Saturday, June 30, 2012

My Thoughts on Health Care and Personal Accountability


So, here it goes.  I have decided to try and tackle the issue this week with the Supreme Court upholding Obama Care.   Let me state my conclusions and then explain my thoughts.... some of which will not be popular with my friends.  After spending a couple days examining how I feel about the issue I think that upholding the health care act was correct as Justice John Roberts interpreted the Patient Protection and Affordable Care Act.  Before some of you adamantly disagree let me explain some things first.  Just because I think that Justice Roberts is correct does not mean I am necessary in support of the way the Health Care Act is written.  I do feel something had to happen.  We NEED healthcare reform.  I do see some troubling pieces in the legislation.  But it is written as a tax and Justice Roberts’s interpretation of it is correct constitutionally.  The Presidents selling it to the US people as not a tax was deceptive. 

There are definitely good pieces to this legislation.  Let me list the pros and cons as I see them:

PROS:

·      Patients with pre-existing conditions will not be denied coverage.
·      College students can stay on parents program until 26.  Means 6.6. million young adults were able to sign up for coverage on their parents’ plans, including 3.1 million young adults who would have been uninsured without the law.
·      Provides increase in preventative care...much needed in our reactive based system.
·      Insurance companies can no longer limit the amount of coverage you can receive in a lifetime.
·      Preventive care --including mammograms for women and wellness visits – are available at no charge for everyone on Medicare.
·      Patient care must make up 85% of premiums limiting administrative charges.
·      Improved Medicare Prescription Drug Benefit for over 65 were drug cost kill the elderly.
·      People who retire prior to age of 65 will have fewer problems keeping health care.
·      Should reduce the premiums of people who don't have employer based insurance.... probably will do nothing for premiums of those who have employer based programs

CONS:
·      Government intrusion into health care.  We already spend more money then any other country on health care and are ranked 31st in the world for services.  I do not see Government bureaucrats decreasing the cost.
·      Decision-making power is turned over to bureaucrats, who pay no price for decisions that are costly or wrong.
·      Benefits insurance companies...large health care companies...drug companies...my medical and drug stocks took a nice increase. 
·      Hurts small start up health care business because of taxes.  Many sold off the day after the Supreme Court decision.  Small business is the countries backbone.  No incentives to start up a small company to create new health care advances.
·      Congress passed it as unfunded federally, which means a huge burden on state governments already broke.  Anyone in special education knows that the government’s promises for funds should not be believed.
·      People do not have a legal right to "opt out".  No body likes to be controlled.
·      Wealthy retirees face a BIG hike in Medicare premiums as much as $300-$700 a month.
·      Many employers will opt for penalties over the high cost of providing health insurance, which will put more into a government subsidized programs.  Eventually I see big business doing this as well.  Which means ultimately the government run program will control most people's insurance.
·      Unemployment will rise.... once the 2014 mandate hits employers will need to cut cost. 
·      The healthy and young will now have forced premiums to cover those with pre-existing and serious conditions
·      Primary care physicians will have to serve more customers, while facing decreasing reimbursements from both Medicaid and Medicare. This will lead to poorer care and fewer doctors.  We already are in a shortage.    You think your waiting times have been long now...just wait.

Now for some more thoughts over the past couple days.  I have seen many posts from people who I know have struggled with medical bills against Obama care:  Really?  Those who have bee saddled with large amounts of Dr. bills should know how terrible navigating the waters of health care has been over the past few years.  We struggle and we have insurance.  We have worked out payment agreements with several doctors over the years to pay a small amount each month.  When you walk out of the office of any Dr., do you have any clue as to how much it will really cost?  What other industry has this system.  I go anywhere else I know what the costs are the day service is provided.  I go to the Dr. and I have to wait and see.  Having a child with special needs, I like that an insurance company can not now deny us because of Tyler's Fragile X...even though he cost no more at this point than any other child.

I have also seen people posting against it whose parents receive Medicare/Medicaid assistance.  Are you willing to give this up and pay for your parent bills?  I am not.  My dad has received government assistance for many years now because of his medical issues.  Giving this up would have meant certain death years ago and a large financial bill passed on to my mother.  It is still difficult but without the government assistance he has received he would not be here and I sure am glad he still is here with his family.  Should I deny this to anyone else?  I am a pro-lifer...consistently!  I cannot say I uphold the sanctity of life and then believe assistance to the medically needy should be denied. 

I do think we are in trouble as a country and this topic will either tear us apart or could be the necessary step to help bring us back to the middle.  I have already stated in a previous blog how I believe we are being pulled so far to the right and the left that the middle is missing.  I pray this moves our country to the center.  I see lots of hatred amongst the extremes but I think both sides are wrong.  We do not need a repeal as the right is now shouting for... we need to fix the parts of this plan that put our country at risk.  We need to figure out how to relieve the stress on small businesses that this legislation will place.  Can we honestly think that 27 different taxes will not impact the middle class?  The left is shouting victory but everyone I ask to tell me what is in this legislation cannot begin to tell me.  Is legislation good for the people when it takes two weeks to read and a group of lawyers to interpret?  This administration is consistently deceptive with the legislation they pass. 

Ultimately, here is the problem as I see it.  WE...yes, ALL of us...are failing in our personal responsibilities.  I recently wrote the following for an ethics class that may best explain my feelings with the problem of letting the government be the watchdogs of our healthcare.  Government has a long list of corruption and failings when they are the ones responsible to watch over an industry...how's the housing market?  Remember any issues with businesses who the government bodies failed to catch (Enron, Worldcom, Bernie Madoff...)?  Many of the government watchdogs have been investigated for fraud and corruption. 

