An Idea for Real Healthcare Reform

One of the many flaws of the Affordable Care Act is that it increases demand for healthcare but does nothing to increase the supply of healthcare providers i.e. doctors.

An important metric of the strength of a country's healthcare system is physicians per capita which is usually given as the number of physicians/1,000 of the population. According to the CIA World Factbook and similar references, the U.S. had 2.45 physicians/1,000 population in 2011. The left loves to point to European countries as examples for the United States to emulate. For example, France has a physicians per capita of 3.19, Germany 3.89 and Switzerland 4.05. America's number is even less than Uzbekistan's 2.53. Obviously, physicians/1,000 of the population is only one indicator and doesn't tell the whole story but it is significant. 

An important factor in the shortage of doctors in the U.S. has to be the high cost of medical school. Typically, a new American doctor starts his or her career with hundreds of thousands of dollars in student loan debt. To help alleviate this problem, I propose the creation of the Civilian Medical Training Corps which would be modelled after the Reserve Officer Training Corps or ROTC.

CMTC would offer promising American students a full scholarship to a civilian medical school in exchange for five years of service in an underserved region of the country or perhaps a VA hospital. After that, the doctor would be free to practice medicine anywhere they chose but would still be required to donate their time one weekend a month and 2 weeks a year just like a military Reservist. An additional benefit would be they would also be available during times of crisis such as natural disasters. The students would be selected through a national competitive exam. So how much would this program cost? A quick check of the numbers follows.

In order to increase the physicians per 1000 to 3 it would require an additional 170,500 doctors. To do this in 10 years means 17,050 doctors per year at a cost of $3.41 billion which is a little less than 4% of the U.S. Department of Health and Human Services (HHS) $87.4 billion annual discretionary budget. To raise the physicians per 1000 to 4, the cost would be $9.61 billion or about 10% of the annual discretionary budget. This seems to me to be a worthy use of HHS funds.

Would this proposal significantly improve the healthcare system in America? I guaran-damn-tee you it will have a more positive effect than Obamacare's fiddle farting around with the insurance system!

Do Nothing House or Do Nothing Senate? You Decide!

Amid the growing Veterans Administration scandal where allegedly veterans were placed on secret waiting lists and at least 40 reportedly died before receiving treatment, the highly partisan, do nothing, obstructionist, Republican-lead House of Representatives (paraphrasing President Obama here) passed a bill 390-33 to give the Secretary of Veterans Affairs the power to fire anyone found responsible for gross violations. Perhaps something like, oh I don't know, creating secret waiting lists to get the number of those awaiting treatment down in order to meet department goals and receive bonuses? The bill was passed yesterday with both Democrat and Republican support. It was only 3 pages long but when it went to the US Senate, it was immediately tabled. The Senate didn't have the time. Understandably, Senators are very busy and have many issues competing for their time so they have to use their judgement to prioritize what they act on. So what was a higher priority for the US Senate than fixing the Veterans health care crisis? Well for 50 of the 100 Senators (all Democrats), it was writing a letter to the NFL urging them to force Washington Redskins owner, Dan Snyder, to change the name of his football team. Keep in mind, Congress has no say or responsibility for dealings with a private business like the Redskins. Senator Bernie Sanders (I-VT), chairman of the Senate Veterans Affairs Committee and a self-proclaimed socialist who caucuses with the Democrats, explained that they didn't have time to hold hearings or read the bill - the 3 page bill! That didn't stop them from passing the Affordable Care Act without reading it. So have the Democrats learned their lesson or are their priorities just out of whack or both? I'll leave it to the reader to decide for themselves. I think you can guess my position. In the meantime, perhaps some money should be invested in Evelyn Wood Speed Reading courses for all the Senate Democrats so they can get through those pesky 3-page Republican bills coming from the House. But that's just me!

Democrat High Fives All Around for Meaningless ACA Enrollment Number

There is an old military saying, "When you are up to your ass in alligators, it's easy to forget that the original mission was to drain the swamp." For the Affordable Healthcare Act this seems very apropos. The liberals won't remind you but the original goal of healthcare reform was to insure the alleged 40 million Americans who didn't have health insurance. Now for a little math: 7.1 million divided by 40 million is 17.8%. Would most reasonable people consider this success? This is just one of the many ACA "alligators". Even if one believes the number provided by the Obama Administration, there is no way to draw any real conclusions from the enrollment number reported Monday following the end of the first open enrollment period for the Affordable Care Act (aka Obamacare) but that didn't stop the President and his fellow Democrats from crowing and doing a victory dance at a press conference. Funny how Mr. Obama didn't take any questions from the media - as if they would have asked any tough ones. In order for the number to have any meaning, we need to know the details. How many of the 7.1 million didn't previously have health insurance and how many of that number had to replace the insurance that they had and were happy with but lost because the new law 'declared' it inferior? Well the Administration won't tell us. There are many reports that millions of Americas were in this situation. Rand, the highly respected think tank, has determined that 6.3 million Americans lost their insurance due to the ACA. That would mean that only about 900,000 of the 7.1 million are actually newly insured. And how many of those who had to replace their insurance now have higher premiums and higher deductibles? Uh, well we don't know. How many of the supposed newly insured have actually paid their first premium? Again, we don't know but can one really be consider enrolled if you haven't paid? What about the percentage of the 7.1 million enrollees are having their new insurance subsidized by the government or how many people have been added to the Medicaid rolls? Again, no answers are forthcoming. Why not? When you have a program that encompasses one sixth of the U.S. economy, it is essential to set up a mechanism to accurately assess its effectiveness. You need metrics and getting those metrics would have been easy to get, if they had only asked these questions on the website but they didn't? Why? The answer is because they didn't want to know. This is precisely why conservatives hate big government programs like this. One would have to be ignorant, profoundly stupid or an ideological zealot to believe that the enrollment figure is any indication of success at all. If you are among the believers, you now have the facts, so you are down to two choices. So which one are you?

Should Have Used GoDaddy

First impressions are important and I think it is safe to say that www.healthcare.gov blew it. Whether or not you are a fan of the Affordable Care Act (aka Obamacare), the roll out of the government health insurance exchange website certainly gives one reason for concern. So far, America's initial contact with the system via the website has been an unmitigated disaster. The ability to use the site has been very frustrating even to the numerous liberal TV journalists who have tried to access the system on air! In interviews yesterday and today, John McAfee, the founder of McAfee, Inc (the big software security company) said, "The site is hacker's wet dream!" He went on to predict that thousands of Americans may have their identities stolen due to security vulnerabilities in the www.healthcare.gov website. Another interview I heard with a software designer, said the site appears to be poorly designed, badly implemented, and apparently not tested prior to launch. In fairness, the government only had 3 years to have the site built. All this for the incredibly low price of only $394 million according to this morning's Washington Post. Maybe they should have just used GoDaddy.com?