ZingerKing

True Cost of Health Care, ObamaCare, Threat to Medicare, HHR Analysis of Health Care Legislation, HHR Health Care Reform

ZK — Tue, 27 Apr 2010 12:59:00 GMT

We will still have 23 million people not covered by health insurance. This is better than the current 32 million not covered but it means that this legislation that will cost $2 trillion in its first five years will cover less than 10 million additional people during that five year period.
Senior will lose health care benefits. HHS estimates that 50% of seniors will lose the Medicare Advantage coverage.
Corporations will begin to eliminate coverage through private health plans and force employees into the government exchange to purchase health care on their own.
We will lose many doctors as they "retire" from the bureaucracy and lower pay of the new health care system. This will reduce the availability to care and will increase the cost for care. HHS estimates that the cost of health care will increase under this bill, not decrease or even remain the same.
The new long-term care program is not a viable business and funding model and is certain to fail.
HHS estimates that 15% of all hospitals will fail in the next 5 years due to Obamacare, creating further problems with availability of care and therefore higher prices.

The bill will accomplish banning the insurance practice of dropping high risk patients, increasing the number of Americans covered by a health insurance policy and will make health insurance more affordable to some through taxpayer subsidy (sometimes called taxes) of premiums. But lets be honest, we could have accomplished many of these objectives with simple legislation and did not require impacting every single American and throwing our current system of health care in upheaval to achieve this result.

Health Care reform is desperately needed in this country. The biggest anticipated failure of this legislation is the lack of cost control. The cost of the program is currently estimated at approximately $2 trillion in the first 5 years of use. That is made up of more than $1 trillion in new taxes from 2010-2019, more than $300 billion operating loss as reported by HHS and don't forget the $500 billion allocated in the 2010 Federal Budget for health care reform. (PS, I'm sure the administration wants you to forget that little $500 billion because they I'm sure that we will hear how the administration has reduced the overall cost of the budget when reelection comes in 2012 --which is not a reduction at all).

The Conclussion:

Anyone that knows the health care industry and cost structures knows that trying to control the health insurance companies to reduce overall costs is like trying to put controls on the auto insurance companies to reduce accidents and theft of cars. The insurance company is not the source of the problem.

ObamaCare is destined to fail the way it is written. Costs will go up, availability of health care will go down but the number of people covered will increase (at a cost of $86,000 per new covered life from 2015-2019 and this excludes the hidden cost of higher health care). Zinger, like most Americans, wants health care reform. I'm sure the political rhetoric will try to convince us that it will be wonderful. I for one will not listen to Nancy Pelosi when she tells us that the program is good, that we will just have to wait until it is implemented to find out. I don't have to put my hand in a fire to know that if I do I will get burned. No thanks Ms. Pelosi, you can keep this change too.

We can only hope that Congress goes back and revisits this legislation with an eye on real reform.

Here are some recent articles that speak to the Health and Human Services Analysis:

National Review

Health care reform Is going to cost more and impact seniors

Kaiser Foundation analysis of Health Care bill

Who Said It?

"The Constitution does not just protect those whose views we share; it also protects those with whose views we disagree"

                                             Ted Kennedy
                                             The Lion of the Senate
                                             Proponent of Health Care Reform

Today's ZingerToon:



Shameless Request For Support:

ZingerKing operates without advertising or government funding (obviously). The purpose is to inform and educate its readers about economic and political issues that affect our lives.

Help ZingerKing grow. Have you Zinged someone lately? Please forward a link to ZingerKing to a friend, family member or neighbor. If you enjoy reading the Zinger please subscribe (see the subscribe box at the top of the article in the purple side band). Subscribers receive the "Morning Briefing" when published with a link to the full article. Your email address will not be sold to others and will not be shared.

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Pelosi, Social Security, Health Care Reform, False Media Polls

ZK — Fri, 26 Mar 2010 01:14:00 GMT

2) Health care reform receives world praise from….Chavez and Castro.

3) Social Insecurity. The deficit and debt is about to go higher, much higher.

4) Political polls in the hands of political pundits will result in lies and manipulation.

Who Said It?

"The ignorance of one voter in a democracy impairs the security of all".

