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Archive for the ‘New Ideas’ Category

Bills and Regulations should be written for the Citizens

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Our constitution and amendments are detailed in less than 7600 words. We have courts who ‘interpret’ those words – often resulting in a 5/4 split occurring along partisan views, not actual reading ability.  Most ethical tradesman could review our constitution without the application of partisan subjectivity, however, our current laws are now written to avoid any lawyer challenges, but does this really serve the common citizen?
For an example of our current system of laws, check out the ridiculous length of laws/regulations regarding vehicle registration.
We need to change the manner by which laws, to include regulations, are written and reviewed.  We have thousands, (and thousands), of pages of Law – how can you know you are not performing some illegal activity?
Our elected representatives should be required to write the laws but we all know this may not be possible so I suggest the following form that is limited to two pages (12 font):
‘Bundling’ is not allowed.

The Gist:
The desired result of this bill, (I.e., lower taxes for people making xxx to xxx).

The Bill:
This section consists of less than two pages of verbiage describing the law in a common sense manner easily understandable to most citizens without reference to extraneous documentation. This document will completely explain the law.

The Proof, Duration, and Analysis of this bill:
Here is where the sponsors dictate the required response if this bill does not achieve the ‘Gist’. (I.e., Dissolve the bill after two years of demonstrated failure).

If you are an elected representative and find this construct impossible to perform – contact me and I will write the bill for you.

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Hate and Media

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Cigarette commercials are banned from television. Drinking alcohol products is not allowed in TV commercials. Why?
Advertisements lead consumers to use a product. Ads convince people to purchase products. Cigarettes and alcohol are not condoned because ads will lead people to employ and enjoy the products. So – advertising some products is strictly controlled.
But hate is available 24/7. Hate is disseminated in our social media. Hate is broadcast in the news. Hate is briefed in academia. Hate is broadcast by politicians. Hate is also condoned, supported, and preached in our media.
Even worse, much of the hate is created by lies, propaganda, and a constant barrage of derisive division meant to inspire class warfare. Hate mongers, provocateurs, and the dishonest purveyors of news often falsify history. Misinformation constantly appears in social media. And amazingly, people wonder why violence occurs. Violence possibly instigated by the constant stream of dishonest hatred ‘advertised’ every day. The mob absorbs and believes this hateful stream. They don’t read. They only think what ‘advertisements’ tell them to think. They become the indoctrinated.
Will the mob target me, (and you), for not wanting to hate?

Education in America is Free

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Do you know the cost of education in America?  High schools often spend over 10k per student, but anyone with a computer and internet access has many free courses of education.  Over ninety-eight of our public libraries also have free access to computers and the internet but they are ‘challenged’ to meet demand, according to a report by the American Library Association.  Just think; free education.  Interesting courses created by professionals cover a myriad of topics.  Here are a couple example areas that provide free courses:

http://www.einstiensnetwork.com

http://www.openculture.com/freeonlinecourses

Of course, knowing how to read is very helpful but there are many video courses also available on U-Tube.  Yes, you can even learn to read on the internet.

If you are attending one of those schools where the ‘System’ spends an average of 11k or more per student, (U.S. Census Bureau’s Survey of School System Finances), you can augment your learning for free.  Taking internet courses can surpass the education provided by going to a public school teaching at the level of the slowest or uninterested student.   Grades also limit the availability of courses by demanding education be taught based on the age of students.

The shortage of educated Americans could merely be the result of our population not having a desire to learn.  Many people blame parents, dysfunctional families, and dangerously poor neighborhoods, but this may also be the result of our schools.  Bullies, poor teachers, political correctness, and slow uninteresting courses impede the intrinsic desire to learn.

There are no bullies in the classroom located on the internet.  No school buses or travel along mean streets is required when a student can log in from home, apartment, or hovel if internet access is available.  The internet also provides untainted courses lacking the indoctrination and brainwashing offered by many local public schools.

Sure you can easily graduate high school at age fifteen …here comes the but…will you have credentials?  For High School in some States, the answer is Yes! (Try Wisconsin).

