Health Plan – Ground Rules

I am not an expert at the ways of politics. Nor do I have access to actuarial material to know if this works. But in a few columns, I intend to lay out a health plan. This initial column tackles how we get people enrolled equitably.

First some assumptions.

  1. It needs to be single-payer. Anything other than that will leave too many exposed to cracks an crevices of not having insurance.
  2. Everyone needs to participate. If it does not have everyone, it will quickly devolve into an adverse selection program.
  3. There needs to be a mechanism by which low income individual and households are subsidized.

When you look at these basic assumptions, the only viable provider is the federal government. It pains me to say that, but it is true. Currently they are the only organization that has the ability to to reach everyone in both collecting premium and monitoring the subsidies.

Every working American is currently sending payment to the government throughout the year. The collection and processing infrastructure is already there. Its called the IRS and payroll deductions.

Yes there are people that are not currently employed, but if they are drawing unemployment, they should be filing a tax return. For those individuals that currently are not required to file a return? Start requiring one. A 1090EZ form takes less than 5 minutes.

Now we have everyone “enrolled” and those that have a means to pay are paying. That leaves only two things to work out

  1. What will be covered
  2. Subsidies for low income households

Admittedly when I say that, it is a clear over simplification. But the rest is administrative details. And while the devil is in the details, moving the conversation this direction as opposed to stops the posturing of politicians. When you strip away the ability to use “Health care is a right” or “Premiums keep rising” as talking points at your latest press conference and turn instead to the debate about pricing schedules for prescriptions or procedures, the rhetoric stops and the true work can begin.

We can also stop talking about the “individual mandate” and start calling it what it is, a tax. True, no one wants to pay more taxes, but we all think someone else should. Whether it is the liberals screaming the rich don’t pay their fair share, or the conservatives screaming the poor should pay something. Or the corporations should pay. Or we should do away with this deduction or that deduction. We all want “someone else” to pay.

Let’s agree though. Everyone should have access to basic health care and it is in our best interest to ensure that everyone, even those without financial means, do indeed have that access in a usable form. We have long ago accepted that providing a basic level of retirement security is something we will pay for. I believe the American people will do the same for health care. We just need to put politicians in office that would rather make that happen as opposed too many that view holding office as an opportunity to showcase to the world how bad the other side is.

As for the details, over the next few weeks, I will throw out some thoughts on those.

*I originally wrote this about a year ago, but never published it. That was long before anyone conceived that Donald Trump would be elected or that the Republican attempt at reform would flame out. 

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Talking Taxes

Obviously this is a hot topic right now with The New York Times releasing three pages of Presidential candidate Donald Trump’s 1995 income tax return. Many people are shocked and angry that based off the information contained in those three pages, it is possible that Mr Trump could have avoided paying taxes for 18 years. While I am no fan of Mr Trump, what exactly is the problem?

Seriously that first question was rhetorical. It’s obvious, a billionaire avoiding taxes for nearly 2 decades while his vast fortune exploded. It isn’t fair. It isn’t right. It’s a civic duty to pay taxes. Our schools and roads are falling apart, while some billionaire pays nothing to help. It’s pretty obvious what the problem is.

So I’ll ask another question. Why is this issue with Mr Trump a problem for you? Again I am no fan of Mr Trump, but step back a moment. No one has accused that fraud was committed. Everything appears legal. I’m siding with Mr Trump on this one and chances are you do nothing that Mr Trump didn’t do. It’s a simple question really. In fact Mr Trump’s running mate Mike Pence asked this very question of the Democratic VP candidate Tim Kaine in the debate last Tuesday. Do you take every deduction you are entitled to? Not that I am a conspiracy theorist, but it is interesting to note both times Mr Pence asked the question, Elaine Quijano, the debates moderator interrupted before an answer could be provided by Mr Kaine. So ask yourself, do you take every deduction you are entitled to? That’s all Mr Trump did.

So what’s the issue. Why are you angry that Mr Trump took every legal deduction and as a result had many years in which he ended up owing no taxes? If you really look at it, the reality is you’re probably mad because of one or two reasons. You don’t like Mr Trump or you’re jealous of the Mr Trump’s success. Don’t stop there though, substitute any wealthy person for Mr Trump. Are you still as angry? Better yet substitute yourself for Mr Trump.

I took every legal deduction and as a result had many years in which I ended up owing no taxes.

You bastard, how could you do that. It is your civic duty. Are you still angry? I hope so, because then we can get at the real issue. The tax code. That is the fundamental problem. That this could occur based on our tax code, not that it is Mr Trump.

