Back to Basics

The automobile industry and the labor unions have caused the problems they face today.  They have been on a free ride for years, taking advantage of the American consumers, and it finally backfired on them.  Mismanagement, gasoline prices, government regulations, labor costs and an apathetic attitude have all contributed to their failures.  The taxpayers should never have been held responsible for their actions.  This is unconstitutional, but no one in our federal government seems to be awake.  Is anybody home?

Gasoline prices are one of the problems.  Guess what, this is nothing new!  Back in the 1970’s gas prices started rising to a whopping 50 cents a gallon.  People were outraged.  Speculation was that if gas went over $1 a gallon people just wouldn’t be able to afford to drive any more.  My husband owned a foreign car at that time that got 45 mpg.  It was nothing special, just your basic automobile.  You can’t find cars today that can produce that kind of mileage.  We also purchased a new car – a 1975 Pontiac Trans Am equipped with the V8 400 engine.  One of the less efficient cars of the time, it only got 20 mpg.  Wow, a muscle car that actually beats many of the vehicles today in gas mileage standards.  So, back in the 70’s with the impending doom of higher gas prices, nothing was done to combat the issue.

In the 1980’s gas prices again became an issue.  American cars just weren’t providing the gas mileage consumers wanted so they turned to foreign imports.  Foreign cars were not something I had ever imagined owning, I always stuck with American products.  But in trying to find a car that would get better gas mileage the foreign cars provided something American cars could not.  We found a Datsun that could get 35-40 mpg, and as a second car found a Mazda that got 30 mpg.  Gas prices during this era would rise and fall even dipping below the $1/gallon mark.  It was still a concern of the American public, but nothing was being done by the automobile industry to address the issue.

Back in the 1990’s my daughter joined the electric car club in high school.  These high school students created alternative fuel vehicles and had yearly competitions between schools to see whose car was the best.  These students were able to design and build cars that ran off alternative fuels.  With limited resources they were able to succeed.  But their efforts didn’t impact the auto industry and gas prices continued to rise.

Occasionally you would hear of alternative fuel vehicles on the market.  Most were very restricted in marketing and often only available to government agencies or only on lease agreements.  They were never made readily available to the public.  One big problem with these alternative fuel vehicles is that they took the gasoline version and then converted it to an alternative fuel.  This made the car cost prohibited, because you not only were paying for the original car but all the additions to convert it.  Other manufacturing changes came along, like going from carbureted engines to fuel injection.  Emissions played a factor in the changes, and not always on the positive side of the mileage factor.  Yet no real alternatives had been produced.

During this time we again were looking for a new vehicle, and once again opted for a foreign car, one that gets 35-40 mgp or more.  American cars just didn’t offer what we were looking for.  They didn’t get the gas mileage, were uncomfortable to drive and cost more.

A few years later it looked like there might be some alternative fuel vehicles, at least some hybrid versions, being released that might fit the bill.  Saturn had announced a hybrid and we were extremely interested.  Unfortunately it seemed to die out, never to be heard from again.

Now it is almost the end of the first decade of the 2000’s and still no real alternative fuel vehicles are being produced by the big auto manufacturers.  We’ve had almost 40 years of dealing with higher gas prices and yet in those 40 years no automobile manufacturer could produce a vehicle addressing this issue.  40 years of failure and we need to bail them out!  If any one of them had put forth the effort and developed an alternative fuel vehicle at an affordable price they would have the market edge of every automobile manufacturer.  Bailouts wouldn’t have been necessary.

So due to the auto industries own deficiency we face more government regulations, including the government telling you what vehicles you can and cannot drive.  This is a ploy to force people into purchasing vehicles since the American automotive industry can’t seem to draw the consumer in without government interference.  Cash for Clunkers was just that type of program.  Give people government money so they can go out and purchase a car, because they surely won’t do it on their own in this economy.  To make it sound legit, we’ll sell it as an environmental strategy taking old gas guzzling vehicles off the road making way for more efficient vehicles.  Since the government now owns GM, we have to get the market rolling.  People took advantage, but most bought foreign made cars.  More tax dollars wasted.

Are there alternatives out there?  There might be.  A small auto manufacturer in California has developed a vehicle that runs off battery power/solar power with a gasoline backup system.  It is a rather unusual vehicle, but could provide the technology for future vehicles.  The solar power charges the batteries and when the batteries are fully charged, the excess power can be used to cool your car while parked.  Imagine actually looking to park your vehicle in the sun instead of the shade in the summertime and being able to enter a cooled vehicle!  The gasoline backup system is supposed to get 300 mpg and cars are equipped with a 2 gallon gas tank.  They have been addressing the government imposed issues as well as manufacturing problems, so the cars are only available to California residents.  Interest has peaked around the country and they have a huge waiting list.

