Monday, January 25, 2010

We The People

Politicians have certain protocols to follow if they are seeking election. Massachusetts Attorney General Martha Coakley thought these protocols did not apply to her when she ran for the U.S. Senate seat formerly occupied by Ted Kennedy. In a weird way, I can see why.

Coakley, a Democrat, was (1) running in the bluest of states and (2) was running to fill a seat held by a Kennedy (a family which is as traditionally Democrat as they come). Her election into the U.S. Senate should have been a slam-dunk, to say the least. These conditions probably gave Coakley an invincible feeling, so much so that she became her own worst enemy by operating her campaign as though her election were a "sure-thing".

Coakley didn't learn from the mistakes of Secretary of State Hillary Clinton. She didn't learn that in order to be elected, you actually have to be likable. She publicly stated she had no interest in shaking the hands of Massachusetts's voters "outside in the cold, in front of Fenway Park". There was a photo distributed of her helping a man who had fallen down near her. She was demonized as a politician who lacked sympathy for her fellow man.

But her biggest gaffe came when she referred to Curt "Bloody Sock" Shilling as a Yankees fan. Running for the U.S. Senate in Massachusetts and implicated one of the Boston Red Sox's most beloved pitchers, a pitcher who helped lead the team to their first world series championship and ending an 86 year drought of being a fan of their arch rival and most hated nemesis. When I heard this sound bite, I knew whoever this candidate, whoever she was and whichever party she was affiliated with, was dead in the water.

Coakley showed her electorate that she is out of touch with the people of Massachusetts and by no means a humanist. Was it really a surprise that she lost this election? That Ted Kennedy's seat in Congress has been relinquished to the opposing political party and Hell hath frozen over?

For those readers who believe this election was another referendum on President Obama, I cannot completely consider it so. Coakley committed too many gaffes to solely contribute this historic change to the policies and agenda of our current President. But it does demonstrate one important trend in America;

"We the people" are beginning to become mobilized and involved in politics again. "We the people" are growing weary of the career politician who is more concerned about special interests than those of the people he or she represents. "We the people" are educated. "We the people" are making our voices heard. "We the people" are reminding our elected officials they work for us and they serve as we see fit.

Senator Scott Brown understood this. He told the people, his seat was not that of Ted Kennedy, but it was "the people's seat". More and more Americans are beginning to realize that every seat belongs to US; to the populous that makes up the United States.

This is a very proud time for us as Americans. More individuals are becoming involved in politics, more people are registering to vote, more people are actually voting, and incumbent politicians (and all politicians) are realizing they are held accountable for their actions. We are seeing a trend in American politics that I have always wished to see; the demise of the politics of apathy. And if this trend can be attributed to the election of President Obama, then this may be the only "change" I can stand to support.

Wednesday, November 11, 2009

Part II: Incentivizing Health Care: Another Solution

This is not the first time I've addressed the health care reform package that President Obama is championing. However, today I feel a little bit torn about it.


The conservative and the economist inside of me knows that if this health care bill passes, it will dramatically change our health care system as we know it. As I have previously stated, a government option that offers health insurance with lower premiums than private insurance will eventually lead to the end of private insurance as we know it.


And that's where I'm torn. Private insurance companies, by design, were intended to help individuals obtain health care when they need it most and not avoid bankruptcy for doing so. But recently, it seems that health insurance companies are more worried about their bottom line profitability.


And that's what has always scared me (and maybe even you) about health insurance companies and the health care system. It's part of the reason I avoid hospitals at all costs and minimize my dealings with health insurance companies. I'm always afraid of something being considered a "pre-existing condition" or a procedure not being covered by insurance.


As much as I despise the rhetoric of the Obama administration and the Democrats who are fighting for this health care bill, I have to admit I have heard these horror stories more than once; people being dropped from health insurance coverage or being denied a life-saving surgery because a health insurance company considers such a procedure as "experimental".

Some pressure needs to be put on these insurance companies, but not so much that it will cause them to fall like a house of cards. Insurance companies are essential to health care. Without insurance companies, who pay for the full cost of health care (minus premiums and out-of-pocket costs), essential medical advancements will discontinue. Scientists don't research and develop advancements in health care because it makes them feel better about themselves, they do it in part because the procedure will net them a return on their investment (as well as recognition and fame).


