Frank Salvato, Managing Editor

You Say You Want a Real Solution
August 21, 2009

As the debate over health care reform rages on – and despite the fact that the debate should be over how to provide true health care affordability to all, if in fact the goal of the "overhaul” is genuinely about the good of the downtrodden – we hear one retort from Progressives, Liberals and neo-Marxists, both in government and out: Where is your plan if you don’t like ours? Truth be told, there are several conservative and Republican crafted plans but Madam Pelosi and Mr. Reid won’t entertain them and the agenda-driven mainstream media won’t cover them. But one thing is evident, even to the intellectually challenged. If the goal is truly to provide health care affordability to every American citizen, there are ways to do it without the heavy hand of government.

Most honest Americans agree, our health care system – the system that provides medical service, i.e. doctors, hospitals, clinics, etc. – is the best in the world. It certainly does not need reform or government intervention. If you need proof it comes in the form of the richest and most powerful people in the world coming to the United States for treatment, especially when every other avenue of treatment has been exhausted. To fall prey to the notion that the "health care system is broken,” is to be gullible to a fault.

The cog that isn’t meshing correctly in the machine that includes patients, doctors, hospitals and insurance companies is the insurance company cog. Many in our country would like to see more affordable prices, inclusionary coverage for those of us with pre-existing conditions and security in knowing that if a catastrophic medical event happens to us we won’t be driven to the poor house by increased premiums of unfunded procedures. As our health care insurance system exists today, these desirable elements are not within reach of everyone. But by including a few simple provisions and/or pursuing a few sensible avenues, Americans can have affordable, functioning health care insurance for all without creating a government-run health care entity.

Anti-Trust Laws
Currently, health care insurance providers are exempt from facing anti-trust or competition law prosecutions. Anti-trust laws are defined as having three main elements:

"Prohibiting agreements or practices that restrict free trading and competition between business entities, including, in particular, the repression of cartels.

"Banning abusive behavior by a firm dominating a market, or anti-competitive practices that tend to lead to such a dominant position. Practices controlled in this way may include predatory pricing, tying, price gouging, refusal to deal, and many others.

"Supervising the mergers and acquisitions of large corporations, including some joint ventures. Transactions that are considered to threaten the competitive process can be prohibited altogether, or approved subject to ‘remedies’ such as an obligation to divest part of the merged business or to offer licenses or access to facilities to enable other businesses to continue competing.”

By making the health insurance industry vulnerable to anti-trust action the industry would be forced to compete without injecting a ridiculous and dangerous government-run health care insurance entity into the market. Competition would not only lower the cost of health insurance but it would compel the capitalistic nature of the private sector to find a way to market their services to new and emerging demographics.

But with exposed liability comes risk and that risk must be marginalized as best it can in an honest and ingenuous way...

Tort Reform
As it stands now, doctors and hospitals are practicing protective medicine, and not necessarily preventative medicine. We can define protective medicine as the steps a doctor or hospital needs to take to ensure that they don’t become targets of opportunistic and frivolous lawsuits. In order to unshackle doctors and hospitals from the practice of running every conceivable test on a patient in an effort to protect them from trial lawyers like John Edwards, for example, we have to hold trial lawyers like John Edwards accountable when they file opportunistic, frivolous and over-reaching lawsuits.

This is not to say that doctors and hospital administrators don’t make mistakes, mistakes that should result in victim compensation. They do, even as they demonstrate why we refer to the medical profession as a "practice.” Humans are fallible. But threatening the overall capacity of the system to benefit both the individual and the community, even in the awarding of legitimate compensation for wrongs that may have occurred, serves neither the community nor the individual.

"Tort” can be defined as a system for compensating wrongs and harm done by one party to another's person, property or other protected interests. "Tort reform,” demonized by the political Left, refers to proposed changes in the legal system that would reduce tort litigation or limit damages.

It is always hard to place a value on someone’s life and/or limb – although it seems that where the value of life is concerned a certain Dr. Ezekiel Emanuel, brother of President Obama’s Chief of Staff, Rahm Emanuel, doesn’t have a problem – but we as a society cannot succumb to emotion when weighing the facts of the matter, especially in malpractice litigation. Trial lawyers, like John Edwards, use the facts of the case when they go to court, but they also mold those facts to have the greatest emotional impact on the jury.

While the subject of tort reform is wide-ranging and contentious, one way to reduce the emotional element of medical malpractice lawsuits would be to follow the letter of the law. Juries in malpractice lawsuits should be made up of a jury of the defendant’s peers. If the defendant is a doctor then the jury should be made up of doctors. If the defendant is a hospital administrator then the jury should be made up of hospital administrators. And so on and so forth. Understanding fully the circumstances surrounding any medical malpractice event would, in and of itself, bring reality into the awarding of compensation for damages incurred.

