Tag Archives: Obamacare

Repeal Obamacare!

(AP Photo/Alex Brandon)

 

There is no doubt that The Patient Protection and Affordable Care Act — AKA Obamacare – has failed to achieve its most fundamental objectives. The primary goal of the legislation was to make health insurance available to all Americans, with the parallel promise that this health care would be affordable. Obamacare has failed on both points and is so flawed it should be repealed.  

While 17 million Americans have been added to the rolls of those insured, there are still over 25 million who remain uninsured. Furthermore, those who have been able to obtain medical insurance are finding that the coverage is anything but affordable. Once the newly insured are signed-on, the insurance companies (unencumbered by regulation) are systematically raising the cost of coverage by as much as 30 to 50 percent annually.

There are (at least) three reasons for the failure of Obamacare: 1) Obama was willing to give up on principles in order to get any law passed. 2) To gain their support, insurance companies were allowed to participate in the design of the plan in a way that would benefit them financially. 3) The Republicans were unwilling to support any plan that would guarantee insurance coverage for all Americans.

The problems with Obamacare remain unresolved because it has become no more than a ball in a political rugby scrum. The plan’s supporters – mostly Democrats — are struggling to find ways to fix the unfixable, while Republicans remain fixated on blanket repeal. Both of these approaches to Obamacare talk at the problems but fail to offer real solutions. Have you noticed that one group is not complaining about Obamacare? That would be the insurance companies, because they are too busy piling up huge profits from Obamacare.  

As a general proposition, the Republican Party believes that medical care is a privilege not a right. They believe all Americans should have all the healthcare they need and want, just so long as they have the resources to pay for it. As a result, every single GOP presidential candidate’s position on healthcare starts with repeal of Obamacare, but none of them offer even a hint of an alternative. Can you just imagine the chaos and confusion that would ensue in the health-care arena if Obamacare was simply repealed and no viable alternative was available?  

The Democrats, on the other hand, act as though the “right” to have healthcare coverage means that it should be free; as if there was no real cost involved. Can you just imagine how costly and confusing healthcare will be if Obamacare is allowed to continue down its current path?      

The good intentions and objectives of Obamacare were admirable, but for reasons outlined above, the design and implementation of the plan were both botched and it is beyond repair. The longer Obamacare is allowed to stumble down its current path, the more costly and inefficient it will become.  The goal of insuring all Americans at affordable cost will never be met. The Republicans are right – Obamacare should be repealed. But the Republicans are callous and dead wrong to suggest that the healthcare – or lack thereof – for millions of Americans should be left to the caprices of the insurance companies, driven by profit alone. Does it seem fair to you that an individual’s access to reasonable healthcare should not be determined by the weight of their wallet?

There is a Better Path to Healthcare for all Americans

Already in place, time-tested and working effectively (as any government program can) are the Medicare and Medicaid programs. Medicare provides effective and efficient medical care to millions of Americans 65 and over. Medicaid – a combination of state programs funded by the Federal government – provides medical care to millions of low income individuals.

The point is that these two programs have processes and procedures in place and are in point of fact administering healthcare (from private hospitals and physicians) for millions of Americans, but not for all. So the question is: Why not repeal Obamacare and replace it with the two national healthcare programs already in existence and functioning effectively? The simplest and most direct way to offer all Americans basic healthcare at affordable costs is to expand and enroll everyone – at any age – into Medicare or Medicaid.

This can’t be done with a flip of the switch, but an organized expansion phase-in over time could make it happen. For example, in the first year those age 60 to 65 would be eligible for Medicare, then the next phase would include those 55 to 60 and so on until everyone was covered.

Of course, adjustments and changes would have to be made to both systems, but these would be more administrative and cost-control measures. For example, premiums and deductibles for coverage could be adjusted based upon income or wealth. There is no reason why someone making $1 million a year should pay the same premium or deductible as another making $50,000.

There is not space in this blog to delineate all the adjustments that would be required in order to make Medicare and Medicaid work for all Americans, but they are more administrative in nature and don’t go to the core of the programs. Ultimately the Medicare and Medicaid programs could be merged. The point is that we have two time-tested and functioning programs providing healthcare for millions of Americans, so why not just do the right thing and expand them to include all Americans?