Some action does need to be taken to correct the problems with insurance companies addressed in Part I of this column. One of the first steps in correcting this problem is to introduce a national not-for-profit (NFP) health insurance company. This company will not be publicly traded and will not seek to exclude the "uninsurable" to retain profitability. In essence, it would act much like heath insurance companies were originally intended to act.


This national NFP insurance company would have lower premiums (due to a minimized focus on profit) and would entice individuals (both healthy and sick) to obtain coverage with this new company. This would increase competition with other health insurance companies, making private insurance companies decrease their premiums to appear more attactive to consumers.



There are currently local NFP health insurance companies. All I'm arguing for is a national NFP insurance company that everyone could be insured with. Have the government provide this company with additional tax breaks (more than the traditional 501(c)(3) not-for-profit) so a local NFP establishes itself nationally to compete with the private insurance companies. This government investment would be a considerable amount less than the current price tag of the bill in the Senate. With this private solution to the market problem, a government solution would not be needed (i.e., the proposed health care bill). Let me be clear, this is not a government run health insurance company, this is a government incentivized private health insurance company.



If the government still wanted to mandate health insurance coverage, they could. If the government mandates that all insurance companies have to accept applicants, regardless of pre-existing conditions, it would probably just mean more business for the NFP health insurance company.


With an NFP insurance company that has lower monthly premiums, more individuals with less income would be able to afford coverage. The government could even further incentivize the success of the NFP health insurance company by offering individuals that take out coverage with the NFP a tax break or rebate for their coverage. The government could go further and still create a government run option so long as the option was designed only for those individuals who fit between the gap of those covered by Medicaid and Medicare and those who can afford the NFP insurance company premiums (an even smaller subset of those estimated to benefit from the health care bill). This way, only these individual can obtain coverage under the government run plan and people could only obtain coverage if they meet income qualification criteria.


The point is, rather than push forward a bill that is very cumbersome and dramatically reforms our current health care system, our Legislature and President both need to look at incentivizing better health care rather than legislating it. The price we would pay for incentivized care is far less than we would pay for the heath care bill as it stands.

Part I: Incentivizing Health Care: The Problem with Health Insurance Companies

Let's face it; there's money in medicine. When was the last time you saw a doctor (not a medical student) driving anything other than a Mercedes Benz, BMW, Jaguar, Volvo, or another expensive car? We spend a great deal of our gross domestic product on health care; everyone knows that. But the problem is we have too many people trying to extract profit from our health care.



The biggest culprit today, and the focus of the health care bill, are the health insurance companies. The purpose of insurance companies is to allow people to pay a small premium so that if a qualifying event were to occur (auto accident, surgery needed), an individual would have that event covered.



People can provide insurance for themselves; it's called self-insurance. The problem is people are reluctant to self-insure but at the same time want to avoid risk.





One of the first things I learned in Economics 101 was about self-insurance. If people were to take the same amount of money they paid in health insurance premiums and just save it (or invest it), if a qualifying event were to occur, they would be able to cover themselves. The problem is (as mentioned above) people are reluctant to self-insure. The growing account balance is too much to resist and people are tempted to use that money for things other than health care. So people who are risk averse elect to pay health care premiums and essentially never see that money again until a qualifying event occurs.



But because health insurance companies have a responsibility to their shareholders to remain profitable, their best interests are not your best interests. Your best interest is to have that life-saving surgery or receive treatment for what they call a "pre-existing condition". Their best interest is to (1) extract the maximum amount of money from you without you dropping their health insurance or (2) cover your health care costs as long as the premiums you pay are greater than what you cost the company.



But insurance companies don't just charge monthly premiums; that was just not enough. Never mind you pay them anywhere from $100 to $1,000 in premiums every month, if you do get sick, need prescription medicine, or go to a doctor, you have to pay a co-pay. If, God forbid, something life-threatening happens to you, then you have an out-of-pocket expense that is paid in addition to your premiums. Even worse, if something else life-treatening happens to you in the same year, then you pay more money to hit your maximum out-of-pocket expense and then insurance benefits cover 100% of the remaining costs of health care. Exactly how much money should we pay to a company for our health care?



