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Thanks to the current debate about health care reform, one issue that has garnered public attention is the concern about rationing of health care, and the conversation, if it can be called that, has necessarily focused on the elderly.
First, in the interest of full disclosure, I am one of the elderly, actually the very elderly in the view of most. I have lived a long and full life, much longer than I thought I would when I was in my 30s and 40s, even my 50s, and I have experienced a series of health crises along the way, some of which have landed me in the hospital.
That I am still around and functioning reasonably well at the ripe old age of 80 is testimony to the miracle of modern medicine and the skill of the doctors who have cared for me. And, since I ran a hospital for almost seven years, I also have a pretty good idea of how they function and what they can or cannot do for patients.
That said, should senior Medicare patients be worried about the health care plan that is currently being hotly debated across the country? In my opinion, yes. Although the “public option” appears to have been dropped from the House legislation, it will very likely appear in some other form in the legislation that is ultimately adopted.
However, as a beneficiary of Medicare insurance, I am primarily concerned about the specter of the rationing of health care, which is a major component of all government health plans. Canada, the U.K., Oregon and Massachusetts, to name the most widely cited, all ration care in addition to requiring people to wait to see a doctor or to have various tests done, such as MRI’s, CAT Scans, or be admitted to a hospital.
Furthermore, Medicare is already a major financial loser, with an unfunded liability of about $11 trillion for the current beneficiaries, even before adding another 74 million Baby Boomers to the pool. In other words, it loses money, big time.
To me, the claim that it is possible to provide health insurance for an estimated 45 million additional people without increasing the deficit or significantly raising taxes is ludicrous. The non-partisan Congressional Budget Office has scored the cost at about $1.6 trillion. It’s a simple concept, and no matter what the proponents of expanding the nation’s health care insurance may assert, not only will costs go up, but it must necessarily result in rationing of health care services. In addition, providing health insurance coverage for another 45 million people will also cause a significant shortage of doctors and nurses, which will increase the difficulty of getting care when it is needed.
What else concerns me, as one of the nation’s elderly citizens? How about out-of-control deficit spending?
Given my age, you may wonder why that would matter to me. The answer is easy: Uncontrolled spending is inflationary, and inflation is an extremely worrisome problem for seniors, most of whom live on a fixed income. Rapid inflation reduces purchasing power by depreciating the value of a nation’s currency, and its most virulent form, hyperinflation, causes money to depreciate so rapidly that it quickly becomes worthless. With the present administration, that worries me. Those who are living on a fixed income are the most vulnerable to the effects of inflation, and I would at least like to have the purchasing power of our income last as long as my wife and I do.
Another concern for the elderly is what happens when they reach the point where they are no longer able to care for themselves. The cost of assisted living or nursing home care is prohibitive for most people, many of whom may become a financial burden on their families. Not everyone has children who are willing and able to care for an elderly parent, which can cause a variety of problems.
The elderly alos worry about the potential loss of their eyesight or hearing, especially to the degree that it threatens their ability to drive a car. In that sense, we are like teenagers. The ability to drive is very important to our sense of independence.
Finally, and perhaps the most worrisome concern for the elderly is the possibility of becoming afflicted with a condition like dementia, Parkinson’s or Alzheimer’s. For a generation of people who have generally led independent, active and productive lives, the specter of these diseases can be especially troubling.
Fortunately, aging is not all bad. In spite of advancing years, there are still many benefits, such as reading, taking an afternoon nap, watching our favorite T.V. programs, good movies, and remaining active in a variety of other ways, such as playing bridge or golf and enjoying the company of friends and family. In my case, I write. It helps keep me alert, informed and engaged.
If Social Security checks are not going to be increased for two years because the Cost of Living Adjustment (COLA) has not gone up, does that also mean members of Congress will forgo their annual pay raises as well?
I’m kidding, right?
Well, only partially. Since annual increases in the compensation of legislators in Congress are also pegged to COLA, will they still be entitled to a pay raise in 2010 if the COLA has not increased? And, if they do get a raise, should they voluntarily decline it?