Can you continue learning?  Absolutely.  Education is still free, (mostly), but credentials are not.  Employers want credentials that demonstrate ‘higher’ learning.  Educated people who have not spent hundreds of thousands of dollars paying for credentials are often considered unqualified.  A growing form of class division is growing in America.  “Uneducated’ people are demeaned by those offering credentials as proof of superiority. This is a paradigm followed by employers who assume only credentialed people are learned. How do they know?  The major successes of individuals who have not completed a ‘credentialed’ degree demonstrate the fallacy of this concept.  Steve Jobs, Larry Ellison, and Dave Thomas are only a few examples.  Still, in the real world, most resumes require a credentialed preamble.

Some people overcome this problem by lying on their resume.  To me, lying demonstrates a significant lack of education, but lying seems an accepted practice zealously performed by academia, politicians, corporations, and most of our media.  The liars usually have degrees and diplomas.

One cost saving option is to seek education, (and credentials), from a foreign country.  India, for example, provides a Medical school program taking less than five years and the costs are much lower than U.S. schools.  Almost twenty percent of Doctors currently practicing in the U.S.A. are foreign born and there is a predicted future shortage of medical service providers.

One can also search employment prospects where capability may be more important than paper degrees.  Software, programming, and networking acumen may be areas of interest because home practice and study can improve capability.  Many military schools are also exceptional.  The training may not produce credentials but many employers appreciate the capabilities learned through service and sacrifice. The government supports the costs of continuing education.

A foreign friend once commented, “I would have liked to get a job in the U.S. but the employers want a technical degree to operate a copy machine.”  The bottom line concerning the cost of education is really the cost of buying a credential.  Education may be free but the paper product of a degree is still worth buying if you want to join the ‘educated’ class and gain a good job.  Employers have yet to figure out how to hire based on capability. According to the 2015 Training Industry Report, on average, employees received 53.8 hours of training per year.  Your diploma allows entry into a business where training is required to perform tasks demanded by your employers.

The good news is America still has some of the best schools in the world.

Health Care Reform Helps Insurance Companies Profit

We could subsidize Health Care service providers:

The cost of giving every licensed physician $100,000 would only be $90 billion per year.  This sounds ridiculous and expensive.  Ninety billion dollars spent with no detailed government oversight. People would have to pay co-pays and buy medical insurance without Government assistance.  Poor folk would get the same care without a lot of paperwork.  Dissolving Medicare and Medicaid would allow a free market to sell services for about fifty bucks a month per person. Yes, current payroll deductions would continue in order to augment compensation for all medical personnel relegating catastrophic health insurance to be bundled with car and home insurance schemes.

But:

No one seems to like the idea of giving tax dollars to doctors, nurses, and healthcare professionals.  No…, no, no, we can’t do that–our politicians, (and voters), would rather give insurance companies your tax dollars.  The enlightened goal is to provide everyone with a ‘plan’.  We are fated to accept the voters demand for subsidized health care insurance.

Payment of your medical bills gives dividends to stockholders and companies who are in business to make a profit.  They need to give higher dividends, don’t they?  After all, the yearly compensation for the Aetna CEO was a paltry twenty-seven million in 2016.  Stock options helped a lot.

Our health plans subsidize insurance companies in order for them to make money from your illness.  Sounds harsh, doesn’t it?  Your medical bill – if you can figure it out – includes profit for the stockholders, compensation for insurance sales persons, insurance executives pay, insurance buildings, advertising costs, and finally – your doctor’s salary.  The bookkeeping and bureaucratic overhead alone adds only about thirty percent to your bill.  The government argues that their portion of overhead is low.  That bears some truth because the bureaucratic efforts are made by the providers, (more on that later).  The government must ensure the fair and correct spending of your taxpayer dollars and their oversight requires massive record keeping and the development of forms.  Just remember–the government is here to help… to help…to help.

Some details collected from Justfacts.com:

Roughly, 60 minutes of paperwork are performed for every hour of emergency department care, 36 minutes of paperwork for every hour of surgery and acute inpatient care, 30 minutes of paperwork for every hour of skilled nursing care, and 48 minutes of paperwork for every hour of home health care. “Each time a physician orders a test or a procedure, the physician documents the order in the patient’s record. But the government requires additional documentation to prove the necessity for the test or procedure.”