When you add that insurance companies drop the coverage of select individuals because they are "uninsurable" (which means they can't turn a profit on them) and do not cover some "experimental" procedures, it just adds more evidence that the insurance market has had a breakdown.



Insurance companies had to fight moral hazard (when people abuse insurance programs with the overuse of health care) by introducing co-pays and out-of-pocket costs. This was because there was no disincentive to seek medical care anytime someone thought they needed it. Introducing a co-pay makes people forfeit more money to seek medical care. Insurance companies made the co-pay small enough so that it wouldn't completely dissuade people from seeking needed medical care, and large enough to stop people from seeking medical care for trivial ailments). Since insurance companies were first created to help people insure themselves against bankruptcy in case of a medical emergency, their incentive changed to consistently being profitable once these health insurance companies became publicly traded (and had share holders to keep happy).



A capitalist government is supposed to step in and correct a market problem with either policy or incentive. But the incentives in the health care bill are the ones being discussed today. The health care bill will create an incentive for healthy individuals to switch from their private or employer provided health insurance to a government option because it will, no doubt, be cheaper than their current health insurance premiums.





Another main concern of the health care bill is that, much like the health care plan in Canada, a government run health insurance plan will result in long delays for care. Some estimates say it may take 6 months for someone to receive care for a pre-existing condition. However, emergency care will be provided on an emergency basis. That being said, healthy individuals will worry less about the long waits for health care, as select the government plan in order to capitalize on costs savings on health insurance premiums. The healthy individual will only care about the speed of which emergency care is administered (which will be the same as under any health care plan) as they will not require regular or frequent doctor's visits. Only (1) the individuals with pre-existing conditions and (2) the sickest individuals that have private or employer provided health insurance will avoid the government plan. This will cause the same death-spiral of health inurance discussed in one of my previous columns.



Previously, I argued that the best solution is to put the uninsured on an expanded Medicaid program. However, this may not necessarily address the problems we have with insurance companies. The biggest problem I've identified with insurance companies is that they are profit-seeking companies because they are publicly traded. My solution to this problem will be discussed in Part II of this column.

Thursday, November 5, 2009

Breaking Down the Election Results

The election results from Tuesday have people on both sides of the political spectrum talking. The Right and Left are debating if the election results are a referendum on President Obama.

I initially thought the election results demonstrated the voters have shown their dissatisfaction with the President's policies. However, after doing my research, I've come to the conclusion that you can't make that conclusion from this past Tuesday's election results. Here's what I found.

I looked at the three major elections covered Tuesday night. They were the Gubernatorial elections in New Jersey and Virginia and the election in New York Congressional District 23. I first had to ask myself if these states were traditionally blue or red states (traditionally Democratic or Republican) as this should play a large role in each respective election.

New Jersey is a traditional blue state where Democrats over the past two decades have enjoyed a 10 to 15 percent advantage over Republican opponents. I must admit a Republican win in this state is a very impressive one. In New Jersey, Chris Christie (R) defeated John Corzine (D) with 49% of the popular vote to Corzine's 45%. This is the only election from Tuesday that may resemble a referendum of Obama.

Virginia traditionally slightly favors Republicans over Democrats, making Virginia a red state (or really, a pink state). Over the past two decades, Republican candidates in Virginia have experienced only a 1 to 5 percent advantage at the polls. But if you look at the 2008 Presidential election, you will see that Virginia was one of the states Obama won (with 52.7% of the popular vote). Obama's win in Virginia in the 2008 Presidential election marked the first time in 44 years that a Democratic Presidential candidate has carried the state. Obama's win in Virginia was more of a referendum (of former President Bush) than Bob McDonnel's (R) Gubernatorial win in Virginia could be considered a referendum of President Obama. In essence, McDonnel should have won this election and did so in landslide fashion (winning 59% to 41%). The recent elections results show me Virginia is moving from a slightly red to swing state status.

