Monday, March 29, 2010

OPM, horse races and middle school

OPM - Other peoples money- otherwise known as opium- an addictive substance extracted from seed capsules of the opium poppy

The definition of OPM, as it relates to politicians, should be an addictive narcotic, such as taxes, taxes, and more taxes, extracted from Americans, and then spent addictively to enhance their own chances of being re-elected.

In all fairness, I used to suffer from OPM. But it was in my teen years, so please do not hold it against me. When I was in middle school, my father used to take me to the race track to bet on the horses. He would stake me $20 to bet on the ten horse races of the day. Now even in middle school, I could do the math. My father wisely put me on a budget of $2 a race, so I would be able to bet on a horse in each of the ten races. You see, if I ran out of money before the last race, I would get bored, and start annoying my father while he was trying to hit the trifecta on the last race. So $20 it was, and being the wonderful child I was, I stuck to the budget.

Now if I got lucky, and actually won a race, I would have extra to bet on future races, or to keep as winnings. Since I was only in middle school, and did not have any money of my own, and was also not of legal age to gamble, my father placed the bets for me. So what actually occurred was that my father would make my bets for me, with the twenty dollars that were actually his!!

So what happened?

How did I manage the $20?

First let me go into how a middle school child, with no skin in the game, budgets at the race track.

Regardless of outcomes, win or lose, each day we would go to the track, I would get another $20 to bet. The frugal guy that I was realized that I started with none of my own money, so if I ended with nothing, I lost nothing. I had no skin in the game. So, whether I got lucky, which rarely occurred, and won a few races and had $40 left for the final race, or as would usually happen, I lost most of the races and only had $2 remaining for the final race, I would invariably go for broke. There were no downsides. I got to play the horses with my father's twenty bucks! If I lost and went home with nothing, it was exactly what I started with.

So now, being an adult, I look back at those days, and ask myself these questions.

Would my decision to go for broke on the last race still have occurred, if my father did not always give me $20 more each time we went to the track?

Would my decision to go for broke on the last race still have occurred if my father allowed me to keep any amount over the initial $20 he staked me at the beginning?

Would my decision to go for broke on the last race still have occurred if my father allowed me to keep all money left after the last race, including the initial $20?

Would I even gamble if it was my money that I was gambling?

As you answer these questions, let me make a leap of faith and use the logic, or lack thereof, of my betting patterns, with our politicians and the healthcare reform law just passed..

Politicians are making go for broke bets, with our tax money, because they assume they can always come back to us and get more. The politicians have no skin in the game, so they do not see any downside to profligate spending. Politicians, in essence, are acting like I did, when I was a middle school student. They see a neverending amount of money coming to them each year to spend, and spend it they do. They go for broke each year, because there are no downsides. They will just get more to spend the following year, and the year after that, and the year after that, and so on and so on......

And why not, they are not spending their own money, but are spending other peoples money, opm. Unfortunately for taxpayers, it is our money they are spending!!

The new healthcare reform law actually spends a greater percentage of OPM, by putting limits on out-of-pocket medical expenses for individuals and families, and with large government subsidies. This will further shelter individuals from the true costs of healthcare, thereby raising demand, raising costs, and further worsening the upward curve in healthcare inflation.

To me, it comes down to individual responsibility. We need to put the power of the healthcare dollar back in the hands of individuals. Each individual needs to have skin in the game, and be responsible. If they need assistance, the government can give them help with a health savings account to budget for themselves, backed by a catastrophic insurance policy. If they know this savings account will not automatically be replenished, they may budget themselves responsibly, and make better and healthier decisions!

Final question:

Who is better at budgeting expenses?

Government or individuals?

Friday, March 26, 2010

Letter To New Jersey Governor Chris Christie

March 26, 2010

Living in New Jersey, we have a new governor, who actually happens to be a republican in a very liberal state. He was elected, he states, to get rid of corruption and to balance a state budget that is billions in debt, without raising taxes, and to make the state an easier place to do business. My fear is that he has focused too much on budget cuts, while not fully researching how Obamacare affects healthcare for New Jersey residents.

I have written a letter to Governor Christie, emailed on Friday, March 26th, 2010, a copy of which is shown below.