The Discussion:

Nancy Pelosi:

Did you notice when Nancy Pelosi walked to the Hill to chair the vote on health care? She walked down the street, with guards, carrying her gavel. Please explain to me why the Speaker of the House would walk down the street carrying her gavel? Congress has underground passages to connect to the Hill without walking outside. Secondly, why is the gavel in her hand and not on the podium in the house? Something is not right about this picture. Either she is tempting fate, trying to instigate trouble or flaunting her power. To me, it was the walk of shame.

At a time when the Democratic leadership was cautioning about threats and bad behavior, please tell me why she would do this? And to think, they called Tom Delay "The Hammer".

Health Care Reform:

The United Sates has received world praise for passing health care reform. Hugo Chavez and Fidel Castro have sent congratulations. Have you heard of any other country sending congratulations? I haven't.

Social Insecurity:

For years we have known that Social Security and Medicare were going broke. Many people disregarded the warnings. Other people simply said that we will be able to resolve this problem before they become insolvent. Then there are those that didn’t even bother to understand the magnitude of the problem and went about their daily life.   Some didn’t realize that the trust funds that were set up to store the money for future generations of payments had been depleted by Congress and used in the general funds to pay for excessive spending in prior years. The trust funds have no money, none, zero.

Up until last week we were told that Medicare would have sufficient funds until 2016 and Social Security would go in the red (meaning they were spending more money than they were collecting) in 2014 with bankruptcy in 2024 (unless something is done to save it). Well, things have changed. As a result of the recession, Social Security is now spending more money than they are collecting. Additionally, we anticipate that it will take at least 5 years for the economy to absorb all of the unemployed workers, which means that Social Security will most likely not be able to recover to a positive cash flow where they are collecting sufficient tax to pay current beneficiaries. From this day forward we may be operating at a loss.

What does this mean? Remember the $3.7 trillion budget deficit this year. How about that $12.7 trillion dollar national debt? Both are about to balloon. The only way to pay these bills is to print more money and accept the inflation consequences or borrow money. From China? How about anyone that is willing to lend us the cash we need.

Our government must get focused on rebuilding this economy and doing it fast. The administration seems to be willing to allow the economy to recover at its own pace, which it will. In the meantime, the economy struggles, unemployment remains around 10%, incomes remain depressed and government tax collections are declining which increases the budget deficit and national debt.

So, to all of you that think this thing is going to fix itself, it is time to start paying attention to what is going on. The administration is committed to tackling immigration reform (a payoff for a health care vote), financial reform (thank goodness that Chris Dodd is retiring so he can attack this problem without concern to his political life, because it is over) and cap and trade (there’s a real jobs builder). Maybe they should start with budget reform.

Who can forget President Obama’s speech after Brown won Ted Kennedy’s Senate seat from Massachusetts…..Jobs, Jobs, Jobs… That’s what he said. Sorry, it doesn’t feel that way. Secondly, that lack of jobs is disclosing the true vulnerability of our economy as the social programs that require a continuous feeding of tax revenue from workers go belly up. Social Security, Medicare and Medicaid have become current liabilities and not future liabilities.   The future is now.

The Polls:

I read two polls in the past week that show how the media distorts the facts. Huffington Post, which is a liberal blog, posted a report that said that the public is now supporting health care reform. What they didn’t say is that this poll is done twice a week by a different polling group asking the same questions. The group that did the poll that week reported that public opinion has changed in favor of health care reform. What they didn’t say is that all other polls done by different groups asking the same questions showed the public was against this reform legislation, with the exception of two other times in the past 6 months. Interestingly, the other two times where done by the same firm that brought you this weeks numbers. I would say they don’t know how to survey.

I also read another Huffington report that said their survey shows that the majority of Americans (53%) support the health care reform or would support it if the bill were more liberal. When you look at the data, what they didn’t tell you is 82% of Americans support the bill or would support the bill if it were less liberal. Only 13% wanted the bill more liberal and 42% wanted it less liberal.

The moral of this story is that there is a survey for everyone. It also shows that the media must think that no one is reading or really evaluating the facts and just listen to their biased rhetoric.

Who Said It?

"The ignorance of one voter in a democracy impairs the security of all."

                                                                                     John F. Kennedy

Today's ZingerToon:

Recent ZingerKing Articles:

Articles can be found under “Recent Articles” in the purple sidebar. Older articles can be found in the archives that are stored by month. These are found at the bottom of the purple sidebar as well. Here is a list of the most recent articles.