Lastly there is the election in New York's 23rd congressional district. In this race, Bill Owens (D) defeated Doug Hoffman (Conservative Party) for New York's seat in the U.S. House of Representatives. This was a highly contested seat as the 23rd congressional district has been traditionally Republican since 1993. The only reason this seat was up for grabs was because President Obama appointed the sitting Congressman, John M. Hughes (R), as the Secretary of the Army leaving a vacancy.

New York is one of the most heavily fortified blue states in the nation. Democrats here enjoy an advantage of 20% at the polls. The fact that Secretary Hughes maintained this district for 16 years is very impressive and most likely a testament to the work he accomplished for New York. In one of the bluest of blue states, where Democratic candidates enjoy a 20% advantage in the polls (exception to Secretary Hughes), was it really a surprise that Bill Owens (D) won the race? He defeated his challenger with 52.03% of the popular vote (Doug Hoffman received 47.97% of the popular vote). The fact that Hoffman was so close to Owens does not necessarily hint towards a referendum of President Obama, but may mean the district kept some loyalty to the Republican party after Hughes vacated his seat.

Needless to say these three elections boast some referendum qualities, but the others do not. The data is so inconclusive, I wonder how some people can consider these elections a referendum on President Obama. I'm conservative and not even I can make that leap.

The point is, people have tried to read too much into this election and are making predictions as to the results of the 2010 midterm elections. Only time will tell what will happen and although I anticipate Republicans winning back some seats in Congress, using this election as a litmus test for President Obama's policies goes a bit too far in my opinion.

Thursday, October 22, 2009

I Should Never Be A Sports Writer

Very rarely do politics and sports intercede (the last time was the Mitchel report about steroid use in baseball), but when they do, I sometimes feel the need to jump ship from politics and take my soap box in the sports arena.

Senator Orrin Hatch (R-Utah) recently asked President Obama to investigate the Bowl Championship Series under the Sherman Anti-Trust law. This may be one of the first truly bi-partisan efforts that I can fully stand behind. Quite frankly, Senator Hatch might be a genius if he pull this off.

We all heard President Obama say that if he was elected President he would "throw [his] weight around a little bit" to influence a college football playoff system. Well, Mr. President, this is one campaign promise I do not want you to break.

Senator Hatch represents Utah, where his home school (the University of Utah) went undefeated last year, yet was passed over by the BCS system to play in the national championship. Instead, Florida and Oklahoma were invited to play in the national championship game.

There has always been a cloud of controversy surrounding how the BCS championship game is selected. There are "BCS conferences", conferences whose teams get automatic bids to participate in top-tier bowl games where non-BCS conference teams do not. Teams that play in the top-tier bowl games receive more exposure, revenue from ticket sales, and have a better advantage when it comes to recruiting and transferring ticket revenue to less popular sports.

Senator Hatch argues the BCS violates anti-trust law because the system "has been designed to limit the number of teams from non-privileged conferences that will play in BCS games". He adds the BCS system "artificially limits the number of nationally-relevant bowl games to five. The result is reduced access to revenues and visibility which creates disadvantages to schools in the non-privileged conferences."I completely agree with Senator Hatch's claims. The BCS system is inequitable by discriminating against schools from weaker conferences.

The call for change is nothing new. Some say the regular season acts as the playoff system in that every game is equally important to your post-season success, but in my opinion a playoff would show which teams can play better against better teams. Pretty much every major conference team schedules teams from weaker conferences, like the Sun Belt (a garbage conference) or even Division I-AA teams (like EKU and Morehead) to get more wins and become bowl-eligible. That's like Middlesboro and Bell County playing West Jessamine Middle School to get more wins and pad statistics. But because it's the norm and the culture of college football programs today, no one really questions it. [On a side note, as much as I dislike them, a big kudos to USC for playing both Notre Dame and Ohio State on the road and coming away with wins; watch them in the BCS bowl picture this year.]