 

Maybe It’s Time For Something Different

I have no idea if this makes sense or not. It certainly will not make people feel comfortable unless society changes as well. But, who knows, maybe it is drastic enough to work.

Let’s do away with security at airports and train stations.

Crazy, huh?

Think about this for a minute or two while I expand on the thought. Most recently Brussels exposed a fundamental problem we face. Where do you put the security measures? Current set-up at airports has everything after parking, drop-off, bag check and check-in. While it may be true that the current measures prevented the explosives from reaching an airplane, they did nothing to stop the carnage at the airport.

Maybe we put security outside the airport building itself. Wouldn’t that however mean a would-be terrorist simply moves the target outside the building. Maybe we move it off the property all together and only allow travelling passengers to enter the airport grounds. Again, a would-be terrorist simply needs to relocate the point of explosion. This scenario never ends unless we put security at the front door of every American. In the words of Frank Horrigan, “That’s not gonna happen.”

So what do we do? Let’s fight back in the most extreme way possible. Let’s drop all the charades of security and devote every penny and ounce of effort to intelligence and shut them down before they can get started. Will there be airplanes blown up? Probably. Will explosions occur and people be injured. Likely, but guess what it is happening and will continue to happen under the current system. That’s why I said charade. If a terrorist wants to target a location, there is very little we can do once the plan is in motion. Any action we take with security measures only relocates the specific location. The plan needs to be stopped before it is set in motion.

I am not suggesting we target any group, ethnic or otherwise, we need to be on the vigil against evil in whatever form it comes. There are plenty of evil people from every imaginable group you can sub-divide us into. Whether it is white supremacists, Muslim extremists, disenfranchised youth of any race or religion. Terrorists come in all shapes and sizes. My thought is if we can be welcoming, yet vigilant toward all people, the isolation or persecution these folks feel will be diminished. This will lesson the occurrences.

Just a thought.

Do Not Let This Happen!

Before I get into my dissertation. Let me state my best wishes to the family of Justice Antonin Scalia.

With the passing of Justice Scalia the political world will no doubt be put into a tailspin. Should Obama nominate a new Justice? Will the Senate confirm them? Unfortunately, I think this will get ugly. Which is pathetic.

First of all, yes, President Obama should seek to nominate someone as soon as possible. Believe me, while I am not necessarily a critic, I certainly am not in the cheering section for President Obama. But whether I or anyone else is a fan of the politics, the simple fact is, it’s his job. Right there in the US Constitution. “shall nominate, and by and with the Advice and Consent of the Senate, shall appoint Ambassadors, other public Ministers and Consuls, Judges of the supreme Court” Read it yourself if you don’t believe me.  Article II Section 2 Ironically, as much of an origianlist as Scalia was and as clear as this clause is, I think he would be one of the strongest supporters of President Obama nominating a new Justice.

Now who President Obama chooses as the nominee will say a lot about his motives. Does he have the best interest of the country at heart? If so, he will look to find someone that can be confirmed with relative ease. Even if that means compromise. Is he looking for a fight to truly make this an election issue? If this is the case, we will see someone that is a clear ideological appointment.

Lastly, the Senate has these same questions. Will they choose to make a fight of someone that is a compromise type candidate? Or will they do what needs to be done and get a Justice confirmed?

My fear is that all the worst will happen. President Obama will dig in his heels, for the opportunity to “make” the court into his image of what it should be. And the Senate Republicans will do everything in their power to stop him from making any appointment.

It’s Time!!!

It all begins today.

The Iowa caucuses will take place tonight and will no doubt dominate the news on any station you happen to be viewing. I will be making my prediction on the outcome, but first I want to say a few things about the candidates.

Not singularly, but collectively. Seriously, is this the best we can do? I have no idea what happened to this country that we can not find a single candidate better than this slate. Just looking and listening, would you honestly choose any of them that you would be truly proud to stand up and say, “That’s leader of my country!” I don’t mean this too be entirely negative and I know each one has good strong aspects worth getting behind, but as an entirety, they also all lack something.

Whether it is Donald Trump, who lacks anything resembling the ability to an international statesman, or Hillary Clinton, who most of the country agrees is not trustworthy, they all carry a strong negative. Some more strong than others.

Now for the predictions. I claim to have no political insight and I do not have a connection to any candidate. I just like to make predictions. I may be way off, but I don’t care. It’s a fun little game. Before I get into the Iowa caucus predictions, I do want to put a few general long term items out there.