  • “Many forms … must be completed daily by clinical staff to submit to the government to justify the care provided to skilled nursing facility patients.”
  • Medicare and Medicaid “rules and instructions” are more than 130,000 pages (three times larger than the IRS code and its associated regulations), and “medical records must be reviewed by at least four people to ensure compliance” with Medicare program requirements.
  • “A Medicare patient arriving at the emergency department is required to review and sign eight different forms—just for Medicare alone.”
  • “Each time a patient is discharged, even if only from the acute unit of the hospital to the on-site skilled nursing unit, multiple care providers must write a discharge plan for the patient. This documentation, as long as 30 pages, applies to all patients, regardless of the complexity of care received within the hospital or required post-hospital setting.”
  • In addition to regulation by state and local agencies and private accrediting organizations, hospitals are regulated by nearly 30 federal agencies.

Our government cannot think about giving tax dollars to health care professionals when paper pushers are more necessary to guarantee profits for insurance companies.  The massive government database contains items for every illness to include getting bitten by a duck or walking into a lamppost. They even have an item designation for walking into a lamppost for the second time.  Yes, the government will document your lamppost ‘problem’.

Who pays for all this?  You do.  Does the doctor really make out financially?  The admin persons at the hospital can make more than a surgeon.  Do you want that Admin professional in the operating room?  Don’t worry – admin is always there in spirit.  Someone must ensure the stockholders make a profit.  Is your deductible paid?  How much will the government kick in?  Does the patient ‘plan’ ensure this procedure is cost effective?  Everyone should be concerned with the last statement.  What happens if the procedure is not cost effective?   Does the cost/benefit/risk analysis allow a bone marrow transplant for a patient deemed terminal, (without one)?  Ask the insurance company or hospital admin – the only case I know of concerns a deceased mother of two who did not meet the criteria.

Whatever health care system you like should exclude stockholder dividends.  Your bill should not include a dividend to stockholders gambling on making money from your illness.  Some CEO should not be making millions each year by managing insurance schemes that profit from people requiring medical attention.  People are actually demanding government-sponsored monopolies because politicians tell them there is nowhere else to go and no other method of eliciting professional service.

All hospitals, including Non-profits, currently absorb the costs of services provided to the poor.  (Insurance covers costs in order to make a profit and do not include non-paying patients).  For example: According to the research by the research of Craig Garthwaite, Tal Gross and Matthew J. Notowidigdo, the cost of each poor patient in Tennessee is over a thousand dollars.  The hospitals lose money unless Medicaid shares the burden.  Your taxes pay for that as well.

A single payer plan will allow the Government to ‘help’ everyone by raising taxes and dictating the costs of all benefits.  ‘Medicare for all’ is a mantra for single payer advocates.  Sounds good, doesn’t it?  Cuba and Canada enjoy the benefits of single payer.  You may experience Canadian relatives taking residence in the USA in order to get medical attention but such activities would never happen if Our government took over health care and dictated the compensation to all medical providers.  Our government has a proven and cost effective record of … ‘helping’.  You can relax and feel secure when your doctor enters the operating room and tells you, “I’m from the government.  I’m here to help.”  Hopefully, you can understand the language used.

Twenty percent of our doctors currently come from foreign countries and there is a predicted shortage of doctors in our future but never fear – government insurance schemes will provide succor and it will only cost a couple TRILLION dollars.  Of course, we may have to deal with the government directing our lifestyles in order to keep premiums low and profits, um, manageable. Drinking soft drinks and eating meat may become as unhealthy as owning guns.  Government mandated bicycles could replace electric cars and who would want to go to school for 14 years to become a low paid doctor employed by the government?  A small increase in taxes, perhaps an extra TRILLION, might cover the expense but don’t worry, we can always raise taxes.

Now may we discuss subsidizing the providers instead of subsidizing insurance companies run for profit and controlled by government bureaucrats?

Health Care and the Government

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Not approving Ryan Care was a narrow escape from an increasingly intrusive government that seems bent on controlling every aspect of American lives.

Most people would prefer to see a doctor when they have an illness or physical complaint. They would not willingly take a sick child to an insurance outlet or government building unless they had no choice. (Imagine taking a feverish baby to the DMV for treatment). Yet when you enter the doctor’s office and notice all the busy people that greet you from behind a desk – what do you think they are doing? They are filling out forms and documenting your access to insurance companies and government agencies who dictate the cost of your visit and the care you are entitled to receive.

Countries having high levels of subsidized health care, France and Italy are good examples; require that everyone pay into the government health fund. In America we all pay 1.45% of income, (hiked by an employer tax of an additional 1.45%), into our Medicare system but only people getting Social Security get the benefits. In 2015 the American Hospital Insurance Trust Fund garnered 275 Billion in taxes and spent 646 billion in services for only 15% of the population, (according to AARP).

