Science Archive

0

Voyager 1…Leaving The Solar System

Voyager 1, a space probe launched in 1977, was planned as a 20 year trip to photograph the most distant aspects of our local neighborhood.  Since its launch on September 5, 1977, Voyager 1 has traveled almost 11 billion miles, giving us spectacular pictures of Earth and our closest neighbors.

Voyager has become one of the most famous of items of ‘space junk’.  Several movies, including the first Star Trek movie, had Voyager as a core plot point.  A series of messages and sounds were added to the probe, intended to be a greeting to any alien race that encounters the probe.  In recent years, Stephen Hawking lamented the sending of the message, stating that any race that encounters it will likely lead to humanity’s doom.

Crescent-shaped Earth and moon

Earth and the Moon, 1977

Voyager also gave us some perspective of our small place in the Solar System, let alone the universe…

Earth as the 'Pale Blue Dot', 1990

It gave us our first look at our neighboring planets as well.

Great Red Spot

Jupiter's Great Red Spot

Most of the great space adventures of our generation have passed with the end of the cold war…but Voyager simply keeps going on into the depths of the eternal darkness.

2

2010 Predictions…A Look Back

So you can see my predictions of the year 2010 here, if you wish.  My 2010 predictions weren’t too bad…but in hindsight, I have to say that I have outdone myself.  Regular typeface is my original prediction, and bold is my current commentary…

  • President Barack Obama will sign a health care reform bill…but not until well after the State of the Union, and only with a lot of difficulty.  Democrats will fight another civil war on the public option, taxes, abortion, and illegal immigrants.  CORRECT!
  • Democrats will try for a third stimulus, in which Obama will try to focus on tax cuts, but progressives in the House will push him to spend more on government programs.  CORRECT!  ASSUMING YOU ARE COUNTING THE CURRENT TAX BATTLE.
  • Obama’s Budget Director forecasts a 4.0% growth rate next year…the rate of growth will be much less, closer to 2.5% for the year.  SO FAR, ACCURATE.
  • We will see narrowing of job losses in the beginning of the year, but some of it will be smoke and mirrors as the government hires 700,000 temporary workers to carry out the 2010 census.  By the end of 2010, the overall rate of unemployment will still be in the double digits.  CLOSE.  WE ARE SLIGHTLY UNDER 10%.
  • The stock market will have a mediocre year, rising 7-8% to around Dow 11,300 by the end of next year.  Businesses, however, will again be profitable.  Hiring will start in earnest in the end of 2010.  NOT BAD…THE DOW IS UP ABOUT 8% FOR THE YEAR.
  • The Federal Reserve, in a bid to halt inflationary pressures, will increase Fed rates by middle of the year.  The dollar will actually gain value…and gold will stabilize or drop in price.  However, oil prices will rise to around $100/barrel.  WRONG.  THE FED IS STILL TRYING TO FLUSH MONEY INTO THE SYSTEM.  OIL IS AROUND $80.
  • Legislatively, Democrats will have greater and greater difficulty in passing anything.  Cap-and-trade, immigration reform, and card check will all die an ignoble death.  TRUE.
  • Obama’s attempts at budget deficit control will go to naught, as Democrats fight among themselves over which they should do:  tax increases or budget cuts.  Ultimately, nothing will be done, and the deficit for 2010 will be around $1.5 trillion…or about the same as 2009.  In other words, matching the largest national yearly deficit in world history.  CORRECT!
  • Almost nothing will get done by Congress, as Democrats (not Republicans) will virtually bring the legislature to a standstill.  FALSE.  REPUBLICANS STOPPED MOST EVERYTHING, TO THEIR CREDIT.
  • By summer, Tea Party protests will be ravaging the nation, as the protesters fight for control of the Republican Party.  Conservatives will be pitted against moderates, and in most races, the conservative will triumph; for example, Rubio probably will oust Crist in Florida.  Democrats will giggle in glee, remembering the outcome of NY-23.  But who has the last laugh?  ABSOLUTELY, POSITIVELY CORRECT!
  • Obama’s poll numbers will stabilize in the spring, as unemployment numbers artificially are leveled off.  However, as the year progresses, and unemployment stays in double digits, Obama’s popularity will drop below 40%.  As time goes on, Obama will be blamed more and more for the economy, and his laying the blame with the prior administration will sound more and more like whining.  FALSE.  ALTHOUGH MUCH IS TRUE, OBAMA’S POPULARITY HAS LEVELED IN THE MID-FORTIES.
  • Republicans will gain 8 Senate seats.  I will be more specific in my 2010 election prediction article, but briefly I predict Arkansas, Colorado, Connecticut, Delaware, Illinois, Nevada, Pennsylvania, and New York to flip (I know, I am an optimist).  I predict Republicans will pick up 40 seats in the House, just short of the majority, but will try to entice additional Blue Dogs to switch parties.  It will be that close.  2010 will be a historic landslide, ala the Second Republican Revolution.  NOT BAD!  REPUBLICANS GAINED 6, NOT 8, SENATE SEATS.   AS FOR CONGRESS, I WAS CLEARLY PESSIMISTIC, AS THE GOP PICKED UP 63 SEATS…BUT CORRECT ABOUT THE LANDSLIDE!

As for my ever pathetic sports predictions:

  • Alabama will defeat Texas for the BCS Championship.  CORRECT!
  • The San Diego Chargers will finally break through and win the Super Bowl.  NOT QUITE.
  • Kansas Jayhawks will win the NCAA Basketball championship.  NOPE.
  • Pittsburgh Penguins will repeat as NHL Champions; the L.A. Lakers will repeat as NBA championships in a classic series over the Boston Celtics.  LAKERS CORRECT, PITTSBURGH NOT SO MUCH.
  • The United States will finish 3rd in the medal count at the Olympics.  WAY TOO PESSIMISTIC!
  • The Red Sox will outduel the Yankees, and win the World Series.  NOT EVEN CLOSE.
  • O.K., my ‘homer’ picks were horrendous last year.  Here we go:  The Pistons will miss the playoffs, and get the 8th pick in the Lottery.  The Red Wings will lose in the 2nd round of the NHL playoffs.  The Tigers will miss the postseason once again, this time by 5 games.  The Lions…who cares; I am a Redskins fan!  The Skins will get Mike Shanahan as coach, dump Jason Campbell as QB, and will draft Sam Bradford with their first round pick, which will guarantee that he will be a major flop in the NFL.  And my beloved Michigan Wolverines will get back to a bowl…but only an average one.  FRANKLY, NOT BAD, NO?

