More on the Health Care Debate

One of the --frankly--sillier things I have heard from critics of a government health program is: "I don't want a government bureaucrat coming between me and my doctor."

As opposed to an insurance company bureaucrat?

Let us examine the presumption that a government bureaucrat (as opposed to an insurance company bureaucrat) is not competent to adjudicate billing and fee issues between physician and patient.

First of all, the government bureaucrat will likely know what he or she is doing. To get a job, a government employee must describe and document KSAs (Knowledge, Skills, and Aptitude) for the job in question. Getting promoted also requires either documenting KSAs or performing elements of the job at a higher level of performance to the satisfaction of a superior; just ask anyone who has ever applied for a federal position. By the way, the federal KSAs are public record.

On the other hand, the insurance company bureaucrat may have no experience whatsoever. There is no way to tell.

The government bureaucrat has little incentive to deny a claim for cost reasons, because his or her job performance is not measured by bottom-line considerations. Rather the government bureaucrat's work performance is measured against performance-based objectives including speed of processing claims, accuracy, judgement, client satisfaction.

The insurance company bureaucrat is very much judged on how much money he or she save the company (read; number of claims denied).

In our current system, you have an insurance company bureaucrat between you and your doctor; who may have worked at a Kentucky Fried Chicken last week and is, in any case, not working for you but for the company's bottom line.

I'll take the government bureaucrat.

40 years along...

Before I forget. I joined the U. S. Navy 40 years ago today. I was 17 years old, getting off a bus at Naval Training Center, San Diego, and scared stiff. The sailors who met the bus made my high school gym coaches seem like weenies.They were loud, coarse, and scary. What the hell had I gotten myself into? It didn't take long to decide that I had made the biggest mistake of my life (all 17 years of it!).

I had no idea--I could not have conceived--that 20 years later I would look fondly on that day as the day I first put on the uniform that I was about to retire.

Today, 40 years later, I still smell the salt air at Nimitz Island, I still hear the martial music blaring from loud-speakers as seaman recruits learn to march to John Phillip Sousa's cadences, and I remember a lot of 17 and 18 year old kids setting out on their greatest adventure.

Health Care; Go Big, Go Long, Go Single-payer

Well, I have been on hiatus for a few months. Once the elections were over, the creative juices sorted of slowed; work picked up; the energy and concentration needed to opine--well--sort of dissipated.

But, I've been listening to the debate on health care; on television, radio, street-corners, my sister's kitchen, anywhere people get together with differing views on the subject. I though, what the hell...

For starters. Obama needs to go big and go long. Go straight to single-payer. Tell Americans the truth. Single-payer is cheaper, it allows cost containment (without which no health plan will work), care will improve, it will be a boon to business, and Americans who want Cadillac care can still get it through their choice of insurance plans.

The difference will be that health care will no longer depend on employers -- and will no longer burden employers. That should translate to higher wages; since money that could have gone into wages has been sidelined into paying for the spiraling increases in health plan costs. It should also translate into lower prices for goods and services because the cost of providing employees' health care should no longer be a factor in setting prices for said goods and services.

What is single-payer? It is the big "government-run" health plan that the Republican leadership in Congress is doing their best to scare the wits out of Americans with. It is, in fact, Medicare for all Americans, regardless of age. Medicare is one of the most effective and cost-effective programs this country has fielded. With an approximate 4 percent administrative overhead, it is one of the cheapest to operate. Doctors point out Medicare's success in cost-containment every time one of them quails at taking on a new Medicare patient -- because Medicare sets limits on what can be charged and scrutinizes treatment and testing options.

It is late and I am drooping, but I have more to write on this topic and I hope some will be there to read it.