Now my body is subject to government meddling

Each party has their own favorite private decision subject to meddling. For the Republicans, their meddling includes friends, especially intimate ones. Having let their party be hijacked by the right wingers who hate everybody and everything not associated with white christian men. They fill their airwaves with invectives against women who work; against immigrants who do jobs Americans won't do (when was the last time you met an American who was willing to work picking fruits), and people who would rather be intimate with others of the same sex.

Now, the Democrats decide that I am incapable of making a decision about what, when and how much medical care I actually need. Despite the fact that I am the subject of the right wingers invective (being a woman who works for a living), what the Democrats did upsets me more. Why? Simple. Being insulted by a bunch of folks who think Christianity is about suppressing economic freedom for 53% of the nation's population pales in comparison to a bunch of folks who think that I am incapable of making my own sick care decisions and think that I should have to not only be forced to pay for a cadillac plan for myself, but for others as well.

What the nation really wanted was insurance reform: outlawing certain practices that allows insurance companies to reduce their risk to almost nothing while reaping profits that make Wall St look like incompetent profiteers. In a true capitalist system, the higher the profit, the greater the risk. The insurance companies rigged the system so they can make huge profits while taking very little risk. Practices that the electorate wanted outlawed are dropping people from coverage when they actually file a claim for sickness, outlawing pre-existing conditions, charging women more than men because they can get pregnant (huh) and denying coverage to children with genetic conditions that left them debilitated. These conditions left a huge segment of the population unable to obtain coverage at any cost.

Americans do not want the government meddling with their health plan; Americans do not want cutbacks in Medicare. Instead of just being satisfied with insurance reform, the Democrats decided that they know what kind of medical care people should have. Moreover, they provided no way for healthier people to opt into less expensive plans simply because these people do not get sick often or if they do get sick, refrain from entering the system until they either suffer major trauma as in an auto accident or a hunting mishap, or acquire a debilitating condition that requires aggressive medical intervention, like cancer. While it is true that the US has one of the best medical systems in the world, it is also true that even for simple mundane things like an EKG, the costs are way out of proportion for the service rendered.

In our hodgepodge of insurance coverage, one option really stood out with the potential for really putting the brakes on overuse of medical procedures: the high deductible plan. Plans like these are designed for catastrophic care; and in my informed opinion, catastrophic, major medical is where the U.S shines. What high deducible plans do though is make the consumer conscious of the cost of "extra care" or a diagnostic test. If a consumer knows that a diagnostic test costs $1200, and all the test would do is confirm what the doctor already found through a good physical exam, the consumer may just opt to take the doctor's word for it and not sign up for the test. Putting the brakes on extra tests really will slash the amount of money we spend on health care.

Although health plans may not cover things like lasik surgery, chiropractors or naturopaths, there is no IRS regulation prohibiting the use of Medical savings accounts or Health savings accounts to cover those costs. People who have high deductible plans with a health savings account not only can cut down on overutilization, but also, use the savings account to pay for CAM, when their health plan won't. While there may not be expensive case controlled studies validating CAM, there is quite a bit of evidence that such care keeps people out of the hospital by working with the body's natural defenses or modulating the inflammatory responses which is implicated in a lot of modern conditions.

There are two interesting quirks in the health care legislation which will lead to a massive redistribution of health care resources. One is the mandate that all people get coverage or face a fine of upto 1% of their income. First, the mandate may be unconstitutional because the fine is called a "fine" rather than a "tax". A tax may be the only legal levy that Congress is allowed to enact on such a widespread scale. Of course calling it a tax is politically unpalateable. Regardless of the constitutionality of the mandate, the mandate itself will have an interesting effect: healthy people of all income levels will pay the fine, and the older you get, the better off financially you are to pay the fine. The Senate bill has no provisions for halting the rise of premiums on older people and in fact specifically allows insurance companies to raise rates on older people. If the fine (or tax) is a maximum of 1%, why not pay the fine? Even for seniors who do not qualify for subsidies, they are much better off paying the fine. When they get sick enough to require medical care, the non-discrimination clause in the bill will prevent an insurance company from denying coverage. When that happens, the premiums will be a bargain considering how much medical care costs.