To: Chris Christie (R-NJ), Governor

I urge you to take all available actions to protect New Jersey from a federal government takeover of healthcare. Such actions include filing a lawsuit against potentially unconstitutional provisions and securing New Jersey's ability to opt out of federal mandates. More than a dozen states have already filed such lawsuits challenging the individual mandate and Medicaid provisions in the bill. The Medicaid provisions alone will likely cost New Jersey billions of tax dollars we cannot afford.

I urge you to direct your Attorney General, Paula Dow, to join with these other states in doing everything possible to protect my rights to make my own health care choices, and also to protect physicians, so that they can offer the best care possible, without government or insurance interference.

As an independent family physician, I would welcome you to come to my medical office, which has given up all insurance contracts, other than Medicare. You will find that cost-effective high quality care occurs to a greater extent when the insurance companies and the government stay out of healthcare decisions.

I urge you to not repeat the same mistakes that other politicians have made, by listening only to your political appointees. To get a real view of healthcare today, you need to talk to independent physicians, without ties to hospitals or other institutions. Only then can you get enough data to formulate a real-world opinion on the state of healthcare in New Jersey.



So let's take a vote.

What response will I get?

A: Form letter
B: None
C: Real response by letter or email
D: Governor Christie acceptance to visit my office

My hope is for choice D, while I expect choice A.

Wednesday, March 24, 2010

Obamacare- Good or Bad?

Healthscare 101

Obamacare is now the law of the land. Very soon, health insurers will be more heavily regulated by the federal government.

Will this be good or bad for individuals, and insurers?

I care more about individuals than insurers, but insurers still play a large role in healthcare. Without insurers, we have no protection from large medical bills. But the long asked question is , Why does it have to cost so much, and can't the government do something about it?

The above question was asked, and answered by the Democrats who control our government. They singlehandedly took over the system without any bipartisan support. If the changes are deemed to be good, they will be seen as heroes, as achievers. But if the changes fail, they will be held accountable.

Today, I want to focus on the health insurers and what will happen to them under Obamacare.

First let me set some conditions. Let us assume the following:

1) No more pre-existing conditions
2) Children? may remain on family policies until age 26
3) No more lifetime limits on coverage

There are others, but I have not yet found the time to read thru the 2700+ page law. It is next on my list after I finish reading War and Peace.

Let us look at what will happen to insurance premiums with just the above three conditions.
All three will raise their cost of doing business, and increasing the amount they pay out in claims.

So the insurers have a few options:

1) Raise their premiums to compensate
2) Pay doctors and hospitals less
3) Try harder to ration care

Now I will take these one by one.

1) If insurers raise their premiums, Obama and the Congress will scream bloody murder, further vilify their industry and try to move public opinion towards an even greater government takeover of healthcare.

2) If insurers try to pay doctors and hospitals less, a breaking point will occur where doctors stop participating, with some even retiring. Can you say, a further shortage of doctors available, resulting in longer waits for care?

3) If insurers try harder to ration care, individuals and employers who pay the premiums will revolt, causing the federal government to try for a further takeover of the system. Employers will decide it is not worth it to pay for health insurance for employees, in essence, pushing their employees into the government insurance exchanges, which will eventually lead to the coveted "public option".

The end result, as I see it, is as follows:

1) Insurance premiums will go up, up, up
2) Insurers rationing of care will go up, up, up.
3) Insurers profits will go down, down, down, with many mergers, before outright going out of business.
4) Physicians and hospitals will also merge, and be effectively run by the government.

Obamacare has been skillfully set up, to be a success. But the success it seeks, will be in destroying the private healthcare system as we know it today!

Tuesday, March 23, 2010

Intro to Healthscare 101

Healthscare 101

There is a new healthcare law of the land. It was signed into law on March 23, 2010. Will it provide for a better healthcare environment for our country? Or will it destroy what has been the best healthcare in the world?

That is the purpose of this blog and hopefully I will be able to put real life meaning into the changes we are in store for. And it is why I have chosen to call this blog, Healthscare 101.

This blog is different from my office newsletter, which will continue to focus on health and wellness. My office newsletter is sent by my office via email by free subscription, and is posted on its own blog sometime after. The Healthscare 101 blog will be available, but you need to subscribe by going to the SUBSCRIBE TO section of this page.

The writings on this blog are opinion only. Please feel free to leave comments, whether pro or con. The comments will be moderated, so please remain civil.