What happens when the Watchdogs fail?

Sadly it seems we are fast becoming a society that wants to pass the buck and duck the blame. Personal accountability and responsibility are buzz words about what people should do but are hard to find in practice. We raise our kids to tell the truth and when someone calls we do not wish to speak too we tell the children to say I am not here.   Justifying our behavior in every manner of selfishness. We teach children to respect their elders and then talk bad about our leaders and scream at the television about how moronic so and so is. We have been told to work hard and save. Yet, the average household in America is carrying $15,956.00 in credit card debt (www.creditcards.com). Amazingly, as a society when the watchdogs fail we are surprised to find they were in some manner looking out for their own selfish interest. Why are we still shocked?

I find it interesting that the editors in my ethics book about frauds and scams started the section on watchdogs with the quote "One feature that separates developed from developing countries is the degree of corruption. Most developed countries have institutional arrangements or government organizations designed to identify or control the amount of fraud" (Matulich & Currie, 2009, p. 263). What about the history of countries who have been developed for a long period of time? It would seem that history has shown, civilizations that reach their pinnacle start their demise when corruption starts to set in and the watchdogs become involved with the very thing for which they should protect society. This was the case with the Roman, Russian, and British Empires. 
There is the moral of all human tales;
’ Tis but the same rehearsal of the past,
First Freedom, and then Glory—when that fails
Wealth, Vice, Corruption—barbarism at last.
And History, with all her volumes vast,
Hath but one page—
—Lord Alfred Byron
Lord Byron's quote shows the tail of corruption is the tail of developed societies. We have laws to govern what should be done when the watchdogs fail. Restitution should be made and crimes accounted for within the scope of the law of society. In all the examples of the ethics book on fraud and scams, when failure was found it was stopped and those responsible paid the price in some manner. It is the way of a civilized people. The problem appears not to be what should be done but what does the growth in fraud and scams prevalence indicates about our society in general. The 1975 essay by Edward Goldsmith shows how immoral and political decay led to the fall of the Roman Empire. In his essay Goldsmith (1975) says the following:

Self-government is only possible among a people displaying great discipline and whose cultural pattern ensures the subordination of the aberrant interests of the individual to those of the family and the society as a whole. Under such conditions, there is little need for institutions and, as has frequently been pointed out, the only institution that one finds among tribal peoples is that of the Council of Elders whose role it is to interpret tribal tradition and ensure that it is carefully observed and handed down as unchanged as possible to succeeding generations. (Goldsmith, 1975, p.1)

What should be done when the watchdogs are caught napping at the prevalence in recent years are we as a people should examine what has gotten us to this point. We have become selfish and gotten away from family and society as a whole. Institutions and government have risen to take the place of personal responsibility and accountability. We have focused on selfish ends and failed to hand down traditional values to the past couple generations. It would seem we have demoralized an entire generation who now turn to the media to glorify what used to be considered dysfunction. The hope is that in recent years we have started to see many businesses create corporate responsibility codes. They are becoming more invested in stakeholder ethics and the understanding that there are more then just shareholders (Freeman, Stewart, & Moriarty, 2009). Reports also show a searching from our youth for jobs that can make a meaningful difference rather then a load of money (Payment, 2008). The millenials have grown up watching corruption, crisis, and chaos, and are hoping to figure out a way to not have it repeat. Let us hope that the next generation does a better job in the role of watchdog.

I wrote the piece just before the Supreme Court ruled to uphold Obama Care but find my feelings to be the same.  We must take care of those who cannot take care of themselves but not in a way that enslaves people to the government. We must be honest and that includes the government.  This administrations way of bypassing congress, passing legislation packaged as something it really isn't, leaking information cannot be the way of our countries future.  I hope our countries youth are not so busy glorifying teenage pregnancy, Jersey Shore, deception to not get voted off the island or out of the house, that they will see through the lies and get us back on the right track.  We need Americans...not Republicans and Democrats.  We need parents to raise their children...not by videos but by example.  We need to get back to loving our neighbors and giving our extra to those in need.... not storing it in storage containers.  We need to turn off the TV and read to our kids.  We need to focus on our own accountability before screaming about others wrong doings.  We need to stop spending what we do not have.  Imagine if everyone spent what he or she spends on their credit card payment as a donation to a non-profit organization, which helps others.  But we cannot afford to give because we can't afford what we have.  We are paying for items we don't even have anymore.  What if we had a nationwide yard sale?  Cash only because we don't want to add the debt issue.... all proceeds go to offset insurance for the poor?  All items not sold given to the needy?  Yeah, yeah...I know...we are all busy that day.


References

Freeman, R. E., Stewart, L., & Moriarty, B. (2009). Teaching business ethics in the age
 of Madoff. Change, 41, 37-42.

Goldsmith, E. (1975). The fall of the roman empire. Retrieved from http://www.edwardgoldsmith.org/28/the-fall-of-the-roman-empire/


Matulich, S., & Currie, D. (Eds.). (2009). Handbook of frauds, scams, and swindles: failures of ethics in leadership. Boca Raton, FL: CRC Press.


Payment, M. (2008) Millenials: The emerging work force. Career Planning & Adult Development Journal, 24(3) 23-32. 

2 comments:

  1. Great analysis. I appreciate the lack of bias, and I feel smarter after reading this essay.

    ReplyDelete
    Replies
    1. Thanks Andrew. A appreciate your feedback.

      Delete