Behind closed door politicking is alive and well! What could we have expected? We elected a bunch of Chicago-style politicians… sneaky, corrupt and nepotic. What I resent is that all the backroom wheeling-and-dealing is going on with our tax dollars. Why does a Floridian have to pay for Nebraska Medicaid? Need I go on?
So it's time to kick the bums out! And I mean ALL incumbents, of both parties. The Democrats need to be booted out for their arrogant, self aggrandizing social experimentation, regardless of the consequences, just to have a “historical moment.” Hogwash! They should be prosecuted for violating their oath of office… protecting the United States Constitution. Instead they are trampling on our citizen rights!
The Republicans are just as culpable. Their own incompetence and shortsightedness has led to this single party majority that we face in the congress and in the presidency. All we need is some Supreme Court staking to the left and we can join the Venezuelans with our own brand of faux-democracy.
What amazes me is that the Republicans are so mealy mouth. Hey wake up! This is not the time to play possum and hope for the best in 2010. This is the time for a Revolution! Walk out of both houses of Congress in protest, NOW, refusing to do ANY business that excludes the US electorate that sent you to Washington. How can you continue representing us constituents if you are excluded from the participative democracy extolled by our Constitution? It’s time for a good old sit-in. Not whining, no one is listening! Sit on the Capitol steps until the ruling party acknowledges that they have hijacked our constitution and its legislative process. If Harry, Nancy and Barack don’t take notice, the national media sure will. How could they not? All of you standing, arm in arm, in solidarity on the Capitol steps would be a monumental photo op. Anything short of this Revolution, you Republicans will also be on the chopping block come next November!
Monday, December 21, 2009
Friday, May 22, 2009
What about the Patient?
All the talk about health care reform coming from all directions! There is President Obama’s proposal, which is simply a mantra to do something for the sake of change. But do what, we ask? We just get a list of platitudes!
Then there are the Doctors and Hospitals, the so called Providers. What do they offer? More platitudes, but with a twist… don’t create problems! This is their hymn for “stay out of our pockets.” As if we didn’t already have a problem?
Next the Insurers and Health Networks put in their two cents (including the government). They claim to be the payers of health care. Uh, really, are they? Where do they get their money to pay with? Their platitudes chant for cost controls! The government adds to the rhetoric, with universal coverage… NOW!
And not to be left behind, there are the technocrats, chomping at their bits for all those trillions of dollars to be spent. Clamoring… “Everything can be fixed if we only had electronic medical records.”
What we really have is a bag full of fighting cats. A lot of noise and if you get too close you’ll end up with nasty scratches.
So what is missing in all this empty discourse? Who will be affected by the hip-slinging proposals? Who will bear the brunt of the statistical one-upmanship? And most important, who will pay for it all?
Well it’s the PATIENT stupid! Isn’t the patient what it’s all about? Shouldn’t all others serve the patient, not their self-interests?
We need a fundamental principle from which to derive what can be done to reform health care in the US, and it isn’t inside that bag of angry cats. We need to define our health care system from within a single principle, and challenge health care purveyors and stakeholders to converge on getting us there.
So what is this principle? Be I so bold to suggest:
Empower the Patient to choose when and what to consume from a patient-centric, market driven health care delivery system.
All else will fall in its natural place!
Then there are the Doctors and Hospitals, the so called Providers. What do they offer? More platitudes, but with a twist… don’t create problems! This is their hymn for “stay out of our pockets.” As if we didn’t already have a problem?
Next the Insurers and Health Networks put in their two cents (including the government). They claim to be the payers of health care. Uh, really, are they? Where do they get their money to pay with? Their platitudes chant for cost controls! The government adds to the rhetoric, with universal coverage… NOW!
And not to be left behind, there are the technocrats, chomping at their bits for all those trillions of dollars to be spent. Clamoring… “Everything can be fixed if we only had electronic medical records.”
What we really have is a bag full of fighting cats. A lot of noise and if you get too close you’ll end up with nasty scratches.
So what is missing in all this empty discourse? Who will be affected by the hip-slinging proposals? Who will bear the brunt of the statistical one-upmanship? And most important, who will pay for it all?
Well it’s the PATIENT stupid! Isn’t the patient what it’s all about? Shouldn’t all others serve the patient, not their self-interests?
We need a fundamental principle from which to derive what can be done to reform health care in the US, and it isn’t inside that bag of angry cats. We need to define our health care system from within a single principle, and challenge health care purveyors and stakeholders to converge on getting us there.
