US Supreme Court Approval Of ObamaCare Will Institutionalize Universal Price Controls

If US Supreme Court does not dispose of ObamaCare in total, it will institutionalize universal price controls. Much is stated about how the individual mandate erases freedoms but conventional wisdom has ignored how decades of government price controls and regulations have erased health care provider freedom to innovate. Consequently, the nation has an inefficient and quality challenged health care delivery system masked by the suppliers of innovative technology and drugs. Who, if subjected to government mandated price controls "to control cost" may have achieved just a fraction of the innovation we take for granted today.

Price controls historically have cultivated poor quality, fraud, lost talent, shortages, surpluses, etc., and health care suffers them all. For example: a quality chasm was identified in the 1999 Institute of Medicare Report, and to this day, poor quality is still a cash cow as CMS uses savings from price ceilings to reimburse preventable medical errors (minus a few). When Intermountain Health System focused on preventing medical errors, it took a loss on every Medicare patient because CMS price ceilings underpay excellence. Price ceilings have caused a shortage crisis in primary care physicians. Plus, the limits in income contributes to the “less than stellar” medical school applicants in recent decades as the talented students choose price control-free careers. Price floors have resulted in overpayments to cardiologist (recently and painfully corrected) creating years of surpluses and waste. The same for CT scans because CMS’s pricing system is slow to respond to technological advances that lowered costs while increasing value. Just Medicare fraud approaches $150 billion annually and the Center for Medicare and Medicaid Services is clueless in how to lower the volume.

Yet, CMS an inefficient and quality challenged federal agency under ObamaCare will be tasked to implement universal price controls and hundreds of thousands of pages of regulation to coherce the nation's health care delivery system into something CMS can not achieve, an efficeint, quality driven system. Only a fool who would lie 39 times in his own biography would tell Americans this would work, which is why a system of universal price controls and regulations is called ObamaCare.

Decades of CMS underpaying excellence has made excellence a cultural misfit in the nation’s healthcare delivery system. And decades of CMS rewarding failure has filled the nation's quality chasm with a culture of failure that ObamaCare, if held constitutional, will put inefficiencies and poor patient outcomes on government steroids sending the nation's health care delivery system down the toilet that the US Supreme Court should be flushing ObamaCare down.

Effective Hospital Leadership Wellness Program Increases Patient and Financial Outcomes

Want to improve employee health? Make sure all levels of management exhibit robust leadership skills. A study of 3,100 men over a ten year period determined that individuals under a manager that is inconsiderate, opaque, uncommunicative, and a poor advocate were about 60% more likely to suffer a heart attack or other life-threatening cardiac conditions. Employees under a manager who was considerate, transparent, communicative, and a great advocate had 40% LESS chance of these problem. Poor leadership trumped work load and whether the employee smoked, exercised or had a weight problem which are the traditional focus of a hospital wellness program.

A second study of 4000 government bureaucrats found that cold-like symptoms where primarily caused by job-stress, dissatisfaction, and poor office relationships. These symptoms are also reflect poor leadership skills.

We know health care’s quality chasm is rooted in its leadership chasm where communication-breakdown is at epidemic levels, transparency is an orphan, being considerate is a political calculation and being a great advocate of other’s work is a selective process if it exist at all. Could dysfunctional leadership be why health care spending is 10% higher for hospital employees than it is for the general employee population?

Maybe a leadership wellness program with a top to bottom evaluation of which leaders inspire their employees to excellence and who demoralizes them to mediocrity could lead to healthier employees, patients and finances.

Why ObamaCare Will Cost Millions of Jobs

Historically, states like Hawaii and Tennessee that made serious efforts at universal health care suffered financially. Hawaii's effort developed during the 80s when health care costs were just starting to explode and by 1992 Hillary Clinton herald it as a success with 98% of its population covered. It was killing small businesses and Hawaii's business climate ranked 49th. Today, Hawaii only insures 92% of Hawaiians and political leadership has determined that "there is no silver bullet" to cutting health care costs. Tennessee realized quickly that its effort was going to bankrupt the state. The US Congress is not that astute or courageous to admit failure.

Why is universal health care unaffordable? In 1965, the US government introduced Medicare and Medicaid which has devolved to a system that utilizes price controls to control cost while ignoring patient outcomes. Price controls underpay excellence (page 12 Obama's economic council June 2009 report) and for decades the federal government used the savings to pay for preventable medical errors making poor care a cash cow and quality care a money loser.

