Monday, October 26, 2009

Health Care Reform Plan Submitted For Your Approval

Selected key features of this plan:

- Requires employers to provide adequate health insurance for their employees, who would share in underwriting its costs. This approach follows precedents of long-standing under which personal security--and thus national economic progress--has been enhanced by requiring employers to provide minimum wages and disability and retirement benefits and to observe occupational health and safety standards.

- Includes certain deductibles and coinsurance features, which would help keep costs down by encouraging the use of more efficient health care procedures.

- Workers and unions would have a direct economic stake in the program (which) would serve as an additional built-in incentive for avoiding unnecessary costs and yet maintaining high quality.

- The national standards prescribed, moreover, would necessarily limit the range within which benefits could vary. This provision would serve to sharpen competition and cost-consciousness among insurance companies seeking to provide coverage at the lowest overall cost.

- Any time the Federal Government, in effect, prescribes and guarantees certain things it must take the necessary follow-through steps to assure that the interests of consumers and taxpayers are fully protected.

- Accordingly, legislative proposals have been submitted to the Congress within recent weeks for regulating private health insurance companies, in order to assure that they can and will do the job, and that insurance will be offered at reasonable rates. In addition, States would be required to provide group-rate coverage for people such as the self-employed and special groups who do not qualify for other plans.

- Another vital step in my proposed program is the Family Health Insurance Plan which would meet the needs of poor families not covered by the National Health Insurance Standards Act because they are headed by unemployed or self-employed persons whose income is below certain levels.

- Medicaid would remain for the aged poor, the blind, the disabled and some children.

- Beyond filling gaps in insurance coverage, we must also turn our attention to how the money thus provided will be spent---on what kind of services and in what kind of institutions.

- It brings together into a single organization the physician, the hospital, the laboratory and the clinic, so that patients can get the right care at the right moment.

- Utilizes a method of payment that encourages the prevention of illness and promotes the efficient use of doctors and hospitals. Unlike traditional fee-for-service billing, (it) provides comprehensive care for a fixed annual sum that is determined in advance.

- Under this financial arrangement, the doctors' and hospitals' incomes are determined not by how much the patient is sick, but by how much he is well.

- Ought to be everywhere available so that families will have a choice between these methods.

- One of the greatest hazards to life and health is poverty. Death and illness rates among the poor are many times those for the rest of the Nation. The steady elimination of poverty would in itself improve the health of millions of Americans.

- Includes the following measures to extend health care to more Americans--especially older Americans-and to control costs:

Additional Persons Covered:

--Persons eligible for Part A of Medicare (hospital care) would be automatically enrolled in Part B (physician's care).

--Medicare (both Parts A and B) would be extended to many disabled persons not now covered. Congress (should) eliminate (Medicare part B's) monthly premium payment and finance Medicare coverage of physician services through the social security payroll tax. This can be done within the Medicare tax rate. If enacted, this change would save (billion$) annually for older Americans and would be equivalent to a 5 percent increase in social security cash benefits.

- The overall health program encompasses actions on three levels: 1) improving protection against health care costs; 2) improving the health care system itself; and 3) working creatively on research and prevention efforts, to eradicate health menaces and to hold down the incidence of illnesses.

- A truly effective national health strategy requires that a significant share of Federal research funds be concentrated on major health threats, particularly when research advances indicate the possibility of breakthrough progress.

- Working together, this Administration and the Congress already have taken some significant strides in our mutual determination to provide the best, and the most widely available, health care system the world has ever known. The time now has come to take the final steps to reorganize, to revitalize and to redirect American health care--to build on its historic accomplishments, to close its gaps and to provide it with the incentives and sustenance to move toward a more perfect mission of human compassion.

- If the Administration and the Congress continue to act together--and act on the major proposals this year, as I strongly again urge--then the 1970s will be remembered as an era in which the United States took the historic step of making the health of the entire population not only a great goal but a practical objective.


That's correct. The 1970s. In fact, the above excerpts are from a speech by President Richard Nixon to Congress on March 2, 1972. To read the entire speech, click here.