So the illustration here is that we already have a universal insurance system that is paid into by every worker but the benefits are only distributed to retired people and the outlays for this insurance scheme exceed the inputs by about 371 billion dollars a year. The numbers get MUCH worse as they are analyzed to include every citizen.

Consider, for a moment, what insurance is supposed to provide. Health insurance is supposed to pay for the professional services, equipment, and drugs provided by licensed physicians and hospitals. In order to Control prices and services the government and insurance companies create rules, regulations, and make an effort at price fixing procedures. They require immense databases to achieve these goals and you can appreciate the health code designation of being bitten by a duck as just another line item under their scrutiny. If you think that is a bit complicated, there is another entry for walking into a lamp post. Too much? How about the designation of having walked into a lamp post for the second time?

Clearly we have too many ducks, lamp posts, and regulatory constrictions that are meant to control costs but inadvertently end up controlling lives and behavior.

Since the insurance is supposed to pay for professionals – take a look at what we could do with the 275 billion collected every year:

Give every licensed physician $100,000 …. .90 billion per year.

Give every registered nurse $30,000 ……… 90 billion per year.

Give every hospital $17 million………….…95 billion per year.

I just ran out of Medicare funds at 275 billion but our government spends over 646 billion on Medicare and adds another 546 billion with Medicaid, (2015 numbers). Where does this money come from? The general fund supplies the extra largess – – in case anyone is noticing our country currently has 20 Trillion in debt.

Well what if we doubled the tax rate for Medicare and now garnered an extra 275 billion for:

$75,000 for every licensed Nurse Practitioner…..…..8.3 billion per year.

$45,000 for every Physician Assistant………………3.2 billion per year.

Drug subsidies………………………………….….263 billion per year.

There – everyone in the USA would now be covered to some extent and to receive the subsidies all the accepting parties would have to do is not turn away any citizen from medical services. The government would no longer be in an insurance business where they have proven to be incredibly inept. The Government involvement would be relegated to a disbursement of collected funds to health professionals. The savings in paperwork, regulating, and oversight would actually save about 30% over current medical costs dictated by insurance. If the extra taxes are too big a burden consider paying the extra 275 billion from the general fund while still reducing the overhead by over half a trillion dollars per year.

Nothing is free, however, and the amounts mentioned will still not cover the total expenses. An average doctor’s earnings are about 160,000 per year and how will they make an income – not to mention the pay of specialists who spent years in getting certified?

Co-pays.

Let doctors, hospitals, drug venders, and specialists charge whatever they desire in the form of co-pays. Some doctors in Kansas are charging $50.00 per month for adults and $10.00 a month for children to cover all medical services and they negotiate a discount of over 80% for drugs used by members who pay the monthly service fee. (Only 100 patients would be needed to add 60,000 per year but facilities and staff are still an expense that requires income). Catastrophic insurance can be purchased to cover the large co-pays that may be demanded for major medical services like cancer treatments, transplants, significant surgeries, expensive drugs, or continuing services like dialysis.

In the future, one might see catastrophic health insurance ‘bundled’ with car and home insurance plans. Medicare, Medicaid, and Obamacare would be gone. Only the Medicare tax would remain. Paperwork would be an addition to the IRS tax form.

There is more the government could do of course – Allow health employees, doctors, assistants, etc. to pay minimal or no taxes for example. Tax free health saving accounts and catastrophic insurance sales across state lines could be allowed and perhaps, someday, be offered by employers that allow employees to carry the account privately or onward to new employers.

And what about the poor people who get sick but have no job, pay no taxes, and have no catastrophic health insurance? The poor will always be with us – that is why we paid the doctors up front. No citizen will be denied service by those who promise first to do no harm.

This style of funding should also spur an interest in more people willing to become doctors which are currently predicted to be 90,000 short by 2025.

Concrete and predictable medical costs have proven to be elusive when payments are made by governments and insurance companies. If someone else is paying – the billing is of little consequence to the patient. In this subsidized system, transparent costs would allow patients to seek the best service at the lowest co-pay. No two hospitals charge alike and most patients only get solid costs after services have been rendered.