The interesting thing is that younger people will be better off paying the fine also. Undoubtedly some of them will qualify for subsidies as they just don't need health care as much as older people do. Even unhealthy young people need less care, heal faster and can tolerate unhealthy dietary choices without suffering the consequences of such a decision. Moreover, when they do get the modern chronic conditions, no insurance company can deny them coverage and they too will benefit by using the money they saved by not paying premiums and putting these funds to work making more money.

Of course, that leaves the insurance companies with the sickest people. More seniors will be forced on to Medicare because they can no longer afford the premiums; programs like Medicare Advantage allowed Seniors who had the means to pay a very low premium (something like $80 / month for a couple). Medicare Advantage had higher reimbursement rates, so they were able to find willing providers. Without Medicare Advantage, many of these people will be forced to Medicare; with the low reimbursement rates of Medicare, many seniors will not be able to find any doctor accepting new patients. If the intent was to deny seniors medical care without saying it, the new health care bill does exactly that.

While the health care bill does not use the phrase "Death panel" (and I doubt it ever did), the effect is the same. What difference does it make to overtly deny medical care to seniors or make reimbursement rates so low that no doctor will see them? The effect is the same: denying medical care to the elderly.

So what we have is a major shift of health care resources away from the elderly with families consuming most of the health care dollars, subsidized or unsubsidized. In fact, families with children may be the only group of people who are not sick to purchase health insurance. Younger people and healthy older people will opt to pay the tax because it is to their financial benefit to do so. If alternative health care providers are locked out of the reimbursements due to a Western medicine bias in all areas of the government, then their patient pool will consist largely of the healthy and many of these doctors can change their practice paradigm from specific conditions like low back pain to wellness centers. Many of these patients will be more affluent and more educated, have access to better quality food.

While the health care legislation is bad medicine, certain segments of the population are now better off and there will be a demarcation between the healthy and not-so-healthy, where the healthy end up being cash customers to alternative medicine providers and the not-so-healthy customers use their new found coverage to enter the sick care system and perhaps get sicker. Meanwhile those who choose to opt-in will end up paying the bill.

It goes without saying that the way to prevent this is to create a single payer system, where large insurers like Aetna administer the plan for all enrollees (the entire nation). Everybody is enrolled and everybody gets coverage. There are certain advantages to this: providers have no incentive to refuse patients, because the reimbursement rates are uniform. Premiums can be more easily regulated because the payer is not the one who collects the money. A single payer system is not to be confused with the so-called public option. In a single payer system, the government merely collects the money. The government is not an insurance company. It is up to the money manager to negotiate rates and process claims. With the public option, the government is one of the insurance companies. Being administered by an insurance company, the actual implementation would work like it does with large self-insured employers, where companies like Aetna already administer their plans.

Going back to the days of my youth (in the sixties), I can opt out of the health care system, pay the tax, and pay my providers in cash, just like I do now. Doing it this way allows me to use the exorbitant premiums for other more productive uses. Paying for more medicine than I need is an unproductive use of my funds.

John Dennis - 2010

Political pundits are probably wondering why John Dennis is even bothering to challenge Nancy Pelosi in San Francisco's 8th District; let alone even admitting that he is a Republican. Wonder no more. He actually has a chance, and a pretty good one to actually capture the seat. San Francisco is a politically dynamic place, where people on either end of the political spectrum toss their hats into a discussion regardless of the actual political views of the person to whom they are talking, and both sides feel just as strongly about the correctness of their views. The one thing, though, that everybody agrees upon is that this is a free country and San Franciscans love their freedom.

