BURTON RIDGEWAY,

ON HEALTH INSURANCE
The only plan that Democrats and Republicans; Liberals and Conservatives, can possibly agree on. That’s a fact!

(BurtonRidgeway.com)

41 countries have a longer life expectancy than the U.S. I am certain that medical care in those countries are wholly tax supported, so there are no “uninsured“. There is “Good” and “Bad” in any idea that comes down the pike; what follows is the best possible, from all mentalities, in spite of the preferences of entrenched, and selfish interests; the idea of a single-payer system would put us into a mess of a conversion project that would get it off the ground only to crash before the wheels rise a half inch.

Warning!
If you are committed to eliminating profit-motivated private enterprise from any part of a national plan, you should not waste your time reading further; this plan deals with reality, on its terms, and fiscal responsibility, not rigid adherence to idealism that ignores the value of balanced books, and caters to human nature.
Besides; anyone involved in promoting another approach is not about to disconnect; aside from declaring wasted time, effort, and expense; you would be flexible, and the media will pick on you for being a chameleon, and/or, indecisive.

Massachusetts Legislators passed a bill mandating that all residents of the state be insured.
Aside from state plans being a bad idea, it’s fine! But, without controlling costs, paperwork, abuse, and overuse, of medical care, it will fail; there is no such provisions that I could see.

I need more on treatment while in other states, and I need to know how the model estimated “the $20 billion savings in administration costs the first year alone, and $5.2 billion in bulk purchasing of drugs in the first year.” How? Governmental Extortion?
In any case, state-by-state solutions will, at a certain point in the future, leave a few states without a plan, and Congress will step forward to establish a single program that would crash within a year, if that long;
Let’s do it now!! ! ! ! ! Because the baby-boomers will be entering Medicare in 2008, and my proposal would head off nervous breakdowns, and bankruptcy.

A TRUTH:

If we had a system that provided the most extensive, and scientifically advanced medical care possible to all who want it, with no exceptions, we would have a 90% tax rate on incomes above $25,000, considered just fine by those who would not be exposed to it. Rationing a nationally directed health care system is essential.

Worker’s Compensation benefit programs as separate coverage has outlived the idea.

The cost of prescription drugs could be reduced tremendously, only with the inception of the “FECMA. ”

*******

You could print-out this page; of necessity, it is longer than the other briefs. You could reserve it for potty-reading. And, if you want to promote it’s ideas, send it to your favorite paper, or news station. If you disagree with some points, cross them out, underline those you strongly support, and write in your own comments. Make this page your own statement. This includes, absolutely, your sending comments to me! ( Respectful!!! )

Above all, if you want the following proposal discussed in the political arena, you won’t see it done unless you send it to your political party, their candidates, and the present legislature. That’s a fact! Their proposed solutions to the health care dilemma are terrible

This plan, or anything like it, has no chance of being seriously discussed in government circles as long as we have our current money-driven election system. Insurers, sales agents, and every other special-interest who sees this as a threat will go hell-bent to bribe ( to speak politically”) office-holders who have a say in it. Without my solution to the election problem, this health-care proposal can be only a dream, because it is not the product of a political mentality.
See my brief on campaign finance reform.

THE PLAN

Basic care-Major care

A * BASIC * MEDICAL CARE POLICY mandated by the national government, issued and administered by participating private insurers, with no new government department to run it - HHS could facilitate and oversee the system. This would be more intelligent than beginning with total coverage, and building a massive bureaucracy only to have it collapse. What we now have in place and proven successful can do the job without complications.

Because millions of Americans do not receive needed medical care, and our mobility, it should be the national government that sponsors, an efficient, effective, and uncomplicated program of * basic coverage *, easily understandable to the average person, and managed by people who know what they are doing, and who would protect themselves against billions of dollars in fraudulent claims, without major changes in their systems.

Both national and state government programs, run by civil servants, politics, and government budgeting, have proved to be a redundant debacle.
Leaving it to individual states to mandate along these lines is not the way to fly; temporary residents, and traveling Americans present administrative problems with this approach that would call for medical facilities in each state having to deal with each other, each controlled by their own state regulations; a mandated plan should be limited to basic coverage, be the same for all, not a free-to-choose variety that is offered by insurers which confuses us, and adds cost for benefits that are actually marketing tools. This must be a *national* mandate.

The current problem of Wal-Mart - as an example-competing with prices paid for by abusive hiring practices, and avoidance of unionization, would be at an end. They, as all other employers, would no longer be faced with the basic cost of health care, which is not really what employers should be doing in the first place. They were given this responsibility over time for being closest to the dollar when earned, just as the income tax withholding law grab the money before we could spend it. It has become burdensome and is in no way necessary. The retail playing field would be leveled with this plan, at very little cost to all of us. AND, employers would no longer feel compelled to fire or retire older workers to keep the cost of their benefits down.
Additionally, the knowledge and experience of older workers and lower-level executives would not be lost to the need to reduce overhead.

This *Basic Plan* would guarantee doctor and hospital care specified limits on each element of treatment, according to a “usual/customary“ fee system currently used by insurers.

A nation-wide universal computer program, developed, funded, and operated by all insurers as a group, would drastically reduce paperwork by about 95%.
American spending for health care exceeded $5,600 per person in 2003, or 15% of our gross domestic product, as reported by the Organization for Economic Cooperation and Development. The elimination of administrative duplication, and complications alone, would reduce that figure by at least 20%.

This plan would relieve employers from the burden of supporting expensive plans which makes it difficult to fight competitors in countries where taxpayers carry the *full* load.

People would use their own doctors, without having to confirm him or her as a registered “Participating Provider“ with the insurer of their choice.

No mandated plan should provide expensive heart, skeletal, and other replacement surgery for those at the end of life; a transplant for an 80 year-old should be out of the question, unless that person is currently fully functional and productive. Yes! We have the right to decide that - It has nothing to do with deciding who lives and who dies. Rationed health care is essential, in any publicly financed plan.
( There would be nothing to prevent anyone from paying for their own uncovered surgery, or insurers offering a separate plan to cover such possibilities. )

A task force formed early in the Clinton administration, consisting of economics professors, analysts, and computer modelers were asked to create a model of an American universal health care system. One conclusion they produced is that no universal system could exist with private alternatives; there must be no competition. Additionally, it was reported that at least thirty percent of Medicare expenses went to people who did not live another year. But, basic, rather than total, coverage, as a universal plan, would work.

