Friday, February 26, 2016

Politics as theatrics (and please, give us a grown up for a candidate)

The Wall Street Journal ran an op-ed today about the rancor of Roman politics. The author focused on the tactics of the extraordinary orator, Cicero, and the theater of politics centuries before Christ, and millenniums before Trump/Sanders, et. al. The author posited that nothing has changed in that regard, except in the modern era our social media is instant and ubiquitous, whereas theirs was tempered by the slow slog of their times. 

No doubt, those Roman citizens were more preoccupied with finding their next meal unlike us worrying whether "Trump has a healthcare plan" or "Sanders' spending is realistic" or what else Hillary has hidden from us.

So about the GOP presidential debates: Take Trump out (please) of last night's Houston debate on CNN, and the entire dynamic changes. The debates would still be sharp, intense, but for certain, more intellectual and less childish. A Tumpless debate would still feature worthy verbal combat, but it might help sort out winners from whiners. 

Unless Trump triumphs (which to me is worse than Saddam Hussain rising from the dead) and wins the nomination, I believe the GOP/Democrat campaign debates next fall will be more civil, but even more intense, intended to draw political blood from the contestants. I don’t think it’s hard to imagine what Ted Cruz or Marco Rubio would be saying about Mrs. Clinton. And she already has her playbook at hand on whomever emerges from the GOP field.

A lot is at stake in this election - maybe even the survival of liberty in the United States, and civil order in the world. I teach my American Government students that those artificial lines in the sand we call state borders are nothing more than that – lines in the sand. The U.S. could “Balkanize” overnight. You might want to start planning where you would move, but I'm pretty sure I’d end up in the Republic of Texas.

There is great and grave danger in the world. This, too, is predictable. Prophets told us about it millenniums ago. Whom we pick for President of the United States in 2016 may see a rebirth of freedom, or the acceleration of grave trouble.

Our challenge is to see through the theater and understand the character of the actors, and from that, predict what they will do to preserve liberty.

Tuesday, December 24, 2013

A Subarachnoid Hemorrhage for Christmas

December 24, 2012, on my treadmill, about 8:10 AM. Rosanne upstairs, sleeping in. The pressure started at the base of my neck, pushed up the outside of my head, and pinched off my ears - that's how it felt to me. "What was that!" I thought, stepping off the treadmill.

Then the headache. Wow. Never had anything like that before.

December 24, 2013, on my treadmill, about 8:10 AM. Rosanne upstairs, sleeping. How ironic. Are we people of habit? I chuckled. And wondered.

Don Gehrig, MD, told Rosanne to take me to the Emergency Room, where I was to tell the nurse, "My doctor believes I'm having a brain bleed, and I need a CT Scan right away." We followed his instructions. A few hours later, I woke up in ICU at St. Joseph's Hospital in St. Paul, Minnesota. After 11 days, they removed the spinal tap, and my final four days in the hospital were far more comfortable.

It's obvious I recovered or you wouldn't be reading this. But why write it?

While experiencing the health care experience at St. Joseph's in what the hospital called the aneurysm center of the United States - or was it the world? - I realized something: The work I had been doing since 2005 held great value. Protecting the world's best health care system (speaking here in a broad sense) is an important mission. Making sure others could receive the incredible care I experienced is a noble and important pursuit.

All that surrounded me at St. Joe's was not, however, just the product of an isolated system to provide health services. Not by a long shot.

At least four critical elements built this marvelous care system:
The relatively free market-based economy of the United States, and the riches that economy has generated making investment in health care possible.
People. Smart and motivated people, gifted to care for others and willing to pay the price to master themselves and the human condition that demands their help.
Science. Scientists. The never-ending pursuit of knowledge and the application thereof.
The Creator. God created science and order. He created human life, and all life. He created freedom. He set me free.

Many memories flood over me this Christmas Eve, relative to my brain bleed. Three remain constant:
So many friends who visited and cared.
Family who gathered around me (not the Christmas tree).

And lest you wonder, I told the neurological psychologist who tested me this past July that somehow, I think my brain is working better now than ever. But for sure, I do not recommend a subarachnoid hemorraghe as a cure for a tired old brain.

God be praised.

Saturday, July 7, 2012

Roberts' Court, ObamaTax, The Perfect Storm

Justice John Roberts is getting his well-earned comeuppance from myriad sources. You might be looking for my take on his decision. Good. Sometime down the road I shall surely give it.

But there is something far more urgent as a result of the Robert’s Court decision on ObamaCare, er, ObamaTax. The effect of the decision is far more critical today, and in the next few months, than the substance of it – said substance to now be subject to endless, and sometimes valuable discourse.

Roberts’ strange decision forces a political response. Casual (and lazy) critics of ObamaCare counted on the Court to throw it out. No longer. Critics who know why it is bad law, and those who are learning “what is in the bill” and discovering how bad it is, cannot hide behind the court’s robes.  

The fight over ObamaTax is in the mean streets of American politics. Everywhere present.
It is bad law. It is your duty to tell everyone why, and then make the case to throw its authors out of office. Furthermore, it is your duty to elect new officials who pledge to throw out ObamaTax, and begin the journey toward sane and sound private market health care.