They love their freedom to express themselves and act or dress in ways that would be socially unacceptable elsewhere. They love the freedom to spontaneously block a city street in a densely populated part of town to protest something or express satisfaction of something. And, above all, they love their freedom to live their lives as they see fit, whether its with a spouse of the same gender or under a freeway overpass. With this love of personal freedoms, it is no wonder that many are embracing the campaign of someone who is challenging the status quo of an incumbent percieved to be trampling upon other people's freedom.

What outsiders see is something entirely different. Outsiders see a city full of people who are to the left of even organizations like MoveOn.org. A lot of this perception is media driven. The reality is, though, that San Francisco's demographics has changed quite a bit in the last decade or so, certainly since the mid-1980s. Politicos of larger cities do not change that quickly and San Francisco is no exception. What outsiders do not see are the incremental changes, who is moving out and who is migrating in. San Francisco was a major beneficiary of the in-migration of younger, entrepreneurs who fueled the dotcom boom. Many of these people have a somewhat libertarian bent to their political biases and for a variety of reasons settled in the city itself.

The media also sees libertarians as "Republicans", even though many are socially liberal. It is true that many do run under the Republican banner. But many can easily run under a moderate Democrat banner as well, as Democrats tend more to respect people's differences, even if they want to tell people how to live their lives. The ideal Republican who can win is one who runs on a platform of respect for liberty, respect for people's love of freedom. The unsuccessful one is a Republican who insists on using socially divisive issues like abortions or gay marriage as a way to differentiate themselves from their opponent. Such arguments do not fly in San Francisco as people there generally respect eachother's differences and many thrive on it.

John Dennis is running a smart campaign. His goal is not to convert San Francisco into a bastion of conservatism. The campaigns' goal is really to tell people how the Democrats are stomping upon their freedoms and doing so with legislative games that stymie healthy debate. As long as he sticks to the freedom message and stays away from socially hot button issues, his chances of actually winning improve substantially. It is too early to predict whether the freedom message will resonate with some of the entrenched interests, but it probably will resonate with the newer residents who grew up elsewhere.

Posture and Dog Walking

I just got back from a conference; one of the vendors had an interesting product: a back pack that isn’t really a backpack. Instead it has two bags and they hang from the shoulders like a vest rather than along the back. There are two clip on straps in the front – one across the breastbone just below the collarbone and another across the pelvic girdle, used to support the pack while seated. Such an ingenious idea; you don’t have to remove your pack while waiting or using public transportation. There is another strap, which really comes in handy for dog walkers – a nylon clip belt that supports the pack by resting the pack on your hips.

I haven’t tried this on an actual dog walk; this backpack solves a couple of problems:

• Putting all the dog’s equipment somewhere, be it leashes, treats, balls, frisbees and plastic bags. In addition, there are the things the sitter needs, such as cell phones, car keys and in cooler climates an extra layer of clothing.
• Righting the forward posture that almost invariably comes as part of dog walking.

It also a great pack for people who like to hike and intend to be gone for more than a couple of hours. They now have a place to put their keys, maps, water, power bars (or other energy bar) and a water resistant light weight jacket in case the weather changes.

Maintaining posture is important. One of the things I notice about a back pack that sits on a person’s back is the tendency, as the day wears on or the pack is more than a few pounds, for the walker to to tilt the center of gravity forward as the trapezius starts to tire. Putting the center of gravity forward creates a pelvic tilt that turns off the muscles in the back of the legs, creating low back pain. Pelvic tilts due to forward leaning posture is one of the leading causes of chronic low back pain. Eventually the person develops an intractable knee problem and it becomes painful to walk the dog, especially dogs that like to walk ahead, as most dogs do.

Dogs, like other animals, respond to energy and body language much more readily than people do. Sometimes our frontal lobes, the pride of being human, gets in our way. A hunched over posture sends a very subtle signal to the dog that the handler is not in charge. Submissive dogs or dogs that are lower on the totem pole in a pack tend to walk with their tails lower and their heads hunched forward. The top dog or pack leader walks with its tail high, head and ears perked up. In a human, what the dog is really responding to is the shift in the power center from the center of the body to outside the body.