This plan should include, or be accompanied by, legislation that would mandate that all *punitive* damages for malpractice be paid to charities; Attorneys should be compensated by a formula that would prevent them from filing unjustified lawsuits, and be relative to the time and effort expended.
Settlement should be permitted with an inexpensive court procedure that declares malpractice to have been committed, without which the lawsuit, as to the extent of damages, would not be accepted by the court. Medical providers should be punished for mistakes, but not in sums that make a mockery of justice, and make lawsuits against providers and insurers so lucrative.

The ability of lawyers to select and shake up juries with self-serving and emotional reasoning should be replaced with as much technology as possible to find *truth*, which law schools, and the courts, teach is not relevant. I think it should be!
Hundreds of thousands of dollars in malpractice insurance premiums paid by each doctor, and medical facility, would then be reduced to a few thousand, and premiums for medical insurance would drop like the preverbal ton of bricks.

It is essential that there be federal legislation prohibiting court intervention in cases of the terminally ill, and a procedure that confirms the appropriate termination or limitation of treatment, by a standing committee of medically qualified people, in each state. We all know about keeping alive the “living dead” by relatives who can’t let go; not when it effects the cost - to all of us - of medical care!
A single national non-political authority should establish a standard for all medical treatment, protecting providers from litigation; we need protection from those with wants that cost the rest of us too much.

There must be no installation, or administration fees for issue of coverage, or ID card.

************************* Financing this plan would cost us a lot less than any national plan now being considered; a surtax on personal income for each wage-earner - married or not - is one way to pay a large portion of the cost.

MAJOR MEDICAL COVERAGE

Every insurer participating in the issue of the Basic Plan must be required to offer a privately-owned Major Plan, approved by the Directorate of this program, outside the purview of state insurance departments; this program would relieve states of the need to govern medical insurance plans, though the plans would be designed to meet medical costs of each area.

All insurers should be mandated to cover, to minimum extents, and stipulated minimum benefits, listed major procedures. Each insurer would be free to compete with premium and more liberal benefits, but we should not have the same plan offered by two or more insurers, with one covering A. B. G. and K. another A, G, and K, and another A, B, and K, yet all charge the same premium and leave it to the insured, at the time of need, to find that the insurer he had chosen, doesn’t cover cancer of the vagina unless it had originated in the hypothalamus.

A single physician spends about $50,000 annually to confirm coverage and negotiate contracts with dozens of insurers, and pharmacies, and meet with requirements of those insurers to measure up. This is a big factor in selling the need for a national health plan of *total* coverage, but my plan would accomplish the same savings without the taxpayers assuming the losing proposition of socialized medicine because of the above point: as is the case with the Basic Plan, Major Plans sold by insurers would be required to provide identical minimum benefits so would not require confirmation by other than computer contact, which would be called for in any program. Afterwards, additional benefits offered by the particular insurer would be required to be made known *to the insured!* relative to the current treatment.
Additionally, the same savings would be experienced by insurers as they reduce their administrative expenses, and some cost of competition, for an additional reduction of premiums for Major Plans.

Everyone would be expected to cover themselves for expenses above the benefits allowable by the national *Basic Plan*. Charities could buy coverage for their beneficiaries on a group basis, thereby relieving such charities, and taxpayers, from the burden of financing the entire cost of care for a patient, and be the means by which the poor acquire major coverage equal to the rich.
With this plan in effect, surcharges added to medical costs from welfare patients, and other overhead losses experienced by hospital emergency rooms, would no longer be.
Hospitals would no longer carry the burden of a contradictory system that demands humanism, but causes excessive losses by that very demand, due to the lack of full financing. The existence of federally mandated care demands a national plan to support it.

SUPERMAN

In cases of injuries and illnesses that take medical costs above a private Major policy’s mandated annual, or lifetime maximum, perhaps one million dollars, in major medical policies, the Basic plan would return to pick-up all bills at 100% of the UCR ( Usual, Customary, and Reasonable ) schedule, with close monitoring of the care and billings of what I call, “The Christopher Reeve benefit.”

* * * * * * *

In Addition, the Basic plan should cover trauma care ( victims of street shootings/stabbings, accidents, rapes, etc ). No hospital should be bankrupted by mandated emergency care; and fees should not have to be hiked-up for everyone else to recover their costs. ( “loss-shifting.“)

This system would cost each American less than we pay for both one’s own policy, and share of the tax burden for those on welfare, especially in hospital emergency rooms, which cost hospitals astronomical sums, recoverable only by loss shifting, inflated welfare claims. And taxes.

Premiums paid into a system would cover *all* American citizens, so the multitude of healthy people who rarely use coverage would guarantee its success.

This approach could move the American health-care “non-system” from 37th in the world, to first, in both efficiency and total over-all net cost. It would also eliminate bad debts ( uncollectible bills ) said to be experienced by individual practitioners that increases medical costs by 20%.
With care available to everyone, medical costs would be reduced as the population becomes healthier, which, of course, would reduce the premiums to be charged by private insurers, thereby allowing many more people to afford them. The natural reduction of abusive over-billing would reduce it even more.

Private major plans, having a deductible equal to the national Basic Plan’s maximum coverage would cost less to administer than regular coverage due to the elimination of small claim amounts, the much smaller number of claims made, and elimination of additional paperwork for *Major plan* benefits, that are carried by the same insurer as the Basic plan.

It is also essential that coverage be provided to early retirees who are being left high and dry by their employers who, of necessity, quit providing group coverage to those who retire before 65, and alter, terminate, or increase, premiums paid by retirees in later years. Private policies at so old an age are prohibitive in cost; there should be a way to soften the blow.

REPLACES ALL OTHER BENEFITS

The national plan’s coverage would replace all national, state, county, and local health, and accident coverage of any kind. Workers Compensation, Social Security Medicare ( it would be reduced to act as a Major Medical policy, in the hands of insurers, with an appropriate reduction of premium ), state Medicaid, and programs within county welfare plans, age being of no relevance.

It is, to my thinking, ridiculous to have a fragmented conglomeration of government coverage; states legislating a variety of solutions - each state a different approach - dividing the population into groups: if you are in this situation, you are covered here . . ., if you’re in that situation, you’re covered there, “ this new plan will put you in among . . . “, the limits for this are . . . the limits for that are . . . Veterans go to the VA hospital, etc.” . . . Poor members of minority groups are some of the major losers.
This reminds me of the time long ago, when I stood before an assembly of dry cereal boxes on the grocery shelves trying to decide which of the hundred boxes to try.

