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Every public servant ought to have their salaries/wages AND benefits directly tied to the ones crammed down the throats of the people. For example, they should never make more than an additional 10% of the median income of every man, woman and child in the country INCLUDING the illegals. The financial effects of any new legislation should be IMMEDIATELY applied to legislators, bureaucrats and their cronies the very day it passes. They want to require vaccinations? Let them ALL (and their special interest lobbyist cronies, and anyone who does business with the government, or is given power by the government) be the first ones. Line 'em up! Allow warrantless wiretapping? Let's publish EVERY CALL they make, on their cells, home phones and office phones FIRST. Where are THEIR 1099's? How many thousands of businesses and individuals do they want to give their tax id numbers to? They do this crap because IT DOESN'T APPLY TO THEM AND IT NEVER WILL.

Before any real fixes can be implemented to our health care system, the American people need a more broad-based understanding of what drives costs, and why everything seems so complicated. There are "common sense" solutions, but it takes boldness to present them, the patience to allow the conversation to move forward, and eventually courage to implement them. Most of my ideas are not original; I've just never seen my "spectrum" of ideas proposed anywhere else. What if we approached the issue by first considering dismantling government bureaucratic control over our lives?

Both Democrats and Republicans are responsible for the current mess. Employer-based health plans came into existence as a way to sidestep wage and price controls during World War II. Medicare and Medicaid were signed into law in the mid-1960's. In a non-partisan study conducted by the Congressional Research Group for 2007 expenditures, it was discovered that of over 2 trillion dollars in national health care expenditures, 60% of it was attributed to public sources. Worried about government taking over our health system? Sorry, folks, it's already here!

Through the Medicare system, politicians and unelected bureaucrats decide the price of medical goods and services for seniors. "Waste, fraud, and abuse" is rampant within the system. Medicaid, administered by the individual States, is not a completely funded Federal mandate, forever creating budget crisis within State governments.

COBRA, mandated by Federal law, has become an industry to itself. Administering and understanding it has become a national nightmare. HIPAA, signed into law in 1996 to help simplify "portability" of employer-based health plans, has only succeeded in increasing Federal scrutiny over our lives; virtually eliminating "medical privacy."

State governments control which insurance companies will be allowed into their jurisdictions. For individual and small employer plans, State bureaucracies control what benefits will be included in the plans, and their pricing structures. The insurance company "filing" can either be held up or denied by a State bureaucracy.

Hospitals and providers can also be held hostage to government dictate, both at the Federal and State levels. When they are forced to accept reduced payments for Medicare and Medicaid patients, they can "cost-shift" some of their losses onto the private sector plans and the uninsured. When the point is reached, though, where the reimbursements are below their overhead costs, refusal to treat these patients becomes the only option to staying in business. Hospitals, under Federal mandate to treat all who enter with life threatening situations, do not get reimbursed for illegal immigrants walking in their doors.

So what are the solutions? Why not consider replacing our current private sector employer-based system, and public sector entitlement system with an individual ownership system, with vouchers and subsidies supplied based on financial need? (Veterans benefits as offered through the Veterans Administration would remain separate). Eliminate our entire current State and Federal health care bureaucracy, including the Department of Health and Human Services, and replace it with an agency that oversees just the funding aspects, and the creation of a commission that would set up a base plan, including its pricing and benefits mandating.

The cornerstone "base plan" would be a high deductible plan with a health savings account attached to it. There would be a deductible of $5,000 individual/ $10,000 family, with 100% coinsurance. For each month premium is paid in a calendar year, an individual / family gets that full amount as a tax credit, not subject to income limitation. Whatever contribution was made into the health savings account, (up to the deductible amount), a full tax deduction would be allowed.

If an individual / family could not afford the deductible portion, they could apply for vouchers, subject to qualifying factors. If an individual / family could neither afford the monthly premium, they could also apply for a federal subsidy, again subject to qualifying. Those individuals / families who found themselves in sudden economic hardship could apply for a temporary voucher or subsidy. The "qualifying" aspect would be based on some percentage of Federal poverty guidelines.

Enrollment would be voluntary. All adults 21 and over living within our borders would be eligible to purchase health insurance plans. Only U.S. citizens and legally documented residents, though, would be eligible for vouchers and/or subsidies. Hospitals treating illegal immigrants could turn over their costs to the Federal government for reimbursement from the individual's home country.

