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Title: Blog by Novelist William S. Frankl, MD

Archive for January, 2010

An Alternate Economic Plan For America

Sunday, January 31st, 2010

It is my opinion that the one trillion dollar  “stimulus bill” and the Senate and House  Democrat Healthcare bills will escalate spending and ultimately take this country to a point beyond which most Americans will receive more in government benefits than they pay, an awful way of life.
However, the Republican Party in the House and Senate have devised what they call a “Road Map for America’s future,” which they first proposed in 2008.  The major authors of this proposal are Representative Paul D. Ryan of Wisconsin and Senator Tom Coburn of Oklahoma.  The following are the major elements of the Road Map:

Health Care.  It would restructure the tax code to allow all Americans to obtain affordable health insurance that best fit their needs and would thus shift control and ownership of health coverage away from government and employers to individuals.  There would be a refundable tax credit $2,300 for individuals and $5,700 for families to purchase insurance available across state boundaries and keep their policy even if they move or change jobs. The Plan would also establish transparency in the price of health care and acquisition of  quality data.
State based high-risk pools would make affordable care available to those with preexisting conditions.  In addition to the tax credit, Medicaid would provide supplemental payments to low income recipients so they could obtain their health coverage of their choice and wouldn’t  be confined to Medicaid.

Medicare.  The plan would preserve the existing Medicare program for those 55 years or older.  For individuals under 55, as they became Medicare eligible, they’d obtain a Medicare payment averaging about $11,000 used to purchase a Medicare certified plan.  The payment would be adjusted to reflect medical inflation and the individual’s income, with low income individuals receiving greater support. The plan would also provide risk adjustment so those with greater medical needs would receive higher payments. The plan would fully fund medical savings accounts, and allow everyone to set up these tax-free accounts.

Social Security.  In the Road Map, the existing social security program for those 55 or older would remain unchanged.  For those under 55, the plan would offer an option of investing one-third or more of their current Social Security taxes into personal retirement accounts, like the Thrift Savings Plan, which federal employees have.  These accounts could be passed on to their heirs.  The plan would make the program permanently solvent by combining a modest adjustment in the growth of initial Social Security’s benefits for higher income individuals with a gradual modest increase in the retirement age.

Tax Reform.  The Road Map would offer a simplified system that promoted a more fair and less complex tax code that would fit on a postcard.  It would have just two rates: 10% on income up to $100,000 for joint filers and $50,000 for single filers, and 25% on taxable income above these amounts with a generous standard deduction and personal exemption up to $39,000 for a family of four with no tax loopholes, deductions, credits or exclusions except the healthcare tax credit.  It would eliminate the alternative minimum tax.  It would eliminate taxes on interest, capital gains, and dividends, thus promoting savings.  It would eliminate the death tax and would replace the corporate income tax with a business consumption tax of 8.5%.

In my estimation, the road map would reduce the national debt, allow business to rebound and grow us out of the recession, stop the growth of the federal government, and restore individual initiative, entrepreneurship, and opportunity.

Is there a  chance the Republican Road Map for America’s Future will be accepted as a blueprint for America? Unlikely, but one can only hope

Two Notable Events in January, 2010

Sunday, January 31st, 2010

There were two notable events that occurred in January. The first was the death of the author, J. D. Salinger, who died at the age of 91. He is best known for his novel, CATCHER IN THE RYE, although his novels (or perhaps best classified as novellas) FRANNY and ZOOEY, RAISE HIGHER THE ROOF BEAM,CARPENTER, and SEYMOUR are considered small masterpieces, as is his marvelous short story, A PERFECT DAY FOR BANANA FISH.

CATCHER IN THE RYE is considered a defining work of what it’s like to be a teenager, and his character in the novel, Holden Caulfield, is a portrait of the quintessential alienated teenager.
Salinger avoided the limelight, indeed becoming a recluse for most of his life. Nevertheless, he was celebrated by the literary world, and CATCHER IN THE RYE is considered by many literary critics as one of the best novels of the 20th century.
The second event is remarkable in its potential to be a major blow to the United States, and make it a secondary power, at best. The Obama budget to be presented to Congress in February contains only a small increase in funding for NASA, effectively killing the Moon and Mars Projects that proposed to put astronauts on the Moon and then on to Mars. Instead, NASA will have “Global Warming” as its major project––– what nonsense! what a disaster!

We are thus leaving space and handing its future over to China, India, and Russia, and possibly others, including private enterprise which can’t possibly marshal the resources and the technical expertise to carry out manned space travel.

Unfortunately, the Obama Administration does not understand that the future of humanity resides in space. The United States has been one of the prime leaders in this field for over four decades. One can only hope that this dreadful decision that will cripple NASA can be reversed in the near future, and America can once again take its place beside other technically advanced nations as one of the great leaders in Man’s journey into our solar system and beyond. Otherwise, our country will be relegated to the dustbin of history.

A Sinking Ship or Just a Bad Storm?

Thursday, January 28th, 2010

January has been a tumultuous month in American politics. The Democrat health care bill continued to roil the Senate.  Corruption ran rampant in “Harry Reid land.” And then came the January 19th cataclysm in Massachusetts where Scott Brown, an obscure state senator (remember Obama?) won the special election for the Senate seat formerly occupied by Ted Kennedy.  Brown beat his Democratic opponent 52% to 47%. And with that, he removed the 60 vote Democrat filibuster proof majority and made likely the demise of the health care bill.

The Democrats went bonkers, scurrying around to fix the blame on each other, the Republicans, and of course the president, who had gone to Massachusetts to campaign unsuccessfully for Coakley, the Democratic candidate.

So, despite 59 Democratic senators and an overwhelming plurality in the House, the future appeared bleak for them.