Regarding Workers Compensation premiums paid by employers going to the department distributing them to the insurers, they would be reduced by this merger. So would the cost of administering it as separate coverage by specialized insurers.
Premiums would still be rated according to claims and particular industry experience, and several states can get a break from horrendously mismanaged, unnecessary workers compensation systems.
On-the-job injuries that result in costs *exceeding* the Basic plan benefits would be covered by major medical insurers, paid for by premiums for the plan. Injuries from off-the-job, would be covered by the employee’s personal major plan, if any.

A national Basic Plan should call for a single premium per person, the same for all ages and genders, paid to insurers by the plan administrator, and should not be an HMO. It should be insurance, plain and simple medical reimbursement, with certain preventive-care features, and an annual deductible per insured; (family plans would have two deductibles maximum), before any reimbursement for treatment - except for accidental injuries ( no deductible ) - and a basic examination every two years.

There is no reason to have an insurance program treat people at 100% of cost, from dollar one; there is every reason to demand that earners pay at least one week’s income each year, per family member, to treat their out-of-hospital illnesses, before asking everyone else to chip in. ( That was the basis for the original $50 deductible, in 1948)

Reasonable deductibles promote not only reluctance to see a doctor for simple problems to be resolved by personal care, but incentive to eat and live healthy lives; our bodies are our own, and responsibility to care for it should not be government’s, or the rest of us.

This plan would replace any such employer-provided coverage, relieving employers from the burden of administration, and reducing prices for their services and products, though large employers ( including governments ), unions, and associations, could choose to offer group-rated commercial Major Plans, and/or HMO’s, which would have so high a deductible (equal to the * maximum * of the national Basic Plan), that the cost would be much less on that count alone.
Charities, as well as government, would be able to buy group coverage of Major plans. Oh! And, once again, members of Congress would be covered by the same plan as the rest of us. HAH!!!

Premiums for Workers Compensation, state programs, and SSA Medicare would be redirected to this program, and a separate SSA Medicare program of basic coverage for elders would no longer be necessary.

Small employers who now provide medical coverage would then be able to afford additional employees. Perhaps 200,000 unemployed would be removed from the public dole.

Funding of VA hospitals within the federal budget would be redirected to this account. Veterans would then go to any doctor, or hospital, for one hell of a lot better treatment than in present VA hospitals, according to reports. Special care for combat victims can be contracted to regular hospitals with needed facilities ( present VA hospitals would be sold to private operators, adding a great deal of “found money” to the new system. )

Basic benefits should be adjusted to the annual federal budget; national prosperity would provide a higher basic benefit maximums, a depressed economy would reduce such maximums - not retroactive for any treatment-in-progress.

The Basic Plan should be open to all practitioners. Providers who care only for the wealthy should not be permitted out of the system, because ALL legal residents must be covered by the basic plan.
This means that even the wealthy would receive the Basic Care coverage, but no doctor would be required to care for those who are without Major Medical coverage, or their own ability to cover excess costs.

Medical procedures such as abortions, erectile dysfunction ( not the result of surgery, diabetes, or chemical treatment ), cosmetic-surgery, attempts to prevent or cause pregnancy should not be covered; San Francisco’s coverage of sex-change operations for civil servants is an abomination, not because of any objections to sex-change, but that it is Not an illness. Such a “need” should be paid for by the “needy” one.

Expenses must be medically necessary to a physically productive/active life for treatment to be covered, all else should be left out of a publicly-supported program.

As for the drug companies charging more in the US than anywhere on earth, that’s because all other nations force them to agree on a lower price structure, the USA does not. As a result, I imagine the high prices they charge Americans is a loss-shifting practice.
With a national plan, the pharmaceutical companies would be forced to treat Americans as they are compelled to treat others; price control is an unacceptable practice in the US, but price agreements in medical plans are not. A national plan will eliminate the hold the drug makers have over us by compelling them, if they in-fact lose money in other countries, to level the playing field by demanding higher fees elsewhere. As long as we keep a national plan at a basic level, we can keep our superiority in the medical field by not going socialistic; trying for a complete national publicly-supported medical care program will prove disastrous.

As for price control over medical care itself, the UCR schedules that the national plan and insurers follow would be the only control over abuse we would accept; court decisions would have to tell over-chargers to “eat it!” Socialist and populist desire for price control of medical care would be, in my opinion, destructive of excellent medical care, and give government more power over us than I find acceptable.

The national plan would also cover, with low maximums, and no deductibles, at 100%, basic bi-annual examinations - alternating with the bi-annual exams in Major Plans that cover it - and well baby care to the age of six months. The plan would have annual and lifetime maximums dictated by allowable UCR ( Usual, Customary, and Reasonable ) benefits.

To be covered by the National Plan, bi-annual examinations must be *required.* They should include; mammograms, prostate, EKG, cholesterol check, Tryglicerides, etc., during appropriate ages, and patients will be required to follow doctor’s orders to correct each and every health condition detected. Failure to correct should call for execution, but that’s unconstitutional, so other less drastic punishments should be decided on, with pressure to correct being the goal. Though refusal to correct is a constitutional right, pressure, and punishment, should be applied. I’m not kidding! Otherwise any plan will go bankrupt. Private Insurers should have the right to increase premiums on major plans for failure to correct.
As for annual exams, it has been observed by researchers that annual exams are probably not necessary; perhaps not. But for those over 45, it should probably be. Let the medics make that decision for this program. >BR>

It has been reported that minority races in the US die from strokes, diabetes, and AIDS at rates higher than whites, and black people have higher negative blood counts; this should be attacked with vigor by the basic plan. We all have a lot to gain from this, in many ways.

Because this plan would cover all of us automatically, on the same date, there would be no pre-existing condition clause.

There would be low benefits for maternity care. ( I don’t believe in normal maternity benefits, as I don’t believe we should be legally able to insure a house against fire, then light it up, along with the neighbors watch it burn, and collect the money. If you can’t afford a kid, don’t have one. . . or two, or three. All pregnancies covered by any plan at inception of this program would have to be covered immediately.
I want to see the elimination of coverage for normal deliveries. Private insurers could choose to cover it where the pregnancy is not pre-existent - for a fee; it should not be mandated by government, or be in the Basic Plan. Nothing that can be planned, and carried out, should be insured. Instead, think of saving bank sinking funds.)

Illegal aliens should not be covered under any condition, though another fund would have to be provided for care until returned to their country, ASAP! ( The fact that employed illegals actually pay taxes they never will be able to collect needs to be addressed. )

To prevent one of the cheating practices, the Basic plan must include a stipulation that all treatment that can reasonably be administered by nurses - RN’s or not - should be reimbursed to doctors and hospitals based on the assumption that such treatment had been administered by the appropriate designation of assistant, or nurse, even when the doctor had given it.