Oh, and of course, the obligatory JibJab piece:

0

Cap-And-Trade: Why Lie If You Don’t Have To?

The Obama Administration this week released a report to underline the effects of global warming on the United States.  This predicted higher ocean levels, water sources depleting, worsening droughts, etc.

Pretty scary.  Until you realize how much of the science was manipulated.

Roger Pielke was one of the key scientific sources of the report.  The University of Colorado reseracher blasts the report (which uses much of his data to substantiate the findings).  “This post is about how the report summarizes the issue of disasters and climate change, including several references to my work, which is misrepresented.”

In his blog post, Pielke piece by piece shows how the report completely twisted his findings.  If you want to know point by point where the falsehoods are,  I advise you to read his blog post.

Here is the crux of Pielke’s findings, that were conveniently omitted from the White House report:

1. Over the long-term, U.S. hurricane landfalls have been declining.
2. Nationwide there have been no long-term increases in drought.
3. Despite increases in some measures of precipitation . . . there have not been corresponding increases in peak streamflows (high flows above 90th percentile).
4. There have been no observed changes in the occurrence of tornadoes or thunderstorms
5. There have been no long-term increases in strong East Coast winter storms (ECWS), called Nor’easters.
6. There are no long-term trends in either heat waves or cold spells, though there are trends within shorter time periods in the overall record.

Couple points.  First, Pielke is NOT a nonbeliever.  He is not a celebrated opponent of global climate change.  He is a scientist, and he believes that the scientific method should be used to analyze these things.  I don’t think we should hold him up as a political hero or anything.  He is just one of many scientists that want to be honest about their work.

I never really agreed with the Bush Administration policy on global climate change.  I thought they were much too passive.  However, they altered scientific data for their own purposes, and the Obama White House is doing the same.

The American people want honest answers.  The honest truth is that scientists do NOT absolutely know what the repercussions of global warming are; the science is not that clear. That is fine.  The public can understand that.  They can’t understand people lying to them.  This is especially discouraging from Obama, who had promised science above politics.  In this case, he has not held to that statement.

This doesn’t even start to discuss the CBO numbers on Cap-and-Trade, which are horrific.  Heritage has a great discussion that can be read here.

I am a big believer that we have to shift our energy from carbon sources to non-polluting sources.  I believe in green energy.  One can be a big believer in these things without having to believe a falsehood.  And one reason the American public does not trust the government on this issue is because on both sides, they continue to lie to them.  I would rather have an honest debate about what should be done, then people telling me things that are not true.

YOU CAN READ MY VIEWS ON THE ENVIRONMENT HERE.

2

US Backs Down to North Korea

After passing a UN resolution, and then getting permission to block North Korean ships that could be transporting weapons of mass destruction technology, now what happens?  The Obama Administration backs down.

The ship left North Korea last week, but it has been heading along the Chinese coastline, so far avoiding international water.  What the U.S. does once it catches up to the ship is another question all together.  Because of Chinese demands, the UN resolution does not allow the United States to board the ship forcibly.  Adm. Michael Mullen, chairman of the Joint Chiefs of Staff, said Thursday that the United States would not forcibly board a North Korean ship but, in accordance with a recent U.N. resolution, would request permission to search the ship or press any port the ship docks in to inspect it for illegal materials. Permission from the North Koreans?  A highly unlikely scneario.

North Korea has stated that it will view any forcible action as an act of war.  They have said the will enact retribution 100 to 1000 fold upon their enemies if the ship’s ‘rights’ are violated.

All this comes upon rumors that Kim Jong-Il has ordered an ICBM missile to fired in the direction of Hawaii around the July 4th holiday; nice of him to celebrate our independence.  I am assuming (and hoping) that it doesn’t look anything like this:

Fireworks Show

Defense Secretary Robert Gates has ordered missile interceptors and radar equipment deployed in and near Hawaii.  “We are in a good position should it become necessary to protect American territory,” Gates said Thursday.  I point out, this is the same missile defense system that Mr. Obama denigrated in last years election campaign…

I had previously stated that I supported Obama’s strong stance on this.  Well, I equally dislike his backing down.  There is simply one word for this:  wimpy.  The North Koreans have been throwing threat after threat at the United States since this began.  They took 2 U.S. journalists prisoner.  And what does Obama do?  Admit defeat and surrender.

Obama was confronted with the first foreign policy test of his presidency, just like Joe Biden suggested would happen.  And apparently, he has failed.  He has given North Korea full reign to do as they wish, and he has no one to blame other than himself.

5

Medicare: The Preamble to the Public Option

c/o Michael Ramirez, IBD

c/o Michael Ramirez, IBD

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/15/AR2009061501545.html

The Health Care debate has been heating up in the last few days.  This week, the CBO estimated that Democrats plan to cover health care will cost, at the low end, $1.6 Trillion…or more than 50% more than Obama has stated.  Another CBO report said that if they implement the Public option, and slowly roll it in, that 15 million of the 45 million people now without insurance could be covered; at a cost of $1 trillion. $1 trillion for a 1/3 solution?  Not much of a bargain for a public option that is supposed to ‘reduce costs’.  And the public is starting to notice.

So when Democrats talk about the ‘Public option’ on medical care, what are they talking about?

Let us simplify it:  they are talking about making Medicare universally available.  They want a similar program to cover people from birth to death.

Here is the problem:  Medicare has no answers to the major problems with our health care system either.

That’s the message of a report yesterday by a commission that advises Congress on the federal medical program for older Americans.  To eliminate wasteful spending, policymakers must transform economic incentives for doctors, hospitals and other providers of medical services — though it isn’t clear how, according to the report.