What's In The Way of World Peace

The Implications of Health Care Legislation

Health Care Experiments and Pilots Are Parking Lots Of Political Decisions

Confessions of an Academic: Obama's Advisors.

America's Health Care, Universal Health Care

The President's State Of The Union Speech

Supreme Court Rules On Corporate Political Advertising

A Republican In A Democrat's Seat. Brown In Kennedy's Seat.

How Parenting Style Shows Up In International Politics. Non-Verbal Communications.

The Role Of Government: Provider or Enabler?

The Corruption Of Health Care Legislation

Inflation Is Coming, Inflation is Coming. Inflation And The Deficit

The Administrations Decision Process For Afghanistan

President Obama's Job Fair and Search for Jobs

President Obama's Afghanistan Strategy and Speech

Shameless Request For Support:

ZingerKing operates without advertising or government funding (obviously). The purpose is to inform and educate its readers about economic and political issues that affect our lives.

Help ZingerKing grow. Have you Zinged someone lately? Please forward a link to ZingerKing to a friend, family member or neighbor. If you enjoy reading the Zinger please subscribe (see the subscribe box at the top of the article in the purple side band). Subscribers receive the "Morning Briefing" when published with a link to the full article. Periodic alerts are sent to subscribers only with important updates and insights into critical issues. Your email address will not sold to others and will not be shared.

Write To Us:

You can comment on any article by clicking on the comment button at the bottom of each article or you can write to us at ZK@ZingerKing.com

World Peace, Iran, North Korea, Nuclear ambition, Palestine and Israel, Saudi Arabia

ZK — Mon, 22 Mar 2010 19:46:00 GMT

Today's ZingerToon:

Health Care Experiments and Pilots Are Parking Lots Of Political Decisions

Confessions of an Academic: Obama's Advisors.

America's Health Care, Universal Health Care

The President's State Of The Union Speech

Supreme Court Rules On Corporate Political Advertising

A Republican In A Democrat's Seat. Brown In Kennedy's Seat.

How Parenting Style Shows Up In International Politics. Non-Verbal Communications.

The Role Of Government: Provider or Enabler?

The Corruption Of Health Care Legislation

Inflation Is Coming, Inflation is Coming. Inflation And The Deficit

The Administrations Decision Process For Afghanistan

President Obama's Job Fair and Search for Jobs

President Obama's Afghanistan Strategy and Speech

Shameless Request For Support:

ZingerKing operates without advertising or government funding (obviously). The purpose is to inform and educate its readers about economic and political issues that affect our lives.

Help ZingerKing grow. Have you Zinged someone lately? Please forward a link to ZingerKing to a friend, family member or neighbor. If you enjoy reading the Zinger please subscribe (see the subscribe box at the top of the article in the purple side band). Subscribers receive the "Morning Briefing" when published with a link to the full article. Periodic alerts are sent to subscribers only with important updates and insights into critical issues. Your email address will not sold to others and will not be shared.

Write To Us:

You can comment on any article by clicking on the comment button at the bottom of each article or you can write to us at ZK@ZingerKing.com

The Future Of Health Care, Implications Of Health Care Legislation, ObamaCare, Congress and Health Care, Election 2012, President Obama

ZK — Thu, 18 Mar 2010 13:50:00 GMT

Have you Zinged someone lately? Please forward a link to a friend, family member or neighbor. You can sign up to receive ZingerKing by entering your email address in the box on the right (Subscribe). You will receive the Morning Briefing and a link to the full article whenever anew article is published. Your email information will be kept private. _________________________________________________________________________
Thursday March 18, 2010
The Weekend Edition

Today’s Zinger:

The Only Score That Matters Is The Final Score

The Morning Briefing:

Since the health care insurance reform bill is front and center this week I thought I would get my crystal ball out and look into the future of health care in the United States. I know this may be a little dry reading but I wanted to get these points out before the final bill is voted on.

Yes, I believe that Congress will pass the health care insurance reform legislation. I doubt that Congress will rely on parliamentary maneuvers to get it done. It will be a clean majority vote with the slimmest of margins to win. Enough deals, bribes and intimidation will take place in the backrooms of Congress to win approval for this legislation. I would hate to be one of the Congressional holdouts this week. Waterboarding would be more humane than what they will be going through.

