's citizenship or legal status," and made it illegal for different levels of care to be provided, based on the definitions in the Act. In other words, whether you're a Mexican citizen living just across the border from a hospital in Texas, or the wealthiest American citizen in El Paso, TX with the greatest medical insurance in the world, you will both receive the same level of care if you have the same emergency medical condition and go to the same border hospital in El Paso.

Next time, we continue our look at how accessible medical care is in America. Until then, best regards...



© James P. Rice 2009

Intermezzo

WARNING! Today's post is a bit longer than normal.


Good day, family and friends!

Since my last post on the 13th, I've been doing some serious soul searching. I have to admit to being more than a little surprised and shocked by the response I received from the definitions I provided, not only from my friends and family, but from others outside my Facebook 'Friends' list who read my blog. While the responses from my 'Friends' list were considered, reasonable, and in the spirit of open debate and discussion, the others were considerably more vitriolic. These less than intelligent individuals also chose to expose their true cowardly nature by sending their comments to me via e-mail rather than posting them in either of the open forums available. Both sets of comments, however, did serve to underscore the most fundamental problem with most political debates these days, and in particular the Healthcare debate: how can we have a rational, reasoned, intelligent debate about anything when we can't even agree on the most basic parameters of the debate?

I could become redundant right now and once again go into excruciating detail of how I went out of my way to make certain I did not get the definitions I used from any source that was even remotely "Conservative" on the political pendulum, but I won't. What has happened, though, is that I now understand what the main protagonist in two novels I recently read was put through as I am experiencing now it myself.

In Terry Goodkind's novels, Soul of the Fire and Faith of the Fallen, Richard Rahl believes that he can convince the citizens of a small country to join his empire by simply sharing the truth with them. The truth is that Richard's empire is dedicated to justice, to protecting individual rights, to ending corruption and cronyism, and to allowing everyone the freedom to strive to be their best free from the fear that it will arbitrarily be taken away from them. The Order (Richard's opposition), on the other hand, believes that Man is a base creature whose only purpose in life is to help others with no thought for himself. The Order preaches social justice and entitlement, mandates charity, condemns personal excellence, and justifies murder, rape, and pillage as tools necessary to bringing 'true equality' to the masses. Unlike Richard, though, The Order doesn't bother with the truth. They instead use propaganda, misinformation, and outright lies to manipulate the masses. They demonize business owners as wealthy elitists who just want to side with Richard so they can continue to keep all the money earned for them by the common workers. They promise a new era of prosperity for the common man while punishing the 'greedy.' They use whisper campaigns to blame Richard's faction for everything that goes wrong...even natural disasters. They spread rumors that Richard doesn't care about the unemployed and would rather see impoverished children die. In short, they stoke the fire of fear in the common people.

In the end, 70% of the people vote to side with The Order. Richard withdraws his entourage and leaves the people to their fate. The Order moves in and the people discover the truth...that they have voluntarily enslaved themselves to a culture of death. From this, Richard finally realizes that truth does not automatically win every time and you can't force people to be free. He learned that no amount of logical, reasoned, factual discourse will ever change an opinion based on feelings. In fact, more often than not, the attempt to change such an opinion will lead only to animosity, derision, and outright hostility. This is where the response to my blog has left me.

As I read comments that called me things like "hatemonger", "racist", "Republican stooge", and "ignorant inbred hick", I decided I was done. Why should I even bother if just the definitions I provided were eliciting this sort of response from the effete thugs who are only interested in promoting their own agenda? It became very clear that no amount of rational, logical analysis and discussion would dent the shell of partisan intolerance in which these 'enlightened' individuals had wrapped themselves. I was done trying to be a rallying point for the vision of personal freedom and personal responsibility laid out by our forefathers. I would no longer bear that standard as long as I was viewed as nothing but a 'hick in a flyover state' by the snobs living in the elitist bastions of Los Angeles, San Francisco, Seattle, Chicago, Central Austin, and the East Coast. I had decided to drop my analysis on Healthcare in America.

This is where my brilliant youngest daughter comes in. I was discussing with her the frustration (and to an extent, depression) I was experiencing as I tried to have an intelligent discussion when she cut to the chase and asked me a single question: "Why did you start your blog in the first place?" That one question was like a lightning bolt. She made me realize that I had wandered far off track. As stated in my very first post, I started blogging "as a way to work out my thoughts on everything that is happening to our Nation and around the world." I didn't start this blog to educate or enlighten anyone else. If that happened along the way, it was gravy. But the meat of my blog is my own thoughts.