Under the title of Public Health & Workforce Development are a number of grants, scholarships and other programs, providing training, services and a whole new array of studies relating to health care – a lot of money being spent to support the expansion of government, special interests, illegal immigrants and labor unions, but little to help solve the health care issues.

The first expansion is the establishment of the Public Health Investment Fund, which requires deposits from the revenues of the Treasury in the amount of $88,700,000,000 over 10 years. This money is authorized to be appropriated by the Committee on Appropriations of the House and Senate for carrying out the activities under the designated public health provisions. These areas include Community Health Centers, National Health Service Corps Program, National Health Service Corps Scholarship and Loan Repayment Programs, Primary Care Loan Funds, Primary Care Education Programs, Nursing Workforce Development, The National Center for Health Statistics and the Agency For Healthcare Research and Quality.

To make these programs even more appealing is the stipulation that “Amounts appropriated under this section, and outlays flowing from such appropriations, shall not be taken into account for purposes of any budget enforcement procedures including allocations under section 302(a) and (b) of the Balanced Budget and Emergency Deficit Control Act and budget solutions for fiscal years during which appropriations are made from the fund.” More spending without any concern for balancing the budget or controlling the country’s deficit. We don’t have it, but let’s spend it!

The first program – Community Health Centers – will obtain increased funding in the amount of $38,800,000,000.

The National Health Service Corps is being amended allowing the Secretary to issue waivers to individuals who enter into a contract for obligated service to pay for their education. It further raises the loan repayment amount from $35,000 to $50,000 and will be adjusted thereafter to reflect inflation. Additional appropriated funds for this program are $796,000,000 over the next 10 years. Additional funding is authorized in the amount of $3,171,000,000 over 10 years to cover the National Health Corps Scholarship and Loan Repayment Programs.

The Frontline Health Providers Loan Repayment Program will be established to address unmet health care needs in certain areas, populations, or facilities as designated by the Secretary. Individuals participating in this program must agree to serve for a period of 2 years in a health professional needs area specified in the program. This program has a clause that if there are an insufficient number of applicants for the program, then all excess funds from the program will be transferred to the National Health Service Corps to recruit more people to take advantage of this fund.

The Secretary shall establish a primary care training and capacity building program consisting of grants and contracts to plan, develop, operate or participate in accredited professional training in the field of family medicine, general internal medicine, general pediatrics or geriatrics. Funds for this program are from the Public Health Investment Fund in the amount of $3,023,000,000 for 10 years and will include the following:

• Capacity Building in Primary Care – grants to specialties of family medicine, general internal medicine, general pediatrics or geriatrics, with preference given to entities that train individuals who are from underrepresented minority groups or disadvantaged backgrounds.
• Training of Medical Residents in Community-Based Setting – a program established for the training of medical residents in community-based settings, with preferences given to entities that support teaching programs addressing the health care needs of vulnerable populations or are a Federally qualified health center or rural health clinic, as well as preference to those training individuals from underrepresented minority groups or disadvantaged background.

• Training for General, Pediatric or Public Health Dentists and Dental Hygienists – grants and contracts to plan, develop, operate or participate in an accredited professional training program or oral health professionals, with preference given to individuals who are from underrepresented minority groups or disadvantaged backgrounds.

Grants for Health Professionals Education – Advanced Education Nursing Grants is being amended, including increases in dollar amounts for the Nurse Faculty Loan Program. Funding for this program is $1, 450,000,000 over 10 years.

The Public Health Workforce Corps is being amended and expanded by the following: Creating the Public Health Workforce Scholarship Program, Public Health Workforce Loan Repayment Program, Enhancing the Public Health Workforce, and Preventive Medicine and Public Health Training Grant Program. Appropriations for these programs total $642,000,000 over 10 years. The Enhancing the Public Health Workforce even includes provisions for veterinary medicine! I’m not sure how veterinarians will provide quality health care to people or decrease health care costs, but it’s nice to see even our animals will be included in the grant programs.

Under the Subtitle “Adapting Workforce to Evolving Health System Needs” there are a number of grants and programs including:

• Health Professionals Training for Diversity, which includes scholarships for disadvantaged students, loan repayments and fellowships regarding faculty positions, and educational assistant in health professions regarding individuals from disadvantaged background.