So the bill will pass with much fanfare and rejoicing, but what will be the short and medium term implications. Forget the political wrangling of both parties such as the Republicans screaming irresponsible and a budget buster and the Democrats lauding the success for all Americans and the bill being revenue neutral. Those choruses of political bantering don’t require much of a crystal ball. But what about the care we will receive, the taxes, the cost of care and the future of the medical industry?

In the next 10 years, much of how America views the success of this bill will be based on who wins the 2012 elections. I believe Barack Obama will win reelection and his reelection will have significant implications on the future direction of health care beyond the current insurance reform bill.

In the Short Term:

Many Americans will be pleased because in the very near future there will be a law that insurance companies can no longer discriminate against those with previous conditions that in the past has caused them to lose or never be able to attain insurance coverage.

Medicare cuts are planned for later this year. I doubt they go through. Congress will vote to delay the cuts until after the November election cycle. Much of these cuts will have little impact on medical outcomes, but Americans base their quality of care on availability and treatment offered. These are the very things that will be impacted by the cuts. In the coming few years, seniors will notice the change and the Republicans will be sure to remind them. Keep in mind that Medicare will be insolvent by 2014. These reductions of costs of Medicare and moving these funds to the general health care fund will mean that the easy cost reduction work needed to make Medicare more solvent will be over and there will be no overall reduction in health care costs.   Tougher work is ahead for Medicare in terms of more cuts or higher taxes.

New taxes on goods and services will be implemented to pay for health care. Just like FDR, the administration will rely on sin taxes and not the income tax to garner new revenue without calling attention to it. Taxes on the wealthy and those with employee based insurance plans that are deemed “Cadillac plans” will begin as outlined in the health care insurance reform bill. There will be no real benefits occurring for five years. (Remember the implementation begins in four years and takes two years to roll out). There will be sufficient tax revenues stored up to meet the early years requirements of the bill. Don’t forget that the 2010 Federal Budget included $500 billion as a down payment on health care reform. Combine this with 4 years of taxes at $100 billion a year and Medicare cuts of $100 billion by implementation and you have a trillion dollar nest egg to start the program. There will be a lot of debate as to whether the bill is really debt neutral.

There will be a near term increase in the cost of care and pharmaceuticals as providers and insurance companies try to position for future cost cuts (the old raise the price before the sale to make the buyer feel good about what they got. This happened the last time health care reform was proposed). Premiums will begin to go up for those that buy insurance independently. The inclusion of the many Americans that have preexisting conditions will push the total medical outlay higher and will result in higher premiums for this group.

If you are currently in a group plan through your employer or you are a government employee or you are a union employee you will most likely experience few changes in the short run.

The medical industry will begin to reposition itself. Those providers that relied on MRI’s, CT scanners, laboratories, pain centers, etc will begin to move/sell those assets to others as this will most likely be a key area of cost reduction in the future. Some providers will stop accepting Medicare patients due to the reimbursement rate. Some doctors will plan their retirement for 2015, but not to the high rate that many predict will leave. The medical colleges will see a large increase in applications for General Practitioners and there will be legislation to enable Licensed Practical Nurses to have a greater role in primary care due to the anticipated shortage in front line medical professionals. We will probably see one of the largest labor organizing movements in history as the health care workers are targeted by the unions.

America's ranking in health will improve. Currently we are ranked by the World Health Organization as 38th in health care. It is not because of quality of care, but rather because of access to care by our citizens. With more people covered under the program, our world ranking should improve dramatically.

Medium-Term:

Now remember, this is 2014-2016 (just as this program goes into full implementation).

Many companies will opt to pay the government penalty and not provide health care to its’ workers since the penalty is cheaper than premiums. The government will have a windfall of revenue but there will be more than an offset in higher costs to provide incentives to those that will be required to buy health care. Many young people will opt out of the system and if caught pay a tax penalty. There will be a constitutional challenge (which will start in 2011) to the bill based on forced participation.

The government response in 2014 depends on who wins the election in 2012. If the Republicans gain control of Congress and the Executive Branch, I do not believe there will be a major change in the bill with the exception of real tort reform, an easing of the participation requirements and greater competition. Once this bill is enacted, like all social programs, it is impossible to take anything away. Besides, there will be enough momentum towards 2014 that it would be a train wreck to radically alter the path.

