My Health Care Bulletin Number One

President Obama prescribed some guiding principles he wants in Health Care Reform rather than trying to write all the details. Notice none of them include naming the issue Obama Care. Guess he gets his name on the building without having his lobbyists do it behind the scenes.

In this post, I have combined my important Necessary Principles Behind The Principles (NPBTP) with those from Politic.com. This does not mean my Principles are Secondary, just trying to give due respect for the leadership displayed by both Obama and Politico.com.

There is however, one Primary Principle (another PP, along with Partisan Principles, Pure Partisanship, Putrid Policies)) I will assert ahead of the Obama Eight, and that in multiple dressings is this:

1. DO NOT MAKE THE MISTAKE BUSH MADE WITH IRAQ.
2. TAKE YOUR TIME, THE TIME IS OF YOUR CHOOSING.
3. LET THE NATIONAL DEBATE HAVE MORE TIME.
4. DO NOT POLITICALLY RUSH A BILL THROUGH WITHOUT BETTER RESEARCH.
5. YOU WILL REGRET IT AS BUSH SHOULD BE REGRETTING GOING INTO IRAQ SO QUICKLY.
6. NOT THAT OBAMA CARE NOR AN IRAQI INVASION ARE WRONG, RATHER, DO IT RIGHT OR DO NOT DO IT.
7. CAN YOU THINK OF ANY OTHER WAYS TO RESTATE THIS SIMPLE SINGLE MESSAGE?
8. TALK TO YOUR REPS AND SENATORS DURING THE AUG RECESS, TELL THEM TO LISTEN, LEARN AND TAKE THEIR TIME.

Much of the following is from Politico.com. I do not necessarily endorse everything Politco says, as they will not necessarily endorse my comments, even if they ever stumble on them.

1. Protect families’ financial health. The plan must reduce the growing premiums and other costs American citizens and businesses pay for health care. People must be protected from bankruptcy due to catastrophic illness.

Translation: The health care debate isn’t just about the 47 million uninsured Americans. In fact, Obama more often cites the frequency with which medical bills force underinsured families into bankruptcy.

Per Chief: The inclination of government and individuals for that matter to try to protect citizens, voters, neighbors, family, friends and strangers from catastrophic results is admirable in a socialist or a capitalitic econonomic system or any benevolent system for that matter. Given the givens, however, it is impossible to completely achieve, so any embedded attempt to do so should be looked at so very carefully. Without planning (legislating) realistically, the likely uncontrolled growth of costs and benefits to voters and special interest groups, will mean and potentially prove, that, “good programs” like Social Security and Medicare, the most “successful” social programs in our country, will also head toward bankruptcy. This good inclination, like all “successful’ social programs will be hard to change in the future.

2. Make health coverage affordable. The plan must reduce high administrative costs, unnecessary tests and services, waste and other inefficiencies that consume money with no added health benefits.

Translation: The insurance industry needs to shape up.

Per Chief; The most under discussed relevancies by everyone on all sides who utter the phrase “health care needs reform” (all for such different reasons) are these facts I value as premises behind any reform discussions. Think of them as part of the “whereas” moment.

First, we have no single “health care system”. We have multiple “systems” understandably self organized historically over time in various political environments, with various special interests having their way as always and with an inefficient and conflicted combination of Federal government “governing legislation and regulations” combined with states rights to “legislate and regulate”.

Second, the result is we have a haphazardly developed and conflicted quasi government run health care system ALREADY, in the aggregate. Free enterprise never had a chance to flourish and provide consumer and competitive choices at all, given the barriers and “don’t step on the crack or you’ll break your mothers’s back” environment that the only part of free enterprise most can see in this mess, is actually the legislatively and regulatorily bombarded insurance industry it is easy to make the bad guys and the ones we target for reform. Big mistake.

We need a comprehensive, carefully thought our reform, not a political rush to make important special interest happy while hanging us in a rush to “justice”.