Therefore, thanks to my daughter, I have decided to continue my analysis of the Healthcare issue. I will continue to write about the facts, experiences, and opinions I deem relevant. I will continue to document my sources for my own use. I invite you to continue reading and to comment on what I post. I will probably answer questions, respond to requests for clarification, and thank you for your comments. I will not, however, debate anything in the 'comments' section of either my blog or my Facebook account until I have completed the entire series on Healthcare. Then, if you want to debate, I will do so only if you come ready with facts from verifiable sources. If you choose to try to debate anything in this series with 'feelings', I will at best ignore you, and at worst verbally shred you.

Next time, I will finally continue the series on Healthcare in America. Really! Until then...

Best regards...



© James P. Rice 2009

Healthcare in America: A Clarification

Good day, family and friends!

Well, it appears that I'm on the right track. The definition I provided for American Progressivism alone generated quite a debate in Facebook...so much so that I decided I needed to clarify a few points from what I've posted so far before I go any further.

First point: the definitions I provided, specifically those for the political philosophies, are not mine. Those are the definitions provided by universally recognized experts in their fields; experts such as:

> The editors of The American Heritage® Dictionary of the English Language, Fourth Edition;

> Ronald J. Pestritto, Shipley Professor of the American Constitution at Hillsdale College;

> William J. Atto, Ph.D., American Historian and Researcher specializing in the 19th Century and Assistant Professor of History at the University of Dallas;

> Herbert Croly, founder and first editor of The New Republic.

Second point: the only personal opinion I have so far presented in this series is that the debate on healthcare in America "is rapidly devolving into shrill screaming matches split along the lines of political philosophies." As this series continues, I will make a point to indicate when I am expressing an opinion. I will also be providing a complete bibliography of my sources at the end.

Third point: I am not making this a contest between Good and Evil. I provided the definitions of the various political philosophies in order to provide a foundation for the various proposals that have been made to fix, improve, and/or change healthcare in our nation. I firmly believe it to be of the utmost importance that we understand the philosophies and motives behind the various suggestions so that an informed decision can be made.

Finally, please keep the input coming. I really do love any and all thoughtful questions, comments, and criticisms about my blog. Keep in mind, though, that if you take exception to data that I quote from a documented source, please take it out on the source and not the messenger.

Next time, how accessible is Healthcare in America?

Until then, best regards...


© James P. Rice 2009

Healthcare in America: The Issues

Good day, family and friends!

As promised last time, I have one more term to define...

A-mer-i-can Pro-gres-siv-ism - noun
The political philosophy that blends socialism and fascism, originally outlined and defined by John Dewey and Herbert Croly at the end of the 19th/beginning of the 20th Centuries, and embraced by Theodore Roosevelt, Woodrow Wilson, and Franklin Roosevelt. Progressivism is a system of government marked by centralization of authority under an elite administrative class, stringent socioeconomic controls, marginalization of individual rights, limited private ownership of property, moral relativism, suppression of the opposition through terror and censorship, and typically a policy of belligerent elitist nationalism. The progressive philosophy views the common citizen as rabble incapable of self-determination and in need of guidance by the intellectual elite. Since its inception, this movement has been known as Progressivism, New Nationalism, Social Progressivism, Intellectualism, The New Deal, Liberalism, and American Progressivism.*

Some of you may be wondering why, if I'm trying to take a completely logical, scientific look at the state of healthcare in America, I'm defining so many terms that most people deem to be political. Its because one must understand the source of a problem before one can focus on a solution that actually resolves the problem and does not make it worse in the long run. The definitions of these political philosophies are important so that we can understand the source of many of the ideas being thrown around as 'solutions,' and by extension, the motive behind many of these ideas.

But the true starting point lies with the first three definitions I provided: healthcare, healthcare system, and insurance. I'm starting here because, when most people speak of 'healthcare in America,' they are actually lumping together two different issues...Access to Healthcare in America, and The Affordability of Medical Insurance (a.k.a Healthcare Coverage) in America. Therefore, my analysis and accompanying suggestions of solutions will be split into these two categories. starting with Access to Healthcare in America.

Until next time, best regards...



* Summarized definition consolidated from The American Heritage® Dictionary of the English Language, Fourth Edition and American Progressivism by R.J. Pestritto and William J. Atto.


© James P. Rice 2009