MENTAL ILLNESS:
Unlike physical illness, this type of problem cannot be easily, if at all, confirmed; it needs special attention, and insurers had always given it that by limiting benefits. Give Psychologists/iatrists the opportunity to fill their calendars, they will take advantage of the opportunity. Wouldn’t you?

Depression is a problem that pretty much shows itself, and former California Governor Davis had signed legislation to require insurers to cover this problem (1999, AB 88). Once again, let there be recognition that, regardless of necessity, we cannot mandate additional coverage without essential limitations, while demanding that premiums/dues not be increased to cover it. Congress is addressing the same questions, and I’m sure many - too many - CongressMembers, and promoters, will insist on additional benefits under federal law, while hollerin’ about high premiums.

ADMINISTRATION

Participating PRIVATE INSURERS, selected by each individual, would then issue and administer the Federal Plan’s policy, and offer their own versions of overriding Major Medical plans, with varying deductibles. They should be permitted to exclude any, or all, of the medically unnecessary procedures as in the Basic plan. All deviations from a norm must be clearly listed on the page immediately following the one with the name of insured and policy number.
Employers should be able to avoid, if desired, group policies, and the responsibilities associated with them, by assuming the premiums of their employees’ personally acquired Major policies. This would, theoretically, permit mobile people to carry the same Major Medical policy forever.
Insurers could offer an option to add an HMO rider to the group coverage they provide, or a separate policy for employees who want to keep their own policy, which would add more generous benefits.
Private major benefits plans should be permitted to require bi-annual exams, in alternating years with the National Basic Plan, as part of their accumulating deductible.
Those who apply for a private insurer’s HMO rider should be required to sign an agreement that ( s)he has read and understands the HMO concept, accepts it, and knows that (s)he will be shot if (s)he hires a lawyer, or files a complaint to Big Brother about the way it works. Participating providers should be required to do the same. Too much non-participation by insureds would, and should, declare the HMO concept - though ideal - unworkable. I believe it is workable, but only if the public knows what to expect, and when Big Brother is not expected to protect us from reality. . . and all malpractice-lawyers are held incommunicado, or sent to a war zone.

Insurers would also process applications for the Basic coverage by mail, or on the internet, and take effect at the initial visit to a doctor, who would forward photocopies of proof of identity ( see my brief, “national ID card.”) to the insurer.

Insurance agents writing the national plan on individuals, would probably not increase costs, because they would be selling and servicing group Major benefit plans, and personal Major Benefit plans to their own clients, while writing other coverage ( casualty, life, disability, * long term care *, dental ). It would serve their own purpose to gain the exposure to new prospects for just a minimum sign-up fee, absorbed by the insurers. ( Everyone has to be considered! ! ! ! ! ! )

To reduce large claims from children in poor families, Insurers should combine to set up medical care clinics in every school within their common territories of operations.
* Insurers can offer provider-discounts to parents who earn less than a certain amount, for their children’s major benefits, if they authorize frequent examinations for their children in these clinics.
* The expense of doing so would be to their advantage, in the form of less expensive medical care. Certainly to the nation’s benefit.
* States could offer incentives to insurers to do so. Insurers could support shared clinics in poor neighborhoods.

Street people, drug addicts, prostitutes, and the like, would be automatically covered merely upon entry to any doctors office - which could be a social service agency - they would, however, know that their existence, and health conditions, would then be on the record, and that particular doctor, or medical clinic, would be their medical care facility, until they should relocate - state borders being irrelevant. The medical facility would register them for the coverage on-line.
There’s a few problems with this to be ironed out, but it’s not difficult. Legislation would have to include an assurance of guaranteed confidentiality of records and treatment.

I am emphatically in favor of state legislation that would authorize medical care providers to place attachments on assets and income of patients without Major medical coverage, who have incomes exceeding twice that of the average production worker, in event of failure to pay one’s medical bills that exceed coverage by the national Basic plan. This levy would be held in a trust pending court judgment; interest would accumulate to date of collection, or refund.
Such legislation would be intended to “get” those with the wrong priorities; legal recourse does currently exist to recover in court, but this suggestion provides a more speedy system that provokes the well-to-do youth and not-so-youthy, to meet their social obligations, or fees would have to include a factor to cover such losses. That would be wrong!

Insurers would handle claims for both plans, and be subject to audit by federal auditors of the Basic plan claims payments.

It could be made possible for insureds to maintain both plans with the same insurer, moving administration of the Basic plan as they move the Major plan.

There will be no additional bureau, or a new one in place of present one’s. This would provide additional reductions in government overhead at all levels. A present division of the Department of Health and Human Services (DHHS) could oversee the entire system.

The premiums for the basic coverage must be electronically deposited to each participating insurer's bank on the last day of each month, by the DHHS, or the US Treasurer, for its assigned insureds during the *coming* month; the same dollar amount per person, as agreed to by an annually rotating tripartite of unrelated private actuaries.
There must be no promissory notes, or delayed payment. This must be in the legislation as an absolute. There must be no duplication of the present Social Security larceny by legislatures, and Presidents, who feel that such borrowing does not call for repayment; ever.

The federal plan would naturally cover those on welfare. Premiums for these recipients would be paid monthly to the DHHS. Street people and prostitutes would produce particular problems, of course; it would catch many AIDS, and VD victims/spreaders, and however possible, help them.
When, and if, we legalize controlled narcotics distribution, we could coordinate that with this program for treatment and withdrawal. ( See my drug-war brief. )

Mandated fee schedules would be necessary; a balancing act between what’s reasonable, and what reduces a Doctor’s dedication to the patient must be considered. People work for money; it buys necessities. Those who educate themselves for fifteen years to become Doctors, then spend their lives ready and waiting for emergency calls from patients and hospitals, want more than an average income or anywhere near it, and they deserve it. We expected them to save our lives, for heaven’s sake ! ! !

It would be necessary for a meeting of three interests: AMA, Insurers, and government, to produce the UCR schedule. It should not be addressed by Congress until asked to vote “Da”, or “Nyet” on the finished product. There should be differing fee schedules based on geography, considering the difference in real estate values, and the price of bread.
Federal Courts should compel an agreement in a reasonable time, and mandate a solution if an agreement is not reached by a date specified in the legislation that births the system.

Each procedure should have the same fee, accepted by all insurers, government or private, by geographical area. Patient-agreements to pay extra, even to an HMO, should not be of public concern.