The president indicated that the reason Brown had won was that he had spent too much time pushing his agenda and not enough time explaining the health care bill to the public. And that he had neglected the pain the people felt about the economy–––unemployment (10%), continued loss of jobs, and the lack of any concerted effort to deal with these issues. And finally he indicated that the same discontent that had led to his election was the same discontent of the Massachusetts electorate that had elected Brown! What nonsense! Brown ran on a platform to: kill the health care bill; oppose cap and trade; oppose the
prolifigate spending by the Congress and the Administration; and strongly backed spending money to buy weapons to protect the public from terrorists but not to pay lawyers to Mirandize terrorists (the ” Christmas Day bomber ” and Major Hasan).
So, on January 27th, President Obama gave his First State of the Union speech before Congress.  For days, the ” talking media heads” had opined that Obama would “tack to the center ” politically and focus on the economy and not health care.  Well as usual, they were wrong.

The speech, in my opinion, was a loser.  It was much too long ––– an hour and 15 minutes plus.  His delivery was flat.  He was patronizing and demeaning to Republicans.  He chastised the Supreme Court (!) for its free speech decision on corporate contributions during elections, warning that foreign companies would now determine the outcome of U.S. elections (totally wrong––– it’s illegal for foreigners to contribute in U.S. elections, and besides that never came up in the Court’s decision).

Obama came across as angry.  He insisted on pushing his health care bill, his cap and trade bill, and an educational program that would end up with the vast majority of the American people paying for the student loans for those opting for a career in government as opposed to those going into the private sector.

He did spend a good bit of time on trying to increase the job sector and cutting spending to decrease the deficit.  But we’ve got a three trillion dollar deficit next year and nine trillion dollars (or more) in 10 years.  So how much is saved by his freeze on spending –––– Oh, somewhere between 15 and $25 billion, a drop in the bucket.  Perhaps the president needs  new financial advisers to help him with mathematics.

There is much more to criticize, but why continue. Obama wishes to totally revamp American society.  He wants to have more and more people working for the government as it gets larger and larger, and for those who aren’t government workers, with chronic unemployment, they’ll all be on the government dole.

Perhaps, November 2010 will help stem the tide.  But don’t count on it.  Republicans are well known to screw up.

An Alternative View of Healthcare in the USA

Saturday, January 2nd, 2010

The Seattle Times (11/25), Dr. John Olsen, past governor for the American College of Cardiology, writes, “We keep reading the same old statistics about the poor quality of healthcare in the United States as a justification for how it needs to be fundamentally changed,” with some of “these notions” having “been cited so frequently that they seem to gain traction simply from their repetition.” Dr. Olsen points out, however, that American medicine has “deciphered the genome and developed dialysis, bone-marrow transplantation, and catheter-based cardiac interventions,” and Americans “can get advanced imaging studies or virtually any laboratory test performed promptly and reliably.” Therefore, he concludes, “amid all the turbulence, let us pause and give thanks for the bedrock of American medicine that is the envy of all the world.”

Healthcare Pork in 2010

Saturday, January 2nd, 2010

The following is adapted from a Dana Milbank column in The Washington Post on December 22nd:

There was an extra cost for the Senate bill – lots of Christmas gifts under their tree, or what could also be called PORK!
Here is what the Obama Administration gave away to get the bill passed – This is our money and it was not listed as part of the cost of the Senate bill! And, we thought those Senators who fed at the trough were standing up for what they believed in. Here is what they got:

$100 million in extra Medicaid money for Louisiana, requested by Sen. Mary Landrieu (D-La.).

$100 million in extra Medicaid money and a “carve out” provision that would reduce fees for Mutual of Omaha and other Nebraska insurers , this time for Sen. Ben Nelson (D-Neb.).

Connecticut got $100 million meant for a medical center in Connecticut for Sen. Christopher Dodd (D-Conn.)

Sen. Bill Nelson (D-Fl.) secured a grandfather clause will allow Floridians to preserve their pricey Medicare Advantage program from cuts imposed in the other states.

Sen. Max Baucus (D-Mont.) secured Medicare coverage for anybody exposed to asbestos – as long as they worked in a mine in Libby, Montana.

Sen. Tom Harkin (D-Iowa) won more Medicare money for low-volume hospitals commonly found in Iowa.

Sens. Byron Dorgan and Kent Conrad, both North Dakota Democrats, will enjoy a provision bringing higher Medicare payments to hospitals and doctors in “frontier counties” of states such as – let’s see here – North Dakota!

Hawaii, with two Democratic Senators, will get richer payments to hospitals that treat many uninsured people.

Michigan, home of two other Democrats, will earn higher Medicare payments and some reduced fees for Blue Cross/Blue Shield.

What socialism means in Vermont: Sen. Bernie Sanders is getting larger Medicaid payments for his state (neighboring Massachusetts will get some, too).

The Senate and House bills must be reconciled and then go back for a vote in the Senate and House

Pelosi and Reid are conferring with each other about how to reconcile the differences between the two bills. It is possible they might avoid a formal conference committee because of the many procedural hurdles to appoint conferees, including Republican opposition and various time consuming matters pertaining to rules and procedures.
So, some sort of “informal” conference committee could be established, bypassing congressional rules. In such a committee a few Senate and House Democrats might literally write a new bill (taking pieces from each of the House and Senate passed bills). Both chambers of Congress would have to approve the new bill.

So, if you like all this, clap your hands and wait for the bill that no one will read and will vote for anyway. If you don’t like this, you and all your friends should flood the phones and e-mail mailboxes of these senators and congressmen urging them to vote against passage of the bill. Who knows? They might even listen to you. But don’t count on it.

William S. Frankl, MD, All Rights Reserved