Maybe the common ground is starting to show.....COST CONTROL

Common ground for "Republicans" and "Democrats": In an op-ed piece today in the WSJ by Michael Gerson called "Obamacare's Antidote", the man makes a good point: Obama rules with his throwing money at problems but of course, this is just a distraction and at the end of the day, until there are COST controls put on the COST of health care services we're just going to keep robbing peter to pay paul. Obama's ideas are crystallizing into an ill-organized long-term game of hope-enomics of shifting costs rather than addressing costs of the services, equipment and pharmaceuticals individuals require.

WSJ Op-ed writer views: As Gerson notes: "The administration, it turns out, has no serious plan to control health-care costs. Government health programs of the type Obama seeks to create are not good at cost control (as Medicare has proved) -- unless they aggressively ration expensive care to the seriously ill and elderly (as more muscular European models have done)."

Gerson concludes: "The political fight on health care remains lopsided in Obama's favor, but the policy argument is growing more balanced. On the Republican side, Americans will see scary changes and more individual costs; on the Democratic side, government control and possible rationing, at a price we can't afford."

Gerson is right on the money in pointing out issues: Without COST controls someone's paying and the idea of RATIONING health services to control costs will not be successfully sold to the American people.

Here's the common ground: We agree with the problem. However, we don't agree with the solution. So in Obama land, with the avoidance of "conflict" that appears almost pathological, we see failure to make decision as the preferred route which in Washington speak always means delay action by throwing out money.

Health Services are the goal and health insurance is the means of obtaining that goal:So what's an administration to do? The first problem is that it's been a long time since President Obama had to worry about the cost of or the availability of health insurance or the ability to pay for it. Similarly, the civil servants in government have not had the worry of being denied coverage. In an effort to AVOID health care conflict between different opinions, Obama is EXPANDING the number of civil servants and therefore the number of people who will get this cushy health insurance option. But civil servant benefits, including those of our representatives are a sacred cow that must lose their sacred status. Our lawmakers have no skin in the game, their health insurance coverage is good and tweaking medicare, medicaid and every other program makes the commitment to NOT touching the giveaway of civil service health benefits ridiculous. Now, the Republicans want to tax employer sponsored health care and this option should ONLY be explored if it applies to civil servants.

Rationing is not the answer but is a by-product of our current system: Rationing health services is not especially scary, we already have rationing in coverage of one exam a year, ten visits to a physical therapist or psychologist, drug coverage up to a limited amount. Rationing is not the problem, the problem is that the COST of services means that those with more money can buy better health services and "care"...of course, this also already exists. A seventy two year old patient with Medicare and benefits from being a civil servant already receives better care than an individual on Medicaid. Rationing, therefore, should not be a policy, but is already a result of a system that charges too much for health services, that has many services available as medical technology expands, and that motivates its providers to utilize all those services to cover their own butts in terms of defensive medicine. Even if an insurer won't pay for a rich person's self-attention, that person can simply go and purchase it on his own, receiving the additional benefit of being able to avoid the invasions of privacy that go with going through an insurer. Rationing could be controlled by charging more and TAXING people who run to the doctor for more than one check up a year, who routinely submit to test after test just because they can. This form of rationing would address the PERMA PATIENT, the guy you know who sneezes and runs to the doctor.

The MYTH of COMPETITION: It's unbelievable that the competition argument is still going on. Insurance companies already are present in multiple states AND within those states, there are usually one or two that dominate. Competition among COSTS of insurance are based solely on the amount of coverage people obtain AND the profile of the consumer. There is no other competition. Further, services providers work with codes and while some providers charge more, the COST of these services is pretty much the same otherwise the USUAL and CUSTOMARY concept could not exist. The idea of competition has really devolved into turning consumers against one another so that people say why should I pay for that fat smoking guy, this is not competition that will solve the health services problem because if anyone who is sick is subject to exclusion or overcharging then only well people will have "insurance".

The good news is that the IDEA of controlling COSTS is correct otherwise we have to keep coming up with more money to pay for less medical care. The idea of controlling costs requires that health insurers, including the governmental groups that can pressure insurance companies MUST negotiate better rates for services instead of negotiating away quantity of coverage. This requires someone who is willing to face conflict: Insurers must take less without providing less and providers must charge less. Obviously this impacts their profits which are compensated for through increased numbers of patients. Increased numbers of patients are accommodated by limiting the number of times people visit physicians and obtain other services that are NOT necessary which can be determined by categorizing the perma patients as CHRONIC and thereby eligible for higher rates being charged.

At least, the common ground exists.