Free markets are based on just the opposite principle so no one should be surprised by health care's unaffordable inflation rate. Adam Smith warned that government never competes in free markets, it manipulates them (health care, education, mortgage industry). Unfortunately, we have a Congress where half believe government needs to manipulate markets and half have various degrees of belief in free markets. So, the vehicle that has made the US an economic power is being destroyed in the US Congress.

In 1999, the Institute of Medicine estimated that 100,000 patients die annually just in hospitals. This number has since been increased to 200,000 plus and if we included all of healthcare, the annual preventable death toll exceeds the total US troop deaths for all of World War II. ObamaCare is designed to inject the present command and control policies government used for decades to achieve these preventable death tolls which failed to lower costs and increase quality with a massive dose regulations and oversight. We know this will fail because the second most regulated industry by the federal government is nursing homes where federal and state regulations dictate every minute of patients existence in a highly controlled environment. A progressives dream for all of us.

This three decade experiment continues to fail annually for over 2 million patients. Yet, ObamaCare conceived by feelings and ideology is on a projectory to subject 310 million to the same failures because of a weak, self-serving U.S. Senate. Consequently, American's economic future will parallel the Hawaiian experiment as ObamaCare gains strength in underpaying excellence for budgetary reasons and rewarding failure for political reasons, small business will weaken and large business with leave costing millions in lost jobs.

The alternative is a health care system that pays for excellence and NEVER failure in a manner that health care professionals are inspire to daily pursue excellence in achieving the most efficient delivery of quality, universal care. The savings from decreasing poor care and inefficient systems will approach 50% of this years health care costs which is sufficient to cut premium costs while giving all American orderly access to health care. We will get here but first we need to let ObamaCare bring us to the abyss so progressives can see the lights of hell. It is how a decaying culture behaves.

What The New York Times Censors

For a few years, I have found the New York Times censors my post in response to an article. I use no foul language and stay on subject so I am posting my censored writings here.

The following was submitted on April 1, 2010 responding to Gail Collins "Mitt Romney, Liberal Icon."

Thron
Tyler, TX
April 1st, 2010
7:41 am

RomneyCare and HawaiiCare were two lessons that ObamaCare fails to learn from because each is trying to insure risk in a system that underpays excellence and rewards failure perverting free market principles. First, HawaiiCare was given birth by a special exemption the US Congress approved decades ago and in 1993, HillaryCare herald its achievement of 98% coverage. Unfortunately, the burden of rapid premium inflation on Hawaii businesses destroyed the business climate (ranked 48th) and today only 90-93% are insured. This same rapid increase (7-13%) is Massachusett's present experience even though, like ObamaCare, citizens were promised 25-45% drop in premium costs. Why? Actually, Obama's economic council in a June 2009 report stumbled on the core problem of an inefficient, quality challenged health care delivery system when it stated Medicare and Medicaid do not pay for quality or value, but do pay for poor quality. In other words, these two public options for decades have underpaid excellence and used the saving to underpay failure.

These perverted incentives have neutralized free market principles in the delivery system. Since these public options have the power of government, government allows costs it does not want to pay to be shifted to its competition, private insurers. These unwanted costs are added to private insure premiums allowing the left to declare that Medicare is more efficient than private insurers ignoring that again government's perverse incentives have neutralized free market principles in health insurance.

Today's automobiles are 40% cheaper than forty years ago adjusted for inflation even with all the high tech and safety feature. Why? Free markets and not until this nation's government understands how free market principles inspire individuals to pursue excellence when paid for excellence and eliminate failure when penalized for failure, will we have the most efficient delivery of quality, universal, integrated care. Meanwhile, ObamaCare in its present design and goals will bring economic Armageddon. Maybe not today, but like bankruptcy it starts slow and then a rapid ending.

ObamaCare Ignores Previous and Present Failures At Universal Health Care

President Obama continues to bring feelings to a fact fight. He pontificates that mandated universal health care will control health care costs and is good for a failing economy. Yet, he lived in Hawaii which has failed at mandated universal health care coverage making one wonder, just how bad was his cocaine usage?