So what is this principle? Be I so bold to suggest:
Empower the Patient to choose when and what to consume from a patient-centric, market driven health care delivery system.
All else will fall in its natural place!
Sunday, March 22, 2009
The Health of Our Health System
For this rant, let me qualify that in a prior career I was a Hospital Administrator and Health Care Consultant… for 15 years. I worked for the New York State Hospital Association as a Hospital Management Consultant. I was the Director for Planning and Management System at Mercy Hospital, a 500 bed hospital in Miami, FL. I was the Vice President of the South Florida Hospital Association, a consortium of 43 hospital located in Date, Broward, Palm Beach and Monroe Counties, serving 50% of Florida’s population.
So with the above pedigree I open this blog thread with the intention of encouraging all casual readers and fervent followers (do you exist?) to comment and voice your opinions. Obvious from the heading of this posting … we are participating in a dialogue about what we see is the state of our current health system. If it’s sick, then how do we treat it? Moreover, can we cure it? Lastly, and extremely important, who does the curing and how will the patient, our health system, pay for its treatments?
I’ll start the discussion on a topic that will provide a foundation for all points of discussion, opinions and pompous prognostications. So here goes…
Is the consumption of health care an “unalienable right” or is it a “welfare right?” The former being described in our Declaration of Independence as endowed by our Creator. The latter form of “rights” is merely a claim for legal entitlement attached to individual interests and preferences. In other words “rights” that requires someone else to provide for what an individual may want.
These welfare rights are imposed obligations, contrary to the intent of our Constitution, where people assume risks and obligation via contracts. This sets a dangerous precedence, where the notion of rights as entitlement combined with public property and money leads to political and social conflicts.
Ask yourself this question… should my property, in the form of taxes or otherwise, be taken from me involuntarily to deliver health care to others that choose to behave badly, say smoking cigarettes or taking controlled substances? We can take this quandary one step further. Am I responsible for the genetic misfortunes of others? What about a personal preference to be in harms way? A federally funded health system would have you and me pay for Evil Knievel’s hospital bills.
… your turn.
So with the above pedigree I open this blog thread with the intention of encouraging all casual readers and fervent followers (do you exist?) to comment and voice your opinions. Obvious from the heading of this posting … we are participating in a dialogue about what we see is the state of our current health system. If it’s sick, then how do we treat it? Moreover, can we cure it? Lastly, and extremely important, who does the curing and how will the patient, our health system, pay for its treatments?
I’ll start the discussion on a topic that will provide a foundation for all points of discussion, opinions and pompous prognostications. So here goes…
Is the consumption of health care an “unalienable right” or is it a “welfare right?” The former being described in our Declaration of Independence as endowed by our Creator. The latter form of “rights” is merely a claim for legal entitlement attached to individual interests and preferences. In other words “rights” that requires someone else to provide for what an individual may want.
These welfare rights are imposed obligations, contrary to the intent of our Constitution, where people assume risks and obligation via contracts. This sets a dangerous precedence, where the notion of rights as entitlement combined with public property and money leads to political and social conflicts.
Ask yourself this question… should my property, in the form of taxes or otherwise, be taken from me involuntarily to deliver health care to others that choose to behave badly, say smoking cigarettes or taking controlled substances? We can take this quandary one step further. Am I responsible for the genetic misfortunes of others? What about a personal preference to be in harms way? A federally funded health system would have you and me pay for Evil Knievel’s hospital bills.
… your turn.
Wednesday, March 4, 2009
The Not So Rich… Obama’s Fallacy
So here is the deal. In 2008 I was getting taxed at the rate of 26%... that is all my taxes withheld divided by my gross salary. OK… fair enough. I figure that giving ¼ of what I earn to Uncle Sam is acceptable.
I am a Technology Architect and Consultant. My company sends me all over the world to work with their clients wherever they are located. I am considered a Mobility Asset and for that reason, I have no permanent office, other than a dedicated room in my home. I do the road warrior 3-4-5 shuffle every work week – three nights away, four days at the client site and the fifth day at my home-office. I am always home during the weekend. My weekly travel expenses range between $1,500 and $2,500 each week, and contractually, these expenses are paid by the client as part of the fee for my services.
Enter IRS tax hell. Did you know that if you work for more that a year away from where you live and the location were you do your work is the same city or with a 50 mile radius, then all of your travel expenses are considered by the IRS taxable income? That’s right, my airfare, hotel, auto rental, meals, parking, etc. are TAXABLE INCOME. If you don’t believe me go to http://www.irs.gov/publications/p463/ch01.html and see for yourself.