3. Aim for universality. The plan must put the United States on a clear path to cover all Americans.

Translation: Don’t expect universal health coverage all at once. Health insurance for all is the goal, but how to reach “universality” is the question that most threatens the negotiations. Driven by their distrust of insurance companies, labor unions and progressive Democrats want a government-sponsored plan to compete with private options. Fearful that government will drive them out of the market, the insurance industry is adamantly opposed. During the campaign, Obama pushed for a public plan option, but he has not indicated whether he is wedded to it. The insurance industry also favors individual mandates, such as a legal requirement that every American obtain insurance. Obama did not endorse such a mandate for adults, saying they would buy insurance on their own if costs were reduced. Libertarians say mandates will eventually mean a nationalized system.

Per Chief: I vote for universality. Let’s fix what we have first, then we will know what the costs are of covering everybody. An enlightened public debate can then help our leaders determine how to achieve that and how to pay for it. Best to know the costs first, right?

4. Provide portability of coverage. People should not be locked into their job just to secure health coverage, and no American should be denied coverage because of pre-existing conditions.

Translation: Obama wants a government-organized marketplace, known as an exchange, where Americans can compare and purchase plans of their choice. This is where the controversial question of a public option comes into play: Should a government insurance plan compete with private insurers? Obama and Senate Finance Committee Chairman Max Baucus (D-Mont.) have both said yes. Insurers in the exchange would be prohibited from denying coverage based on pre-existing conditions. The industry says it can’t be expected to pick up the costs from expensive new customers if young — and cheaper-to-insure — customers aren’t directed into the system through a mandate.

Per Chief: Portability is a red herring. A well thought out reform will include individual owner ship of the ‘plan” from the vendor they choose. No one should have to be employed to be insured. That and other parts of the existing “systems” is a flaw that needs to not be entrenched, it needs to be removed.

5. Guarantee choice. The plan should provide Americans a choice of health plans and physicians. They should have the option of keeping their employer-based health plan.

Translation: Don’t get scared — Obama doesn’t want to pick your doctor. This is a deliberate message switch from 1993-94, when interest groups funded the famous “Harry and Louise” ads that cast the Clinton plan as an effort to remove choice from the equation. And no socialized medicine, either. As Baucus says, they are looking for a “uniquely American” solution, which means maintaining the employer-based health plan.

Per Chief: Yes, let’s have a “uniquely American” system. Let’s organize it around effective government regulations that come out of the reform debate, and citizens should have choices, some of those choices may be partially subsidized by the government if we think we can afford it. The choices will be similar to what is available today in restaurants. Many providers compete for price and product and buyers can leave at anytime and not return if they do not like the product for any reason, including price and service. A rational role for the govt might be a limited FDIC type insurance for the anticipated failures of some providers, not as a competitor one of the most obvious Trojan horses I have seen (today at least) and which would have the same undesirable consequences as the historical Trojan Horse.

6. Invest in prevention and wellness. The plan must invest in public health measures proven to reduce cost drivers in our system — such as obesity, sedentary lifestyles and smoking — as well as guarantee access to proven preventive treatments.

Translation: Get in shape — and get used to hearing a lot more about “individual responsibility.” Quit smoking. Exercise. Eat better. And, to encourage a healthier diet, perhaps a fast food tax? Well, maybe not. Americans value their personal choice and wallets too much. Look for Democrats and Republicans to talk a lot about preventing chronic diseases.

No further comment needed.

7. Improve patient safety and quality care. The plan must ensure the implementation of proven patient safety measures and provide incentives for changes in the delivery system to reduce unnecessary variability in patient care. It must support the widespread use of health information technology and the development of data on the effectiveness of medical interventions to improve the quality of care delivered.

Translation: The payment system is backward. Physicians

receive money based on the amount of care they provide — the more tests and visits, the more they make. Obama and others want to shift to a quality-based payment system that rewards good care. And there’s also a movement to expand a concept known as medical home, which encourages practitioners to develop a comprehensive care management service to ensure that patients are filling their prescriptions, going to rehab and shopping for the right food.

8. Maintain long-term fiscal sustainability. The plan must pay for itself by reducing the level of cost growth, improving productivity and dedicating additional sources of revenue.

Translation: Read his lips: Taxes are needed, but they won’t do it all. The system needs a complete overhaul to create more efficiencies. Otherwise, costs will keep rising and more taxes will be needed — which is why Obama’s pushing principles 1 through 7.