The Sage Observer

National Healthcare

          I have discussed this subject before; but, especially in light of current events, I would like to discuss it again today–perhaps, even more candidly. I’ll be honest with you. If I were a member of Congress when the Patient Protection and  Affordable Care Act (PPACA), aka Obama Care, was passed, I was so angry with rejectionists like the illustrious Kentucky Colonel, Mitch McConnell, I would have voted for that bill without hesitation, even though, however, I was, in all honesty, really not in favor of it. I say to you as I have said to others, the law is an exercise in masturbation. I told that to my friends then; and, also, I wrote President Obama, telling him that, too (He, eventually, thanked me for my letter but didn’t mention the subject of healthcare). Today, four years later, I feel even more negative toward it. This law has good intentions, but it fails the people of this country. I see a train wreck coming. It is coming, and it’s going to hit hard. When it does, the American people are going to be mad as a swarm of bees. Mark my word. Don’t forget I said it, Mister Politician.

It is anything but affordable for the masses of the people; it is confusing, bordering on being unintelligible to most; and it is so complicated and expensive, it could drive all of us, people and government into bankruptcy.   In tackling our problem of healthcare, President Obama made the same mistake as President Clinton; by, in his effort to be conciliatory and bipartisan with the Republican Party, invited the major stakeholders in the medical industrial complex to the negotiating table, assuming that consensus there would bring reform. Who are those stakeholders? They are the pharmaceutical, hospital, physician, and insurance industries–the primary focus of all of them being profits, with the interests of the people being last on their list. They not only fought the administration on this, they fought within against themselves. I ask you. Who ever heard of the customer or client coming in first on the list of any insurance company? Really!

          I submit to you that healthcare is not a commodity like oil, sugar, pork bellies, credit default swaps, housing, automobiles, and so on. Healthcare is not adaptable to or compatible with the free market (a myth at best) in any way, shape, or form. Who beside the most skilled can intelligently evaluate an insurance policy; who but the most skilled physicians can evaluate the abilities of a doctor; when you need to go to the hospital, how often is it you who has the decisive choice as to where to go; and, lastly, who of you is able and has the expertise to knowledgeably determine the proper drugs you should take when you are ill? I am certainly not qualified and neither are almost all of us.

Healthcare is a need of all of us–a need we share in common. Accordingly, it should be governed in common. Healthcare is our RIGHT. How do I justify that? It is stated as such in our Declaration of Independence. We all have the right to life, liberty, and pursuit of happiness. We should be allowed to have and enjoy that right. We need a system that will work, one we can afford, and one for which we have the ability to pay (Surely no one thinks it can be free). We need a single payer, national healthcare system modeled after Medicare with, like the VA, the ability to negotiate prices.  

Immediately! I hear someone cry socialism. In this individual instance, why should you care if it works? As one person once said, “It doesn’t matter if the cat is white or the cat is black. The cat we want is the one that catches Mice” (or something like that). A single payer healthcare system will catch mice. If we were talking about the whole country going socialists, we would need, I would think, to sit down and have a long talk about the matter–a very long talk. In this instance, however, no one is even thinking about that. We already know socialism has failed as a whole, so this isn’t even the subject of the matter. We need a system that works for us.

Let me tell you about that word, socialism. The word socialism is inflammatory; used, primarily, to arouse and anger people in order to influence their minds in one direction or another. To most people, it is something bad, from which one will turn away with rejection. We hear it every day from those who don’t believe in government, usually some form of anarchists. It usually comes from those who want to control your mind and lead you in the direction they want you to go. Do you really need that kind of people?

I want to call your attention to a fact of the matter. When Medicare was made into law in the 1960’s, it was up and running in a year. The Patient Protection and Affordable Care Act (PPACA) was passed four years ago and still is not working, some provisions of which are being moved back even now, as we speak. Medicare, on the other hand has been in effect for over forty years and working just fine even now. How about that? Our illustrious politicians haven’t been willing to even so much as give single payer national healthcare a national hearing for consideration. Is that Democracy?