Can Everyone be Happy?

Of course not everyone will be happy with these changes, but when is everyone ever happy with any action?

The Republicans are going to have to disabuse themselves of the belief that health care is a privilege and not a right. They accept basic education as a right, why not basic health care? Aren’t both of those part of the Constitutional right to “life, liberty and the pursuit of happiness”? The reality is that of the 47 largest industrial nations in the world, the United States is the only country that does not consider basic health care as a fundamental right of its citizens. But Republicans can be happy too. They can take credit for repealing Obamacare and swallow the expansion of Medicare and Medicaid. After all, every Republican president since Nixon has accepted and expanded Medicare and Medicaid. 

The insurance industry will certainly not be happy. So what?! The insurance companies have had a free-hand to provide health insurance for Americans for over 50 years. They have done a miserable job. If you had lots of money and were in good health, you could buy all the health insurance you wanted. But woe betide the individual who was poor or had a preexisting condition. Besides, the insurance companies could make a ton of money selling supplemental policies (as they do today) that pay the deductibles for Medicare, or for extra care not covered by Medicare.

The hospitals and doctors will not be happy. Don’t be so sure. I have hear many hospital administrators and doctors complain about Obamacare, but I have never heard any complaints about Medicare. Sure, they will complain about Medicare’s attempt to control costs and for not reimbursing the hospital or doctor for what they want to charge for their services. But have you ever heard of a hospital or doctor going bankrupt because Medicare or Medicaid didn’t pay enough for the services they provided?

And the Moral of the Story …

If we (as we should) want to provide effective, affordable healthcare for all Americans – despite age or resources – we have to recognize that, for all its good intentions, Obamacare is not the answer and it should be repealed. Doing nothing or “letting the market determine” who gets coverage is not the answer, either.

But the answer in right in front of us. Medicare and Medicaid has worked for millions of Americans and with just a little effort we can repeal Obamacare and replace it with these systems that have proven to work. So?

Obamanemia: (noun) 1. A Chronic Ailment Caused by a Lack of Leadership and Management Skills.

No matter how lofty ideas and goals may be, they will fail without strong leadership and effective management.

So you’ve got some great ideas for a new business. Maybe you’ve discovered a way to make your company work better or even change the very industry in Obamanemicwhich you work. You also have this great vision of success and accomplishment. Maybe see yourself as a consummate entrepreneur or transformational leader who will stir the passions and loyalty of followers. Most of all, you are absolutely convinced that what you want to do is the right thing to do, not only for you but for others as well. If so, then say hello to President Obama and multitudes of others who have felt this way, only to fail. Their dreams fell prey to an ailment now coming to be diagnosed as the Obamanemia Syndrome: a failure to exhibit consistently strong leadership and management.

There’s Something Missing . . .

Simply having a great idea, a passion to be successful, a willingness to take a risk and a commitment to work hard is great—but it’s not enough. Nothing will come of this – other than disappointment – unless you can demonstrate strong, consistent leadership traits and effective management skills. It’s like you have promised your friends a wonderful dinner and have all the makings splayed out on the kitchen counter. But if you have no idea or experience putting these ingredients together to make the dinner come out as planned, then what you have is a recipe for disaster and disappointment. Despite great ideas and a passion to succeed, it is the inability to exhibit strong leadership and management skills that causes one to suffer from Obamanemia.

More words than there are grains of sand on the beach have been written in an effort to inoculate people with the leadership skills and management techniques to keep them from becoming Obamanemic. But the best way to become immune is to observe real-time, real-life examples of the challenge to leadership and management that others have faced as they attempted to implement a new idea or change. The best current example available is President Obama and his desire to bring forth health care reform.

A number of leadership and management principles are essential for implementing any new idea or to bring about change. Just a few of these would include:

  • The ability to demonstrate a clear need for the new idea or change that is understood and accepted.
  • A well-defined, simple, effectively communicated vision of what is to be accomplished.
  • Understanding that complicated problems are best resolved with simple solutions.

Much can be learned by reviewing how these principles were followed or violated by President Obama as he sought to reform health care in America.

Point One: Is health care really sick?