Walking tall, with the shoulders back, head held high sends the dog quite a different signal: now the dog has no reason to think it is in charge. The dog senses the strength coming from the solar plexus, which is where it should be. All commands, like heel, wait, stop, sit or down originate from the power center and the dog responds appropriately. While the dog may not heel, the dog will not pull on the leash as much except when he has to go or senses a prey-like animal, like a squirrel. It is very difficult to train a dog out of predatory behaviour, like lunging after squirrels.

Since dog walking requires certain equipment, especially for those who do it professionally, having the right equipment is important. A pack that sits on the handler like a vest goes a long way as that frees the shoulders to issue commands or signals to the dog through the leash. A leash is not just a tool to restrain a dog from running off and hurting herself; it is also a tool that can be used to communicate with a dog and if used correctly, the dog will respond to it. Dogs are pretty strong animals, and for many of the larger ones, even those that weigh as little as 25 lbs, issuing a correction or command with just the handler’s arms does not transmit enough force to the leash to be effective. Getting the entire body behind the leash gets the dog’s attention, as that snapping sound stops a dog in his tracks almost immediately.

Mechanically, getting “behind the handler’s body behind the leash” implies that the handler issues the commands from the power center – the solar plexus. To do that, the handler must be walking with shoulders back, back straight and head up. It is not possible to maintain that posture if the handler is hunched forward, with a ten pound bowling ball hanging off the neck. No wonder people who walk that way tire more quickly. In the standing tall position, whether running or walking, the propulsion happens at the solar plexus, and the legs follow along and the job changes to counteracting the force of gravity, which the legs do very well. Such a posture is biomechanically efficient and the walker can walk much more quickly and handle the dog or dogs much more easily. That solar plexus center is known as Chi.

In this position, the handler has better control over the dog and can react much more quickly when the dog decides that the handler is much less interesting than the adjacent flower bed, or worse, the curb. That also allows the handler to issue commands like Wait with authority so the dog really does stop her forward motion (assuming, of course, that the dog understands the word Wait).

So if you really want to get out and walk your dog so that the experience is a pleasurable and allows you to bond with your dog, stand tall, put the dog on a shorter leash and hold it with both hands in front of your navel. The dog will soon get the message that you are in charge and soon you can walk your dog with your arms at your side, which is a much more natural position without the dog bolting at the sight of a moving leaf.

Yet more tax increases

Yesterday, the White House announced a deficit reduction package that includes a mixture of spending cuts, mostly on non-defense discretionary domestic spending and letting the Bush-administration tax cuts expire. The package does reduce the deficit by some amount over the next 10 years, but the deficit, even with these proposals will still be staggering, totaling trillions of dollars. Most of us know what a trillion dollars look like on a piece of paper, the number '1' followed by 12 zeroes; but to actually be able to incur a deficit that large and still be in business is mind boggling.

Yesterday, I closed my doors with a mere $5000 in debt. Sure, it would be nice to be able to stay in business and run up my debt to $1,000,000,000,000; but no bank would ever allow me to do it. Why do creditors allow the US government to do it? In fact, why do we allow our government to do it? After all, we are the ones footing the bill ... eventually, when our lenders, like China, demand their money back. The knee jerk reaction, of course, is to "tax the wealthy", "tax big corporations", "tax capital gains", "tax Wall Street", "tax big bank executive bonuses at 100%", "tax cadillac health plans", etc. All these have floated around Washington, and various state capitals since the recession "officially started" in 2008.