COST CONTAINMENT would have to be a part of this system, as it has to be of the current one. Doctors must be free to prescribe treatment according to their expertise, but not free to rip us off; controls have to exist. At the same time, we should pay realistically reasonable fees for tests, to prevent serious lack of availability because clinics could not afford to provide them. At the present time, women have to wait as long as five months for a mammogram, due to the low fees from HMO’s. This must be addressed. The fee schedule should be based on the supposition that state-of-the-art technology is used.
Retired Doctors and RN’s could be involved with treatment-approval by insurers in both Basic, and Major plans. Cost containment is not, in itself, evil.

NO PLAN, OR INSURER SHOULD HAVE THE RIGHT TO BONUS PROVIDERS TO DO LESS, OR KEEP A SECRET FROM PATIENTS.
THE ESSENTIAL HMO COST CONTAINMENT PROVISION should not be government’s business; whatever cost-control provisions a particular HMO offers would have to be fully revealed, and understood by each buyer - buyers are, and should be, responsible for the choices we make. Keep legislation ( the circus ) out of the market, and our own right to be stupid. . . or ignorant, ( who should make it their business to have intelligent friends ).
Legislation could insist on a more simply-worded contract and adjoining explanation; not that it would do any good.

NOTE: The problem of large employers firing older workers in favor of younger, or hiring many temporary foreign people without providing coverage, for the purpose of leveling or reducing group insurance premiums, is resolved by this program’s level premium per person regardless of the average age in that group.
Insurers should be expected to mandate that any Major group coverage be on 100 percent of their employees working thirty hours weekly, or 2000 hours yearly. And be the same for each, even if covered in another country, and not covered by this program.
( Group premiums should be calculated to consider the number, if any, of foreign employees, to reduce the premium average per covered person.

Employers could add HMO riders to their programs as they choose. There’s also the POS. ( Point of Service = flexible dual choice plans ) Just as income is the most natural and ideal thing to tax, but is too abusive in its application and enforcement, HMO’s are ideal, but an attraction to abuse, by patients, physicians, social idealists/opportunists, issue-hungry media, and politicians, which makes it a thing that cannot work. Social warriors now demand that the very basis of HMO’s: participating providers agreeing to a fee structure, and controls, be dropped, yet have an HMO. It’s asinine!

The award-winning movie, “As Good As It Gets,” with Jack Nicholson and Helen Hunt, shows Nicholson helping Hunt get her son the medical treatment he needed, which her over-loaded HMO doctor passed off as unnecessary. The movie certainly did show a short-coming of the HMO concept: to keep with “’affordable” fees, it needs to control costs. In business, this is an accepted concept, in medical-care, it’s not.
I believe Doctors should refuse to join an HMO if (s)he, the Doctor, in order to make one’s practice successful, must operate with a higher fee schedule, and more time with each patient. If dedicated Doctors leave their HMO’s in large enough numbers, the insurers, unable to operate with such a high fee schedule, will stop selling HMO’s. Surviving HMO’s will charge more, and have less patients, and that would be that.

SO, because of the destructive involvement of government in the marketplace, the HMO should be allowed to find its own membership, or die, with government having nothing to say about it. Let the PPO reclaim its dominance. There is nothing preventing insurers from offering, as they do, selected HMO features within their PPO products. The PPO is an excellent system to bring down the cost of medical care; it’s actually the best. But Doctors must be held responsible for their decisions, not the HMO, or Government.

NOTE

I have included HMO‘s as a possible supplement to the Basic Plan, but it doesn‘t seem possible. With the primary coverage being provided by the Basic Plan, HMO’s, which cover primary care, cannot operate. So, unless someone can think of a way to have an “HMO supplement” to a reimbursement plan, HMO’s must go the way of the Blacksmith; PPO’s and regular medical reimbursement plans would prevail.

Lawyers ARE evil. It’s their job; they, and their clients want them to be. They must, however, be reined in. We must pass legislation defining malpractice, and experimentation. Offices of Arbitrator should exist to judge objections before legal recourse would be honored, and such legislation should provide for penalties other than money, where it is proper. Awards must relate to the claimant’s income. Attorney fees must be limited as well, so that many medical malpractice sharks would seek other specialties if they want to continue receiving hundreds of thousands, or millions, of dollars yearly.
Otherwise, there’s no hope for costs to be reduced, or even to level out, without killing our health-care “system”; how many medical schools would exist in the near future if the profession didn’t pay for the knowledge, talent, and the discomfort of practicing it? ( I can no longer find a doctor with a sense of humor while dealing with a patient. Where, oh where, is Hawkeye Pierce? )

Speaking of alcohol, etc., Even with surcharges on premiums, these products should be taxed at the point of purchase, to cover the cost of caring for users of such products who exceed the Basic plan benefits, and have no Major plan. ( A provision for this contingency should be factored in. )
Victims of self-abuse must be made to realize how damaging our tastes are, both in health, and money. We could then attempt to reduce our premiums by eliminating the taste. This tax must be deposited directly to the account of the department administering the Basic system premiums.
I drink, by the way).

I believe it advisable that this organization be a Commission, out of Congress’s control, and budget, thereby protecting the money, and keeping politics out of its management. Instead of being a division of the DHHS, the Commission members should be appointed by the President, with advise and consent of the House alone, and should not be dismantled, or adjusted, without House approval.

Additionally, this program should provide incentives to people to take vitamins and minerals, by covering them, not as prescriptions, but as a separate benefit within the separately marketed prescription drug plan. In fact, a stipulated vitamin regimen based on age, and gender, for both ill and healthy people should be tax deductible.

Cyclists and helmets need to be considered; many argue for mandation because we all pay for the medical costs of cyclists without, or with insufficient, coverage. This is true. But we must keep legislation, and administration to a minimum. Let there be an exclusion rider on the basic plan, for hazardous sports, hobbies, and occupations. Insurers would then offer such coverage to the Basic and Major plans for extra premiums. Then we could stay out of the lives of people who like excitement. The argument for mandation of helmets, and the quality thereof, would then have no power. The same applies to auto seat belts: let there be no law to wear them, and no legal recourse to claims if damaged when not wearing one. Let there be a “Tough luck” rider on all policies, auto, medical, life, and disability, when damaged while not wearing a seat belt, and let laws *requiring* the wearing of belts be rescinded. ( Being income-productive will, of course, make it impossible to get passed.)

Dental care related to deterioration should not be covered, now or ever; accidental damage is always covered by medical policies. Insurers should be left to provide this in the marketplace. A rotting mouth should not be society’s problem.