Despite the fact that over 40 million Americans had no health care coverage and that millions more were under-insured, President Obama was never able to convince a majority of Americans that reform was needed; let alone that government was the solution. As a result, there was no great ground swell of support for the changes he proposed. This inhibited Obama’s freedom to present a clear vision outlining his ideas for a better health care system and sucked him into a pedantic debate over the cost and effectiveness of the existing system that is both confusing and unwieldy.

If, as a leader, Obama had focused the debate on the morality of a health care system that was based on privilege rather than right or need – something that people could have understood – he would have been in a much better position to control the debate, gain acceptance of the need for change and engender support for his vision. The tenor of the debate could have been: American citizens have a right of free speech, a right to vote, a right to receive a basic education; along with a right to fire and police protection. Should American citizens be denied the right to receive basic health care? Or is health care a privilege reserved only for those who can pay for it?

After all, of the 50 largest industrial nations in the world, America is the only country that does not offer basic health care as a right of every citizen. This was a simple, specific issue that everyone could understand and decide. Once Americans had decided whether heath care was either a right or privilege, the debate over “if” something should be done would be over.

The failure of President Obama to crystallize the health care debate in such simple terms opened the door for those opposed to change to control the discussion and delay the process. In effect, he was drawn into a debate trying to justify the workings of the new system that had not yet been quantified. This allowed the opponents to shift focus away from the need and attack the solution. The failure of Obama to clearly delineate and gain acceptance of a need for change was the first symptom of Obamanemia.

P0int Two: Making the complicated more complicated

There was no question that the existing health care system was complicated, inefficient and selective in benefits offered. President Obama made the mistake that many bureaucrats and weak leaders make and that is to assume that a complicated problem can only be solved with an even more complicated solution.

By the time Obamacare emerged from the sausage factory called the United States Congress, the bill was 2,000 pages in length and contained 350,000 words of government-speak. In addition, over 11,000 pages of regulations were needed to explain what was in the 2,000 pages. It is estimated that more people understand the meaning of life than understand the meaning of Obamacare. The only result that can come from offering a complicated solution for a complicated problem is to give everyone a severe case of Obamanemia.

President Obama failed to understand that the way to solve a complicated problem is to offer a simple solution. And it’s not like a simple remedy was not available. Instead of needing 350,000 words to parse out the solution, it could have been done using just 10 words:

All American citizens will be required to enroll in Medicare.

Since its inception in 1965, Medicare has been refined and restructured numerous times and has proven to be an effective provider of health care for citizens over age 65. The rules, administration and structure are in place – and its web site works! A simple solution – and one that everyone could understand – would have been to simply open up Medicare to those below age 65. (I know there is more to it than we can go into in this post, but the point is that if an objective can be attained by making an existing system better, it is a lot simpler than trying to invent a new system.)

Point Three: Chowing down on the elephant

The final point that brought on Obamanemia was a management failure. You know the old saying that the best way to eat an elephant is one bite at a time. Obama tried to eat the whole elephant in one bite and that will always give you a good dose of Obamanemia. No matter how you slice it, offering initial coverage to over 40 million participants and fundamentally changing the system in one fell-swoop on day one is a virtual impossibility. Obama did not understand what all successful leaders do and that is that big changes are best implemented one step at a time. Do simple things, but simply do them till the goal is reached.

It’s not that Obama did not have examples to follow. Given the highly-charged caustic political debate and resistance to Obamacare, it may be surprising to fdrmany that when Social Security was introduced in 1935, the opposition and emotional debate was even more scathing. Although he was not accused of being a foreign-born Muslim, Roosevelt was branded as a socialist out to destroy democracy and capitalism. Just as with Obamacare 75 years later, the opponents of Social Security called it unconstitutional and fought to have it repealed. They even took their case to the Supreme Court where just as with Obamacare, Social Security was ruled constitutional by a five to four vote.

There was one big difference between Roosevelt’s approach to Social Security and Obama’s to health care. Roosevelt did not try to eat the elephant in one bite. When Social Security was introduced, less than five percent of the workers were eligible to participate. Roosevelt may have wanted everyone covered, but as an effective manager he understood that the path to universal coverage was one step at a time. He recognized that once the basic concept was accepted, then over time – step by step – the final objective would be achieved. So even though Roosevelt faced as much, if not more, opposition and criticism as Obama, his understanding of managing change made him immune to Obamanemia.