The commission, consisting of representatives from all interested parties of the health care system, would establish the base plan benefits and pricing structure. Insurance companies, subject only to licensing and bonding requirements within each state, would be allowed to offer any array of product and pricing models, as long as they offered the base plan alongside their other products. Any product that deviated from base plan mandating would require waiver forms to be signed by the consumer.

All claims would now be processed within the private marketplace. Let the insurance companies and providers fight the battle of "waste, fraud, and abuse!" State arbitration panels could be established to check the abuses of insurance companies themselves. Excessive decisions against them could trigger higher bond requirements in a given State.

There would be guarantee issue, individuals not subjected to pre-existing condition limitations, as long as they applied for coverage within a 90-day requirement, and maintained continuous coverage. All organizations that market health services or products to the public would be required to post prices on a Master website.
In regards to tort reform, an arbitration panel would be established within each State to adjudicate grievances from individuals, or their estates. Legislated maximums would be established for non-economic damages. An individual / estate could waive their right to arbitration for both economic and non-economic damages, but a "loser pays" system would prevail within our civil court system.

These are the basics. How initial funding of this is to be accomplished might be determined after "numbers crunchers" determine a ballpark figure for its initial cost. Some type of minimal employer tax, preferably for a set number of years, would be easiest, as businesses would no longer be burdened by providing and administrating health plans to its employees. As costs to employers would be reduced, more monies would be available for wage / salary increases.

True competition should emerge, triggering more efficiency, and cost control within the entire health care system. Politicians and government bureaucrats would be stripped of a portion of their power and control over ordinary people and the private marketplace. It is time to finally inject some common sense into the national conversation. Isn't preserving the best health care system that the world has ever known worth it?


Richard Kops, independent health insurance agent in Minnesota for the last twenty years.

I agree Bill, Charity is not a virtue it's a VICE.....

"I know a failsafe way to fix Social Security. Every Congressman MUST retire from Congress on nothing BUT SSI. No golden parachutes, no retirement funds, no gratuities, not PAC funds, nothing. Social Security would be fixed in a week."

Well, how about peace in the Middle East by relocating the UN to Jerusalem? Now that's a thought...

Now I understand why Ron Paul failed to make it past the presidential primary....he makes too much sense!

@Myron Goodrum

You have said it quite well. Thanks for this post.

The world has countless graves of people who believed "it can't happen here" or "it can't happen to me." But it happened to them and absent some divine revelation of one's immunity, it can happen to any of us. Yes, plan accordingly.

I agree the path of government in the US (and many places around the world) will be: more. This will continue until the economics forces it to stop. Two things are certain ‒ 1) government will not contain itself, and 2) the market will force the issue eventually. Once this happens, the promises break, and the people will look for an alternative.

Very few places in the world will be immune to this (even so, having a way out is a must).

What I think about is what comes after, and where is best? In this, if there is some hope anywhere in the world for freedom, liberty, and limited government, I believe it will be in the US (or some subset of the current US – nothing says it will stay whole). This is because the people in the US (naively) have the philosophy of freedom. They have scales over their eyes today; once the scales are lifted (when the promises are broken) they could very likely say "how could we have been so dumb."

At least, more possible in the US than elsewhere.

Am I a defeatist or optimist? Because I see whatever the US government wants, it gets. To feel that its not about the people, but all about the government? Especially when I see government ultimately get's what the politicians want, despite our objections.

We the people, I think it was 55% or 65% of us against the health care bill, told our representatives' we did not want government mandated health care. But they passed it anyway, leading us to believe...with out reading it or understanding all the ramifications of it. In light of this, why should we believe that when it comes to any legislative actions, we could expect them to act any different in the future? Or have acted any different in the past? With track records like that, who in their right mind would ever believe in a system based on that?

It's a pattern that's been played out since the 1800's. I personally do not expect any meaningful change in the minds or in the actions of the people or the politicians when it comes to figuring out the government's game. A game which seems to be all for one (the government) and one (government) for all. This, of course, is at the expense of freedom, liberty and power to the people.

It is also clear to me that a perpetual treadmill ‒ the belief that we, the voters, can make a difference – is designed to exhaust our will and eventually deliver us up frustrated and willing to accept whatever compromise the bureaucrats decides is best.

Nations come and nations go. Why should we think that the US will be different? Or that it will eventually stop self-destructive actions on its own or at the behest of its people? What evidence do we have of other nations doing this? None. What example do we have of a government downsizing itself 50% or more? I say it is not possible for a government to limit its internal & external growth to save its own nation, its founding principals, its people or their way of life.