Malcolm Gladwell, author of “The Tipping Point”, and “Blink: The power of thinking without thinking”, in an article in the New Yorker magazine, August 2005 issue, offers us in what he calls, “The department of public policy, the bad idea behind our failed health-care system”, reasoning that begins with a rotting mouth of teeth constituting a problem that our health-care payer system fails to provide for.
Never mind his solution, (not that he has one), let’s just consider his pre-supposition that a person who fails to care for one’s teeth has the human right to have everyone else pay to save them, as a basic benefit in medical coverage.
I myself have a mouth full of false teeth; I never developed good dental habits, so throughout life, rich or poor - mostly struggling, I have paid for repairs, and replacements. Never once thinking that others should pay for it.
No medical plan can survive if rotting teeth are covered with regular medical benefits. Dental insurance, and pre-pay plans are designed to limit the coverage so that the plan can survive, and reasonable coverage can be provided.
If you don’t care for your teeth, no one else should either; it’s *your* teeth!
Insurance must cover only that which is not your fault. The more it’s your fault, the more of the cost should be on your shoulders.

IT’S HAPPENED. . .

. . . just as I said it would: Insurers and HMO’s allowing Viagra to be a covered prescription would open demands for other non ”health” needs. Now women’s groups demanded coverage of birth control pills because it’s unfair to pay for men’s Viagra while not paying for the victims of the new-found upsurge pill; I gather that a condom wouldn’t do.
Insurance is a means by which all covered members help each other pay for unexpected illnesses, and examinations to help each other cover the costs of maintaining good health. So WHY should everyone chip in to help a man get it up? ( except for those whose disability resulted from surgical or chemical treatment for cancer, and such ), or women to prevent what has nothing to do with health? Why don't we just mandate insurers to cover the cost of “gift-wrapping”? It would be a lot cheaper.

This campaign in Congress by the forces of parasitism to mandate coverage of contraception must be defeated. Brown-nosing morons in Congress can be counted on to follow each demand for more coverage, by demands for lower premiums; COUNT ON IT!!!!
Only YOU could fight it. If you see my point, and agree with it. Spread the word with letters to the editor, and your representatives, in both state and federal houses, and on every web page and posting board you know. Tell them to bring up this page; mail it to friends not on the internet.
If you don’t, the ongoing campaign to eliminate a fiscally sound health-care payment system will soon succeed with a national “single-payer system” that will bankrupt us, and give the evil empire more power over us all.
See www.Galen.org for similar opinions on government mandation that invite bankruptcy of any plan to solve our health care financing problems.

ALRIGHT!!!!!

The Third District Court of Appeals just ( 6/27/01) ruled that Kaiser *need not* provide Viagra. I know you-all influenced this decision at my behest. Right?
Now on to contraception.

No! Let’s sing praises for a move made just this week ( 10/05): because of the need to redirect lots of money to help defray the cost for Hurricane Katrina ( New Orleans ), a bill was just approved by the U.S. Senate to end federal Medicaid payments for upsurge pills. But leave it to the brownnosers to delay intelligent moves; the end doesn’t come until 1/1/06.
It’s a shame that we need a catastrophe to do intelligent things.
*Now* on to contraception.

THE RIGHT TO SUE HMO’S

I believe doctors are self-employed contractors with IPA/HMOs ( Independent Physicians Associations ); and should be held personally responsible for their medical decisions, regardless of any decision by, or contract with, an insurer, or HMO.
An insurer that provides an HMO, or insurance benefits, makes decisions - sometimes badly - based on fiscal considerations; providers make decisions, or should, on a medical-needs basis. If an insurer, or HMO refuses coverage, and the doctor decides the procedure is necessary anyway, (s)he should perform it; dedication!
There should be an ability, mandated by states, for providers to call for a non-court, NON-LAWYER, conciliation procedure. The sharks must be kept out of it.
The current legislation activities toward giving the “sharks” access to HMO’s is inadvisable, in fact, criminal.
Additionally, the current attempt to compel insurers to drop their contractual requirement that insureds seek arbitration before filing a lawsuit is misguided and should be defeated.

MALPRACTICE

There must be a much stronger law than at present requiring individuals and firms in the medical-care field to report any disciplinary action taken by them against a medical provider ( Doctor, of any specialty within the medical field, Nurse, or Pharmacist ), within 24 hours of that action having being taken. And there must be a well-policed procedure to record the report, and to place it before a board for judgment, immediately. All medical malpractice must be quickly dealt with; all incompetents must be found out before they do more damage.
Any failure to report an action, or failure to take action where a complaint should have called for one, must be heavily penalized. Or why have a law?

Any national health plan that does not take into consideration the effect it will have on medical providers will be doomed to failure; with everyone insured, providers will be overwhelmed. There will be a need for many more of them, and a need for a more accessible (on the internet ) rating system based on education, length of practice, number of malpractice lawsuits, and complaints filed.

It is essential, even in the current situation, that there be more well-trained, and higher-paid nurses, and interns, with shorter shifts. A good system could finance elimination of the overload. Additionally, hospitals are caving in from the cost of uncompensated care mandated by both government, and common sense. We need leadership, but our political system, and those involved with it, get in the way.
See The Galen Institute’s Health Policy Report at www.Galen.org. for opinions of the same nature.

News reports (5/06) that we are draining nurses from the Third World in droves due to the lack of interest here. This national plan could help finance training of professors of nursing to significantly increase the number of candidates for healthcare careers, ( from both genders); Insurers could finance nursing academies. We should not have to drain talent from overseas, then have to worry about the poverty that drainage caused.

Additionally, with every legal member of American society covered, the time providers choose to devote to patients would be full, therefore, with a nation of full-capacity medical facilities, the cost of care would be reduced, which, together with elimination of bad debts, and huge reduction of claims-administration costs, would reduce medical fees by 50%+.
However, there is now a shortage of nurses throughout the nation, yet there is a demand for universal health care; no one seems to consider the chaos that would result from solutions installed and directed by those with a political mentality.

BACKGROUND FOR THIS BRIEF,
without which you will not fully understand the basis for my thinking. Remember, you could print this out and read it during the next few potty-sessions.

A health-care financing system that covers everyone is inevitable. Health care providers want to be paid; insurers have the money, so they are the target; lawyers are happy to oblige.
The level of dissatisfaction with insurance, and, in particular, HMO’s, is not as extensive as public warriors would have us believe, but HMO’s do have a drawback: Control , which is unappealing to those controlled, who, of course, need to be.