All this rhetoric floated around by populist members of both political parties are rooted in the American desire to be fair, and many organizations have harped on the nice sounding argument that the rich don't pay their fair share. Is this really a true statement? The upper 10% of Americans pay 71% of the taxes. It is true that our tax system is not fair; after all why should 10% of the country pay 71% of the taxes? Moreover the bottom 20% pay about 5% of the taxes. These are just numbers bantered around on a blog. Let's ask how much income is the 90th percentile in income? $500,000? $250,000? Neither guess is correct. It is $113,000, which is an income level that many of our friends or neighbors have.

So raising taxes on them hasn't worked, because they already do pay the bulk of the personal income taxes. It is politically incorrect to advocate raising taxes on the bottom 20%. Yet, unless the government raises more revenue, the country really will go bankrupt. Such spending is unsustainable. While it may be true that the upper 10% do pay the bulk of the taxes, it is not necessarily true that their tax rate (on April 15 when taxes are due) is the highest. With their deductions, their rate may be lower, but since they do make quite a bit more money than the bottom 20%, they still end up paying more total dollars to the IRS.

Before advocating eliminating their deductions and let them pay taxes at their marginal tax rates which are a lot higher, how about if ALL deductions were eliminated for everybody, including corporations, and everybody pays a flat rate, say 15% to start. For many people, most of them in the middle income range, less than the 90th percentile, but greater than the bottom quintile, their taxes would actually go down. For people at the top, their tax rate may go up or down, depending upon how good their tax person is and for people at the bottom, their taxes would go up since many of them don't pay taxes at all.

Fairness is really about no exceptions; the rules are the same for everybody. Eliminating deductions, which do tend to favor the better off, puts them on the same footing as the lower quintiles, since they don't have things like houses that tend to dramatically lower tax bills. Why not exempt the bottom? After all they don't make anything. In the name of fairness. The moment you make an exception, you already created a class of people who are more "privileged" than everybody else. 15% of $10,000 is $1,500; 15% of $1,000,000 is $150,000. The total taxes paid would still be skewed in such a way that it looks like the upper 10% still pay the bulk of the taxes. The difference is that overall tax collections would increase.

Middleman take up a large part of the economy that could be spent on doing more useful tasks. Our tax code is so complicated that entire industries are spawned just to keep up with all the changes. Moreover, equalizing the tax code can get rid of the IRS and any other tax collecting agency that is part of our state governments. Or the IRS can simply be the tax collector, and manage the funds for the Treasury Department. Financial planners would probably still exist, although investment decisions would be less driven by the tax code and more driven by the market conditions. But the tax preparation arm of such businesses would no longer be needed.

It has been argued in the past that the mortgage interest deduction is at least partially responsible for escalating housing prices. That deduction is worth quite a bit. If there was no deduction, home buyers really would pay attention to the cost of the house and over time, people would not buy more house than they can afford. The tax code obscures the real value of the house and the potential buyer has no way of knowing what the house should be worth, let alone what is it really worth. Eliminating it would stabilize the housing market and generate more overall revenue for government.

The flat tax is the only way to go. If the US continues on its present course, there will never be enough revenue, because there aren't enough rich people to tax. What happens over time is the definition of "rich people" change. Soon the threshold for rich people will drop to less than $100,000. Soon it will be anyone with a job, as if job holders do not already have enough taxes to pay. It is time to rethink our tax code before we all get penalized merely because we work and if we do rethink our tax code, how about making it simpler and getting rid of the IRS as an outdated institution?

Republicans win in Massachussetts

In 2008, President Barack Obama amassed a huge war chest by energizing a large following that repeatedly donated money to his campaign through the Internet. This method of fundraising significantly diluted the power of big campaign donors. Millions of followers donating $200-$300 is still a lot of money, even if no one person donated lots of money. President Obama did have his share of moneyed donors, but they didn't play nearly the role as they did with his opponents. This way of raising money did allow President Obama to claim with some truth that special interests did not hold his purse strings as much as hey did for his opponents. Moreover, the Republicans failed to harness the Internet and as a result were way behind in building a war chest and had to rely on campaign finance laws which make it difficult to for donors to donate huge sums of money.