The overwhelming immediate effect of the Roberts’ Court ruling on ObamaTax is simple: the voters will decide. Years from now, the courts will decide once again.

There is precedent for this, and some of you will not like what I am about to say. The 1973 Roe v. Wade decision is as much fatally flawed, created out of emanations and penumbras that never existed, as is the Roberts’ Court. Roe v. Wade set off a tsunami-powered realignment of political parties.

By the early 1980s, social conservatives had abandoned the Democratic Abortion Party for the GOP. The pro-life conservatives included millions of union workers and traditional Democrats. They threw out the progressive Republicans – as one former Minnesota Senator labels himself – and took party control. 

The Perfect Storm – movie, book, and fact – happened with three critical forces aligned themselves. We now have a Perfect Storm for political change. A renegade Court. A Social Democrat President. An unsustainable financial debt and government obligation structure.

In my opinion, the Robert’s Court set in motion what will amount to the last gasp for political freedom in the United States. This Perfect Storm will overturn the Social Democrats and their European-minded President, or the storm will peter out (like most of the global warming warnings), and we will see the end of freedom.

I bet you can’t wait, now, until I write about the decision itself. But while you are waiting, get out on the streets and campaign for candidates who believe in the United States of America, not the European Union.

Wednesday, July 27, 2011

"How much does that cost?" saves billions in healthcare spending

Have you ever bought a durable medical device? If so, did you get a good deal on it, or are you like most people – insurance paid, and you have no idea about its cost?

Sleep apnea may be one of those over-diagnosed conditions. My dad “snored.” I have “sleep apnea.” My guess is that he and I shared the same likelihood of a heart attack or stroke from snoring, and in fact, he did have a stroke – at 85. I am fairly sure it was not from snoring – er, sleep apnea.

Regardless, my doctor prescribed a CPAP. Unlike many that find the CPAP mask claustrophobic, I did not. From the beginning I slept better and felt more rested. My wife, by the way, also slept better as a result of the quiet whoosh of my CPAP instead of thunderous, room-shaking snoring.

Two years ago I had to replace my CPAP. Clutching tightly to my Health Savings Account (HSA) card, and carrying the knowledge of my $5,960 deductible health plan, I went prepared. Allina’s staffer showed me this slick, small unit. The H2O chamber and the blower were built into one device, easily separated for maintenance and carrying. 

“Looks good to me,” I said. “How much does it cost?”

You would have thought I asked “When was the last time you went to Mars?”

“I don’t know,” she said.

When I pressed her for the price she became defensive. I reminded her that in Minnesota the law requires Allina (all medical providers) to give me a price for medical services and products prior to my receiving or purchasing them. “The law requires you to give me a good faith estimate,” I said. I believe for a moment she thought I had her confused with an auto mechanic.

“Well, I don’t know,” she said, protesting, defensively, and revealing her ignorance. “You should call our business office.”

The business office manager knew the law and answered immediately. “$200 a month for a 10-month lease,” he said.

“But I don’t want to lease it,” I answered. “I want to buy it. How much does it cost?”

Hold on to your seat now. The answer is astonishing, especially considering that perhaps 1 out of 1,000 bother to ask the question. “$1,395,” he said. I bought it.

Just in the first 10 months I would have spent $2,000, and Allina would still own it. I never asked how much a new lease would be, or whether they had a “used CPAP lot” to which they sent suckers – er, I mean insured people – when the lease expires.

I saved at least $1,005 the first year. The second year, at least $2,400. But none of this would have happened if, 1) I had a standard PPO health plan with a low co-pay, 2) would not have asked “How much does this cost?” 3) owned a Consumer-Directed Health Plan with an HSA.

My purchase represents billions of wasted healthcare spending each month, and tens of billions wasted each year.  And the motivation for me started and ended with the financial transaction, with me acting as a purchasing consumer.

Today, Allina calls to tell me I need new hoses, masks, filters, pads, and so forth because “your insurance covers it.” Could be, but I’m paying it, and my mask is just fine.

Monday, July 4, 2011

MRIs at a single, flat, affordable price

Eric Haberichter, a Milwaukee, Wisconsin businessman, and his partners are market-changers. Their idea will revolutionize the way individuals receive and pay for MRIs.

Haberichter and his partners conceived of and created Smart Choice MRI. After you read this, I want you to contact Eric for details. If you prefer a human voice to an email, dial 414.431.0309 and tell him Dave Racer said to call.

At Smart Choice MRI a patient can purchase scanning services at a flat price. According to their website, "Smart Choice MRI charges a global, flat rate of $600 per exam regardless of who is paying the bill. Unlike the competition that may offer discounts to patients paying with cash, Smart Choice offers the same transparent price to every patient."

Imagine, no hassling over which view the radiologist will take as a way to determine the price. No matter which view, the price is $600. Have a suspected cancer on the lungs? $600. Think you might have broken your tibia? $600. Brain running on fumes (and you want to see if there's still energy there)? $600.