No one would like to take a car to a mechanic, who never provides an accurate estimate of charges unless they knew someone else was paying, (insurance company). Fortunately, mechanic mistakes can be expensive but are not usually life threatening. Medical services, conversely, are given very little latitude where judgments fail to achieve desired results. Complex problems are weighed in terms of outcome and risks to the patient vs. costs, profits and risks to the insurance providers. Health providers do make mistakes but such errors are often the product of being human where, in the end, we all return to the manufacturer.

How to Repeal and Replace Obamacare and Avoid All the Complaints

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Think about the complaints and concerns instigated by the dire thought of repealing Obamacare:

People would lose the free services provided by Obamacare.

The Government would lose tax income provided by Obamacare taxes.

Democrats will complain and spin any replacement concepts as insufficient – and probably racist.

 

My suggestion is to consider Replacing Obamacare before repealing the act, mandates, and taxes.

Replacing Obamacare with a concrete system would allow all supporters and detractors to review the efficacy of the replacement – before – dissolving Obamacare.  The concerns of replacement aspects will be answered, improvements can be made, and costs can be determined so that health services can be available before the ACA collapses due to an inherent poor design seemingly created for income redistribution rather than health care. The added bureaucracy is astonishing, (and adds about 30% to the cost of health care).

 

The largest issue in this method is cost.  The government would be paying for two health systems during the SHORT time allowed for a comprehensive review.  Still, the added cost can be justified as the price of getting the new system right.  One might note that paying for the medical costs of disadvantaged folk is likely to be a cost in both systems so that should not be considered an additional expense.

The second largest issue is also cost – in terms of lost revenue gained by ACA taxing of citizens already taxed by Medicare.

 

Politically oriented complaints and accusations, name calling, and reports comprised of misinformation and ‘spin’ will be provided by many politicians and media pundits more concerned with gaining self serving power than serving citizens.  Such is the divisive state provided by the last decade of politicians and this proclivity will not suddenly disappear, however, logical and sincere debate should be encouraged for a short period.  Creating another 2000 page series of laws crammed into an Act cannot be allowed.

 

Sounds simple – well, no – but I believe the concept is more reasonable that Repeal and Replace.

What do you think?

Ideas to Support Draining the Swamp

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  1. Delete 30% of all civil service positions.
  2. Limit new regulations and laws to only 2 pages of documentation.
  3. Move the United Nations to a Montana wilderness area. Beautiful setting and a boom for construction in Montana. Attendant countries, diplomats, and administrators would have to pay the local economy for buildings, homes, airports, transportation, and energy. (The current UN building can be employed as a homeless shelter).
  4. Many of those laid off civil service workers can be temporarily employed by deleting or reducing existing written laws to conform to the two page rule. All federal laws should be written so any common citizen can understand the content and desired results of the laws and regulations.
  5. Combine Homeland Security with the FBI and reduce/replace the two top management tiers of most agencies, (CIA, NSA, FTC, EPA, FCC, DIA, DEA, etc.).
  6. Delete BLM, and return 80% of all current Federal lands to the States.
  7. Make English our national language and stop printing other languages at taxpayers’ expense.
  8. Fund inner city Pod transportation for an infrastructure upgrade that will be the envy of the world. (The construction will also provide good jobs for depressed areas and one way to improve inner city problems is to offer a method of escape not provided by local government).
  9. Curtail Request for Changes in existing and future government contracts and ensure that knowledgeable professionals perform design, (not necessarily some military ranking officer with little or no understanding of technical issues). Review the contract process in its entirety. I would suggest a review of the Lockheed Skunk works process that built the SR-71 in 20 months, (1962 and it is still the highest flying, fastest man operated airplane ever built).
  10. Cut existing agency contracts by 50%. Seems harsh but there really is a LOT of fat and it is growing. The personnel cuts in suggestion number 1 will help in this regard. Some contracts may expire under this edict. Good. Rewrite the requirements and issue another contract at a more reasonable price.
  11. Sell unused government buildings or give them away – stop maintaining them.
  12. Exile many criminals instead of incarcerating them – (violence related crimes). Rehabilitate others that demonstrate merit. Long prison terms deserve exile instead of incarceration.  This ‘out of the box’ list comprises only twelve areas of potential improvements. Such changes cannot all be accomplished immediately or simultaneously because of the massive disruption that will be caused by thousands of people losing jobs but when the draining begins, it must be done with a full commitment to lowering the cost and adverse effects of a bloated government. Many more bipartisan opportunities exist. What are yours?