So why am I complaining? Well because since January 2008 I have been traveling to clients located in the New York City and Jersey City (50 mile) vicinity and in January 2009 that makes it a year. So that the $2,000 a week average travel expenses paid to Hertz, Hilton, American Airlines and the local restaurants are considered in 2009 by the IRS to be taxable income. To make this worst, New York and New Jersey take their cut for their state income and unemployment taxes, even though I live and vote in Florida.
Remember 26%... well now it’s 71% and I am not getting any more money than before! Where is the justice in this? My company does give me tax assistance by providing an additional 50% of my travel expenses as additional reimbursement. But the IRS also considers that additional taxable income. Bottom line, I am giving Uncle Sam 53% of my real income, doubling that 2008 26% rate, just because I happen to travel for my profession!
And you want to hear something funny. The added taxable income that I am NOT getting will put me over the $250,000 Obama limit! Yippee, I am one of the rich... give me a break! It’s like triple taxation with nothing to show for it, except for the US economy in the dumps and the feds spending our money like scorned housewives using their husband’s no-limit credit cards!
We need a tea party!
I am a Technology Architect and Consultant. My company sends me all over the world to work with their clients wherever they are located. I am considered a Mobility Asset and for that reason, I have no permanent office, other than a dedicated room in my home. I do the road warrior 3-4-5 shuffle every work week – three nights away, four days at the client site and the fifth day at my home-office. I am always home during the weekend. My weekly travel expenses range between $1,500 and $2,500 each week, and contractually, these expenses are paid by the client as part of the fee for my services.
Enter IRS tax hell. Did you know that if you work for more that a year away from where you live and the location were you do your work is the same city or with a 50 mile radius, then all of your travel expenses are considered by the IRS taxable income? That’s right, my airfare, hotel, auto rental, meals, parking, etc. are TAXABLE INCOME. If you don’t believe me go to http://www.irs.gov/publications/p463/ch01.html and see for yourself.
So why am I complaining? Well because since January 2008 I have been traveling to clients located in the New York City and Jersey City (50 mile) vicinity and in January 2009 that makes it a year. So that the $2,000 a week average travel expenses paid to Hertz, Hilton, American Airlines and the local restaurants are considered in 2009 by the IRS to be taxable income. To make this worst, New York and New Jersey take their cut for their state income and unemployment taxes, even though I live and vote in Florida.
Remember 26%... well now it’s 71% and I am not getting any more money than before! Where is the justice in this? My company does give me tax assistance by providing an additional 50% of my travel expenses as additional reimbursement. But the IRS also considers that additional taxable income. Bottom line, I am giving Uncle Sam 53% of my real income, doubling that 2008 26% rate, just because I happen to travel for my profession!
And you want to hear something funny. The added taxable income that I am NOT getting will put me over the $250,000 Obama limit! Yippee, I am one of the rich... give me a break! It’s like triple taxation with nothing to show for it, except for the US economy in the dumps and the feds spending our money like scorned housewives using their husband’s no-limit credit cards!
We need a tea party!
Friday, February 27, 2009
Yippee… We’re ridding Obama’s hand basket to Hell!
Populism prevails. Let’s picture the outcome of our federal government spending trillions of dollars that it needs to borrow from China, Europe and Russia, our new bankers and mortgage holders.
Setting is in the Whitehouse about dinnertime. Phone rings…
Obama: Hello?
Person on phone: Is this Bolak?
Obama: Who?
Person on phone: Bolak Omaba
Obama: I’m sorry… there is no one here by that name. You must have the wrong number.
Person on phone: Yu no tlickie me. I no yu be Omaba. You be deadbeet. Pay up tlilion dalas intelest you oe now. We can make bad fo yu!
Obama: Uh… I said you have the wrong number.
Background Voice: Honey, who is that on the phone? Is someone threatening you? You look pale!
Obama: (putting his hand over the receiver) Shhh. It’s the Chinese again asking for their interest payment.
Background Voice: Oh my God! When are they going to stop harassing us? They know we don’t have the money right now. What do they expect?
Person on phone: I leepete… pay up mista Omaba! We get money by tomolow oh we put led an bactelia in all stuff we make fo Wallmalt.
Obama: (still covering the receiver) Oh my! They are threatening to taint all of the goods we import from them with lead and SARs. I have to do something. (pause, with a thinking frown)
Background voice: Can’t we sell some more government bonds or print some more dollars to make a payment.