If the Democrats are elected I believe there will be a change to the bill. This is based on rising premiums, rising health care costs and rising taxes. The Democrats will blame the insurance companies for these problems and push for a single payer system saying it is the only way to rein in the excesses of these insurance companies (even though it is not the insurance companies that will create the higher costs, it is the providers). If President Obama wins reelection he will say that he gave them a chance and they didn’t perform. Personally, I believe the way this bill is written will tee up this exact situation.   For many Americans, this is the ultimate goal and this bill is a is a step towards achieving that goal.

The health information network, which Zinger strongly supports, will begin to roll out in a small way. Remember, when the government undertook the replacement of the air traffic control system it took 10 years to develop. I doubt the government will have the health information network fully operational for at least 10 years.

So, its 2015 and I predict that President Obama is reelected in 2012, this time in a squeaker of an election. By midterm in his second term the realities of this legislation will be felt.   Remember, perception is reality. More people will be covered, cost of medical care will go up, but it will be paid by the pre-taxing of benefits since 2010 so there will be little current cost to the program. Many people will be satisfied with the outcome.

I know you will wonder why I think President Obama will be reelected since he has been one of the most polarizing Presidents in history and half the country dislikes his performance. I will save that for another article.

Long Term:

So, up to now, the government has sufficient money to pay the bills. There has been some gnashing of teeth over the changes that have occurred and the program is now fully operational. This is where things will get very interesting. The current health care bill basically punts the ball after 2018 relying on Congress at that time to enact legislation to further fund the program as all of the special deals end. Zinger will look at the long-term prospects in an upcoming article. This is as much health care as anyone can take in one sitting.

Today's ZingerToon:

Compliance Versus Commitment, The Chicago Way, Majority Whip,

ZK — Thu, 11 Mar 2010 18:52:00 GMT

Al Capone

After the election of President Herbert Hoover, U.S. Treasury Secretary Andrew Mellon was charged with eliminating Al Capone through Federal laws of tax evasion and the Volstead act. Elliot Ness was recruited to rid Chicago of Al Capone and the influence of the mob.

The gangsters of Chicago cemented the practice of political corruption. Famous figures such as Bath House John, Hinky Dinky and Mayor Daley become legends of Chicago’s political graft and corruption. Slogans such as “vote early and vote often” became synonymous with Chicago politics. Threats to political power and “safety” were used to influence votes. More than one political figure had been found in the Chicago River with cements boots.

Zinger looks at how Washington builds commitment to legislation and how political compliance will result in failed legislation.

The Discussion:

Many believe that the Chicago way has moved to Washington. With an influx of political figures that cut their teeth on politics in Chicago, Washington has adopted the ways of the mob to get what they want. The Louisiana Purchase and the Arkansas deal (payoffs to politicians for their support of health care legislation) have been updated to current day graft paid to legislators in exchange for their vote. Threats to political power can be seen in Governor Paterson of New York, whose own party went after him when he failed to agree to the Democrats wish that he not run for a second term and piled on during his current problems.

Take the politicians that follow the party line and make no waves. Charlie Rangel has been supported by the Democrat leadership despite the apparent tax fraud, non-disclosure of assets and corporate payoffs. But, Charlie Rangel has been a steadfast supporter of the party system so the system now supports him.

Probably the most naked power play had to be Rahm Emmanual’s finger pointing threat to Congressman Massa, while fully unclothed and taking a shower. Massa was told to support the President’s health care plan or suffer the political consequences. Some of what happened to Massa sounds strangely familiar to Paterson.

Most recently, Blanche Lincoln has wavered on health care legislation As a result, the Democrats were asked why the leadership doesn't strip Sen. Blanche Lincoln of her Agriculture Committee chairmanship, Brown chimed in and said that might be coming next year. An attendee stood up in the back of the room and said there should be consequences for Democrats who don't support the caucus on procedural measures.

Have the political parties turned into the mob? Are they forcing compliance as opposed to building commitment to good legislation? Obviously the political consequences of legislative failure on health care are high. The Chicago Way is in full display. The notion of “Congressional Whipping” and the role of the Majority Whip have gone to a new level.