How should we pay for such a plan? I have given a lot of thought to the matter and changed my mind from when I first wrote about “single payer”. Please allow me to bring another issue into the picture, Social Security. This safety net, also, is moving forward to the day when our government allows it to become a national crisis. Social Security, to the best of my knowledge, is one of the most efficient, well run programs, with the lowest costs of administration of any other program in government. A big reason for this success is that the fund is “stand-alone”, “self-funding”, and not included in our general budget. In this way it is highly controlled and does not affect our national deficit. Our biggest problem with financing this program is, in my mind, five-fold, the recession in our economy, the retirement of our “baby boom” generation, our massive unemployment (Whereas, in the past we had more people paying in than those receiving benefits, we now have less paying in–I am told only three paying in now for twelve receiving.), the aging of our people, and increasing disabled coming onto the rolls. Obviously, payments into this fund have to be increased, and cutting benefits and cost of living adjustments is absolutely unacceptable. Having said that, raising payroll taxes on employers and employees (the money is going to have to come from somewhere) will create additional hardship and political tensions no one needs or can stand just now.

Let’s now get back to the question (or issue) of single payer healthcare. It, too, must be financed. Again, it’s not free. It will be expensive, but it will be a lot less expensive than Obamacare–a lot less. I might, also, call your attention to the fact we are not feeling the full pain of even our current healthcare expenses, as exaggerated as they are. We are paying for a lot of them “on the cuff”–it’s in our deficit. But I digress. We should administer single payer healthcare in the same manner as we do Social Security, with a stand-alone fund into which go all receipts and out of which go all disbursements. In no way should the accounting for healthcare be mingled with the accounting for government. In no way should healthcare funding be allowed to affect our deficit. Tax rates for payments into both the healthcare and the Social Security funds should be automatically adjusted annually for any expense overruns or surpluses. So I don’t cause confusion, in no way should our stand-alone healthcare fund be co-mingled with our Social Security fund. The accounting for both must be kept completely separate and open to the public.

Now, let’s get to the question for which you have been so patiently waiting (if we have come this far and you are still with me, you must be patient). How should we pay for this? I believe we should create two separate and apart national Federal Sales Taxes, a separate sales tax for each fund. For states which presently have sales taxes, we should take advantage of their systems in order to prevent duplication in costs, using them for collection. For states without sales taxes, currently, they should set up a system and be reimbursed by the government for collection. These taxes should be itemized separately on every sales receipt, separate from those of the state.

In conclusion, what will we accomplish by all this?

We will have a national single payer cradle to the grave healthcare system, the cost of which will be much more acceptable to the taxpayer.

We should save trillions of dollars by eliminating insurance profits and reducing healthcare costs through allowing government to negotiate prices (this suggestion presumes that healthcare remains private and government is the single payer). Additional savings should, also, be realized by increased efficiencies.

Employer and employee payroll taxes will be eliminated, a boon to both and a stimulus to the economy.

Healthcare will no longer be a “monkey” on the back of business.

The pressure for reduced work weeks will be eliminated.

Uncertainty of the future will be reduced and business will be better able to plan.

The adjustments and uncertainty surrounding both healthcare and Social Security will be resolved, the tax rates being adjusted annually.

The immense and horrendous worry by our people will be significantly reduced.

And last, but not least, hopefully our people will be more at ease and stable.

Let’s quit fighting. Let’s quit arguing and bickering. Let’s quit the politicking and put our country first. Let’s pull together and  get the job done. Let us implement single payer healthcare and protect our Social Security. This is just one more step in taking back our country from the “power elite”, our Shadow Government. Get with your representatives today. Unlike those of whom we spoke, above, we can’t pay them off, but we can let them know where we stand and how we vote.

Ronald Miller

mtss86@bellsouth.net