Fat chance! Forgive me if my cynicism is showing, but at my age I’ve lost most of my idealism.
Consider the following note I received from a woman whose sole source of income is Social Security: “I am so upset that we are not getting a raise pursuant to the cost of living increase for Social Security. I am on Social Security Disability and was looking forward to the small increase I would be receiving this year!! You are so correct — the prices of food and all other items we need to purchase are frightening! Why pick on us - the ones who need this money the most? I am shocked they are doing this to us the vulnerable!”
Unfortunately, I don’t’ have a good answer for her. Her Social Security income is normally increased every year by an annual Cost of Living Adjustment, but since COLA has not gone up, her Social Security checks will not change for the next two years. Actually, they are likely to go down because, chances are, her Medicare insurance payments are deducted from her Social Security checks, and since the Medicare insurance rates will continue to increase, her monthly net checks will be smaller.
Members of Congress receive an automatic Cost-Of-Living-Adjustment every year unless they vote not to accept it. It will be interesting to see if they are treated the same way as Social Security beneficiaries, that is, if their pay is also not increased in 2010 because the Cost of Living index has not gone up.
Looking at the situation another way, historical data on annual Congressional compensation shows that it has grown from $5,000 in 1900 to $174,000 today, an increase of 3,380% or 31.2% a year compared with the Consumer Price Index, which grew 2,085%, 21.9% per year, from 1913 to 2008. In short, Congressional pay has increased an average of about 10% more per year than the average annual increase in consumer prices.
While the compensation of our “public servants” has increased an average of over 31% a year since 1900, they have also depreciated the value of the dollar to the point that it now costs $26.45 to buy goods and/or services that cost only $1.00 in 1900.
Is that the kind of track record that justifies the size of the increases in compensation members of Congress have given themselves?
In addition to receiving wages that generally exceed those of most of their constituents, members of Congress also receive generous perks and participate in a retirement plan that is generally superior to anything that’s available to most of the people they represent who work in the private sector.
The argument that unless legislators’ compensation is competitive with the private sector it is not possible to attract the most qualified people to public service. I believe that is also a myth. In May, 1999, Gary Ruskin, Director of the Congressional Accountability Project, stated in testimony before the U.S. House of Representatives that a 1996 Roll Call study found that “all but six of the 73 newly elected House Members will receive large pay hikes when they take office, compared with their previous employment. . . . . During the last ten years, House Members gave themselves five pay raises, Senators six. Congressional salaries grew by $42,900 – more than $15,000 above inflation.”
It’s clear that, by any standard, most politicians benefit from an increase in earnings when they are elected to Congress.
Our elected representatives were originally supposed to spend only a brief part of their careers in public service and then return to their lives at home and live thereafter under the laws they passed while they were in office. Instead, over time, they have made politics their profession.
As far as I’m concerned, most politicians are primarily interested in their own careers, and extending the length of their stay in the nation’s capital for as long as possible seems to have become their principal focus.
As Mark Twain said, “I think I can say, and say with pride, that we have some legislatures that bring higher prices than any in the world.”
Every ten years we go through the process of counting the people in America. And, based on the results, the multitude of Congressional districts around the country are adjusted for the purpose of complying with the Constitutional mandate that the members of the House of Representatives be allocated on the basis of the population in the 50 states.
Not surprisingly, including illegal aliens in the census count could make a significant difference in the number of members allocated to the House of Representatives for various states.
Furthermore, beyond the specific requirement to adjust the Congressional districts based on population, taking the census has evolved into a detailed and intrusive series of personal questions that the government wants answered for its own purposes. And, those who refuse to answer them can be subject to heavy penalties.
Following are various facts about the census that you may find of interest:
All residents of the 50 states and the District of Columbia must be counted.
Legally married gay couples will be counted as marriages.
Following the American Revolution, the first census was taken in 1790.
Census figures are based on counts of people who live in residential structures, where they live and sleep most of the year.
The count includes citizens, non-citizen legal residents, non-citizen long-term visitors and illegal immigrants.
Census counts are also used as the basis of apportionment of Electoral College seats for the presidential elections.
