HEALTH CARE REFORM
It's
difficult to listen to people talk about health care reform. Health
care reform is another one of those polarizing issues that have beset
us of late, regarding the economic health of this nation. I don't
criticize the need for dialog. After all, this country is built on the
free exchange of ideas. In the climate where free exchange takes place,
we get good ideas.
Well,
good ideas survive and bad ideas are exposed for what they are.
Everybody wants to go to heaven, but nobody wants to die. Everybody
agrees that health care reform needs to take place, but nobody wants to
bite the financial bullet that will make it take place. That's bad.
What's good is looking at this issue in a new way that will help us pay for more health coverage, for more Americans.
My
pet peeve is that we pay hospitals and doctors whatever they ask for,
without looking behind the prices they charge. With regard to most
other services that the federal and state governments pay for, there is
competitive bidding. If there is sole source procurement, it is because
of the unique nature of the service or goods.
There
may have been a time that medical services were so unique that treating
payments made to doctors and hospitals as if they were sole source
procurements was a fine idea. But now--except for cutting-edge and
experimental treatments and procedures--medical treatment isn't all
that unique. In fact, medical treatment is quite standardized, and
there are usual and customary practices among physicians and hospitals.
(We won't talk about whether that violates any anti-trust laws.)
So,
we're trying to lower the cost of medical treatment and care, aren't
we? Don't we want to use the money we've got to get more services?
That's better than having the reformed health care system cost so much
more that we need to raise taxes, right?
Here's
an idea: require hospitals, clinics and medical organizations to
justify the price of their services. Tell the federal government and
the state governments with Medicaid state plans, that they cannot pay
for medical services, unless they approve the profit margin.
I
can hear the screams. This is a free market economy. We MUST not touch
the profit margin. But..we've done that already. We did that when we
bailed out the failing companies who caused us to be in this economic
quagmire. Some of them had a negative margin, red ink flowing like
blood, until the federal government bailed them out, twice!
Recently,
a high-profile bank announced a profit for it's most recent quarter. It
received stimulus money, and now has money left over after it has paid
for all of its operation necessities. That's a profit and we like it
and it makes the economy grow. We want hospitals and others providing
medical services to be profitable. We want them to survive because we
need them. But we don't want them to gouge us at a time that more and
more people are under served.
Let's
start in the right place with the medical industry. Let's not let the
unscrupulous and just plain greedy swallow up what is a great idea.
Require the hospitals to tell us how much that cutting-edge diagnostic
equipment costs them, so that the states can pay for diagnostic
procedures for patients at a reasonable rate -- not overpay, not
underpay -- reasonable pay. Require clinics to reveal their overhead,
so the state plan can establish a reasonable reimbursement rate for
each patient.
This
idea is not new or unprecedented. Nursing homes receiving Medicaid
reimbursement are now scrutinized in many states, including Ohio.
And
it's not socialism, or even socialistic. It's not Canadian (with all
due regard to our good friend and neighbor). No, it's American, built
on the idea that reform is good when an economic segment has gone bad,
and we can't let the industry bite the dust. So we built a better one.
Americans
always build a better one. At least we have in the past. From the
slaves in the south who worked without pay to build a Southern economy,
mansions and roads, to the urban masses that sprang from European
shores with skills, trades and strong backs, Americans have always had
a better idea. Ford had a better idea. If you are third, you work
harder, and come up with a better idea. Fast food, fast cars, curbside
service, drive through pharmacies, were all better ideas.
Health care reform is American. It's a better idea.
Yvette Carmon Davis, 03/09
I have an opinion about.....
The Deficit
I am not an economist. I think I took one course once, just an introduction, so I know what people are talking about.
I'm
not an expert. If there are experts reading, then forgive me, or send
me an email to correct any misperceptions I might reveal herein.
Having
a deficit is a bad thing. It contributes to inflation. Logically, then,
it's a good thing when a president or congress wants to reduce the
deficit, and a bad thing when the deficit grow.
Our
growing deficit contributed to the crazy economic place we find
ourselves in ("crazy" is not a term of art, but everybody knows what it
means). It didn't MAKE the problem, but it had a part.
Deficit. It means that the government spends more money than it actually has, and thus is in the red, and owes money. To whom?
That
was my question the first time I heard that the federal government owed
money. To whom is this money owed? Who does the federal government
borrow from?
Banks.
I mean, really, who else would loan an entity money, which is already
in the red in billions, and now trillions, of dollars? Hmmmmm.
That
realization made me wonder whether banks take collateral from the
federal government the way they take collateral from you and me for
loans. I don't know.
Segue.
I know that the Federal Reserve "saves" banking institutions when they
get into trouble, to keep consumers from suffering from a bank failure.
The Fed also insures our deposits, so even if a bank has to fail, our
deposits are protected up to certain limits.
All
good. But outside of that process, at the end of the Bush
administration and now in the Obama presidency, we have given stimulus
money to banks. This money saves them from failure, and is also
designed to loosen credit. In tandem, the Fed has lowered interest
rates. All designed to stop our stagnating economy from continuing to
sit still instead of grow.
Then
I think I heard that the stimulus funds give the federal government
ownership interests in the banks. That's part of the reason whey there
was a really short burst of public-media conversation about
nationalizing banks.
Now
thrown into the mix are these prognostications that the federal
government could go bankrupt! Holy moly! Sounds scary doesn't it?
But
not so scary when you consider that the federal government might own
banks instead of having to federalize them in the very near future.
It's hard to go bankrupt when you own trillions of dollars worth of
assets in financial institutions such as banks and global banking
insurance companies.
I'm not an expert....it's just my opinion.
Yvette Carmon Davis 03/09