  1. Hillary Clinton will withdraw from the election – some scandal will come up and the Clinton Dynasty Image can not afford to have her lose another presidential election, so she will drop out citing personal reasons.
  2. Marco Rubio or Chris Christie will be on the ticket – maybe both, maybe the headliner, maybe VP. Not willing to say right now who gets the nomination, but each of these two guys give something sorely needed on the Republican side.
  3. There will not be a major third party bid – however, minor parties will receive a greater share of the popular vote than is usual.

So how do I see the results. First the Republicans:

  • Trump – 24%
  • Rubio – 20%
  • Cruz – 19%
  • Bush – 12%
  • Carson – 11%
  • Christie – 7%
  • Everyone else – < 5%, so we don’t care

On the Democratic side

  • Sanders – 49%
  • Clinton – 46%
  • O’Malley – sorry dude, you just don’t matter in this one

Hope you all enjoy the coverage and let’s get it started.

 

 

Happy Birthday (belated)

Happy Birthday USA!

Sorry I’m late, but I had some things to do and just did not get around to writing until now. Hopefully thing are going well for you. I know its been a tough few years, but things seem to be looking up. 

Sure there are lots of things to work out; money’s still tight, some family squabbles to deal with, and of course parts of the neighborhood seems in some total disarray. 

While I’m not sure what to do about the neighbors, they may just need to settle there own issues, I think it’s about time to get some of these family squabbles settled. And I think if you get some of those taken care of some of the money issues will work themselves out.

You know as well as I do that inviting people into your home has worked out well before and in fact it’s helped you build quite the estate. Sure every time that happened, there were some adjustment issues, but in the end every one turned out to be a welcome boost to the overall good. I don’t see what’s changed to make now any different. You should be welcoming your guests to stay and help fix the place up. Goodness knows there is plenty to do. 

The other good news is that this should also help the financial issues as well. You’ll have some money coming in that wasn’t there before. Sure there will also be some extra costs, but it’s really no different than before. Overall these new folks should make your household stronger.

I say the more the merrier. Don’t ever forget, that’s what built your home.

Vices

Earlier today I had a chance to read about the marijuana laws in the state of Colorado and it got me to thinking about how messed up we are in this country regarding vices. I do not claim to be an expert in any sense on any of these topics and I am not going to discuss pro or con, instead I am just going to speak on how we treat them.

To start the discussion, I want you to imagine a new product. Let me first advise you that the product will be addictive. Experts that have seen information on the product have also determined it will cause significant heath problems. These health issues will not be limited to those directly using the product, but will also effect those in close proximity. It is even likely that people will die due to usage of the product. Would you let me market this product? I am willing to make some concessions. Because of the health issues, I am willing to put a very prominent warning on the package and I will not sell it to minors. Likely, you still would not allow me to sell this product. I am of course talking about tobacco, which is as we all know perfectly legal and accepted product.The farming, manufacture and sale of the product employs thousands if not millions of people. Many levels of our government are increasing funded by taxes collected on the product. Because of these and other reasons its likely this vice will always be here.

On the other hand we have marijuana. Banned federally and minimally accepted as fringe medicinal treatment by some states. Still, millions of dollars are spent and there are thousands of employees in the industry of marijuana. However most of these resources are spent attempting to prevent people from using the product. Again, this is not an endorsement, but imagine the jobs and tax revenue if pot was treated similar to tobacco.

Alcohol is another that fits the category of a vice that is very detrimental to society, but enjoys the comfort of knowing it will never go away. It is true that at one point alcohol was illegal in this country, but I do not see that event returning. Heck even during prohibition, the crooks were often celebrated and many otherwise law abiding citizen broke the law when it came to alcohol. But even above a “protected” spot, alcohol enjoys a celebrated spot in our society. Think many St Patrick’s Day celebrations are happening today without alcohol?  Celebrations and big events involve and promote alcohol all the time. How many beer commercials did you see during the Super Bowl? Yet we are also told, justifiably, of the dangers of drinking and driving.

So many things carry this mixed message it’ no wonder we’re all confused and can seemingly agree on nothing.  Gambling is bad unless it’s a state sponsored lottery, being done on a riverboat or horse track, or happening in Nevada. It’s even illegal to have an office pool for the NCAA tournament, but websites exist to promote it. Sex is bad unless you are advertising drugs directed at enhancing the experience. The list keeps going.

I know I will never see it, but it would be nice to see some consistency applied.