In the BCS system, strength of a team's schedule determines better teams. This may be the case, but what about teams that get hot late in the season that could really do some damage in the playoffs? Sometimes it just takes a few games for a team to hit their stride. Does this mean that the teams that play the best football late in the season are less deserving to play in the title game if they have a loss or two? What about a good team that has a late season loss (which hurts the team more than an early season loss under the BCS computer system's analysis). A playoff allows any doubt as to the supremacy of a team to be removed.

If you make a playoff system for college football, that is a significant increase in funding for school athletics programs. Most people suggest a 16 or 8 team national championship playoff, which I support. Other teams that qualify for bowl games would still receive a bowl but, just not a bid to the national championship playoff. More games equal more money for schools and an uncontested national champion. None of this "split national champions" shenanigans that we've seen recently (LSU and USC in 2003-2004, for instance).

In America, sporting events and sporting merchanide is a major component of our economy. President Obama would be wise to start throwing his weight around now and call this his second "stimulus package". Instead of creating jobs by spending money, he would create jobs and stimulate some spending just by asking the BCS to abolish their current system and just add a few extra games to the post-season. I know I wouldn't mind a few more weeks of football season. In fact it might be one of the things I might praise President Obama for.

Friday, October 9, 2009

This Nobel is "Prized" No Longer

On Friday, October 9th, 2009, it was announced by the Nobel Committee that President Obama was the winner of the Nobel Peace Prize. This is quite an accomplishment for anyone to achieve, especially our President.

But something is amiss here. How could a President who has been in office for less than a year receive an award that is based on the actual work of an individual to bring peace to the world? Did I miss something? Did President Obama help diffuse racial problems in East Chicago? Did he solve the conflict-diamond problem in Africa? Did he personally propose and champion legislation as a Senator that removed the United States from all foreign wars? Is he the reincarnation of Mother Theresa?

There's a lot that we don't know about President Obama, but I seriously doubt that we missed his appearance in the movie, Superman IV: The Quest for Peace. Quite frankly, I think Superman or even Christopher Reeve deserves the Nobel Peace Prize before President Obama does.

What has President Obama done to promote peace in his relatively short time as our Nation's leader? He may have traveled across seas to talk to some heads of state and walked out of a United Nation's address by President Ahmadinejad (so did a lot of other world leaders), but that's normal business for the President (even Bush). So surely these cannot be the criteria for the Nobel Peace Prize!

President Obama is currently in two wars. Doesn't this seem to be a disqualifying characteristic for the Nobel Peace Prize. Granted they are inherited, but nonetheless, should you win a peace award when you are Commander in Chief of a nation at war?

When you look at Nobel Peace Prize Laurettes, one name that is missing and should be included is Mahatma Gandhi. He never won a Nobel Peace Prize and he starved himself for India's independence from Britain. That's a lot more work towards peace than just succeeding President Bush (which I assume is the reason Obama is receiving this award).

It has been publicized that the Nobel Peace Prize was awarded to President Obama based on the "potential" he demonstrates to bring peace. I'm sorry, I didn't know that awards were made based on how good you "might" be. I guess that means competitive sports are finished. We can just award a trophy/championship to the team that starts their respective season ranked above all other teams.

And what's more damning is that the Nobel Committee's deadline for Peace Prize candidates is February 1st. President Obama would have been in office for less than two weeks. That's hardly enough time for Obama to clean the Oval Office and settle in. This further justifies my believe he received the award simply because he succeeded Bush.

The point is, currently we don't know what type of legacy President Obama will leave behind, but I do know that there hasn't been enough done to justify him receiving this award. I don't care if he began making friendly with Muslims; he has just started his work and nothing has come of it. In my opinion, this is just proof that the Nobel Committee either has a severe Liberal bias or a severe Obama bias. Quite frankly it tarnishes the Nobel Peace Prize to award it based on the "potential" someone has to do good rather than the actual good he or she has performed.

I'm not saying that President Obama doesn't have the potential to win the award, I sincerely hope he is capable of establishing peace in the Middle-East. But until that work is done, awarding this prize to President Obama is disrespectful to the work of the men and women who received the award in years past.