To illustrate what it might take to save Medicare, the commission describes how primary-care doctors, specialists and hospitals could be reorganized into “accountable care organizations” (commonly referred to as ‘bundling payments’) whose members would receive bonuses if the organizations met quality and cost targets. To ratchet up the incentives, health-care providers that fail to meet cost and quality targets could be penalized, the report says.  Even then, any projected savings would be highly uncertain, the report says. What is certain is that Medicare cannot maintain its current trajectory, it adds:

“If current spending and utilization trends continue, the Medicare program is fiscally unsustainable. . . . Part of the problem is that Medicare’s fee-for-service payment systems reward more care — and more complex care — without regard to the quality or value of that care.”

Yes.  This is the system that Barack Obama wants to bring to your front door.  Some Democrats, including Tom Daschle, are asking Obama to move past the public option for a number of reasons.  Daschle has joined a bipartisan commission called the Bipartisan Policy Center with George Mitchell, Bob Dole, and Howard Baker calling for a much more conservative health care plan…one that is surprising closer to my own health care plan.

Even worse, Mr. Obama is not telling the truth on this issue.  Many groups (such as the American Medical Association and Insurers of America) are against this, because they believe that this will push private insurers out.  Mr. Obama accused people like me of lying about this.  Is he calling liberal Democrat Russ Feingold a liar? Because Feingold has clearly stated that the public option will lead to a single payer system.  I am sorry, but it is not me that is failing to tell the truth.  I ask one simple question:

How many totally independent health care plans are there for people over age of 65?

The answer is none.  Yes, there are some HMOs and others that work with the government Medicare system, and provide care.  But totally independent?  There are none. Why?  Because Medicare has such a price advantage and monopoly, that there is no competition to be had.  Second, the monopoly is like any other monopoly…smaller players have great trouble competing.  Furthermore, once you give a ‘free’ option, who would choose to pay for it?

People will argue that if Medicare is cheaper, why not continue with it?  Simple:  it is not significantly cheaper.  For one, many of the costs in Medicare are hidden costs; the government shows them in other accounting methods, and not clearly within the Medicare system.  Second, health insurers pay corporate taxes, while Medicare dollars don’t.  And since the Medicare fund is going to run out in less than a decade, those tax dollars are essential to the long term funding of Medicare.  Additionally, in some senses private insurance already subsidizes public insurance.  The public systems (Medicare, Medicaid, and the Veterans Affairs Administration) don’t pay enough to meet costs…so those costs are shifted to patients with private insurance.  Ed Morrissey at AIP has an excellent, more detailed explanation of this.

Second, how does Medicare keep costs low?  Easy:  they ration.  They ration care to patients, and ration payments to doctors.  It is estimated that doctors and hospitals only get around 30% of what they bill.  Let me ask you:  if you went to work , and your boss paid you 1/3 of what he said he would pay you, how would you feel?

Oh, and if you don’t think this is an authoritarian?  Listen to this:

Getting doctors to join accountable care organizations may require pressure, MedPAC Executive Director Mark E. Miller told reporters: “If you want people to voluntarily organize, you may want to make sure that the current system isn’t as pleasant a place to be.”

Understand the repercussions.  Doctors already are stretched to the breaking point, even though they make good incomes.  What will they do if you restrict their incomes even further?  They will provide less service.  They have no incentive to provide after hours services, weekend services, etc.  Right now, they do those things because it is financially beneficial for them to do it.  You think hospitals can or will maintain the same level of services they do now, if they get even less funding?  Of course not.  Government officials would like to think physicians would remain static in their actions:  that is a true lie.

So in short, we come down to the simple reality, no matter what name calling Mr. Obama is involved in:  the only way the Mr. Obama’s plan reduces costs is by rationing, one way or another.  That is a fact, Mr. President.

13

Health Care: How to Control Costs

I am going to try to focus on particular issues within the health care debate, largely because many platitudes are used, but no one gets to the heart of the matter.

Today, President Barack Obama went to talk to the American Medical Association, and talked about how to reduce costs.  And to promote it, he used scare tactics:

“If we do not fix our health care system, America may go the way of GM — paying more, getting less and going broke,” Obama told the AMA’s 158th annual meeting.

He is at least open to some of the more conservative proposals, but his allies in Congress are a different story all together.  Additionally, the President said he may consider tort reform, but without any caps.  That defeats the purpose, frankly, and doctors are unlikely to support that.

How far the President will go to push against the liberal left is still to be seen.  Obama however did make a complete misstatement:  that the public option won’t hasten the downfall of private medical insurance in this country.  That is a fact, no matter how much Obama denies it.  Obama can call me a liar to the day I die…but he is still wrong.  Heck, his own HHS Secretary Kathleen Sibelius said virtually the exact thing in 2007…maybe he should call her a liar as well:

Ultimately, cost, of course, is the biggest problem.  So much so that Democrats are somehow trying to avoid using the CBO numbers…which would be unprecedented.  But the CBO is saying that Obama’s plan as-is would cost $1 trillion…and still not cover 30 million people.  If you wanted to cover everyone, the cost shoots up to $4 trillon.  Yikes.  Additionally, they are using statistics that are outdated, or are totally wrong, thus making the argument even harder.  This is making it very difficult for Democrats to find the votes they need to pass the bill, even in the liberal Congress.

Therefore, cost is the main issue.  You solve this, everything else falls into place.  But let us face some realities right up front.

1. Costs, overall, will increase.

I went into depth on this in my health care review, which can be read here.  But basically, you are going to universally cover health care; so about 40 million uninsured, plus the additional 50 million underinsured. That is 90 million people who are largely not getting full health care coverage today.

Then, you will provide them with full health benefits, preventative care, etc.  Those things are costly, regardless of their longterm benefits.  Thus, upfront there will be an immense increase in health care spending, all things being equal.