The problem with forcing compliance to a political agenda is that the whipped or threatened politician will change as soon as the power base changes and the threat is eliminated. You could see it in the Chicago mob and Chicago politics. Without a true commitment to an agenda that will last beyond the thugs, the agenda is bound to change and nothing will get done because those that were forced to comply will quickly change their position. Commitment is something that can survive challenges while compliance will not.

Looking at the health care legislation, without true commitment to the right legislation and a four-year waiting period until the bill becomes reality, we can expect that any law passed today will be changed (even radically changed or eliminated) before the first pill is administered.

The Conclusion:

Our government is no longer of the people, by the people and for the people. If we the people don’t force change in how our government works, the Chicago Way will become the American Way and it will take more than Elliott Ness to fix it.

We need a government that builds commitment to good legislation, not a government that forces compliance to political ways and bad legislation. The only way this will change is term limits, limit campaign finances and limit the “reelection season” when fund raising and campaigning can take place.

Who Said It:

"An Ounce of Performance Is Worth Pounds Of Promises"

Mae West
American Actress

Today's ZingerToon:

Health Care Experiments, Health Care labs, Health Care Choice

ZK — Wed, 10 Mar 2010 16:48:00 GMT

Wednesday March 10, 2010

Today's Zinger:

Testing Health Care Alternatives Is A Parking Lot For Politically Difficult Decisions.

The Morning Briefing:

My wife recently had to go through surgery. The entire process resulted in 27 different providers being involved. Each one owns their own business with their own costs and profits. Each one must optimize their piece of the medical pie and provide a level of care that ensures that they have done everything in their power to make their piece successful.

Over the past 25 years, medical care has become more and more specialized. For the patient, this has meant an improvement in quality of care in some cases, but it has also meant a decline in care for others that don't have access to care due to cost or a decline in care due to the difficult coordination across providers.

The number one predictor of a successful medical outcome is the number of times the providers have seen and dealt with a specific medical problem. This means the more specialized a doctor or facility at dealing with a particular problem the better the patient outcomes. From the doctors or providers standpoint, this specialization has also meant higher incomes. Specialization has a higher Medicare and insurance reimbursement than general practitioners.

Medical specialists have also learned that owning side businesses to support their practice is convenient for the patient and very profitable as well. Laboratories, Imaging Centers, Pharmacies, Surgical Centers have sprung up to support individual doctors practice needs. These centers have further splintered the medical delivery system.

The Discussion:

There was a time that health care was highly integrated. You went to a doctor, hospital and pharmacy and received most of the care from one or two "profit centers". Not today. As my wife experienced with her surgery, 27 different providers with their own profit centers, surgical centers, imaging centers, doctors, hospitals, medical transport, etc get involved. Each creates some level of redundancy and some level of medical testing that may or may not add to the patients outcome.

Each also creates an extraordinary cycle of billing and paperwork. Each creates their own bill to the insurance company and a bill to the patient. The insurance company creates an Explanation of Benefits Statement (EOB) to the provider and then an EOB to the patient. The bill is usually revised at least once which produces another EOB to the provider and then the patient. Then the provider must produce another bill to the patient. Each provider contact will produce a minimum of 5 billing/EOB events and more likely 7-10 events. This means that my wife's surgery and followup produced over 100 administrative contacts. All of this drives costs. All of this creates the potential for errors.

The reason that the Single Payer System sounds appealing to so many people is that it will eliminate the redundancy across providers. It will also radically alter the health delivery model. It will force the integration of providers and eliminate the incentives that drive some providers to adopt procedures or business options that enrich their practice but does not necessarily increase patient care.

Some European countries have a 2% administrative cost associated with their health care systems. In the United States, it is fair to say that ours is somewhere between 20-25%. These European countries also have doctors on salary rather than incentives that produce more tests and side businesses that produce higher income. There are few medical facilities in the United States that operate under a similar philosophy. Mayo Clinic, Cleveland Clinic, Everett Hospital are examples of a few. These centers are known for lower cost and higher patient care. Doctors are on salary and efficiency of medical delivery is of paramount importance. At the same time these facilities are known for their excellent patient care.

So the question should be asked, is there a way to radically reduce medical and administrative costs without going to the single payer system that we often find in Europe? Absolutely. Reintegrate our medical delivery system, provide incentives for both patients and providers to more efficiently use medical care, remove incentives that are financially motivated and not medically motivated, build the health information network to improve coordination of administration and care and improve medical outcomes. These are just a few examples that could truly bend the cost curve of health care. The problem is a willingness to make the tough decisions.