As free and intelligent people, I feel the only thing we can do is to protect one's self and our family. We need to prepare for the inevitable implosion of our government. History has shown that nations either cave-in upon themselves (thus becoming dictatorships, socialistic, communistic, etc.) or are destroyed and assimilated by stronger more powerful nations. My advice, have an exit plan for you and your family.

Hoping for the best is great, but be prepared for the worst. The fall of the Roman Empire didn't air on the evening news for all to see and its citizens were not warned the end was near beforehand. They drowned in a sea of government induced enthusiasm.

Become an avid reader of history. I found that my love of reading biography's of industrialist who build this once great nation, taught me a lot about the political and economic landscape of the USA during its greatest periods of prosperity. But I had to dig deep for unbiased works. I found a lot of writers with axes to grind and agendas to push.

I continue to see a lot of information related to our history and heritage being buried, obscured and even re-written in an attempt at political correctness. Government didn't build this nation, the people did. From readings of history you begin to see a pattern...a trend. That trend is an arrogant grasping government taking ever more control over the economy, the banks, the people and their personal affairs. I see a government intent on increasing its power to rule over the very people who created it to protect them from such actions by out of control governments.

Is it just me or does anyone else notice that the first 10 amendments to the constitution of the united states actually seems to empower the people, while all the other amendments increase power in the hands of the government?

Anyway, I see more of the same trends on the horizon. The only difference from the average American (or any other man/woman from any other nation) and myself is, I'm not foolish enough to believe that my (and my family's) salvation lay in the hands of a benevolent government or their process's and procedures for fixing anything.

So does that make me a defeatist or optimist? Let me tell you that I am an optimist! Like an investor, I look at all the available information and make an informed decision regarding my future.

What I see as the future for US citizens is worsening conditions for life, liberty and the pursuit of happiness through bigger more intrusive government, more rules, more regulations, tighter government controls on business, money, housing, travel and increased personal & business taxes. As an investor, these are signs of trouble. These conditions make for poor investment returns.

And if that isn't enough, how about this indicator: how government rammed that health care bill through. It's the rule not the exception. Business as usual and a clear indication of actions to expect.

So take a close look around. Is this the type of climate to keep your family, your wealth, your business or your investments attached to? Until there is substantial, and I mean 50% or more reduction in the size and scope of government, you do wise to keep an exit plan ready and waiting. Start now, don't wait. Only you can save your posterity. Nothing else is going to save you from a collapsing government.

That's how I see it.

@ Bionic Mosquito:

I wonder how much more buried planning ahead will be unexpectedly uncovered by anyone masochistic enough to read through that entire 2,400 page law? For example, I understand that a provision exempting the SEC from the FOIA was detected by some hawk-eye. So much for Obama's promises of government transparency. How embarrassing if someone discovered documents showing that over a period of years, the SEC was repeatedly warned about some ponzi scheme and failed to act, as was the case with Madoff.

"Unfortunately for us, this will be seen as an urgent need for the IRS to put yet more richly compensated parasites on their payroll to process another mountain of useless pieces of paper."

If I recall, the same healthcare bill has a provision to hire 17,000 or some other similar number of new IRS agents....

You can't acuse the government of not planning ahead!

Lee White:

Yes, as you correctly observed, Washington will be buried in a pile of billions of 1099s sent in by millions of businesses every year. Unfortunately for us, this will be seen as an urgent need for the IRS to put yet more richly compensated parasites on their payroll to process another mountain of useless pieces of paper. And the DOJ will need thousands more prosecutors to press charges against those who fail to add to this paper mountain. People will then be convicted, jails will be built and guards hired. Thus will be solved America's unemployment problem.

If a camel is a horse designed by committee, then "public service" is employment fathered by academics and industry lobbyists.

Wes, I disagree. Society has no obligation to provide for the needs of anyone, be they afflicted with birth defects or otherwise. People have that moral obligation as individuals or as charitable groups they may form, but forcing people at the point of a gun to provide for anyone (which is what taxation does) is an immoral act of the government. Charity is not the function of government, for health care or any other purpose.

I had an easier time believing that water will run uphill than Obama's claim that this "healthcare bill" would save money.

@Wes on 9/29/2010 9:40:27 AM

"Society has an obligation to help those with birth or genetic conditions."

No, the parents do. To the extent they are not able, family, friends, and private charity are available – but not obliged.

One man's need – however derived – places an obligation on me just because I was...born? Really? Did I sign a contract, or is my "birth" an automatic passage to indentured servitude (rightly called slavery)?