• The Nursing Workforce Diversity Grants is being amended and adding the Coordination of Diversity and Cultural Competency Programs.

• The Secretary will establish a cultural and linguistic competency training program for health care professionals, including nurses, consisting of grants and contracts to develop and implement models of cultural and linguistic competency training. Preference will be given to entities that address cultural and linguistic needs of the population and health disparities, and placing health professionals in regions experiencing significant changes in the cultural and linguistic demographics of populations, including communities along the United States-Mexico border. Obviously this program will benefit all the illegal immigrants coming from Mexico to obtain free health care.

Appropriations for these programs total $1,138,000,000 over 10 years.

Grants and contracts are given to develop training programs to promote the delivery of health services through interdisciplinary and team-based models, with preferences given to entities that demonstrated training to the greatest number of health professionals who serve in underserved communities.

As I initially read and took notes throughout this section I really didn’t grasp the absurdity of the program.  When I started writing this column I was overwhelmed by the stupidity of the thought that someone would actually think this was health care reform and not just a government take over of the health industry.  The public option is based on the same business model (if you could actually call it that) of the Medicare system – the system that is currently failing and going bankrupt today!  So why would one think that applying the same standards of a failing business to another model is going to create success.  Did any of the members participating in the creation of this bill have any business background?  Failure x 2 does not equal success.  With that said, I will continue on my quest at reporting on bill H.R. 3200.

The Public Health option is the portion of the bill allowing the government to sell insurance.  The Public Option is basically a Medicare type program offered to those who do not quality for Medicare, operating concurrently and competing against the private plans offered in the Health Insurance Exchange.  The government controls the Health Insurance Exchange, controls the policies offered within the exchange, and would now be able to sell government policies.  Try side stepping this all you want, but this is a government take over of health care.

Some of the bill’s BS (sorry) just could not be reworded or interpreted, so I had to quote the bill so you could fully understand the vague references and enthusiastic goals of the Public Option.

The Magic Wand of Health Care

The bill establishes the administration of a Public Health Insurance Option, an exchange qualified plan, which is supposed to “ensure choice, competition and stability of affordable, high quality coverage.”  The Secretary of Health & Human Services is responsible to create a “low-cost plan without compromising quality or access to care.”  WOW!  Apparently the magic formula has been discovered to have low-cost insurance premiums that will give accessible and quality care, and if you listen to Obama’s promises, this will not raise taxes.  Since this is similar to Medicare, one would have to wonder why this magic wand hasn’t already been applied to Medicare to ensure the same quality of care without bankrupting the system.

The Public Option will only be made available through the Health Insurance Exchange, so if you cannot obtain insurance through the exchange for whatever reason, you will also not be able to obtain the Public Option insurance either.  (For further information, please visit article H.R. 3200 – The Health Insurance Exchange.)

The Public Option must comply with the requirements that apply to an exchange plan, including benefits, benefit levels, provider networks, notices, consumer protections and cost-sharing.  Different levels of plans will also be offered.  The Secretary enters into the contracts for the public option.  This is similar to that of the Commissioner on the Health Insurance Exchange.

The Secretary sets the premiums for the public option and may allow for geographic adjustments.  The rates must be set at a level sufficient to fully finance the cost of the health benefits provided by the public options and all administrative costs related to operating the public option.

The Secretary will determine the payment rates for services and providers based on similar services and providers under Parts A and B of Medicare.  Since this public option includes services typically not provided under Medicare (such as well-child visits) the Secretary has the ability to modify payment rates to accommodate these services.  The same goes for prescription drugs not typically covered under Medicare Part A or B.

An incentive is offered to get providers to participate, allowing rates 5% greater for the first three years.  Anyone on Medicare knows how difficult it is to find a doctor that will accept patients under Medicare – they just don’t want to get involved with the government program.  So to try to get doctors to even participate in this new Public Option plan, they will allow them to charge more for services just to get them to sign up.  The catch – but only if they participate in both Medicare and the Public Option.  Pediatricians and other practitioners who typically do not participate in Medicare would also be eligible for increased payment rates.

There has been recent talk about alternatives to the public option in H.R.3200. Don’t jump on the band wagon! Although some of the alternatives may prove viable, as long as anything is part of H.R.3200 it is not acceptable.

