#142…science, religion, ETC.: HEALTH CARE MESS: The Way Out

I had a dream about the

Health Care Crisis


Here’s the first step to a REAL SOLUTION




[For MORE use the DOOR.]



…the way for Americans to start.

“We have to pass this bill [Obamacare], so you can understand what it’s about.”¹ says Nancy Pelosi.

“No,” says Adozenseconds, who lost the battle along with much of the rest of America.

In fairness, though, the context of this statement needs to be considered, say Pelosi’s defenders, though their arguments (if you take time to read them) are flimsy and weak. (You can find her first mention of this sentence that’s now all over the media in her 20-min. speech to the National Association of Counties [NACo] on the web before the bill was passed and she was Speaker of the House. As a “speaker-out-loud,” however, Pelosi is not the sharpest tool in the shed.) Oratorical fumbles are most often recovered by the other team.

And what do I know?

Not much less than anyone else in the media. And “knowing things” nowadays seems to be an afterthought in much of our political arguing. Instead of facts about health-care², we’re fed fables, and sadly few seem to care about the difference. But I’d like to know when I pay an actual medical bill, how many other people I’m paying for who can’t or won’t pay their bills, 3 or 4 or more? I’m responding to those–Democrats, Republicans, Independents, whatevers (of which I’m one)–who are criticized for criticizing the mess we’re in without suggesting any “alternative.”

But no more.

The above 12 long seconds (who said a second was a second, and now who cares?) plus the time it took to actually pass through the DOOR.  The following will take 12 minutes (X 3, if you’re slow) to read.  The execution of my plan will take 12 months+. Congress doesn’t need to approve my suggestions other than to STOP the new Obamacare package immediately. And they wouldn’t have to pony up a dime. Of course, to go further, Congress later (and how our leaders secretly love that word) would have to get to work.

PART I.  Why is this worth looking at?

Several reasons:

(1)  As a nation we’re in serious trouble. And this time we’re digging a hole we can’t climb out of. We have a continuing habit of spending more than we take in. The increase now is becoming exponential. Most people are hardly batting an eye. “We’ve almost always–as a country–spent more than we can (or will) pay for. And everything works out.” But the Affordable Care Act (ACA, the formal name for “Obamacare”) is going to cause unprecedented social, and financial, disruption and grief.

(2)  People are getting angry. On the “nice” side, my plan will let politicians–Republicans and Democrats–off the hook for 18 months. In other words, it will kick the can down the road a little longer.

(3)  It will give President Obama immunity from punishment (which is Congress’s business, of course) for any possible legal missteps he’s made.

(4)  It will make health-care issues much more understandable. I have yet to meet a single person who can specifically answer questions about what’s going on, or one person who has even read the ACA.  How can anyone in good conscience relax, smile, and declare that the ACA will “make everything better”?  And that it’s something we have to “pass to find out what it means.”

(5)  It will give “haters” of the ACA, especially gleeful Republicans, a chance for them to be honest, say something positive, and cause them to stop hiding behind impractical glittering generalities that do nothing.

(6)  It will cost $14,400,000–maybe less.  (That’s “millions” not “billions”–or small change.)

(7)  So, if you’ve read so far, here’s the biggie: It will nullify the Affordable Care Act, or at least table it for 18 months. And, of course, Congress will have to do this. (No divine directive, even a Presidential one, can cancel this.) It will strongly urge insurance companies in effect to let “Time stand still,” or to be more specific, let policy options “retreat to what was in effect before the Affordable Care Act was passed.”

PART II.  Who will do what?

First the “Who”:

Three blue ribbon committees will be created that will work in secret for one year to determine the PRACTICAL AMERICAN TOTAL HEALTH-CARE  (PATH) real cost for Americans in the first part of the 21st century. Each committee will be charged to do exactly the same task. And each will work independently and in secret. There will be 3 final reports: “Path A,” “Path B,” and “Path C.”

COST to the federal government?  $0  (more on cost later)

Here’s how it works:

Three rich, high-powered, intelligent, caring business executives will be asked to “volunteer themselves to step forward” to chair three separate committees to determine the true cost of American health-care for each person, and each “family” (to be defined) for a year and for an average lifetime for people living in the first part of the 21st century. If more than three individuals step forward, the U. S. Supreme Court (who can do no wrong) will be asked simply to pick the “3 best” (for reasons of their own) of those volunteering to head three Blue Ribbon Committees as defined below. A beginning effort by the Court will bring a measure of seriousness to what’s going on. (They may do this as a “friend of the court” in an unofficial capacity if “laws” or “regs” of the Supreme Court make this difficult.) At that point, the Court steps completely out of the picture until the “end.” These chairs (at the outset) will be referred to as “Chair A,” “Chair B,” and “Chair C” in what follows.

In short, each of these 3:

(1)  will be in charge of presenting a complete 200-page written report (no more pages allowed, though numerical summaries of data may separately accompany the report) of their committee’s results.

(2)  will raise funds from foundations, wherever or whatever, to cover the costs as described below. Stipends for service may not exceed those stipulated.

(3)  will select 4 senior fellow committee members, as described below, and weighing their recommendations, select 7 junior members as described below to assist him in this task. Each member will agree to meet face-to-face a minimum of 4 times (more will be probably seem necessary and is allowed) for total compensation of no more than $50,000 per person (but check the ending of this). It is assumed that the 12 members, in addition to meeting the prescribed qualifications identified below, will have individuals who have expertise in, understanding of, and/or serious interest in special issues including: hereditary disorders, preexisting conditions, triage medicine, rationed medicine (which already occurs in organ transplants, special surgeries, and some doctor choices), risk factors, personal responsibility for one’s health, old-age care, mental health care, care for the indigent, and care for the irresponsible.