Obama: (turns on the speaker phone)
Person on phone: No tlicke tlicke. You pay wif gold. No wan no mo funny paper from yu
Obama: (placing speaker phone on mute). Those options are gone. We need hard currency, and now!
Background voice: We can’t count on our European friends. They already cut us off. What about our rich taxpayers? Let’s ask them to pony up some more cash.
Person on phone: (over the speaker phone) You no speak dedbeet? What yu do about money?
Obama: (speaker phone still on mute) Can’t do that, honey. Most of our rich tax payers have found loopholes or left the country. Those that remain would only pay us in worthless dollars. God I wish we had invested in gold before I went on this spending spree!
Person on phone: Yu ansel me yu deadbeet!
Obama: (hangs up phone) I need to call Sam Walton and warn him about the lead and stuff.
Fade out.
Setting is in the Whitehouse about dinnertime. Phone rings…
Obama: Hello?
Person on phone: Is this Bolak?
Obama: Who?
Person on phone: Bolak Omaba
Obama: I’m sorry… there is no one here by that name. You must have the wrong number.
Person on phone: Yu no tlickie me. I no yu be Omaba. You be deadbeet. Pay up tlilion dalas intelest you oe now. We can make bad fo yu!
Obama: Uh… I said you have the wrong number.
Background Voice: Honey, who is that on the phone? Is someone threatening you? You look pale!
Obama: (putting his hand over the receiver) Shhh. It’s the Chinese again asking for their interest payment.
Background Voice: Oh my God! When are they going to stop harassing us? They know we don’t have the money right now. What do they expect?
Person on phone: I leepete… pay up mista Omaba! We get money by tomolow oh we put led an bactelia in all stuff we make fo Wallmalt.
Obama: (still covering the receiver) Oh my! They are threatening to taint all of the goods we import from them with lead and SARs. I have to do something. (pause, with a thinking frown)
Background voice: Can’t we sell some more government bonds or print some more dollars to make a payment.
Obama: (turns on the speaker phone)
Person on phone: No tlicke tlicke. You pay wif gold. No wan no mo funny paper from yu
Obama: (placing speaker phone on mute). Those options are gone. We need hard currency, and now!
Background voice: We can’t count on our European friends. They already cut us off. What about our rich taxpayers? Let’s ask them to pony up some more cash.
Person on phone: (over the speaker phone) You no speak dedbeet? What yu do about money?
Obama: (speaker phone still on mute) Can’t do that, honey. Most of our rich tax payers have found loopholes or left the country. Those that remain would only pay us in worthless dollars. God I wish we had invested in gold before I went on this spending spree!
Person on phone: Yu ansel me yu deadbeet!
Obama: (hangs up phone) I need to call Sam Walton and warn him about the lead and stuff.
Fade out.
Sunday, February 15, 2009
To MSNBC - Genius Extraordinaire
You at MSNBC purport economic idiocy. When is a job paid by the government by borrowing money an economic stimulus? Let’s get this straight. Borrow money to create a job that may pay taxes, which will go to paying interest on the borrowed money? Isn’t this like a snake eating its own tail?
Hey genius… compare this to creating a job in the private sector based on economic incentives, tax or otherwise. Here something tangible is produced and consumed, taxes are paid and wealth is created… without the government borrowing money!
Stop drinking the Democratic cool-aid, flush with giddiness, now that YOU control the legislative and executive branches of the Federal Government. Your mantra that the Republicans are now just a regional party is tantamount of dismissing 49% of the American voters that did not vote for the Democratic Party. Keep it up whiz kid and your ratings should drop to Zero, where they belong!
Hey genius… compare this to creating a job in the private sector based on economic incentives, tax or otherwise. Here something tangible is produced and consumed, taxes are paid and wealth is created… without the government borrowing money!
Stop drinking the Democratic cool-aid, flush with giddiness, now that YOU control the legislative and executive branches of the Federal Government. Your mantra that the Republicans are now just a regional party is tantamount of dismissing 49% of the American voters that did not vote for the Democratic Party. Keep it up whiz kid and your ratings should drop to Zero, where they belong!
Saturday, January 24, 2009
Dear President Obama
Our economy, educating our children, effective health services, mitigating climate change and a rational foreign policy... Your decision to run and the outcome of being elected President now makes these problems, or opportunities if you so embrace them, your executive burden, against which your legacy as Commander in Chief will be judged. There is no wiggle room. No legal arabesques by redefining the word”is.” You cannot shun this burden. You wanted it, so the job is yours.