2.  The myth of Medicare’s ‘efficiency’

This is a complete fairy tale.  From the Wall Street Journal:  Medicare was created in 1965, U.S. health spending has risen about 2.7% faster than the economy and on current trend would hit 20% of GDP within a decade. Every public or private attempt to arrest this climb has failed: wage and price controls in the 1970s, the insurance industry’s “voluntary effort” in the ’80s, managed care in the ’90s.  Here is how the Wall Street Journal editorializes it, and they are absolutely right:

Medicare is an ocean of money surrounded by people who want some. It is not only an entitlement to beneficiaries, but a de facto revenue entitlement to hospitals, physicians, nursing homes, durable medical equipment suppliers and the rest. Even a tweak to the Medicare fee schedule is the small-scale equivalent of closing a military base or trimming farm subsidies. The system will never be as rational as Mr. Orszag desires unless it is severed from politics.

And one other thing…let us remember that medicare itself does not pay taxes…like private insurers.

3. Information Technology is NOT NECESSARILY going to save money.

This is a farce.  As someone with IT background, IT will cost the American Health Care system billions.  Will it make the lives of doctors easier, and hopefully reduced mistakes?  Sure. I am all for IT for those reasons.  But there is proof that IT advances will increase cost, not decrease them; no proof, other than Obama’s word, has shown otherwise.

4. And above all, you want to control costs, you must ration care.

This is the pink elephant in the room.  Every other socialized health care system openly rations.  Obama is a smart man; he knows he has to, but is not willing to be honest with Americans about it.

This is the real reason our costs are skyrocketing.  We are the greatest innovators in medicine, by far.  About 90% of the medical patents in the world come from here.  Why?  Because we are a Petri dish of innovation.  We try technologies long before they are proven as cost beneficial.  Technology moves at such a fast rate, it would be impossible to test all the devices before implementing them; it would stop medical innovation to a stand still.

And most of the Medicare savings Democrats talk about?  They come directly from rationing of care.

Obama is now facing more pressure to reduce costs, but he is doing it in all the wrong ways.  First, he proposes to slow the rate of increase of hospital reimbursements, which will threaten the already shaky hospital system.  He plans to reduce Medicare payments; for doctors, medicare already pays less than 30% of costs…how many doctors do you think will start to opt out of the system?  Eventually, they will have to, because the reimbursements will be less than their own costs.

In addition, the president is proposing to reduce subsidies for hospitals that care for the uninsured as the number of uninsured falls. That would generate $106 billion over a decade, the White House said. Payments would be slowed beginning in 2013. By 2019, payments would be 25% of what hospitals had received in 2013, updated for inflation.  That may be reasonable, if a full system is implemented.

Obama is keeping his major cost savings hidden…likely because he has no really proposition for the hard decisions necessary to really reduce costs.  Moving dollars from one category to another is not cost savings; it is playing a shell game.  His weekly address on June 12 is an example of how nonspecific he is trying to be:

The New York Times had a fairly good editorial about the failure of doctors to reduce costs as well.  They are right in many ways, but they miss some vital points.   First, most doctors do not benefit from over treating patients; this is a small minority of doctors that have interests in their own testing agencies, commonly called self-referral.  For example, if a orthopedic surgeon owns his own MRI center, he is more likely to sent patients for an MRI; there are multiple studies that show this.  However, a family practioner who has no interest in the MRI center is more likely to order tests that are needed.  Obama and the Democrats are avoiding this issue, because of powerful medical lobbies.  Second and maybe more important, the most common reason for doctors to order too many studies is a simple one:  lawsuits.  Tort reform would potentially help in alleviating that.

All right.  So that is where we are.  So how do we move forward?

1. Make insurance personal, and not employer based.

It is frankly illogical and stupid to have your employer be responsible for your health care.  Few things are more personal than your health care choices; do you really want your boss making those decisions?  Additionally, health care should be readily portable.  You should have to think twice about switching jobs because of health care.

There are two reasons why people are still demanding employers pay for health care.  One, historical; it has always been that way.  Second, inertia; people don’t want to take responsibility themselves.  Neither argument carries much weight.

Instead of giving employers a tax benefit for giving out insurance, we should make employers choose; either give that money in salary to employees, or continue to cover their employees.  Most will choose the former, because handling health care is a headache.  So ultimately, it becomes a personal responsibility.

That is a good thing.  Why?  Right now, patients have no idea how much health care costs.  Heck, most doctors don’t know what health care costs.   It is essential to get patients to realize that these things are costly, and certainly not free.  People make choices daily about everything else cost wise; why not health care?  Sure, we need guarantees for disasters and such, but short of that, a system framed on personal choice is much, much more likely to limit costs than one governed by the feds.

2. Give patients more choice AND more repsonsibility.

I am all for more freedom and choice.  That is ultimately what America is about.  Thus, the more rights we give to the individual, the more likely we will have success.  But rights in this society does not come without personal responsibility.

What do I mean by that?  What I mean is that costly procedures that have questionable benefit should not be regularly covered by insurance.  The prime example is life sustaining tools in the final months of life.  We need to change societal expectations about life and death.  Spending approximately $700 billion a year on the final three months of dying patient’s lives is just not smart.  We need to cover hospice care, palliative medicine, etc.  Now, if a family wants to keep grandpa on life support, that is fine…but that should come out of their own pocket.

Examples such as these can be found through out health care.  Why?  Because people don’t ‘pay’ for services in health care.  Thus, they feel entitled to everything.  By making patients make rational choices, we can reduce the waste of hundreds of billions of dollars quite easily.

3. Tort reform.

Obama at the AMA speech came out against caps for malpractice lawsuits, which in my humble opinion signficantly reduces his credibility on the issue of cost reduction.

This is contentious, and clearly as a physician I am not impartial.  But it is more than  just lawsuits.  There is a vicious cycle in medicine of practicing ‘defensive medicine’.  This is basically doctors order often unnecessary tests only because they feel legal retribution if they don’t.  This has to stop.  This has created a terrible culture of misspending in medicine in America.  We need a complete culture change, where we order tests that are unnecessary, and don’t blame doctors or the system when things still go awry.  Medicine is not a perfect science, even if our legal system wants it to be that way.  There should still be legal recourse for negligence, real mistakes, etc.  But this needs to be limited.