I asked Eric about his equipment. He mumbled something about Tesla. Nikola Tesla is, of course, one of history's giants in scientific innovation. But to MRI's, the industry applies his name with a rating. A Tesla 1.5 imager is powerful. At the time I talked with Eric about it, it was the industry standard -- it still is. Smart Choice MRI has it.

Well, ha, I declared. So what about doctors? I mean, you can't just have a nice machine if you lack qualified professional MDs to interpret the images.

"We currently interpret exams from locations across the country.  All of our radiologists are board-certified and have advanced subspecialty training." Eric had a ready answer. His radiologists practice at Cleveland Clinic, though their eRadiology function.

Now, to the point. What Eric has done is to engage his brain, to find a solution to a very real problem: The price of health care services. Eric did this without, and in fact, despite, any federal or state agency telling his doctors or him how to provide services. Eric saw a need, and he is filling it.

When I first met Eric, I told him he needed to franchise the idea. Maybe, someday, perhaps.

Believe it or not, Eric has to overcome institutional reluctance, even with the insurance companies that pay for most MRIs. It turns out, through his experience, insurance companies prefer to pay more - even a lot more - for MRIs, than $600. Their systems are not flexible enough to accept something so rooted in common sense as is Smart Choice MRI. When Eric explained this to me two years ago, he told me of one insurance company that wanted him to bill out at more than $2,000 for the service he would provide for $600.

What is the key development that clued Eric about the need for Smart Choice MRI? Consumer Directed Health Care (CDHC) with its high deductible health plans and Health Savings Accounts (HSA). Individuals began to shop for affordable health care, once they began spending money from their HSAs and their own pockets. Smart Choice MRI became the option of choice for many in and around Milwaukee. You can go there, too (Eric isn't fussy about even allowing Minnesotans into his clinic).

The only unresolved question I have about Smart Choice MRI is why there isn't one in Minneapolis and St. Paul, and your town.

Wednesday, June 29, 2011

“Mandatory Life Insurance,” Cries California Congress Person

Perfect Match for Health Insurance Exchanges

BROADMOOR, CA. June 29, 2011: “Tomorrow I plan to introduce the Affordable Life Insurance Empowerment Act in Congress,” said Arly Esperson, Congressperson from California’s 54th Congressional District. “Now that the Sixth Circuit Court of Appeals has ruled the health insurance mandate is constitutional, I think it’s time we take the next step.”

Today, a three-judge federal appeals court in the Sixth District upheld the cornerstone of the Affordable Care Act of 2010. “The progressives in Congress wanted to be sure the court upheld the mandate before we started moving ahead with the rest of our agenda,” Esperson explained. Esperson spoke about the controversial ACA provision known as the individual mandate that will require every American resident to enroll in a health insurance plan by 2014.

Progressives breathed  a sigh of relief over the decision, Esperson said. Esperson leads the Latte Party Caucus in Congress, a group of lawmakers who believe government needs to do more for “working people. And that’s why I am moving ahead with this new bill.”

The Affordable Life Insurance Empowerment Act (ALIE), Esperson explained, would require all United States’ residents to purchase a minimum of $10,000 in what Esperson called “lifetime coverage.” Ron Kelly, a spokesman for New Mexico Life Insurance clarified the term: “Esperson means whole life or cash value insurance, and it lasts a lifetime, or, well, until death.”

Esperson’s bill would go farther and require everyone older than 35 to own a minimum of $250,000 in term life insurance in addition to the $10,000 whole life policy.  “This will do several things for working people,” Esperson explained. “First, there will be money for burial cost. Second, it will help settle estates. And third, and just as important, the federal tax of 25 percent on the death benefit will help to reduce the national debt.”

ALIE overcomes two hurdles that might otherwise doom the bill: premium cost for low-income people, and accessibility coverage. 

First, Esperson explained that low-income people – the threshold is set at family income of less than $50,000 a year – will receive help paying their mandatory life insurance premiums. “America’s richest individuals often use life insurance to dodge paying estate taxes,” Esperson said. “We will levy a 35 percent tax on the life insurance proceeds of all plans that exceed $500,000.” In this manner, “we will make sure the rich pay their fair share.”

Second, Esperson plans to fold enrollment in mandatory life insurance plans in the Health Insurance Exchanges required by the ACA. “Hey, every state must have the Exchanges, and it would be nothing for Exchange enrollers to fill out life insurance applications.” 

Under ALIE, insurance companies will have to issue life insurance to anyone, regardless of their medical condition or age. “That’s why we mandate ownership,” Esperson explained, “to eliminate cherry picking of insured people, as the life insurance companies do now.”

The other ALIE key feature will help keep the premiums low for everyone, according to Esperson. “We will limit the premium rates on a three to one ratio, so that the younger people will not get stuck paying too high of premiums.” People under 33, according to ALIE, would pay one-third as much as people older than 65.

“This is the perfect adjunct to the Affordable Care Act,” Esperson said. “For the first time in our nation’s history, everyone will have health and life insurance.”

President Obama has remained silent on ALIE.