Congress never acted upon these proposals.

President Nixon. A closet progressive? Unlikely. A Democrat in Republican clothing? No. My political cynicism tells me that this was part of his 1972 campaign for re-election, as well as an attempt to co-opt support for Senator Ted Kennedy's even more far-reaching health care reform plans. My political idealism tells me that the President must have had the best wishes of the American people in his heart, at least some of the time.

Had Congress enacted just a few of President Nixon's health care reform initiatives, then we could have avoided at least some of the heated national debate (angst?) through which we are suffering today.

While reasoned debate is healthy for a Republic, when what should have been dialogues allowing for the free flow of opinions and information concerning two or more sides of an issue, such as health care reform, become angry one-dimensional shouting monologues (see many of the town hall meetings held this summer), then disparate venues for discourse must be explored and used.

Friday, October 2, 2009

Good Economic News From Chile

Today's Santiago Times provided a sign of hope that the worldwide recession may finally be abating. An article entitled, CHILE ANNOUNCES 4.3 PERCENT BUDGET INCREASE FOR 2010, opens with, "While other nations are struggling to cut costs and sacrificing social programs to combat the worldwide economic crisis, Chile´s 2010 budget will grow by 4.3 percent next year and includes a 5.8 percent increase in social assistance programs, Finance Minister AndrĂ©s Velasco announced Wednesday."

The next sentence does give one pause: "The 2010 budget - proposed by Velasco this week - follows news that unemployment appears to have stabilized at 10.8 percent for the second consecutive month." Of course, the official U.S. unemployment statistic is now 9.8%, and I heard on CNN today that if you include those unemployed folks who have either exhausted their unemployment benefits, or who have taken part-time work in place of the full-time jobs they used to have, the figure rises to 17.2%.

But back to Chile. The remainder of the article is as follows:

"Velasco said Chile will meet budget its responsibilities and be one of the nations to most quickly recover from the world economic crisis because, “We were well prepared.”

Under Velasco´s guidance, President Michelle Bachelet’s government implemented a strict savings plan when the economy was soaring due to high copper prices a few years back. That decision was highly criticized by opposition parties at the time (and some within the governing Concertacion coalition), but proved to be a very wise decision. The surplus that accumulated allowed Chile to continue with social programs, increase stimulus spending and provide assistance to the most vulnerable through the tough 2009 fiscal year and on into 2010.

Velasco proposes a balanced budget for 2010 with a 4.3 percent spending increase compared to 2009. Spending focuses on education, social needs and increasing economic activity. The finance minister is projecting a 5 percent growth in GDP.

The budget allocates over US$7 billion to infrastructure spending to build sports and cultural facilities, roads and housing throughout the country. The Health Ministry alone will spend US$5.9 billion, an 8 percent increase over 2009, to build 31 new hospitals, among other projects. That will bring the number of hospitals built under Bachelet´s government to 90, a promise made during her campaign.

Education funding will increase for the third year in a row and represents the largest block of spending in the 2010 budget. The nearly US$8 billion will in part be used to double, from 30,000 to 60,000, the number of laptops awarded to the country’s best performing 7th graders. There are also increases in grants for students to study English, computer sciences or technical fields and those wanting to complete post graduate studies abroad. Velasco stressed that education spending is key to Chile’s future growth, stating, “A good education is a priority for today, not tomorrow.”


The key is Velasco's quote, “We were well prepared.”

A successful business plan should include a budget line item for Bad Debt. This covers customers to whom the business extended credit and who could not pay off their debt, accounts receivable that the company has to settle for less than 100% of the total due, et cetera. The Chilean government should be praised for its economic foresight. Citizens of Chile are now going to reap the rewards of this thinking.

Could the U.S. federal government do the same? The answer is not as simple as it seems. We have voluntarily taken upon our shoulders international responsibilities that a country such as Chile is neither equipped, nor inclined, to accept. Let's hope that the citizens of the U.S. will likewise reap the rewards of that thinking.