Census records and information specific individuals who are included in the census become available to the public 72 years after the census is taken, however, aggregate statistical data is released as soon as it is available.
Statistical information derived from the census is used as the basis for a wide range of planning by government and industry.
The census results are also used as the basis for distributing $300 billion in federal funds to local, state and tribal governments each year.
The first nine censuses (1790-1870) were not managed by the Executive Branch of the federal government, but were conducted by federal marshals who were assigned by the federal courts.
The results of the 2010 census must be submitted to the U.S. President by December 31 of that year.
The census has generally been the responsibility of the federal Department of Commerce and the managers have reported to the Secretary of that Department who in turn reports to the president of the U.S. However, shortly after taking office, the new administration changed the reporting relationship to have the Director of the Census Bureau report directly to Obama’s Chief of Staff, Rahm Emanuel, in the White House.
Here are some highlights of the population figures that will be updated as a result of the 2010 census:
The 2008 estimate of U.S. population is a little over 304 million.
About 80 percent of the U.S. population is white, 12.8 percent are black, and 15.1 percent are Hispanic or Latino.
In 2007, 11.1 percent of the population was foreign born.
In 2000, 17.9 percent of the U.S. population spoke a language other than English at home.
In 2007, there were almost 128 million housing units in the U.S.
In 2000, 80 percent of people age 25 and older were high school graduates and 24 percent had a Bachelor’s degree or higher.
Almost 50 million people age 5 and older had a disability.
In 2007, median household income (half above and have below) was $50,740 and per capital income was $21,587 in 1999.
The results of the census count can have a major impact on the politics of the nation. For example, the Wall Street Journal noted that counting illegal aliens could increase California’s allocation of members of the House of Representatives by nine seats to which it is not constitutionally entitled. The state’s population of 37 million includes approximately 5.6 million noncitizens (15 percent), which would allot a total of 57 members of the House of Representatives to the state, or 13 percent of the 435 members. However, if noncitizens were not counted, California would have only 48 seats, and Texas, which would have 38 members in the House of Representatives if noncitizens are included, would have 34 members if they are not counted.
In an increasingly politicized environment, with billions of dollars and the balance of power at stake, the responsibility for taking the U.S. census and how it is managed are likely to become a significant political consideration that could become a contentious issue in 2010.
The arguments for and against a national health care plan continue to rage back and forth, left, right and center. We are being told it’s an emergency, and if we don’t act now, the economy will be devastated by out-of-control health care costs.
One of the most important lessons I learned in a business career that spanned over 50 years is when someone attempts to pressure you to buy or agree to something immediately, it is invariably the wrong thing to do. And, that’s exactly what we have been getting from the Obama administration and those Congressional leaders or others who have been trying to push nationalized health care on the American people.
As the debate has heated up, a stream of claims and counter-claims has been beamed at the public 24/7: It’s “socialized medicine,” it’s government-run health care and that doesn’t work wherever it’s adopted, private health insurance will be forced out of the market, 47 million American’s without health insurance can’t wait any longer, people are dying, a “national health insurance exchange” is the only way to contain costs and improve the quality of care, people can keep the insurance they currently have if they prefer.
In a July 12 editorial, the Palm Beach Post noted that a study by the Commonwealth Fund concluded that a public plan that paid the same rates as Medicare would save $3 trillion in the decade from 2010 to 2020 compared with $1.2 trillion savings under a private-only plan. They also estimated that a public plan that pays Medicare rates would save $3 trillion in the decade from 2010 and 2020 compared with $1.2 trillion from the private-only plan. Commonwealth’s projections indicated that a public plan also would reduce the number of uninsured from 48 million in 2009 to 4 million by 2012 and that without reform the number of uninsured would rise to at least 61 million by 2020.
Unfortunately, such projections invariably have a way of being wrong, no matter who makes them. Starting with Social Security in the 30s, every social program that has ever been adopted has ultimately cost far more than the estimates that were made when they were first proposed.
Is it any different today? That is, are the cost and savings projections that are being made to “sell” national health care to the public realistic or reliable? I think we can assume that without doubt they will prove to be wrong. The costs will be far greater than current projections and the savings we are being told can be achieved to pay for the program will prove to be grossly overstated or will never happen at all.