In 1994, First Lady Hillary Rodham Clinton declared, “The only place that has achieved nearly universal coverage and has less of a cost burden on its system is Hawaii.” The Clinton administration was so impressed with Hawaii, it got Congress to fund the QUEST program for the 2% uninsured most of whom were suffering from expensive chronic problems that private insurers avoid. Unfortunately, Ms. Clinton’s words contrast with the inconvenient facts because Hawaii’s employer mandate had a significant “cost burden” on small businesses and consequently on the uninsured. Since 1993, Hawaii has not been able to control premium inflation and in 2002 the uninsured levels in Hawaii were reported to be 9.7 percent. The small business problems have existed since the 1990 economic recovery evidenced by Hawaii’s 49th ranking in income growth, 43rd ranking in employment growth rate, the worst business bankruptcy rate and new business growth ranked 48th.

Massachusetts's universal health proponents felt mandating health insurance would cut premium costs 35-45% because the healthy 18-35 population would be contributing with minimal claims and the newly insured poor would forego ERs for cheaper access to primary care. Again, the inconvenient facts have struck liberal land and premiums are growing 7-13% annually and the insured poor are still using the ER rather than a primary care physician at a high rate.

Maine's Dirigo Health based its universal health success on eliminating "charity and bad debt" with a state run insurer not seeking profits or employing high salaried executives. It had one of the nation's "25 Most Powerful Women In Health Care" leading the effort but Dirigo Health has failed to insure the 135,000 it promised, has restricted enrollment, can not controlled costs and insures less than 9000 individuals.

These failed efforts at universal health care are the inconvenient facts that the Democratic Party, President Obama, the New York and Washington media quietly ignore. Not until health care reform focuses on reversing the costs projectory by inspiring the health care delivery system to be in the constant pursuit of excellence will health insurance premiums be affordable. And government mandating affordability through price controls and mandates is the fastest projectory to hyper inflation in health care.

Health Care Reform Needs Democrats To Be Smarter Than A Fifth Grader

If a dog owner reduced a dog's daily ration one ounce every time the dog pooped or peeped outdoors but when the dog pooped or peeped indoors, he added a treat to the daily ration, there would be a lot of "waste" in the house. This is exactly what government health care programs have been encouraging for decades.

President Obama's own economic advisers reported in June 2009 (page 14) that government health care programs do not pay for quality care or value, but do pay for poor quality. Today, Democrats are blaming all the "waste" in government on everyone but government's perverse incentives for causing the 30-40 percent "waste" in health care. A fifth grader would know that paying health care providers for excellence and never preventable failure would take the "waste" out of health care. Instead, the Democratic Party and the President are about to take "waste" to a higher level by giving the federal government more tax and control power that will accelerate the perverse incentives and implement stealth taxes that will mask the real cost of a government controlled health care delivery system. If you think the status quo is wasteful and chaotic today, wait until five years of ObamaCare on government steroids has past.

Decade Old Concept Drives Dallas, Texas Health Care Reform...Maybe

While ObamaCare seeks a strategy for health care reform, Dallas is moving towards what I call a community integrated delivery system (CIDS) to curb inflation. A decade old concept based on Steven Covey’s maturity continuum, CIDS applies these characteristics to health care entities progressing from dependence (what you can do for me), to independence (what I can do for you) to interdependence (what we can do together). CIDS hypothesizes that a true paradigm shift in health care would occur when a coalition of physicians, community leaders, consumers, insurers, hospitals, etc., like Dallas is presently assembling, collaborate to evolve their role in the health care delivery system from dependency to interdependency.

Grand Junction, Colorado without a matrix like CIDS made news with the lowest cost per Medicare patient in the nation while achieving quality outcomes. The achievement reflected years of physicians, at the behest of a major health plan, reaching the independent stage by collaborating to manage patient outcomes. A CIDS model would have been more inclusive giving Grand Junction a greater opportunity to reaching the interdependent stage and the political power to address government’s perverse reimbursement system that underpays excellence and rewards failure.

In contrasts, McAllen, Texas the nation’s highest costs per Medicare patient in the third most expensive state represents the dependency stage. Its health care providers have been described as clueless in seeing the big picture, quick to blame forces around them, convinced they are providing necessary and essential care but the evidence says they pursue revenue “for me” and not excellence “for you.”

If the Dallas coalition lowers costs just 22%, it will equal the national average strengthening its role as a regional health care provider while cutting a major cost in their economy; a win/win for everyone. If they reach the interdependent stage, Dallas will be the nation's high value model for free market health care reform facilitated by the community not controlled by a central government entity.