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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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Term Limits

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Limiting the number of elected terms for Federal representatives seems like a good method of removing long kept public servants who longer serve the public or, in some cases, never served the public.   But who picks the candidates who run for elections to replace the existing congressman or senator?  Limiting the number of terms for any elected representative does not guarantee the replacement will be any different than the existing representative.  Yes, committee controls may be affected but the new candidate could be another denizen of the swamp who will grow to accomplish the same results of the ‘old’ creature who now retires to a lucrative ‘post’ service lobbying position.  My thinking is the concept of term limits is to replace  ‘poor’ representation with an individual willing to perform actual service for his/her constituency.  To be more clear, voters need the ability to select the candidates in order to avoid replacing one miscreant with another shill provided and sold by a party seeking power, not service.

Another point argued by those against term limits is the inception of bureaucratic amateurs replacing seasoned professionals.  This argument may seem specious on the surface but there do exist some honest bureaucrats who are not corrupt, (don’t ask me to provide names).  California has state term limits and the resulting chaos is available for the review of interested people.

Term limits sounds good on the surface but our election process; controlled by campaign money, disinformation, negative propaganda, and a corrupt academia supported by an even more corrupt media needs further analysis in order to avoid making the same mistakes over and over while seeking different results.

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.

Did Jeff Sessions Lie?

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If you ever have to testify in court your legal council will invariably tell you three things.

Tell the truth, answer the direct question, and don’t embellish.

So when you are questioned, “I see that you purchased a Ford automobile and have been using it for transportation during the past two years. Have you had an accident?”

You have not been in any type of accident with your Ford so you answer, “No.”

“But I can show that you were involved in an accident while driving your sister’s Chevy six months ago – Ah HA!” The attack is meant to construe you as a liar.

The news media reports you as a liar. Your representative describes you as a liar on every available news outlet and the Federal Department of Justice is tasked to investigate your lying about personal driving habits and attempting to cover up Chevy fender benders. Cargate becomes a major news story. Ford is implicated in the cover-up.

Watch the questions put to Senator Sessions by Senator Franken.

Sessions did not lie.

Franken already knew that the answer to, “Have you ever met with that ambassador during the last couple of years?” would be, “Yes.” He had to trap his fellow Senator by wordsmithing a question that was contextually specific in terms of driving a campaign, (or Ford), so that it could be construed as misinformation. Of course they were all aware that meeting various ambassadors, (or Chevy’s), is also part of Sessions duties as a Senator.

Biased news agencies, also fully aware that meeting foreign ambassadors is integral to this Senator’s job, also needed a response to an obvious question given in a specific scenario they could employ to demean, smear, and falsely accuse someone of denying an act that was patently obvious and had public witnesses.  The paradox of this demeaning episode is that only dishonest people will construe his answer as being dishonest.

If this makes you fearful about being questioned under oath – just remember three things.

Tell the truth, answer the direct question, and don’t embellish.

Now, tell me, “When did you stop beating your wife?”

Senator Hubris Staff Meeting & Discussions Concerning the DOJ

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Senator Hubris plopped into a padded chair situated at the head of a table lined with sycophant staff members and immediately reached into the basket of croissants placed in front of him.

“Any good news this morning?” he asked around a mouthful of pastry.

“Well, we got the attorney general on the run,” one excited staff member piped enthusiastically.

“I called our press operatives to make sure they report his guilt,” press secretary Bob smiled in satisfaction.

“Is he?” Hubris asked while eyeing the basket.

“Doesn’t matter,” another staff member reported, “he’s guilty until proven innocent.”

“Technically,” Bob hesitated, “he’s completely innocent but we have the media on our side as well as many members of congress eager to play along. Our delays at cabinet membership changes have successfully kept the DOJ populated with our hirelings and they have orders to assure his guilt. We even have support from across the aisle.”

“Support?” Hubris grabbed another croissant.

“Yeah,” an older staff member cleared his throat before continuing, “They knew there was nothing and were very willing to support an investigation of nothing – but we trapped them with this new accusation and now we can hoist them on their own petard, so to speak.”

“Excellent,” Hubris beamed at his brilliant group of cohorts.

“What about research, Sally?” Hubris pointed at the only woman on his staff. “Have we got anything else?”