Kaiser Health News (KHN) is a nonprofit news organization committed to in-depth coverage of health care policy and politics. Kaiser Health News is funded by the Kaiser Family Foundation, a non-profit private operating foundation based in Menlo Park, Calif., which communicates analysis and information on health issues. The Kaiser family is also affiliated with Kaiser Permanente, the California based health care provider. My reading of the foundation reports does not indicate a bias toward the health providers.

The following article talks about the role of health care experiments in finding the best way to cut costs and improve quality of health care. It looks at the example of how a Medicare experiment in the 90's to combine costs/services of doctors and hospitals for Medicare resulted in a 10% cost reduction, but was never implemented because Congress bowed to the powerful lobby of the doctors and hospitals. Here is the link that will open in a new window. KHN Report.

President Obama has recommended that we adopt a test of tort reform in a limited market to determine the value of reducing awards associated with medical malpractice. The Republicans are recommending a slow as you go approach to test various alternatives and see how they work. Will the test of any health care alternative be anything more than parking lots of politically difficult decisions?

The Conclusion:

As a nation, we know that we cannot afford to let the health care situation continue. We have a choice. Go to a single payer system or reintegrate and improve the efficiency and effectiveness our our current system. Each has its pros and cons, but each will require a political strength yet to be seen in our government. The worst thing we can do is a partial fix because it won't really fix the situation and has the real potential for making it worse.

If our politicians continue to see health care as a political win or loss then the wrong decisions will be made. Now is the time to come together and make the tough choices. If we don't, this could be the canary in the coal mine for our democracy. Something this big and important that goes without proper resolution will surely lead to similar results for education, national debt, immigration and war resolution.

The Democrats see health care as a real threat to their political power. The Republicans see it as a real opportunity to regain control of Congress, We The People see heath care as an urgent national need.

Today's ZingerToon:

Confessions of an Academic: Obama's Advisors.

America's Health Care, Universal Health Care

The President's State Of The Union Speech

Supreme Court Rules On Corporate Political Advertising

A Republican In A Democrat's Seat. Brown In Kennedy's Seat.

How Parenting Style Shows Up In International Politics. Non-Verbal Communications.

The Role Of Government: Provider or Enabler?

The Corruption Of Health Care Legislation

Inflation Is Coming, Inflation is Coming. Inflation And The Deficit

The Administrations Decision Process For Afghanistan

President Obama's Job Fair and Search for Jobs

President Obama's Afghanistan Strategy and Speech

The Environmental Impact of Hybrid and Battery Powered Automobiles

Shameless Request For Support:

ZingerKing operates without advertising or government funding (obviously). The purpose is to inform and educate its readers about economic and political issues that affect our lives.

Help ZingerKing grow. Have you Zinged someone lately? Please forward a link to ZingerKing to a friend, family member or neighbor. If you enjoy reading the Zinger please subscribe (see the subscribe box at the top of the article in the purple side band). Subscribers receive the "Morning Briefing" when published with a link to the full article. Periodic alerts are sent to subscribers only with important updates and insights into critical issues. Your email address will not sold to others and will not be shared.

Write To Us:

You can comment on any article by clicking on the comment button at the bottom of each article or you can write to us at ZK@ZingerKing.com

Education, Experience and Wisdom, Obama's Advisers

ZK — Tue, 02 Mar 2010 15:03:00 GMT

Tuesday March 2, 2010

Today's Zinger:

Education Without Experience Will Result In A Lack Of Success. Experience Without Education Will Result In Limited Success.

Who Said It?

Good judgment comes from experience, and often experience comes from bad judgment.

Confessions Of An Academic:

I was raised in a middle class family with an amazing work ethic. My father did not graduate high school, yet he was a recognized expert in his field. His advice and wisdom was sought out by colleagues across the country. My mother was a strong willed woman (an Army nurse that landed on Omaha Beach in World War II) that grew up poor on a farm in rural Indiana. She was a smart woman and fostered my curiosity and a desire to learn and also to be smart and to achieve.

As a boy, I spent my summers on farms in Indiana spending time with my mother’s side of the family. I played on the farm, worked the fields and spent time with farmers and their children.   These were hard working people that weren’t afraid to get their hands dirty. They toiled endlessly to provide for their families. They were loyal to their families, their country and to each other.

