This morning I attended a small business summit sponsored by the new mayor of Nashville, Karl Dean. An overflow crowd heard remarks from the Mayor, the state director of NFIB Jim Brown, and the head of the Nashville Chamber of Commerce Ralph Schulz on the needs of the over 530,000 small businesses here in Tennessee.
Jim Brown of the NFIB talked about the need for less regulation on small business -- a good goal that boosts start-up activity. He also talked about the need for lower taxes and how -- another noble goal. However, in the same breath he warned us that the current tax shortfalls we are seeing across the country as the economy slows do not bode well for entrepreneurs. It seems that there is a disturbing pattern during times like these. Local and state governments go after more revenue from small business owners through taxes and fees to offset the overall drop in sales tax revenues.
But then came a major disconnect for me when he shifted his remarks to health care. Rather than trust the free markets that he so strongly advocates for on behalf of his small business members, Brown applauded our Governor's expansion of the state-run health insurance program to include small businesses through a new program called "CoverTN."
We are seeing this across the country. It started when large corporations such as Walmart began to lead the charge for a federal government healthcare program as a fix for the current healthcare crisis. Large corporations began to signal that they would support a nationalized healthcare policy. Then, advocates for small businesses began to fall right in line.
It amazes me that those who advocate lower taxes and less regulation on one hand are willing to support the enactment of a national healthcare plan that would create a gigantic bureaucratic black-hole of taxes on the other hand. Governmental meddling in healthcare delivery and payment in large part created the healthcare system crisis. So now we are willing to hand the entire healthcare system over to that same government lock, stock and barrel in the name of political expediency?
It doesn't amaze me: most businesses want to privatize profits while socializing expenses and that's what nationalized healthcare is.
Not being able to see the implications, well that's just a human fault. By the name it comes around to nationalizing the distribution of big screen TVs the execs at WalMart would have cashed out by then.
I would hope that at least some entrepreneurs will wake up and understand the folly of the direction we are headed in. I used to say that we had a choice between a gentle stroll toward socialism from the Republicans versus a full spring offered by the Democrats. I am beginning to think both sides have picked up their pace trying to take us in that direction!
oh good, more unfounded, completely speculative claims of knowing exactly what the follees of socialized healthcare. What evidence of meddling do you have? Its the private insurance and pharmaceutical lobbies that have meddled. Look it up.
Speculative? Hardly! As broken as our system is, we still have a large number of people from Canada, England, etc., etc. coming into the US because their socialized system does not allow timely access for many treatments.
Read all of my posts on this topic before you lump me into the "status quo" crowd for healthcare. You and I agree that large corporations in duplicitous arrangements with the government have created the helathcare crisis in the US.
Where we differ is in what to do. Socializing the system will only make it worse. A free and open system will help our healthcare system once again become innovative, efficient and effective.
Part 1 of 2
The largest generational cohort in American history, the Baby Boomers, will be the first Americans to be denied available effective life-saving treatments for reasons of cost. The seeds for this mass liquidation have already been planted.
Imagine that it is 2016, and you are a 65 year old boomer. You have been admitted to your local community hospital with malaise, fatigue, vomiting and cloudy mental status. You have had blood pressure problems and diabetes for a few years, and have just been diagnosed with renal failure. As you drift in and out of consciousness, you are vaguely aware your old family practice physician, who had taken care of you for 20 years, is not around. A religious man, he quietly retired from medical practice in 2014, after the full force of the Obama administration‘s removal of conscience protection for physicians in February, 2009, came into effect. http://www.nytimes.com/2009/02/28/us/politics/28web-abort.html?_r=2
You feel vaguely uncomfortable as you are placed in a darkened room in the Comfort Care wing of the hospital. In moments of lucidity, you wonder if you shouldn’t have some oxygen, an IV or SOMETHING! But the appropriate therapy, kidney dialysis, is not on the approved list of treatments for patients over 65, having been deemed too expensive. The new regulations from the Department of Health and Human Services were presented just last month to your hospital’s Futile Care Committee. http://www.nationalreview.com/smithw/smith200604271406.asp It was decided at the highest levels that for those over 65 years of age, renal dialysis would not be a beneficial treatment, that the alternatives of a kidney transplant were too expensive, and that your quality of life on chronic dialysis would be too diminished.
Your children wonder why you are not in an ICU. They are told that you will be placed on a morphine drip to make you more comfortable as you pass away, and that this is the highest standard of care for your diagnosis and age. It is called terminal sedation. http://www.lifenews.com/bio2397.html You signed an advanced directive indicating that you did not want extraordinary care for a terminal condition, and under the new protocols renal failure, although treatable, qualifies as a terminal condition.
Your children frantically try to find their old family doctor. But your health plan replaced him with a large group of younger physicians, the hospital’s Consortium for Health, a private-public foundation that was created to promote efficiency and reduce wasteful spending in medical care. By 2014 when he left, your family doctor was a dinosaur, having been trained in an earlier era. His medical school was one of the last to retain the original Hippocratic Oath. http://www.pbs.org/wgbh/nova/doctors/oath_classical.html It affirmed the covenantal relationship between the physician and patient, overseen by God, and that whatever the physician did would be for the patient’s benefit. You had felt safe entrusting your health to Dr. O’Brien’s professional judgment.
Not only did the Hippocratic Oath your doctor took decades ago took specifically forbid physician assisted suicide and abortion, it also established patient confidentiality so that your secrets would never be disclosed. That is, until 2012, when physicians participating in the national healthcare system, which included ALL licensed physicians, were mandated to submit your visits to the unified electronic medical record system. This data base was created in 2003 to coordinate medical care, detect emerging health threats, and exchange clinical information. http://pn.psychiatryonline.org/cgi/content/full/38/15/5 Your doctor was very uncomfortable with this policy despite reassurances that HIPAA regulations would maintain your privacy.
But forces beyond any individual’s control began to erode your relationship with your doctor long before he left the practice of medicine. The insurance companies stopped paying him in the late 1990’s for hospital care, preferring to hire “hospitalists” or “intensivists” for greater efficiency in reducing hospital stays. Since office visits were reimbursed at lower and lower rates, your doctor had to see more and more patients in the office to just stay even. So although O’Brien knew you well and was trained to treat conditions such as renal failure or pneumonia, he stopped treating patients in the hospital.
Around 2007 both the hospital and office physicians began to be paid by a formula that rewarded them for saving money on medical care. http://query.nytimes.com/gst/fullpage.html?sec=health&res=990CE7DB1730F932A1575AC0A963958260&scp=1&sq=bonuses%20managed%20care&st=cse When your family doctor was forced to join the Consortium in 2012 because the health plans stopped contracting with individual physicians, a powerful new computer system tracked each doctor’s prescribing habits, referrals to specialists, and utilization of expensive lab tests. But your doctor was an “outlier” in this new system, having been brought up in Hippocratic tradition of doing what was necessary for the individual patient, rather than the Greater Good, the newer communitarian ethic followed by the younger doctors. http://muse.jhu.edu/login?uri=/journals/perspectives_in_biology_and_medicine/v046/46.4callahan.html He was financially penalized for doing too much for his patients, since the formulas based 30% of physician income on “efficiency.”