Friday, September 11, 2009

Just the Facts, Mr. President

Politicians often rely on half-truths and blatant lies to sell their policy ideas. President Obama is no exception. After hearing his address to Congress regarding his health care plan, there are some half-truths and lies that need to be dispelled. Here is a list of them:

(1) President Obama will not sign a bill that "adds one dime to our deficit either now or in the future. Period." Verdict: Half-truth. First, there is no final version of the bill, just versions that are being kicked around and amended (probably as you're reading this). Second, the House Democrat's version would add $220 Billion to the deficit over 10 years as determined by the Congressional Budget Office (which is a non-partisan agency). Democrats say they don't have to claim $245 Billion dollars of the price tag because, and here's where it gets confusing, Democrats already decided to exempt the adjustment of the Medicare reimbursement rates from Congressional rules that require programs to be paid for. Simply put, they decided this doesn't have to be paid for because they decided it doesn't have to be paid for.

(2) President Obama has pledged not to cut Medicare benefits under his plan, but reduce Medicare payments by more than $500 Billion over 10 years. Verdict: Half-truth. The cuts proposed would disproportionately hit Medicare Advantage (which is operated through private insurance companies). Experts believe that a cut of this magnitude will reduce benefits for the 25 percent of Medicare users covered through Medicare Advantage. Supporters of Obama's plan counter that the cuts can be absorbed by improving how Medicare operates and would only reduce the waste, fraud, and abuse of the current system. Any overall affect is largely unknown.

(3) President Obama stated there are 30 Million people who cannot get coverage. Verdict: Close. Depending on which report you look at, the number of people who cannot get coverage varies. Previously, President Obama suggested there are 46 Million people who cannot get coverage, but this is probably an overestimate because it captures those young and healthy Americans who forgo getting health coverage to save money. The 30 Million individuals he used in his address come from the Kaiser Commission on Medicaid and the Uninsured, whereas the 46 Million figure he previously used comes from census data. The 30 Million is the actual target of the program, because these are the individuals that cannot afford insurance because they are poor or near poor.

(4) President Obama argues that preventative medicine 'makes sense, saves money, and saves lives' (paraphrased). Verdict: Lie and a Truth. Not all preventative care saves money, but does save lives. Studies have proven that the specific types of tests mentioned during his speech (colonoscopies and mammograms) cost more money than they save. Detecting acute diseases like breast cancer in the early stages of the disease involve testing many people who would never develop the disease. The costs incurred for a large number of tests, even if they're cheap, outweigh the costs of caring for the minority of people who would have ended up with the diseases without testing. The Congressional Budget Office even agrees that "... for the most preventive services, expanded utilization leads to higher, not lower, medical spending overall". President Obama was right about saving lives, but was wrong about saving money.

(5) President Obama informed the people that changing jobs or starting your own business will not impede you from getting health coverage. Verdict: He phrased it wrong. In the President's speech, he endorsed mandatory health insurance coverage for all individuals (an approach he did not embrace as a candidate). Given his position, in his speech he should have stated, "If you lose your job or change your job, you will have to get coverage. If you strike out on your own and start a small business, you will have to get coverage" (rather than using the words "will be able to get coverage" in his original speech).

(6) President Obama has stated that nothing in his plan will require us or our employer to change to coverage or the doctor we already have. Verdict: Correct at face value only. The current version does not guarantee that people can keep their current coverage. Employers elect sponsor coverage for most families, but under the current bill, employers would be free to change health plans in ways that employees may not like or decide to drop health insurance benefits altogether. The Congressional Budget Office analyzed the House Democrat's version and decided that by 2016 that some 3 Million people with employer-provided health care would lose coverage when employers drop health insurance in order to save money.

(7) And lastly, the comment that stole the show. President Obama stated that his reforms would not apply to unauthorized aliens, to which South Carolina Republican Joe Wilson shouted "You lie!" from his seat. Verdict: You decide. The bill specifically prohibits federal money to be spent on non-citizens. However, illegal immigrants could buy private health insurance, as some do now, but won't receive any tax benefits. However, it has been argued that the system proposed under the bill does not have appropriate citizenship verification requirements in place to ensure illegal immigrants do not capitalize on the program.