A recent survey published in the AMA’s Archives of Internal Medicine reported that providers “approve of” lying to get an insurer to pay for a non-covered test, or treatment of a pre-existing illness known to not be covered; usually major expenses.
My doctor, thirty years ago, told me he would tell my HMO that my visit for a snoring problem was something else. I told him the pursuit of the snore was specifically authorized. I didn’t have to ask him to deceive, he was anxious to do so, yet, he was a complainer of insurers’ continuously questioning claims. I was positive he had no idea he was a hypocrite.
Insurance premiums and HMO dues were then based on statistics, to gather money in advance , which, in the eighties, had to be dropped because they couldn’t catch up. The present campaign to control charges makes predictability impossible.

Lawmakers fail to consider the past relationship between payers and providers that had brought about present attempts to control costs, as the above experience shows. Children never learn from experience, but our legislators are not children!
Many in the public arena demand an abundance of patient’s rights without giving consideration to insurers’ rights; “insurers are evil money-grubbers!”
Now, the legislated right to sue HMO’s will move yet more of society’s wealth into the pockets of law firms, and increase yet more, the cost of insurance; but those in the main ring of the circus don’t permit themselves to take that seriously; they can’t accept solutions that do not come from them.
insurers don’t have rights, they’re R I C H ! ! ! !. . . “BIG Oil !! ! , “Rich Insurance companies,” etc., etc. evil, evil, Profit-driven people. Pot, kettle, black .
Not that insurers are innocent - no one other than myself, is - but they are not as aggressive as they could be in counter-attacking.“

Let’s look into the past for insight to the present; why are we “victims” of claims control? What had made it necessary?
( If you are an insurance agent or executive, old enough to know from personal experience, and I say something inaccurate, please feel free to tell me.)

In the early sixties Doctor’s fees were controlled by non-inflationary insurance benefits; once a policy was purchased, the benefits didn’t increase, so we had to buy another policy if fees rose. It was years between medical fee increases. In the late sixties benefits became adjustable, so the cost of medical care took on more frequent rises. ( Surprise! )

There has always been abuse between insurers and providers; back and forth defensive actions, each defending against the others’ defense. Who started it? Who cares! Providers want more and more fees, and insurers, being on the paying end, have to want more and more premiums, to cover higher benefits, in addition to the same overhead inflation experienced by everyone else. That’s where their ability to pay comes from. It can’t be any other way. But when you add legislators seeking campaign contributions, you get pandemonium.
Lawyers came into it in the late seventies and made the effects of the tension between doctors and insurers look like a love fest; lawsuits grew as the sharks found another way to prosper. ( Now, Congress gave Lawyers even more lawsuit business against HMO’s, to protect “Patient’s Rights.” Telling them that such legislation must provoke higher premiums is like telling the obese to avoid buffets. )

As you know, there is cause and effect to everything, and experience is the best teacher, so why are the kids in the playground ignoring it? Because they don’t know it? They don’t want to? Why else would they not mention the past in their speeches and legislation? Let’s look at it as I see it from over fifty years on a trip through life’s economic reality, from as many perspectives as I’ve had.

“WE” are US , as insurers, medical providers, patients; insurance agents - their personnel, their dependents, the merchants who depend on them-all for business, and their creditors; And employers. ALL of us depend on the economics of medical care and payment for it. We’re all in this; “They,” are Us.

Additionally, we must face the fact that all of us pay the costs of multi-millions of citizens going without an ability to pay for medical care, both in unnecessarily prolonged illness, preventive care, and bad, often deadly, health conditions of the poor and their newborns. When so many employed people can’t afford coverage, we have to pay attention. However, we need to face realities as we do.

The prime reality is that if we all contribute to each other’s welfare, every citizen must be held responsible for one’s life style when we all are compelled to support it, to a degree. The other is that the providers and payers of medical care will always be at odds, with the payers ( insurers ) at a disadvantage: they are in the gun sights of the providers, lawyers, patients, and legislators, and only if insurers can lay the costs on premium-payers, who must lay it on their employers, and government services, can any system of medical care financing exist. If government provided it all, premium ( tax) payers would cover it, right?
Wrong!
Budget deficits would, and the legislators know that. Insurers ( and states ! ) can’t operate in deficit, and have no other source of money. This is the reason why federal legislators feel free to assume and maintain bankrupt systems, such as unstable insurance programs THEY will never have to pay for.

BASIC CONSIDERATIONS:

In connection with the flow of work offshore, I wonder what percentage, per product, would cost be reduced by elimination of employer-paid medical coverage.

1. A “Personal Responsibility” clause should be in any system we produce: Penalties for the use of; nicotine, salt, sugar, animal fat, alcohol, as proved by; high blood pressure, nicotine in urine, overweight, alcohol-related facial complexion, high fat counts in blood, unclear eyes, etc. Each “crime” should be surcharged to a base premium, by private insurers. All physical conditions not the fault of the patient should be factored into base premiums. Those who eat and live healthy should pay less for major coverage; those who are killing themselves must be made to change, or get off the planet; if we are to be each other’s keeper, to any extent - the very basis of insurance, and certainly HMO’s, is just that - the healthy have the right to demand consideration; self-flagellators must be prohibited from enjoying their parasitic preferences at everyone’s expense.

2. The Capitation system of HMO's - where it is operative - should be replaced with the old fee-for-service system, retaining the "gatekeeper," who would work for flat office-visit overhead, recovery of actual cost of tests, ( no mark-ups ), and treatment-time, plus an overall profit-margin. Providers can be counted on to load all fees; as long as government mandates free care in emergency rooms, hospitals must "loss-shift," so they “load” outside services, such as laboratory tests, and may be keeping patients extra days to keep a room occupied. I think they also maintain separate corporations to bill for the services they themselves provide, to receive higher total payment than allowed them. People and firms need to survive, so we have to look at this as a separate problem and install reasonable controls, considering all parties involved, without making any sector a victim.

It is essential that any national plan - private plans too - should eliminate higher fee payment to specialists; a doctor is a doctor! To ease the pressure on general practitioners ( “Primary care providers,”) we need to pay the same fees to specialists as we do to family doctors; in fact, there’s a basis for higher office-visit fees to general practitioners. We should split the difference by equalizing them. I do not here refer to the extent, cost outlays, and complications, of a procedure dictating the fee for a procedure.

There’s a new complaint building about HMO’s demanding patients use contracting providers only. What the hell do the idiots think is the idea behind the HMO concept? Of course you must use a provider who agrees to more extensive controls for the increased volume of patients, that’s what makes the premium lower; They are used more frequently, therefore more controlled; HMO’s *used* to cost less than insurance.