“We…ll,” Sally hedged by shuffling her papers, “We have a connection where his plane was on the tarmac of an airport at the same time as a passenger plane carrying two foreign ambassadors.”

“Of course!” Hubris pounded the table, “We can accuse him of a clandestine meeting.”

Sally shook her head slowly, “Not sure if we want to link planes on tarmacs with attorney generals and secret meetings. The ice may be a bit thin in that arena.”

“I know what you are inferring,” Bob remonstrated, “and our media minimized the reports on those meetings with our DOJ and besides – the constituents have already forgotten the incident.”

“What about the fact,” an exuberant member repeated himself, “the Fact, I say – that the new AG ate at a restaurant that had immigrant servers with visas originating from the country in question.”

“Huh?” Hubris joined several staff members looks of incredulity.

“Meetings with foreign waiters,” the young man continued, “cunningly made to look innocent but when we question him…”

“Ah…, Did you ever direct orders to foreign nationals during the campaign?” Hubris’ smiled like a Cheshire cat in a Disney movie.

“He’s bound to say no,” Bob leaned back in his chair and dreamily looked at the ceiling.

“Did you accept bribes from foreigners…?”

“A refill of his coffee cup,” Sally chuckled.

“Did you give money?”

“Tipped the waiter, no doubt,” Hubris amazed his staff at being the only person they knew who could sneer in delight.

“I’m really glad we can feed the media with accusations that will drown out that last speech,” Bob pursed his lips in satisfaction.

“Yeah – I was afraid we would have to live with that for over a week,” Hubris agreed.

“I also have some leaks programmed to reinstitute the race factor,” Bob’s assistant finally joined the conversation. “This idea of bringing jobs to the inner city is definitely a racist act.”

“There is a danger in allowing people to get jobs and education beyond our control,” Sally offered some analysis. “Minorities with jobs can move out of the generous havens we provide. They could even buy books and begin reading unsanctioned treatises that talk about humanity, history, and character. We really need to keep people unemployed and dependent. Think of the consequences if all our constituents uncovered the truth. We need to control the minorities and make the others feel guilty. Our power depends on it.”

The entire staff nodded in agreement, save one.

“Huh?” the original speaker remonstrated, “I can tell you as a community organizer that we OWN the inner cities.”

Bob frowned, “I wouldn’t put it quite that way,” he murmured.

“We only control the food, housing, and education,” Hubris instructed. “This administration will never get by our years of academic indoctrination and control of the media.”

“To your credit Alphonse,” Bob turned to his assistant, “we only own the social media and teachers union. We always tell the people they are free to choose among the choices we provide.”

“Well, if you want a riot, Alphonse looked chagrined, “I can get you one.”

“Thanks Alphonse,” Hubris tried to lighten the moment. “You have done an excellent job in the past and rest assured we will call upon you and your peculiar talents quite often in the near future. By the way – I had the bank funnel millions of dollars of ‘penalties’ largess into your social justice organization.”

“Is that legal?” Sally questioned.

“Of course,” Hubris quickly replied. “The funds are a penalty and we put into law a provision to allow penalties to be placed into a slush fund of ‘our’ choosing instead of returning funds to customers who were ripped off by banks and other institutions. You see, it’s not a tax and involves no tax payer monies. It’s even a legal tax deduction for those involved. No political financial constraints or ethics overhead and the only people losing money are those people who were not compensated for being ripped off. And they will never know.” Hubris chuckled before continuing, “We can fund all sorts of organizations and community events, including Alphonse’s group.”

“Thank you, sir,” Alphonse twitched his head side to side in nervous enjoyment, “the demonstrators’ wages have been rising along with the violence requirements.”

“Well it seems our people in the DOJ still have control so is there any other new business?”

The staff became quiet until Hubris directed a question to a small man seated at the far side of the table, “Harry – what about the huge history book that I am writing? Have you finished it yet? Might have to make it into two books with all that stuff I gave you, eh?”

Harry stuttered, “I wrote exactly what you told me but the fact checkers have questioned most of the content.”

“How many pages have I written so far?” Hubris pressed.

“Only ten pages are left but that includes the table of contents which looks like we may be losing another page,” Harry looked down at the table in shame.

“Fire those checkers and put back that content,” Hubris huffed. “What have you got for the back cover dialogue?”

“Its gluten free,” Harry replied, thankful he had something positive to report.

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?