(a)  First, Chair A (and similarly Chair B and Chair C) will be a senior member (and the “first” among the seniors). He, of course, consulting with others, will select all the other 11. He will have the tie-breaking vote if internal voting is necessary.

(b)  The 2nd (and a senior member) will be a wise and accomplished medical doctor.

(c)  The 3rd (and a senior member) will be a wise and experienced health insurance executive.

(d)  The 4th (and a senior member) will be a brilliant and successful computer programmer/engineer.

(e)  The 5th (and a senior member) will be a gifted number cruncher, acquainted with probability theory and financial application.

(f)  The 6th (and a junior member) will be another medical doctor.

(g)  The 7th (and a junior member) will be another medical doctor.

(h)  The 8th (and a junior member) will be another experienced health insurance executive.

(i)  The 9th (and a junior member) will be a hospital administrator with practical and financial expertise (not an MD).

(j)   The 10th (and a junior member) will be an elected Democrat in the U. S. Congress, but not a puppet or troglodyte.

(k)  The 11th (and a junior member) will be an elected Republican in the U. S. Congress, but not a puppet or troglodyte.

(l)  The 12th (and a junior member) will be a talented science writer, who is knowledgeable, “short-winded,” accurate, practical, and understandable.  He will be charged with making the final report understandable, and with proper summary detail.

[Proviso 1: One  consideration not to be overlooked: At least 1/2 of the members must be religious, or have sincere tolerance for religious people, and the committee must include “some” evangelical protestants and Roman Catholics, whose groups have done significant low-cost, volunteer, or free service in hospitals, clinics, and other medical facilities for decades all over the world. Proviso 2: Secondly, academic scholars without practical experience should be avoided as much as possible. They will “talk an issue to death” and often take years to decide anything–not a “year” as outlined here³.]

Now a look at cost again:  Realize that the money will come from foundations, or wherever the 3 Chairs can find it.  (Let’s not forget American courage and resourcefulness.) To begin, $14,400,000 will need to be acquired (1/3 by each committee chair). And as one would expect, detailed business records would be kept as to how the money is spent.

Breakdown of Costs:

Stipends to Members                    $1,800,000      [3 X 12 X $50,000 –                                                yes, each Chair can receive $50,000 as well.]

Meetings & Materials                       $600,000       [3 X $200,000 for each                                                                                               group]

Bonuses for Winning Report          $12,000,000    [12 X $1,000,000]

                         TOTAL                  $14,400,000

PART III.  BONUSES?  And for what?

Absolutely!  There are 5 ways in which this “project” is different.

(1)  No Federal money is involved. Resources come from elsewhere. Each “First (as defined above) Senior” member can, and will raise 1/3 of the projected cost, or $4,800,000.

(2)  Each of the 3 groups will select a name for their group and a title for their 200-page report that is no more than 6 words long. Ex.: “Health-Care Costs in America,” or “Real Health Costs, Cradle to Grave,” “Paying for American Health-Care.” (Same name for group and its report; different names for each of the 3 groups)

(3)  Each group will independently, without collusion with other groups, determine (a) the projected cost of American health-care from, say (this has to be better worked out) from 2000 to an agreed date as to the average American lifespan; (b) what part of cost should be “covered” by individuals, and what cost by groups (institutions or governments); and (c ) how collective and individual “catastrophe” should be handled. Complicated? Of course, but possible problems should be identified and “commented on” to form foundation markers for future debate.

(4)  This will be written up by a writing genius (and there are some good science writers around) who can make things understandable for normal nonmedical people.

(5)  The groups will privately compete to come up with the “best” solution to cover this cost according to the “American Way,” addressing the real needs of health-care for everyone. The U. S. Supreme Court (who can do no wrong) will, stepping out of their formal box, decide which of the 3 reports is the best. Each member of the winning group will receive $1,000,000. (Remember, they earned it and we’re talking “millions” not “billions”–small change in terms of the cost of the horrific mess we’re in.)

PART IV.  So What?!

Such an effort will have no binding effort on American law. But one thing it will have:  It will allow anyone running for public office, if questioned, to declare which of these 3 plans, or specific combinations of them, or a specific alternative he will advocate if he’s elected to office.

There will be no stepping away from the health-care issue ever again. And from this point on, there will be publicly available UNDERSTANDABLE information–that makes sense to 3 different, informed, compassionate, practical, and competing sets of eyes–that can be shared, referred to, and debated.

In the meantime, it will be health-care business as usual–even as messed-up as it is. We can always “go on” a while longer, as we have for decades. But within a year (or so) we will have real information to inform our dialogue.


¹ Pelosi’s comment on Nov. 17, 2010, at the Legislative Conference for the National Association of Counties in Washington D. C. has been widely quoted on the Internet. Although we appreciate the attention that Pelosi, Obama, and others have given to the serious problems of health-care, their product, the ACA, has missed the mark of finding a practical solution. We need to recognize our mistake, repeal the law, and move ahead. At Adozenseconds we believe that collecting, organizing, and clearly sharing true facts can be better done, and a new start is needed. This isn’t easy, but it’s not impossible. What’s recorded in this controversial post–with all its flaws, and the dozens of things I have poorly stated, or overlooked–is a way to start. And with my several consultants busy with holiday business, there’s no one to stop me.

² The word “health-care”:  I prefer the hyphenated form, as the word evolves from “health care” on its way to “healthcare” which it will end up. (A similar evolution occurred with “basket ball” and “base ball.”)

³ “Academic,” however, would have to include me, John Knapp II, the one who struggled to put these words together.

Author: John Knapp