I do not presume to know how to fix the problems our country faces, other than treat them as opportunities. Too often the experts, overconfidently, promote meddling, even when common sense and historical evidence contradict the outcomes of their resolve. What comes to mind are the unintended consequences and the chaotic interdependence of complex systems... our economy, educating our children, effective health services, mitigating climate change and a rational foreign policy... the outcomes of which should be in the best interest of our citizens, our nation and the world that we share.
My advice... be bold and act bravely, regardless of public opinion or political consequences. Our government and its politics got us here, with these seemingly insurmountable problems. Changing them to opportunities requires decisive policy action to nudge the outcomes in a “libertarian paternalistic” way... allowing us to make our own decisions, even if mistaken, but your administration can architect our choices to influence those decisions by building a solid knowledge base, sharing information, providing practical incentives and offering meaningful and timely feedback.
So here are some opportunistic thoughts:
Economy – focus on developing a national campaign towards producing and transmitting clean, cheap, renewable energy, creating new jobs here and building our economic leadership worldwide as the “best” producers and consumers of energy. See education, health, climate and foreign policy opportunities.
Education – increase incentives for States to experiment and innovate a coordinated delivery of k-12, vocational, university and postgraduate education so we can reclaim, as a nation, our stature in the sciences and engineering disciplines, promoting ingenuity and the land of opportunity. This is critical in sustaining our the organic growth in a global economy. See economy, health, climate and foreign policy opportunities.
Health – effect a fundamental change in our health care delivery model, where the patient and not the health provider controls the consumption of his/her health services and the willing price that is paid. A systemic change in the delivery model needs significant pressure from the Presidential bully pulpit, amassing enough inertia to realize a meaningful change against the push back of self-interest groups that today benefit from our chaotic, bureaucratic system. See economy, education, climate and foreign policy opportunities.
Climate – increase support and funding for research and development of clean and renewable energy options, its transmission, climate conservation and the efficient transformation of our smokestack industries, thus leading the world by example. See economy, education, health and foreign policy opportunities.
Foreign Policy – Whatever it is, it needs to be consistent. It needs to be communicated. And it needs to be based on our constitutional principles and humanitarian values. Instead of policing we should be coaching. Instead of judging we should be educating. And instead of threatening we should be influencing those that could cause harm. See economy, education, health and climate opportunities.
I do not presume to know how to fix the problems our country faces, other than treat them as opportunities. Too often the experts, overconfidently, promote meddling, even when common sense and historical evidence contradict the outcomes of their resolve. What comes to mind are the unintended consequences and the chaotic interdependence of complex systems... our economy, educating our children, effective health services, mitigating climate change and a rational foreign policy... the outcomes of which should be in the best interest of our citizens, our nation and the world that we share.
My advice... be bold and act bravely, regardless of public opinion or political consequences. Our government and its politics got us here, with these seemingly insurmountable problems. Changing them to opportunities requires decisive policy action to nudge the outcomes in a “libertarian paternalistic” way... allowing us to make our own decisions, even if mistaken, but your administration can architect our choices to influence those decisions by building a solid knowledge base, sharing information, providing practical incentives and offering meaningful and timely feedback.
So here are some opportunistic thoughts:
Economy – focus on developing a national campaign towards producing and transmitting clean, cheap, renewable energy, creating new jobs here and building our economic leadership worldwide as the “best” producers and consumers of energy. See education, health, climate and foreign policy opportunities.
Education – increase incentives for States to experiment and innovate a coordinated delivery of k-12, vocational, university and postgraduate education so we can reclaim, as a nation, our stature in the sciences and engineering disciplines, promoting ingenuity and the land of opportunity. This is critical in sustaining our the organic growth in a global economy. See economy, health, climate and foreign policy opportunities.
Health – effect a fundamental change in our health care delivery model, where the patient and not the health provider controls the consumption of his/her health services and the willing price that is paid. A systemic change in the delivery model needs significant pressure from the Presidential bully pulpit, amassing enough inertia to realize a meaningful change against the push back of self-interest groups that today benefit from our chaotic, bureaucratic system. See economy, education, climate and foreign policy opportunities.
Climate – increase support and funding for research and development of clean and renewable energy options, its transmission, climate conservation and the efficient transformation of our smokestack industries, thus leading the world by example. See economy, education, health and foreign policy opportunities.
Foreign Policy – Whatever it is, it needs to be consistent. It needs to be communicated. And it needs to be based on our constitutional principles and humanitarian values. Instead of policing we should be coaching. Instead of judging we should be educating. And instead of threatening we should be influencing those that could cause harm. See economy, education, health and climate opportunities.
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