And the Moral of the Story …

The lesson for all of us to learn is that even if we have a great idea and desire for a new business, a new product or a belief that change is needed to be better, that is not enough to bring on success. Can we convince others that there is a need for what we propose? Can we lay out a clear, focused vision that others can understand, support and even take on as their own? Do we have the talent and patience to manage the process? Always keeping our eye on the objective, but recognizing the best way to get there is one step at a time. The truth is that unless we can understand and exhibit the fundamental principles of leadership and management, all of our best ideas and intentions will just lead to a bad case of Obamanemia.

 

A Few Raucous Rants Against Random Acts of Revulsion

IT techies, banks and The Tea Party make the perfect ménage-a-trois of nincompoops.

Now that the “Bickering Bickersons” – otherwise known as the Republican members of Congress – have taken their openly self-destructive squabbling that shut down the government back into the shadows of Congressional caucuses, the media has been freed to concentrate on the really important world issues.

But even in the darkness, you can almost “see” beleaguered Republican leader John Boehner as the bumbling civics teacher standing before a Boehnerclassroomful of out-of-control hooligans, attempting to teach something about Modern Government. The “students” are hurling spitballs and paper airplanes, yelling, laughing and breaking up into groups as Boehner tearfully pleads with the unruly mass, “Come on now. Settle down. This is serious.”

As what does the media now identify as serious? Is it the continuing deadly civil war in Syria? Is it the brutal military dictatorship again being imposed on the people of Egypt? Is it the rapidly expanding anarchy in Libya? No, of course not. As far as the media is concerned (at the moment) the number one threat to the future of this country is the thoroughly discombobulated rollout of the web site supporting the launch of Obamacare.

This is supposed to be a great shock? You think there has never been a flawed IT rollout before this fiasco? Of course, the Republicans and the Tea Party primates jump on this web site confusion as if it is a clear message from their God that Obamacare is a bad plan. Obamacare may be a bad plan (but remember, the majority believed that Social Security and Medicare were socialist-inspired acts of the Devil when they were introduced). Still, it is false logic to suggest that a bungled IT system proves the point. It’s a little like buying a fancy new car but when you attempt to drive it off the lot, it won’t start because someone forgot to put gas in the tank. Then claiming the car is defective and asking the dealer to take it back and give you a refund.

If you don’t know that IT rollouts always get mucked up, you don’t know IT.

The problems the Obamacare rollout encountered are not the fault of the health care system, they are the fault of IT systems. Anyone who has spent any amount of time in business working with the geniuses of IT development and systems knows that never – I mean never – in the history of the world has a rollout of a new IT system been without problems. Think about it: How many times have you received a message on your computer, tablet, or smartphone alerting you to “fixes” that needed to be downloaded for your software or Apps? Remember Apple’s rollout of its “turn-by-turn” Maps app to compete with Google Maps? The one that, among other a jillion other glitches, led drivers onto a taxiway at Fairbanks International Airport in Alaska. A rollout so bad it prompted CEO Tim Cook to offer a rare public apology to users for its poor debut performance?


It makes no difference if the change is a simple upgrade, a full-blown “conversion” or a new system; they never initially work as promised. No matter how detailed the plans had been, no matter how much “testing” was completed, or how many “beta groups” worked with the new program, when it is rolled-out for real, it NEVER works as the user anticipated.

But don’t think for one minute that this happens because IT techies are dumb. On the contrary, it is part of their carefully planned and calculated modus operandi. The IT gurus like to think they are smarter than most of us and for the most part they are right. What many fail to recognize is that this is all part of a sinister plan the IT techies have to take over and dominate the world.

It has been my long-held belief that the moguls of IT have always been more of a threat to the peace, security and freedom in the world than the Communist menace ever was. And now we know it is true: The Communists are gone, but the IT people are still here, and stronger, more dominating than ever. The Obamacare muck-up is just another example of their master plan to control all that happens and to allow nothing to happen without their approval. A sub-set of their plan is also to assure perpetual job-security for all their munchkin followers.

You think their plan is not working? Just look how the web site rollout of Obamacare has crippled it and imagine how many millions and millions of dollars (ransom) that will now have to be paid out to “fix” the system. Take note my friends: The problems we are witnessing are not about Obamacare; they are about IT controlling the world.