How about federal employees? How does their health insurance plan work? The Federal Employee Health Benefits Plan (FEHBP) is a private insurance program that is offered to all federal employees, including the President and members of Congress.
FEHBP is a system of “managed competition,” through which more than 100 private insurance plans compete to insure federal employees. The plans stipulate which physicians the insured can see, which drugs can be prescribed, whether the insured can see a specialist, and when and where the insured can be hospitalized.
On average, the government pays72 percent of the premiums and the employees pay the difference. By contrast, in 2008, almost half of all private sector employees paid more than 25 percent of the premiums for health insurance that was provided through their employers.
Of the federal government’s 1.8 million civilian employees (excluding the Post office), the Physicians For A National Health Program (PNHP), reports that only 100,000 of those who are eligible for health insurance are not covered because they can’t afford it. Furthermore, if the same or similar plans were offered to the general public, the premiums would be higher because “federal employees are younger, healthier, and more securely employed than the average person in the general population, making the government workers less expensive to insure.”
The Miami Herald noted in a recent article (“What kind of health care do lawmakers and Obama get?” by William Douglas and Margaret Talev): “Lawmakers also receive perks beyond the federal care offerings. For an annual fee of $503, they can receive health services from the Office of the Attending Physicians, a fully staffed $2.5 million medical office located on the Capitol…Its services include acute medical care, health assessments, X-ray, lab and diagnostic services…Lawmakers can also get medical treatment at military hospitals, including the National Naval Medical Center at Bethesda, Md…and at the Walter Reed Army Medical Center in Washington.”
Mark McClellan, a health care analyst at the Brookings Institution, observed that it would cost nearly $2 trillion to bring the health care of Americans in general “up to congressional-level health care.”
If Obama’s health care plan is adopted, cost estimates will outstrip projections by a wide margin and the savings that are being so highly touted to pay for it will never happen.
The Santa Barbara News Press recently carried one of the most amazing commentaries I have read in a long time – about real estate development in the City of Santa Barbara. Written by Cathie McCammon, who is a candidate for the Santa Barbara City Council, it revealed an appalling lack of understanding of economics and the free-market system. Sadly, the mind-set of this lady is typical of most of the politicians who hold public office today in Santa Barbara County, California and Congress.
Ms. McGammon wrote, in part, “I was very disappointed with the recent Plan Santa Barbara workshops on density and unit size. The hired consultants showed what it would take for a private-sector developer to produce more work-force housing at a profit…Since when is our planning process concerned with the developer’s profit?”
What? Since when should any government’s planning process NOT be concerned with the developer’s profit? Clearly, Ms. McCammon does not understand the concept of incentives. Does she think developers will build anything if the planning process makes it impossible for them to make money?
One thing political leaders and planners should understand is that, other than non-profit organizations, no one in their right mind is going to build housing anywhere without the potential of making a profit. Who would risk their time, energy and capital without a reasonable expectation of gain? Not just to break-even but to make a profit. I’m not sure what Ms. McCammon thinks motivates people to develop property, but whatever it is, developers surely do not do it for their health or because they want to do something nice for their fellow citizens.
I don’t know what Ms. McCammon does for a living, but I have a hard time believing that she would be willing to work for nothing or at a loss, any more than a developer would or should.
A recent News-Press commentary provided readers with an insight into Ms. McCammon’s thinking when the paper noted that the first interview question Travis Armstrong asks candidates for the Santa Barbara City Council is why anyone would want to run for the council?
On AM1290 News-Press Radio: “Travis and Cathie McCammon hash it out,” Travis asked, “why does this old broad want to be on city council?…She spoke in a world- weary monotone and complained that the present council is too mean!! She wants a council that won’t make people feel bad, that tucks them in at night and reads them a bedtime story! WTF kinda people are living in Santa Barbara that they need a council to make them feel good?? That’s not a city council’s responsibility to make you feel good!! She complained about the meetings and comment period…and said people should be able to talk endlessly to the council! What about the people waiting in line? She said people don’t have the opportunity to communicate with the council! Ever heard of email, Cathie?”