In the midterm Congressional elections, there is another phenomenon, this time taking place in the Republican Party. As both parties gravitate towards their ideological extremes, the huge middle, which Barack Obama successfully harnessed in his bid to be the first African American President, has allegiance to neither party. Many of the Republicans running for the open House seats, and some governors, do not have the blessing of the Republican National Committee and therefore do not have access to national funds. While these candidates do use the Internet and other means to raise money, the big story is that many of the grass roots organizers for the Republican party are the so-called Tea Party Activists who detest big government and government meddling into people's personal lives.

The significance of this is that the precinct captain is the one responsible for getting out the vote, registering voters and mobilizing the local political machinery to support a particular candidate. Although the Tea Party activists care little about their neighbors friends, their desire for small government outweighs their desire for the government to keep its nose out of their affairs; so many of them are running as Republicans. Tea Party activists are signing up for the precinct captain positions and are usually unopposed. So the Tea Party activists are enlisting like minded people to register and vote for other Tea Party activists with the means to finance an election or the technical saavy to fund raise through the Internet.

While the Democrats transformed the Democratic Party from the top down, the Republican Party is being transformed from the bottom up. This does mean that in areas with a strong Tea Party presence, the Republicans actually have a chance to win a Congressional Seat, even though the candidate is not "officially endorsed" by the RNC. Eventually some of the more successful Tea Party activists will work their way up the Republican Party and may start a shift in the party ideology towards the center. If this happens, expect the Republicans to gain control of Congress perhaps as soon as 2012.

How did the Democrats let this happen? Sometimes you get too cocky if you are successful. Perhaps their Congressional victories in 2008, along with capturing the White House pushed the Democrats to be too exhuberant about their victories. Essentially they took the independents for granted and assumed that the independents would rather vote Democrat than Republican when push came to shove. Some independents will continue to vote for the Democrats because they value their privacy in personal affairs more than they do fiscal responsibility. Obviously, the voters in Massachussetts preferred fiscal responsibility to social liberalism.

When a state that voted Democrat by 26 points in the last election chooses a Republican Senator, it is time for the Democrats to wake up and halt their slide to the leftist fringes of the party. Just as allowing the fringe to dictate the Republican agenda in the 2008 Presidential campaign doomed any Republican chances of winning any contested election, allowing the fringes of the Democratic party to dictate their agenda will cost them seats in the House of Representatives; they just lost their filibuster proof majority in the Senate. It is time to wake up.

New Years Resolution

January 1 has come and gone and no doubt many people celebrated. 2009 was not a year to remember, with one of the highest unemployment rates in modern history, a war in Iraq and now Afghanistan and record deficits. 2009 did see one historic event: the inauguration of the nation’s first African American President. No matter what one thinks of the job he is doing, it is a historic event worth congratulating ourselves as a nation.

As always with New Years, many people, myself included, make a list of Resolutions. Among the top is to join a gym to become healthier or lose weight. Gym rats notice one thing that happens every year: about a week after January 1, the gym is crowded. The week before they had the whole gym to themselves, even at 5:00 PM, one of the peak times of gym useage. This week and for the next 12 weeks, they have to wait for everything, especially treadmills and showers. Then in March, the membership dwindles to pre-January levels and the gym rats no longer have to wait and the newcomers, having just laid down a year’s fees either prepayment or a contract cease to show up.

Before laying down hard earned money on a gym membership, think of Fido, there greeting you everyday, tail wagging as you walk through the door. Fido is the perfect workout companion: no waiting for the treadmill, smaller carbon footprint, always ready at the door and is satisfied just to get out of the house and be with packmates. If your goal is weight control, walking is among the best exercises. It is also easy on your joints and requires almost nothing in startup costs – just a good pair of shoes. Of course, Fido has to catch up on canine gossip during your walk. Once he catches up, he stops sniffing flower beds and happily walks with you.