There are two types of HMO’s: Independent Provider Associations ( IPA ) and the Kaiser-type; IPA’s are groups of doctors, each in his/her own office set-up, of a different specialty, who contract with the insurer’s HMO division, as an individual member within an IPA. The IPA receives payments and distributes them to their members, who refer patients only to each other. This is the very basis for HMO’s.
On the other hand, Kaiser’s doctors are employees, on salary. Specialists are both in and outside the Kaiser organization, with their own compensation agreements, and a system that provides for lower overhead.
I recommend insurers abandon the IPA/HMO, leaving the Kaiser-type system to those who want to function within it. Insurers should limit themselves to regular medical reimbursement plans with PPO contracts.

3. About 25% of medical costs cover the expense of frivolous lawsuits, generous juries, and baseless judgments; we must protect us all from bad doctors, bad medical decisions, actual malpractice and error, and legislate what constitutes malpractice, error, bad decisions, and which deserve monetary punishment. We should not leave it to the sharks to persuade juries to decide questions they are not qualified to judge.
There needs to be a procedure for claimants to recover true damages without a lawyer. With a negative decision by such a qualified “jury,” a ticked-off patient’s shark would carry a weaker argument if (s)he afterward took the case before a regular jury. The bottom line would be less premium to cover bad court judgments, and out-of-court settlements.
Punishment other than monetary needs to be established. More of the Doctor's personal funds should be at risk before his/her insurer, in every case. (They’ll save on liability premiums! ) We must remove outrageous profits from lawsuits, and make doctors and insurers less attractive to the sharks, while placing on the provider’s own shoulders more immediate penalties for irresponsible, and damaging, personal behavior.

4. FRAUD. There should be very healthy penalties for proven fraud, by lawyers, patients, and providers - fraud adds about 25% for experimentation. We should recover both costs and reasonable profit.. It is however, necessary to declare what is, "success," and who validates the cost.

6. Every premium should be factored to cover the poor. This item should remove any such budgetary factor included within general tax rates, both federal and state. ( I would like to see us add to all basic tax rates a health-system factor, thereby showing the true cost of the program ).

HISTORY

Before the present forms of medical coverage came about, there were two products on the market, basic hospital and surgical policies, with stipulated fees for each procedure, and various annual and lifetime limits; and major medical policies with various deductibles and limits. Major medical took over when the basic plan ran out, if a person had both plans. Due to the stipulated fee schedule, inflation was not a factor.
One who didn’t want to pay for Basic would buy a Major ( $1,000, $2,000, $5,000, $25,000 deductible ) to prevent bankruptcy should a catastrophe occur. It was just fine, except for the poor, the unemployed, and those with other priorities.

Medical fees began to sky-rocket when insurers created the “U.C.R” schedule; in place of fixed benefits, they would pay at 80% of a regional Usual, Customary, or Reasonable fee schedule, after an annual deductible. This exposed benefits to inflation, and set providers free to increase their fees, knowing it would increase the U.C.R. schedules.

A comment

Many ideas are discussed that would return premium outlay to those who don’t make claims against their medical coverage. But none of these ideas speak to the fact that only if *many* people don’t make claims, is it possible for money to be available for those relative few who do. Where on earth do these protagonists think claims payments come from?
The public arena is overwhelmed by so many ignorant, sometimes stupid, concepts that it is no wonder America is a thriving, throbbing circus-tent of clowns.

I read novels as well as many non-fiction topics. Currently I’m reading Jonathan Keller man’s “Survival of The Fittest.” It’s a story of murders where Eugenics is the motive. The Protagonist is a psychologist working with the police. In a scene where he researches some clues, he comes across Eugenics, and the variety of intelligent people over many years, in medical, and social fields, who were, and are, highly respected, believe in selective killing and withholding of medical help for less-than-excellent lives.
Our protagonist gives a number of reasons against Eugenics, all valid, but not on point.
I want to say, for the record, that no other consideration should be given to this question than that purification of a race is always held by those who cannot claim superiority on one‘s own, but must base it on his membership in a race. Then there are the highly intelligent people who become so overwhelmed by their own mental superiority that they lose themselves in exaggerated theories, to compensate for their inability to identify with the human race, as it is. Additionally, there is, what I call, “The Jim Jones/Waco phenomenon: going bonkers from the stress of being over one’s head.

As for withholding expensive medical treatment from “inferior beings” by medical professionals, it must not be permitted because reality demands we accept bad with good as life’s balance; “good,“ alone, is not possible, and searching for it throws us off what balance we hold onto.

As for withholding expensive and complicated transplants, absolutely! , if the patient is practically at the end, and there is another recipient waiting for, or will certainly shortly show up for, that body part. To do otherwise would be stupid.
I am 73; to give me a new heart when a thirty-year-old, or fifty, needs it is an insult to intelligence; if no one is in the wings at the moment, and I am declared one with more to give, then OK, but my age, and health, must be considered, and voted on by a select committee, very, very, carefully, and in the open.

Government must never consider any law in favor of Eugenics.

I INVITE YOUR COMMENTS. But please be civil.
I welcome comments, including references to errors of any kind, which, of course, I never make.

What is your opinion of this web site?

© 1997 burtonridgeway @yahoo.com.

Please visit these other briefs:

A better way to secure our benefits:
Social Security
*
Another tax idea:
Taxes
*
“Political leaders everywhere have come to understand that to govern they must learn how to act . . . who are we really voting for? The self-possessed character who projects dignity, exemplary morals, and enough forthright courage to lead us through war and depression, or the person who is simply good at creating a counterfeit with the help of professional coaching, executive tailoring, and that the whole armory of pretense that the groomed president can now employ? Are we allowed anymore to know what is going on, not merely in the candidate’s facial expression and his choice of a suit, but also in his head? Unfortunately. . . This is something we are not told until the auditioning ends and he is securely in office. . . As with many actors, any resemblance between the man and the role is purely coincidental.”
Arthur Miller, playwright.
A proposed end to the spectacle we tolerate

”The FECMA Conspiracy.”
*
There’s a new source of business for the sharks in here.
Abortion
*
We need a better approach:
"The War on Drugs"
*
Our kids are in trouble:
Public Education
*
Are we destined to go on and on about the right to own an arsenal?
Guns and the 2nd amendment
*
Is it really a threat?
National ID Card
*
Commentaries on the not-so-little things about our legal system.
Law and Order
*
Proposed changes in the Constitution
*
Our cities are terrible!
*
Commentaries on miscellaneous issues and questions:
Misc. >/a>
*
Rev./Rab./Fr. Burton
at the pulpit
*
On Near-east problems
*
For your funny bone:
Thoughts too minor for serious people
*
Home page