Only the first 166 pages address the Health Insurance Exchange and Public Option as part of that Exchange program. The Health Insurance Exchange is STILL a government take over of insurance. A government committee appointed by the president, along with the Commissioner, will determine what benefits will be covered and insurance plans that may be offered. The Commissioner is basically a form of a Health Care Czar WITH all the authority to make decisions that impact our lives. The Commissioner will take bids and decide which policies will be offered to individuals and employers. Anyone with half a brain knows how bidding with the government goes. Will Americans receive choices with only their best interests in mind? Absolutely NOT! Special interest groups are definitely involved, not only in deals with the government but they are on the committee that makes these decisions.

That is only the beginning. Amending the public option would not remove the additional taxes imposed, would not restore what would be taken away from Medicare and continues to decrease Seniors coverage. It also leaves all the pork in the give away programs, grants, studies, etc. It still would not address the problem of illegal immigrants obtaining free care at the taxpayers’ expense. One of the great concerns is that it does not eliminate the denial of obtaining secondary insurance. These are some of the consequences that would remain if an attempt at amending H.R.3200 is made rather than scrapping the entire bill.

I read an article stating that 45 million people in America are uninsured, yet bill H.R.3200 is only going to add 16 million to the ranks of the insured. The cost of the bill and the estimated benefit is not a good indictor of a program worth investing in. The increase in insured population by these estimates is less than 35%. Would any program in the private business world consider those results as successful? The result is a government take over of the health care program, regardless of how the package is decorated. If it smells fishy and you haven’t gotten rid of the fish, then it still smells fishy.

Accusations are being thrown everywhere about H.R.3200. Town Hall meetings are overflowing with citizens rightly concerned about their health care and how this bill will affect them. Both sides are issuing statements in support of their position on the bill.

So instead of just taking the opinion of one side or the other, I made a commitment to actually read through the bill and report on areas I found to be of concern, informing other concerned citizens so they could read those sections of the bill, ask questions of their Congressmen, and come to their own conclusion on how it may or may not affect their lives.

I am not a lawyer, so my interpretation is not from a legal standpoint and should not be taken as such. I am just an ordinary citizen concerned about the government’s involvement in health care.

Currently I have read, word for word, page by page, about the first 200 pages of H.R.3200. I have skimmed the rest and have briefly read the last 275 pages. I am taking notes as I read, forming my own questions. Future articles will be written on specific aspects of the bill. To start, here is my summary of what I have read.

The bill, H.R.3200, provides for two systems of offering insurance to individuals, one through the National Health Insurance Exchange and the other through a Public Health Insurance Option. All insurance plans sold will have to conform to the standards set by the government to participate in the National Exchange program. The policy standards and pricing mechanisms for the National Exchange are set by the government.

The Public Option is the government’s option. It is a direct competitor to the National Exchange. It must also adhere to the same standards of the National Exchange, except that it offers incentives to doctors to participate in this program by means of allowing them increased fees for services. It basically runs under the same standards as Medicare.

There are laws requiring individuals to purchase insurance as well as employers to provide insurance. Penalties in the form of individual, employment and excise taxes are being imposed for those who do not comply.

The bill also includes the pork. Numerous special interest programs are included in the bill, covered at the taxpayers’ expense. Some of these programs include taxpayers paying for college educations for underserved individuals who go into the medical field. Others include mandating medical professionals to become literate in alternative languages so they can communicate with patients, giving additional funds to those states along the Mexican border. Yet another program is only available to individuals who belong to a labor union. These programs amount to billions of dollars. I have not seen or heard much about these programs and have to wonder why.

This bill is going to cost taxpayers billions, if not trillions, of dollars to implement and run. It calls for the expansion of government in all aspects, both federal and state. It encourages discrimination, giving preferences based on racial and ethnic criteria. It calls for government control over the plans and coverage available to you. It further includes mandates for penalties in the form of taxes for those who do not comply. Economically everyone will be hit with the affects of the bill, including higher insurance premiums and taxes. There is no magic wand that can create a program to this extent and be funded without affecting the public and unfortunately middle class America.

Even though supporters claim it gives people the freedom of choice, it gives the government plan an advantage. The government sets the standards and pricing for the private plans. The government also sets the standards for it’s own plans, and then further takes advantage by providing incentives for doctors to choose their plan. Does this provide an unfair advantage and conflict – ABSOLUTELY! I don’t know ANY business that could survive if their competition could set their business standards and pricing. So, anyone that understands business and economics knows that the government run plan will eventually win out to a private option just based on it’s own unfair advantage.