But, your doctor told you that you needed 20 minutes of elevated heart rate. Walking just doesn’t cut it? If Fido is trained to not pull on a leash, here are a few suggestions to increase the intensity of your walk:

• Add a few minute jog interspersed with walking. Fido loves this variation as most dogs love to run, even if they aren’t sporting dogs or don’t have a joint problem.
• March, with high knees, like the Germans did in the old World War II movies. Do this for a few minutes, again interspersed with walking.
• If your dog’s leash has two hooks, attach the other hook to your belt and with a set of 1-lb weights around your wrist, extend your wrists up over your head and move them down to your side and up again. Do this a few times. For larger dogs, attaching the leash to a weight lifting belt works better as those offer more support for your back.
• Vary your pace with walking. This not only raises your heart rate, but keeps Fido mentally alert as she now has to pay attention to you.
• If you live near a park with a par course, visit each station and do the exercise on the station. Of course Fido has to be under voice control in order to do this.

What if Fido is not sufficiently leash trained, pulls or otherwise does not pay as much attention to you as you would like? One training method that works for most dogs is the “red light/green light” method. Dogs naturally pull and do so because it works: they get to go where they want. To stop this unwanted behaviour, keep the dog guessing which way “forward” is. At the first sign of pulling, stop and wait. When the dog stops pulling, start walking again. If the dog still pulls after doing this a few times, then escalate to the next level- at the first sign of pulling, stop and turn around. Keep doing this and after a few times, the dog stops pulling because she no longer knows which way is forward.

Training a dog to follow the leash is a good next step in a dog’s training. Too often, dogs that are not sufficiently trained in this skill dart off to the other side and what happens to you? As you pick up speed, your feet get caught in the leash and you fall flat on your face. Outside of feeling like a fool, you may suffer a skinned knee or if you fall hard enough, actually bruise a bone. Your dog benefits from the demands of learning a new skill and you bond with your dog. Walking back and forth on the same piece of sidewalk may not sound like a lot of exercise; it’s not if you do this only a few times. If you are out there walking back and forth for 30 minutes, that is equivalent to a 30 minute walk and your dog will be tired at the end of the walk.

Bonding with your dog instead of waiting in line for a treadmill sounds like a better use of your limited time, doesn’t it? Moreover, since you don’t have to drive anywhere, you are more likely to carry through with the exercise program. If you add the marches, the short jogs, the par course and the exaggerated arm swings, you will increase your metabolic rate due to increase in lean tissue. At the end of March, both you and your dog will be closer and you will smile at your image in the mirror because you actually carried through with the weight loss resolution you made on January 1.

The Growing Movement to Nullify National Health Care | Tenth Amendment Center

Although I don't necessarily agree with states' rights, as we fought a war over it, this particular article is interesting enough to share:

The Growing Movement to Nullify National Health Care | Tenth Amendment Center

In their efforts to formulate a plan that covered everybody, the plan left a lot of people unhappy. If the final reconciliation bill between the House and Senate comes anywhere near the one passed on 12/24 by the Senate, it will succeed to do only one thing - treat insurance companies like public utilities.

Exorbitant profits by insurance companies is only part of the sick care that characterizes "health care" in this country. The other is excessive costs with no way to control the growth of spending. Our health care, even among the insured, is paid for by someone else. This distorts the true cost of health care; so much that the consumer no longer knows what treatments cost; health care providers have no idea what the true cost of delivering their services are. Meanwhile, insurance companies could care less whether we as a nation are healthier; as with most for-profit business entities, the cheapest, most efficient way of maximizing profits drives business decisions.

So we end up with a system where nobody knows the true cost and nobody cares what the true cost is. What would have to happen in order for the reconciliation bill to really reform health care:

• Merge the payer and payee. In other words, and this is heresy, get rid of 3rd party reimbursement: whether its Aetna, Medicare, or Medicaid. Now the payment for services are tied to what services are needed rather than which middleman can make the most profit. It also means that employers can get out of the business of providing health care and use the money saved to do something constructive like create more jobs.
  