What a world we live in, where every baby born is stamped with the words "I Have an Obligation to Society" right on his/her forehead.

It is apparently a "Liberal" assumption that if folks have medical needs, (needs) which are not being sufficiently met, then it's society's responsibility to meet them. The way I read this is that the NEEDS of recipients takes precedence over the RIGHTS of the producers of healthcare .... all of the doctors, hospitals, insurers, etc., not to speak of the rights of the taxpayers who are going to have to pay for all this neediness. In this regard I sort of cotton to something written by Ayn Rand, words to be said by one of her main characters in "Atlas Shrugged":

The evil of the world is made possible by nothing but the sanction you give it" " John Galt

Once again Dr. Paul's insistence that we harken to the intentions of those who founded our country and its Bill Of Rights is being treated by all too many as just so much clamor to be giggled at. Well, I for one am not smiling! Dis-sanction this monstrosity of a healthcare bill.

Sempre Fi

Lee White you are on the right track with congress being responsible for their own retirement,like we are, but don't stop there. Government employees being paid more than the private sector and furnished retirement and healthcare by our tax dollars has to Click to view linkernment employees have cradle to grave guarantees the rest of us do not have. How many taxpayers taxes do you think it takes to support one average government employee for life, and this regime is hiring more every day.

Not to mettion the tens of thousands that would be required by the laws and regulations they are raming down our throats.
So yes Mr. White the federal, state, local government employees pay and perks need to be rethought along with congress, teachers and social security.I personally think the union leaders will of course fight this more than the union members. This country can not meet its' entitlement obligations as rediculous as they are. Those of us paying taxes to support those entitlements are tired of it and we have no guarantee of comfortable, secure retirements.Does it seem logical that those paying for the retirement entitlements of the afforementioned could very possibly not have the comfort and security in retirement which they paid for others.

Yes government employees pay taxes. Just as soon as they get paid by our taxes they do.There is no graceful way to end this post. Just like there is no graceful way to solve the financial woes of this country furnished to us courtesy of our politicians.

Healthcare is a product, it's not considered discriminatory when someone with a bad driving record pays more for car insurance, so shouldn't it be that someone who's life style choices results in poor health, be require to pay more for insurance? Society has an obligation to help those with birth or genetic conditions.

But with 50% of the US population clinically obese, I 'd suggest that is due to choices. Ron is right on. My solution to SSI is to simply say everyone under the age of 30 is on their own for retirement but still required to pay into the system, and to limit payouts to the amount contributed plus interest.

A few of the healthiest things one can do cost nothing, i.e. fast, drink distilled water, and relax in fresh air and sunshine. Add clean wholesome food to that and the body begins to heal itself. Simple and doable.

Every member of Congress or Parliament should automatically be on high alert when some government tries to urgently push a piece of legislation through to become law.

A whole pile of legislation at once should ring everone's alarm bells and every one of the above members should be obliged to demand openly discuss the answers to "why" so urgent" and "what happens, if we don't" questions...

If a citizen decides to not ask why left is the direction to go, because someone told him/her that it is urgently required, and blindly follows that directive, no one will pity him/her, when s/he falls off the cliff: no one will pay for the consequences.

When a government follows that same "path" we are all demanded to pay for the consequences.

Apart from that, I've never understood, why more would be cheaper than less legistation? Please, anybody, help me with any example, where this appeared to be true? (By the way, extremely efficient Singapore excluded!)

It's time we, the citizens of this world, remember are dear and late "colleague" Mahatma Ghandi und use his "tool" to express our dissatisfaction: civil disobedience until "things" change!

When are we going to take our role and responsibility as citizens?

Anybody? I'm with You...

Just for laughs, how fast will our economy recover when the Republicans get in office And Yes, I agree with Lee White, at $1600.00 per term, per month many more months of S.S. would be available to those of us who worked our whole life without the benefit of a decent education. ... A fan

Dr. Paul

I'm an old retired trucker on Social Security Disability.

Item 1: 1099 forms Truckers could BURY Congress in 1099s within a week. Imagine us buying 200 gallons of fuel at $3.00 per every day (normal). 30 1099 forms every month from 1 million trucks would soon bury ALL of Washington DC.

Item 2: SSI

I know a failsafe way to fix Social Security. Every Congressman MUST retire from Congress on nothing BUT SSI. No golden parachutes, no retirement funds, no gratuities, not PAC funds, nothing. Social Security would be fixed in a week.