4. Decrease bureauocracy and red tape.

I don’t think there is any industry that has as much paperwork as medicine.  It is out of control.  From documentation, to billing, to legal issues, medicine is mired in paperwork.  It is estimated that private care physicians (family medicine, internal medicine, pediatrics) spend at least one quarter of their time on paperwork, and spend at least 1/3 of their overhead on those costs.  And it doesn’t stop there.  The federal government and state governments have overlapping regulations that make things even more complicated for physicians, hospitals, and insurers.  This whole system needs to be cleaned up.  We could reduced paper work by half, and increase physician productivity by one eighth in one single step.  The cost savings could be enormous.

Frankly, the Obamacare and Democratic plan fails in all four of these steps. They are looking at costs savings from a very high level; how can we save dollars on Medicare and Medicaid, shift it to Obamacare; how can we increase taxes, etc.  Medicine ultimaately is about individuals, and if you want real cost savings across the board, you need to clean up the mess and minutia that is limiting the actual process of health care, instead of staring at accounting tables and tax receipts.

Please see the complete Neoavatara Health Care Plan Here.

11

A Conservative Health Care Solution

We as conservatives better get ready for the Obamacare onslaught, because here it comes.

Barack Obama has stated as one of his major goals as President to push through a national health care reform package, preferably by the end of the year.  Frankly, Mr. Obama understands that this is his moment of opportunity. It is unlikely he will ever have more political clout and capital than he has at this very moment.

And Republicans have been virtually silent.

There is a simple reason for that:  They have had no plan for health care (with the exception of Mitt Romney; but his plan in action has been less than stellar…).

This is a simple harsh truth.  For years, we have Republicans make policy initiatives on the edges of this debate.  That is no longer enough.  Health care, very quickly, will become one of largest financial crises this country has ever faced, if nothing is done about it.  And consrevatives better have a workable plan when the time comes.

There are several conservative plans out there, including Newt Gingrich’s plan and Sen. Tom Coburn’s alternative.  Both have intriguing ideas, and are also dead on arrival.  There are three broad health care proposals out there right now:

  • Create a plan that resembles Medicare, administered by the Health and Human Services department.
  • Adopt a Medicare-like plan, but pick an outside party to run it. That way government officials would not directly control the day-to-day operations.
  • Leave it up to individual states to set up a public insurance plan for their residents.

I personally don’t like any of those choices.  I think we need a system where the federal government gives people the money, primarily by tax credits, to purchase their own care.  I also believe that insurance should cross state lines.

But there are allies popping up every day.  Joe Lieberman and Mary Landrieu have come out against a public plan, which is growing in negative popularity daily.  And many moderate Democrats have been fearful of the final budgetary numbers to come out for the total cost of the plan, with Obama already increasing the budget deficit by almost $4 trillion over the next five years.

Insurers have sort of signed on to the Obama plan, but are strongly against a system that would allow a public plan; they know that it would be the deathknell to private insurance in this country.  The American Medical Association has also come out against a public plan, stating that they want affordable health care but health services should be provided through private markets, as they are currently.  “The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.”

But I till think conservatives must present a full, complete health care proposal, if for no other reason than to show a clear ideological comparison with the Obama Administration.  Obama wants a massively enlarged bureaucracy, for which we don’t have the money.  I think there is a better, most cost efficient, and more cost saving way.

I have had multiple blogs on this topic, including what is the problems in our health care system, as well as my page on larger goals and issues that must be addressed, that can be seen here.  But frankly, we must start with our basica tenets that must be achieved:

1.  Universal coverage – We must find a way to fund health care for all individuals.

2.  Universal applications of best practices – This is not to only to ensure high quality health care with uniform standards, but also to implement the most effective strategies.

3.  Improve health care IT, including better, more efficient methods of billing - This will reduce mistakes, reduce fraud, and in the long run hopefully reduce costs, though up front capital costs will be significant.

4.  Transparency - We must make costs and effective practices known and easily accessible to the public.

5.  Tort and Malpractice Reform – It is essential to remove defensive medicine as part of the culture.  Therefore, legal tort reform is essential, while still balancing the legal rights of patients.

In general, I think these are the most important factors is attempting to achieve a long term, successful national health care program, and I don’t think there is much disagreement on these.

I personally have several suggestions for a conservative health care plan that meets those goals:

1.  Provide a refundable tax credit to every American to buy health insurance.

Right now, the tax code favors those working for large corporations, because they get a tax deduction for providing health care to their employees.  But remember, less than a quarter of people work for large corporations, and most new jobs in this country are formed from small businesses.  There is no reason, none at all, that your employer should be responsible for your health care, other than that has been the way it has been done.  Labor unions started this in the 1940s, because there were restrictions to pay increases; that clearly does not apply to the present day.  All reasons for employer paid insurance are pretty dumb, and there is no reason to continue an obviously flawed system.

A $6000 tax credit for families (or $3000 for individuals) would likely make insurance affordable for most people.  I think most people would be better off receiving more income, and then using that money and their tax credit to purchase the health care that would best fit them and their families.  Sure, there should be guidelines of basic, acceptable level of coverage…but I feel the responsibility is better off  in the hands of individuals.

2.  Provide an answer to affordability.

This is the most important issue for those that lack insurance today.  How can they afford additional health care premiums, at a time that they are living check by check?

First, we must establish that if private insurers are going to dominate the market, they must include all patients, regardless of health history.  You cannot leave a huge segment out of the insurance pool, and still expect to cut costs overall.  Yes, this regulation will make health insurance more expensive for most people, but it is a necessity.  It is one of the sacrifices that needs to be made to have universal care.  However, I also think that people that smoke, do drugs, etc. should have to pay more for their sins…life is about choices.  Maybe forcing people to pay for their sins may get them to make lifestyle choices that will improve their health…who knows.  But we have to be careful here…it is a thin line between healthy choices, and government intrusion on personal choice.