• IF the government wants a Single Payer System, it MUST divorce the collections from the General Fund. In other words, the government can't dip its hands into the fund every time it does not want to go through a painful process, such as an actual declaration of war and be forced to raise revenues to wage the war. Now every undeclared war dips into Social Security and the hypocrites in Washington have the nerve to blame Boomers, who collectively as a group put trillions into Social Security.
• Tell Big Pharma to take a hike. Quit whining and play according to the rules of capitalism that it expects everybody else to do. Along with this comes with actual reform of watchdog agencies like the FDA or USDA, so they become real consumer protection agencies instead of a gateway for drug companies to push their synthetic pills on an unsuspecting public. The problem with our current approach is that ONCE you take a prescription medication, you need several others to deal with the side effects. And this cascades with every pill you take.
• Implement Any Willing provider laws to prevent payment discrimination by insurance companies. Of course, if we got rid of 3rd party payments, then the market decides who the best provider is for a particular syndrome. (Note the use of the word SYNDROME rather than disease).

Now liberal skeptics might say that getting rid of health insurance would make health care unaffordable. To see the fallacy in this argument, lets take a look at a similar distortion in the housing market - rent control. Cities that have rent control and got rid of it noticed a big jump in rents. But over time, sometimes a period as short as four months, rents dropped! Not only that, rents dropped below the controlled rates. Why? Because rent controlled units were not that well maintained and in a market where consumers have a choice, the better maintained units go first.

Like other distortions, rent control is supposed to keep rents low. What ends up happening is that slum lords have a guaranteed profit, because rent control is always in areas where housing demand exceeds supply, like San Francisco. There is a decrease in the market rate housing stock, so the prices far exceed the value of land and improvements, which is what the fair market value would be. With a guaranteed profit, slum lords have no incentive to keep up their properties, so housing stock quality declines. In most rent controlled cities, "going out of business" is the only legitimate way to decontrol properties. Landlords who wish to sell their properties go out of business and "wait it out"; waiting it out, of course, means that the landlord has a spare $40,000-$50,000 (or more) lying around, and of course, landlords are able to write this off if he /she takes a modicum of interest in the property so it no longer qualifies as "passive income".

I bring this up as an example of an artificial market distortion, which is perpetrated by legislation that is supposedly designed to help people. But as we saw, the poor people stuck in the slumlord buildings live in housing stock, whose quality deteriorates over time and with the housing market distortions, which fall into the rental market, means they can never seek better housing. Of course, if they move out and live in a cheaper area, they essentially did what the slum lord wanted them to do from the very beginning. Only now, the slumlord does not have to pay anything for their move, since they were not evicted. With health care, our system of reimbursements isolate the true cost of delivering care from those who pay creating price distortions. With market based reforms, such as getting rid of 3rd party payment altogether, consumers can decide if they really need this procedure or that test and over time useless procedures with low efficacy or tests with high rates of either false negatives or false positives will disappear from the health care delivery system, and with this a fall in the actual cost of delivering sick care. And if people wanted to cut costs even further, they can live healthier lives.

Here is the system at work: I have a high deductible plan with an HSA. In the course of an examination, something strange showed up. Like a dutiful patient I went in for an imaging test which was negative. The doctor wanted me to go in for further testing; after doing a little bit of research, I decided to take my chances; I was after all training for a half marathon at the time and the imaging test was considered the "gold" standard for the body part in question. As a consumer I made the choice to stop after the first round of testing. It's that simple. Of course, it does mean that we all have to be a little more informed about what we spend our health care dollars on. If we all paid for our health care, with subsidies given to those who have a demonstrable need, I bet that the cost of health care would decline dramatically and we may actually have real health care instead of sick care masquerading as health care.

If we can do that for cars, which are also complicated, now that most are computerized, we can do it for our own bodies.