Just Follow the Money

Bankers have some of the same objectives as IT people. Since they control the money, it’s their belief they can control the world too, but they are not nearly as smart as IT techies and therefore can’t be quite as devious in their actions. This lack of intellectual capability (I have coconuts in my backyard that are smarter than most bankers) forces bankers to be much more clumsy and blatant in their efforts. In addition, bankers have the individuality and leadership traits of drugged sheep; where one goes, they all follow.

Just this past week we were presented with two more examples of the length and depth bankers will go to achieve personal gain by ripping off customers. First, JPMorgan Chase, without so much as a blink of the eye or an insincere mea culpa, agreed to pay a fine of $13 billion to make government charges of bilking investors go away. You remember that JPMorgan was caught selling-short the very mortgage investments they were pitching to investors. Can you imagine how much money the bank made off these investments if it was willing to pony up $13 billion (only of which $4 billion is expected to go back to investors) in order to make this problem go away?

But that isn’t the most galling aspect of this issue. What is unconscionable – what is deserving of a rant – is that the individuals and executives at the bank who were responsible for these abuses – earning big salaries and even larger bonuses – get off scot-free. Think about it: The executives who perpetrated this fraud on investors suffered no accountability or recrimination at all. How just is that? How much incentive is this lack of accountability going to have in preventing the same type of anti-consumer activity in the future?

In the same week the J P Morgan story broke, a jury determined that Bank of America was liable for fraud related to defective mortgages sold to Fannie Mae and Freddie Mac in a program described as little more than a “hustle” perpetrated on unsuspecting customers. It is not known how much Bank of America (really its shareholders) will end up paying out to settle this fraud, but one thing certain is that the executives who benefited from the scam will not be held accountable or required to pay back of a dime of their bonuses.

Tea Party

As to the final subject – the Tea Party – it is bordering on iniquitous to rant against the group. After all, since there is no rational defense for their irrational strategies and tactics, to mock the group would be analogous to bullying; picking on those who have no way to defend themselves. To be fair, it’s difficult to disagree with some of what they call their “non-negotiable core beliefs.” Who can argue with the desire for less government, reduced government debt, lower taxes and more freedom for everyone? (There are a number of other fanatical fringe core beliefs that not many would agree with, but we won’t deal with them here.) What makes the Tea Party such an irrelevant group of nincompoops is not so much the goals they seek but the strategy and tactics being employed to achieve them. The Tea Party attitude harkens back to the oath of the John Birch Society in the fight against Communism in the 1950s – “I’d rather be dead than red.”

For the Tea Party it is “all or nothing.” As proudly and prominently displayed in Tea Party propaganda, their demands are “non-negotiable.” Anyone seen as the least bit willing to compromise on any tenant of the Tea Party is a traitor. It’s an attitude that cries out: Do anything that can be done to cure the disease, even if it means killing the patient. What this effete corps of imprudent snobs who characterize themselves as the intellectuals of political purity forget is that the very document to which they pay homage – the American Constitution – was possible only because of compromise.

We really should not be surprised by the attitude and obstinate rigidity of the Tea Party. You can tell a lot about an organization by looking at its heroes. What type of organization do you think will emerge when the likes of Michele Bachman, Sarah Palin and Ted Cruz are put up as the intellectual and inspirational role models for the group? It is like worshiping a holy trinity made up of two lethally ignorant dingbats and a foreign-born, ego-maniacal poseur. This brings to mind the old 1970s NBC TV program “The Gong Show” hosted by Chuck Barris. The show is best remembered for the idiots with no talent but a strong desire for the limelight who would happily make fools of themselves on national television. When you look at the antics of the Tea Party and also take into account their three heroic spiritual leaders, a better title for the group would be “The Gong Party.”

And the Moral of the Story …

So many potential rants and so little time. What is one to do? There are a lot of stupid, unjust and unfair things that go on the world today that we can’t do much about, but it does help to once in a while rant about them. It reminds me of what author Jarod Kintz once wrote, “Instead of a Lemonade Stand, I should open up a “You know what I can’t stand” Stand. I’ll sell rants in small, medium and large.”