In a further display of her lack of understanding about the role of government in planning, Ms. McCammon concluded her commentary with the statement, “What we want are proposed projects that will fit within our limited resources of air quality and water, and infrastructure compatible with Santa Barbara’s unique character. We are not San Francisco.”
Santa Barbara may not be San Francisco, but with politicians like Cathie McCammon, they can’t be far behind.
Sadly, Ms. McCammon’s attitude is far too common among people in government today. My guess is that if it ever dawns on her that developers will not build without a reasonable expectation of profit, she will conclude that the only alternative is to have the government do it.
However, we have already seen evidence of the failures in developing housing that are a result of government activism in the housing markets of Chicago and New York. We don’t need to replicate that experience in Santa Barbara County, or anywhere else for that matter. Unfortunately, we can expect more of the same if we do not elect candidates to public office who have a clear understanding of how the system should work.
With all the hullabaloo about TARP, the stimulus bill, the out-of-control spending of the Obama administration, and the health care proposal that’s currently being debated, perhaps one of the most important pieces of legislation in America’s history has started to work its way through Congress. It could just be that the practice of “Birthright Citizenship” may finally be coming to an end.
There are those who will see this as some form of discrimination, particularly against Hispanics, while others will view as righting a serious wrong that has been tolerated by Americans for far too long.
The idea, of course, is to stop the practice of automatically granting American citizenship to anyone who is born here, regardless of the status of their parents. Even children whose parents are both U.S. non-citizens automatically become citizens. This includes more than 400,000 babies who are born within our borders and whose parents are illegal aliens.
Writing in Business Week (July 24, 2009), “Nearly All Wealthy and Emerging Nations Have Eliminated Birthright Citizenship – We Should Too,” Roy Beck, executive director of NumbersUSA, observed: “Maternity tourism is just the beginning of the silliness of birthright citizenship that goes to the babies of foreign students, temporary foreign workers, international travelers – and the millions who break the law to criminally enter this country…This is a huge impediment to efforts to stabilize U.S. population to allow for environmental sustainability. And it is a great incentive for more illegal immigration. Each of these babies becomes an anchor who retards deportation of unlawfully present parents – and who eventually will be an anchor for entire families and villages as chain migration leads to the immigration of grandparents, aunts, uncles, and cousins. Birthright citizenship is an antiquated practice that has been abandoned by nearly all wealthy nations and emerging nations (recently India and Indonesia) and by the majority of poor nations.
On April 2, 2009, Representative Nathan Deal (R-GA) introduced the Birthright Citizenship Act of 2009 to correct this long-standing inequity. It’s interesting to note that the bill has 82 co-sponsors. Rep. Deal also observes that, contrary to the view of those who favor Birthright Citizenship “…federal law (not the Constitution) gives citizenship to an estimated minimum 400,000 babies each year who don’t’ have even one parent who is a U.S. citizen or permanent legal immigrant…The Supreme Court has ruled only that the Constitution requires babies of legal immigrants be U.S. citizens.”
The language of Rep. Deal’s bill is brief and to the point. Consisting of approximately 160 words, it modifies Section 301 of the Immigration and Nationality Act (8 U.S. 1401) to read in part: “…a person born in the United States shall be considered ‘subject to the jurisdiction’ of the United States for purposes of subsection (a)(1) if the person is born in the United States of parents, one of whom is –
(1) A citizen or national of the United States;
(2) An alien lawfully admitted for permanent residence in the United States whose residence is in the United States; or
(3) An alien performing active service in the armed forces (as defined in section 101 of title 10, United States Code.).”
It remains to be seen if this simple, uncomplicated piece of legislation can make it through the snake-pit of special interests and conflicting views of those in Congress and if the president will sign it. So far, he has not acknowledged that he is even aware that it has been introduced, and I doubt that the press will ask him about it. If it passes, given the many questions and pending litigation about his own birthplace, he could veto it.
It will be interesting to see where this goes, but I am confident of one thing: that the American people will be overwhelmingly in favor of it.
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