Second, make it clear to private insurers that if they can’t provide affordable health care, the government will.  This is an ultimatum, but also a frank reality.  Many Democrats are already preparing for a single payer national health care system.  Even a partial system with a large government controlled component would likely wipe out many private insurers.  A recent report by the Lewin Group, a numbers-crunching firm that serves government and private clients, found that a new government plan could radically alter that landscape.  If the public plan were open to all employers and individuals — and if it paid doctors and hospitals the same as Medicare — it would quickly grow to 131 million members, while enrollment in private insurance plans would plummet, the study found.  By paying Medicare rates the government plan would be able to set premiums well below what private plans charge. Employers and individuals would rush to sign up.  In all practical purposes it would set up a monopoly…one which the private market could not compete with.  And that will ultimately lead to the obvious…rationing (by one name or another).

Private insurers must control costs if they plan on surviving.  It is that simple.

3.  Provide Tort Reform

Even in this climate, doctors and insurers are more popular than lawyers.  The legal system has set up a culture where doctors waste money purely to cover their own malpractice liabilities.  It is costly to the nation.  The exact cost is difficult to calculate, but doctors understand that we don’t practice medicine the way other countries do precisely because of this ‘defensive’ mentality.

There must be a fair legal system that caps rewards, lowers malpractice premiums, while still giving patients recourse for mistakes.  The currents system is out of balance.

4. Expand Health Savings Accounts

This is an idea that Washington only got half right.  HSAs could potentially be the answer for those people in the middle of the economic spectrum that are struggling with health insurance.  Allow individauls, employers, and anyone else to donate to a HSA, with no limits.  They can help pay for their insurance premiums and any additional costs from that account.  Allow the account to accrue tax free.  This will allow individuals, instead of the government, to have the power to purchase their own health care, and make individual choices that best benefit them.

5. Improving Heath Care quality and transparency

I generally agree with President Obama’s push to modernize Health Care IT.  I don’t think it will provide the cost savings he is suggesting, but it is a good idea.

Implementing best practices will be more difficult, but possible.  I think we should replace the Centers for Medicare & Medicaid Services (CMS) with a board of doctors and scientists who will make decisions of what studies and practices are the most cost effeective and provide the best outcomes.  Today, CMS doesn’t really do that; they really look at what things cost today, and make judgements that way…that is a very poor way of handling health care.

If something falls outside of ‘best practices’, that doesn’t mean it is outlawed…just that it will not be covered by insurance.  I will give an example as a radiologist:  we get requests for MRIs of extremities because patients ‘bumped their arm’ or ‘fell off a bike’.  This is an absurd use of health care dollars, and there is no indication for that.  Doctors today do those test because they don’t want to fight with patients, and are afraid of lawsuits.  But implementing best practices gives doctors a clear guideline; if patients don’t want to follow it, that is fine; but it will cost them.

This is where the Health Savings Accounts come in to play.  If you prefer a different treatment, the insurer will fund the amount that they would have spent on their recommend treatment; you supplement that with HSA dollars to make the decision you want.  People will sometimes make decisions because of personal reasons, but it doesn’t mean the system should pay for them.  More often than not, patients will follow the best available advice, both because of the science and the cost.  That will cause market forces to make decisions that should, hopefully, reduce overall costs.

One last point on costs:  we should clearly print and publish what every medical procedure costs.  Patients should know exactly how much they are spending, and for what.  Transparency is essential in any free market system.

6. The Safety Net

Ultimately, the one real criticism liberals can have to a plan that allows for this much freedom is what to do with those people that fall through the cracks.  I have an answer.

First, if you don’t purchase your own insurance, your $6000 tax credit will still be used; it will be used to purchase a default health care plan.  The authors of the excellent book ‘Nudge’ give us a hint at the solution.  There should be a basic default, that the government puts you in even if you are too incompetent to choose your own plan.

The plan will be the most basic of plans, providing for preventative care and catastrophic care, and little else.  We must make people responsible for their own health care decisions, while still balancing the needs of the society as a whole.  Thus, these people that don’t make that choice will not receive a tax credit, and will in fact be paying more in taxes because they will not be able to deduct the amount from their income.  It is a penalty for being irresponsible.

Second, we need to make sure that all children are clearly covered under the plan.  This easily falls into my previous suggestion.

Third, I have a controversial suggestion:  those people who do not utilize preventative care, especially for their children, should be penalized.  I am not sure how to carry this out, I am still considering multiple suggestions.  But whether or not preventative care can provide cost savings is questionable; however, there is no debate that preventative care provides for healthier living and better quality of life.  I consider this one of the key benefits of health care reform.  However, our society has become so poor in following preventative care recommendations, I think that people, at least initially, must be forced into seeing their physicians on some regular basis.

So, what are the benefits of this kind of plan over Obamacare?

  • No new huge government bureaucracy.  There is no need when individuals, and not someone is Washington, is making the choices.  Additionally, less government oversight means less power for the government to dictate how you live your life.
  • More choice (and responsibility) for individuals, while at the same time providing a safety net.
  • Key on those best practices that provide the best medical outcomes for the best price.  This may include limiting dollars spent on patients in the last months of life, which provides no benefit whatsoever to the patient, and is usually more about the mentality of the patient’s family.
  • The financial incentives to enter into a plan that focuses on preventative care over treatment of disease should in long run make us a healthier country.
  • Forcing patients to make decisions on their medical care hopefully will make them more knowledgeable about what they are spending on that care…and the hope is, those market forces which have NEVER been used in America properly can slowly drive down costs and misues of health care dollars.

I welcome any suggestions.  I believe this is a good starting point…one that can provide universal care, at a reasonable price, without creating a federal governmet behemouth that is sure to cost more and to fail in the primary goals I have stated, while at the same time maintaining individual freedoms.

2

GM Bankruptcy: The End, and Beginning, of an Era…

c/o Michael Ramirez, IBD editorial

c/o Michael Ramirez, IBD editorial

General Motors this week will enter bankruptcy, a stunning turn of events for a corporation that in many ways defined the peak of American manufacturing over the last century.