As a boy I always thought they were smart. As I got older I recognized that they were smart because of their experience. Working with the massive farm equipment, understanding the planting cycles and the markets for their products allowed them to be successful. They lacked the breadth of experience to know about many “worldly” issues, but they knew far more than many educated experts about farming.

I saw them speak to younger well educated people about farming and the one thing that always stood out in my mind was their knowledge about when and how to do things on the farm. The younger and “smarter” folks knew what to do but they didn’t understand the timing and broader implications of doing it. I always had respect for both, but I also learned that education without experience will result in a lack of success. Experience without education will result in limited success.

I became a college professor. I taught economics, statistics, finance and information systems. During that time I was very self-assured of my knowledge and thinking. After all, I was a member of the best and brightest. I scored well on my college boards and my graduate school exams. I graduated from each program with honors. I worked very hard (my parents taught me to work hard).

I was armed with the knowledge and theories that would surely open the eyes of the world. My students were enthralled with my quick whit and mental gymnastics. In the classroom I tended to be sarcastic and looked at business people as naïve. I made fun of their thinking and their decisions. I saw all the mistakes they made.

I became a product of the institutions that taught me. At one point in my teaching, I went through a change in ambition and decided to enter corporate America (I got married and I needed a real job that paid more money). In corporate America I worked with people of all abilities. One of the greatest revelations should not have been a revelation at all. I learned that even the less educated employees possessed valuable experience that allowed them to make better decisions than some of my well formulated ideas. I possessed the knowledge but lacked the experience. Their experience provided them with the wisdom about how to get things done.

With time, I too gained the experience to marry with my education to become an effective executive. Looking back on my career I realize that I relearned the lesson of my youth while working on those farms. Education without experience will result in a lack of success. Experience without education will result in limited success.

The Obama administration has looked to the best and brightest to advise him.

The Obama administration has fewer people without actual business experience or real world experience than any President in the past hundred years. They are smart, they are well educated and they lack experience and wisdom.

The following chart shows the percentage of the Presidents advisors that have real experience in the area that they advise on.

T. Roosevelt                 38
Taft                              40
Wilson                          53
Harding                     49
Coolidge                      48
Hoover                        42
F. Roosevelt                50
Truman                        50
Eisenhower                 57
Kennedy                      30
Johnson…                   47
Nixon                           53
Ford                           42
Carter                          32
Reagan                         56
GHW Bush                   51
Clinton                          39
GW Bush                      55
Obama                           8

Does it matter? The highly educated without experience assume that they know what is best and certainly better than those with less education. They come off as arrogant, as I did in my youth. What they don’t understand is the intricacies of the entire system that they are trying to change. Its not just getting the policy or the process right, it is understanding how those changes will affect other policies and processes. It is managing the people, rewards and recognition systems, technology, etc., and knowing the strengths and limitations that allows experience to guide results.

When someone with deep experience works on a problem, they understand these relationships because they have lived in that system. The Chairman of a company that I worked for in the 90’s called it “having a feel for the cloth”. It is a reference to a tailor that knows the best cloth and how to sew the cloth to get the best out of it based on the feel of the cloth. Others may be able to tell you the type of cloth, the bias of the cloth and the weave, but a master tailor knows how to make a beautiful garment from the cloth based on feel/experience.

Contrast this to someone that has data and analytic techniques to make decisions. Their data can only provide a view in to a limited aspect of the problem. They will feel very sure about their decisions based on their data, but they don’t know what they don’t know which is the real problem. I worked with someone like this. Never in doubt, but usually wrong is the way we described his decisions.

As the Obama administration continues to pursue it aggressive agenda of health care, cap and trade, two wars, jobs growth, international policy, etc, I ask myself, are his advisers smart people that are self assured about their knowledge and ability but lack the experience to know how to be effective? Do they have a feel for the cloth? Does the President have a feel for the cloth?

Show me someone that is educated, experienced and hard working and I will show you someone that is, or will be successful. Education, experience and hard work by themselves are not sufficient for success.

Who Said It?

Good judgment comes from experience, and often experience comes from bad judgment.

Rita Mae Brown
Writer, Feminist, Activist

Today's ZingerToon:

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