Nevertheless, tort reform is a must in any attempt to reform the health care insurance industry. We can only pray that Progressives don’t use it as a tool to compel Republicans to sign on to egregiously over-reaching legislation.

Health Insurance & Purchasing Restrictions
Today, someone seeking health care insurance in Illinois who finds an affordable plan offered in Florida is prohibited from buying that plan. Americans cannot purchase health insurance across state lines. While there may have been good reason for this restriction at its inception, the need for affordable health care insurance today greatly outweighs the rationale for this restriction.

In an effort to promote competition among the health care insurance companies and, as a by-product, lower health care insurance policy prices, we must allow for the greatest amount of competition. Restricting inter-state accessibility to specific health care insurance plans is antithetical to reducing the cost of health care insurance.

By creating a wide-open national market the health care industry would be empowered to create insurance vehicles for every consumer need, including the consumer with pre-existing conditions and those who simply want coverage for catastrophic events.

With regard to pre-existing conditions...

Government Mandate
The federal government mandates many programs and regulations, some funded, others not. Those regulations are usually overseen by an Executive Branch department or authorized commission. The Environmental Protection Agency and the Security and Exchange Commission come to mind as examples, regardless of their flaws and ineffectiveness. Both of these organizations deal largely with the private sector, making sure that private sector entities are adhering to regulations put into place by those answerable to the citizenry at election time.

Why is it then that many of our elected officials in Washington DC – who understand fully their ability and authority to mandate regulations (just look at what Treasury Secretary Timothy Geithner is doing to the financial industry via regulation and regulatory "reform”) – insist that the only way we, as a people, can provide health care insurance to all is to create another avenue to governmental failure in the form of a government-run health insurance entity?

Now, I am not one for the expansion of government, but it would seem logical – born of common sense – that if faced with the choice of establishing another behemoth government entitlement program, on the one hand, and legislating a regulatory entity for health insurance providers and mandating that the industry provide affordable health care insurance solutions for those all, especially those in poverty and those with pre-existing conditions, on the other hand, well, the choice is clear: Let the private sector do what they do best...sell products.

Private Sector Cooperatives
US Sen. John Kyl (R-AZ) has come out to expose the current cooperative health care insurance proposal making its way around Washington DC as a Trojan horse, as have many others, and they couldn’t be more right.

Any cooperative set up by government would have to use, at least initially, taxpayer money to become established as a viable entity. Further, because no private sector entities – individual or organizational – would be in a position to do so, government appointed board members would have to be seated to establish the cooperative as a functioning entity. When would the government disengage? The cooperative being a non-profit entity, how would taxpayers recoup their money? When would the government seated board members resign?

The idea of health insurance cooperatives is not a bad idea but it must emanate exclusively from the private sector.

If individuals and/or small businesses – and even medium sized businesses – emanating from the private sector banded together to form privately run health care insurance cooperatives they would be in a good position to not only function as a stand-alone health care insurance provider for their members, but to – if the membership was so inclined – glean fantastic discounted rates from existing health care insurance providers should the membership choose to supplement or outsource their coverage.

This model has already been proven to be successful in the farmer’s cooperative and the credit union cooperative models. The common thread in these models is that they are run by their members and not the government, federal or state.

These are just a very few examples of what can be done to reform today’s health care insurance industry without having the federal government encroach further – and unconstitutionally, I might add – into the private sector.

There are solutions to the health care insurance problem that exclude the disastrous notion of socialized medicine and a government-run health care insurance entity. They all emanate from the private sector, the capitalist private sector.

These solutions also do something that every American should not only want to do but is charged to do by our Constitution’s mandate to "Life, Liberty and the Pursuit of Happiness...,” protect the vulnerable – our very young and very old – from the insanity of eugenics-based concepts like the Complete Lives System, advance by the darkened hearts of people like Dr. Ezekiel Emanuel.

In closing, I ask you to consider these two points:

▪ If Progressives and Liberals see the right to privacy when the subject of abortion is addressed, how can they not afford the same right to privacy where any other medical procedure is concerned?

▪ If We the People require government to acquire a search warrant based on probable cause before they can legally enter our homes, why is anyone contemplating allowing government the ability to encroach upon our constitutional right to "Life?”

Feel free to bring these points up at your next town hall meeting. I’m sure the answers you receive will be very creative...