In its bankruptcy petition, G.M. said it had $82.3 billion in assets and $172.8 billion in debts. Its largest creditors were the Wilmington Trust Company, representing a group of bondholders holding $22.8 billion in debts, and affiliates of the United Auto Workers union, representing nearly $20.6 billion in employee obligations.

So GM, the auto behemoth,  enters  Chapter 11.  Chrysler today will (again) be sold to Europeans, this time Fiat, and will no longer really be an American company (again).  Ford is doing relatively well…but that is not so great in the scheme of things.

This may finally be the end of the Big Three.

In truth, this has been coming for decades.  Many insiders knew that without huge reform, the massive car maker was headed for bankruptcy sooner or later.  Its leadership system is as close to a red tape government bureaocracy as you can get.  It has always stood in quicksand when it comes to change.  Its cars have middling sales, and its Union contract is an absolute disaster.

GM has half-heartedly tried to reform for several decades now.  It slowly cut its union workforce. It expanded globally.  It divested from money losers like Delphi, the parts company (who is also in bankruptcy).  It sold off side or spun off side business like Hughes Aerospace, Elctronic Data Systems, and its own financial unit GMAC.  But at the end of the day, its core auto business in North America was stagnant.  It wasn’t even about cars…GM, remarkably, builds fine cars.  It is about more:  perception is reality.

What is worse about the bankruptcy is that this should have happened long before.   We spent $20 Billion of US taxpayer money since last fall, through TARP, to accomplish what, exactly?  The answer is, nothing.   Those, like me, calling for a structured bankruptcy then were villified.  Sen. Corker of Tennessee was the most hated man in Michigan…the only problem is, that we were both right.  Now, before this bankruptcy process is over, the federal government’s investment will be north of $50 billion…for a company whose stock value, today, is worth around $450 million dollars…or about 1% of what the government is investing.

That is in the past.  What comes next is the $64 billion question.

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The Union, to its credit, has agreed to changes in their contract, in exchange for approximately 17.5% of the reconstituted company.   But for all practical purposes, this is the death-knell of the UAW as a major labor force in this country.  There power has been waning for decades, this is just the final straw.  GM is going to become a much smaller company…which means many less union autoworkers.  That is just a reality.

A whopping 60% will be owned by yours truly, the American taxpayer. An additional 12% will be owned by the Canadian government.   Bond holders, for a large part, have agreed as well, realizing that they will never get a fair shake with this administration.  And in the process, 2,100 GM car dealers will disappear…or one-third of the total 6,000 dealerships now existing, which will cost in upwards of 40,000 jobs alone

However, Mr. Obama’s view, frankly, continues to be naive.  He said the government was forced to do this, and had no other choice.  “That was the only way we were going to be able to structure the deal,” the president told NBC’s Brian Williams in an interview taped on Friday.   “My preference would have been to stay out of it completelty,” Obama said. “But the alternative was to potentially see a liquidation bankruptcy in which (an) enormous institution with a huge impact on our economy, particularly in a lot of Midwestern states, simply gets broken up into pieces, and in the current deep recession that we’re in, could have had horrendous effects in terms of the overall economy.”

Maybe, maybe not.  But this is a quagmire.  Now, the government, meaning you and me, own this mess lock, stock, and barrel.  GM is slowly selling off pieces of itself to survive, including money makers like Opal.  What will be left of the company?  Basically, a North American Division of Cadillac, Buick, GMC trucks and Chevrolet.  This is a company, that even in the boom times of the nineties, had trouble making money.  So is there any point where Obama will now pull the plug, declaring GM a failed entity?  Or is GM likely to become like Amtrak…a never ending black hole of government money?

The government share (Government Motors, anyone?) is the most worrying part.  How much day-to-day control will the Obama Administration infuse into GM?  Mr. Obama says he does not want to run a car company…I am not s0 sure.  Obama has placed 31 year old Brian Deese, a not-quite graduate of Yale Law School who had never set foot in an automotive assembly plant until quite recently, has been placed to steer this process for GM and Chrysler.  He is neither an economist or engineer (and he isn’t evenn a laywer); makes you wonder why he is in charge, huh?  This is perfection for someone who wants to alter the car market in this country.  Will the government push GM to bypass SUVs (one of the few areas where they are making money, I may add) for smaller, Euro style cars who  (no offense) no one buys?

The pressure on the White House to impose the ‘green era’ liberal thinking on the most backward American car company will be immense.  And in liberals minds, it makes sense him; you are already trying to impose gas mileage changes, cap-and-trade…why not take the next step, and make GM into a ‘green’ car company?  And will the government make decisions favorable to GM, and detrimental to the actual only private carmaker in America now, Ford?

Obama will have a difficult time fighting against liberal extremist group who will put much pressure on the Obama administration to make drastic, even extremist, changes to General Motors.  Obama, speaking from the White House, stated “What I have no interest in doing is running GM.”

The combination of extreme lobbying from Washington, with the inherent issues GM has, may make this the most difficult corporate restructuring in US (maybe world?) history.  The problem with restructuring is that you need a strong leader that is willing to do unpopular things…GM has no such leader, and Barack Obama certainly is not that man.  So who will lead them from the wilderness?  There are practical realities here.  What if GM needs to layoff another 50,000 UAW workers to survive…is Obama going to go along with that?  How about GM needing to ship more manufacturing to foreign countries…how do you think this administration will feel funding a company that is outsourcing?  These are real issues.

If Obama is willing to sacrifice political capital for the well being and survival of GM, GM has a chance.  If he is not willing to do that, GM is almost certainly doomed to future failure.

0

Climate Change Hysteria

http://www.cnn.com/2009/WORLD/europe/05/29/annan.climate.change.human/index.html

The Global Humanitarian Forum, led by former UN Secretary General Kofi Annan, has warned that 300,000 a year are dying because of global warming, and that more than 300 million people are already seriously affected by the gradual warming of the earth and that number is set to double by 2030.

That is all fine and dandy.  Except, it is a falsehood.

Now, before I get too far, here is what I believe:  I believe there is global climate change.  I don’t think you can deny that.  Is it caused by humans?  Well, I am not sure, but I think there is a fair probability that some of it may be affected by human actions.  I also don’t think it is easy to prove either way.

This report, however, is pure hysteria.

Why?  Well, read the intricacies of the report.  The methodology can be seen here.  Basically, they separate their findings into two categories:  weather related disasters, and gradual environmental degradation.  Fine.  Then they calculate how much of that is caused by climate change.  OK.

Here is the question:  HOW DO THEY ACHIEVE THIS NUMBER?

Easy.  They estimated it.  There was no scientific method in determining this…a bunch of so-called experts just pulled a number out of their hat (or other body parts) and stated this as a fact.  It is no such thing; it is only opinion.

Here is the other problem.  They don’t take any historical patterns into account.  None.  For example, have hurricanes, droughts, etc. actually increased in recent times?  There is no methodology to show that.  So, even if their arbitrary number of 300,000 people dying because of the environment is in fact correct, there is nothing in their study to show that the same proportion weren’t dying before the industrial age.

Here is one claim they make, straight from their report:  (the entire PDF can be downloaded here)

The international community agreed at the beginning of the new millennium to eradicate extreme hunger and poverty by 2015. Yet, today, climate change is already responsible for forcing some fifty million additional people to go hungry and driving over ten million additional people into extreme poverty.

Here is the problem.  Are those people in increased poverty because of global climate change?  Or does the global recession, increased gasoline and food prices, and global conflict affect that number?  Do they take that into account at all?  It does not appear so, looking at their methodology.

This is shoddy science at its worst.  Look, I am a big supporter of green technologies.  You can see some of my policy initiatives here.  I believe we need to alter our behavior for a multitude of reasons:  diminishing resources, geopolitical conflicts, etc.  But having shoddy research trying to back up these claims does not help the effort.  There is a reason that the majority of people in the United States don’t believe in global climate change:  because they feel others are trying to manipulate them.

You want to convince people something is happening?  First, place a few non-believers on your team.  Convince them.  There are a number of non-ideological scientists that don’t believe in human created climate change.  Convince them.  If you can convince them, you can convince anyone.  But like with this research, where every member is a hard core ideologue and firm believer in the results before the study was ever performed, it is purely propaganda, and not scientific research.

There are simple concepts and facts that would convince people to make changes in their lives that can make a significant impact on human produced pollution.  We should be doing that, before we start yelling ‘the sky is falling!’ to achieve our ends.

2

North Korea Nuclear Test, Part 2

By Michael Ramirez

By Michael Ramirez

My overview of North Korea can be seen here.

http://www.cnn.com/2009/WORLD/asiapcf/05/26/carroll.korea.nuclear/index.html

North Korea is testing again…this time, it is testing the strength and will of U.S. President Barack Obama.

North Korea detonated its second nuclear weapon this weekend, in total defiance of the United States and the world community.  The North had threatened to do so unless the U.N. Security Council apologized for imposing sanctions on it following a rocket test on April 5.

This test was much larger than the prior test in 2006.  It was estimated at approximately 10-20 kilotons; that is on par with Hiroshima.  The 2006 test, which was deemed a partial failure by western scientists, was less than 1 kiloton.  The test was felt in China, where it shook the ground, and was felt as far away as Russia.  What this says is that North Korea has now perfected their technology, and likely is well on their way to full nuclear missile implementation.  Again, more good news.

The White House — which less than three weeks ago announced a new diplomatic effort to restart stalled talks with North Korea about its nuclear program — said the test was in “blatant defiance” of the Security Council.  “North Korea is directly and recklessly challenging the international community,” the White House said. “The danger posed by North Korea’s threatening activities warrants action by the international community.”  Obama himself said the matter was of ‘grave concern’.

Yeah, that kind of statement will really scare North Korea.

The reality is that a carrot-and-stick approach is needed with rogue nations like North Korea.  Mr. Obama, and the world community for that matter, are only providing carrots.  Just a month ago, North Korea fired off a ICBM, against UN resolutions.  What was the punishment, one may ask?  A stern lecture from the UN Security Council.  China and Russia could not even agree on any serious sanctions, although they implemented some for show.

Additionally, Obama not only did not restrict North Korean power…he has actually expanded it.  By virtually ending the Strategic Defense Initiative (SDI, or Star Wars), North Korea now is on the verge of be nuclear capable…and able to hit the United States.  Their partially successful ICBM launch in early April means that within 2 years, they most likely would be able to hit, say, Los Angeles.  Yet the President doesn’t think the missile defense program is worthy.  Where is the logic in that?   (My full views on SDI can be seen here)

Frankly, the Obama Administration has nowhere to go now in its policy toward the communist state.  Exactly what do you do, when you said the Bush Administration policy had failed?  And that the only way forward was one-to-one negotiations, which thus far have elicited even more bad behavior?  Additionally, Obama not only insulted countries like North Korea and Iran when he said they were not threat because they were tiny in relation to the old Soviet Union; at the same time, he decreased his own political capital at home in challenging the threat if the need ever arises.

I will predict right now, you will see more rogue nations act up as time goes on.  Iran and North Korea are just the start.  Barack Obama has given them absolutely no reason to fear any retributions; and like little brats, they will push their luck to the breaking point, just to see where the limits are, if there are any limits at all.

http://www.cnn.com/2009/WORLD/asiapcf/05/25/nkorea.nuclear.test.outrage/index.html

UPDATE:  The Security Council passed a stongly worded statement condemning the nuclear bomb explosion in North Korea.    Russia’s U.N. Ambassador Vitaly Churkin, the current council president, made clear in a statement that the condemnation was only an initial response, and that more will follow. He said it was too early to give any specifics.  “The members of the Security Council have decided to start work immediately on a Security Council resolution on this matter,” he said.

This is all meaningless.  Unless China is willing to impose harsh restrictions on the North Koreans, then all of this will only be talk…and again, I will only believe that when I see it.

UPDATE #2: Well, didn’t take long for Kim Jong-Il to prove my p0int…as he has spent the last few days sending mid range rocket after rocket into the ocean, just to annoy the western world that much more.  I guess Obama and the UN’s ‘tough talk’ ain’t working…

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