Straight Platform Politics

Health Care Reform And Veterans – Part 2

Recent health care reform proposals have caused the public to evaluate the health care systems currently operated by the U.S. government, namely the Veterans Health Administration (VHA) and the Indian Health Service. Recent investigations have revealed serious problems within the VHA system.

Earlier this year, the VHA was dealing with the scandal that unsanitary equipment used in procedures infected about 53 patients with either HIV or hepatitis B or C. See Part 1 Then, in June, it was reported that 92 veterans were given wrong radiation doses in a common procedure to treat prostate cancer. These veterans were treated at the VHA facility in Philadelphia.

These problems have caused people to question whether or not the VHA is showing signs of an institutional breakdown. There apparently has been little genuine oversight provided by the VHA and investigations into grave problems produced little improvement. Sadly, the Philadelphia tragedy was allowed to continue for six years.

Funding, of course, is always a problem for anything that is run by the government. Many people cite lack of proper funding as the reason for the decrease in quality health care in the VHA. However, the same thing can be said of the Indian Health Service, Medicare, Medicaid, etc.

And we want the government to run our whole health care system because…….?

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Health Care Reform And Veterans – Part 1

Recent health care reform proposals have caused the public to evaluate the health care systems currently operated by the U.S. government, namely the Veterans Health Administration (VHA) and the Indian Health Service. The quality of these government-run systems is not encouraging.

Some people continue to refer to past studies that found the VHA to be better than Medicare, managed-care systems, and the highest rated non-VHA hospitals. Phillip Longman, in his article “The Best Care Anywhere,” (Washington Monthly Jan/Feb 2005) observed: “Outside experts agree that the VHA has become an industry leader in its safety and quality measures.”

But that was then.

Earlier this year, more than 10,000 former VHA patients were notified that they could have been exposed to HIV or hepatitis B or C through unsafe endoscopic procedures. These procedures involved substandard, unclean practices; some of these procedures were done as long ago as 2003. Three different states were involved – Florida, Tennessee, and Georgia. Unfortunately, 53 patients have tested positive so far.

U.S. Rep. Harry Mitchell, chair of the House Veterans’ Affairs Subcommittee on Oversight and Investigations, had this to say in a June press release: “Most infuriating is the irony that these veterans were undergoing routine medical evaluations to prevent illness, but ultimately, they may be in more danger now than before the procedures. [T]here is no question that shoddy standards – systemic across the VA – put veterans at risk and dealt a blow to their trust in the VA.”

And a blow to our trust in the ability of government to provide descent health care to many more people than just veterans.  See Health Care Reform And The Bridge

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Health Care Reform And The Bridge

Mary Theroux had an interesting opinion piece in the San Francisco Examiner (11/9/09). “After last week’s Bay Bridge failure, Bay Area residents would do well to consider the obvious parallel. If the government can’t build a bridge that keeps us safe, can it really be trusted with the future of American health care?”

An upper deck section of the eastern span of the San Francisco-Oakland Bay Bridge had collapsed during the 1989 earthquake. This section was repaired in a month, but it was necessary to make the eastern span earthquake resistant. The refit and repairs were estimated to cost about $200M and take about 4 years.

But then, after lengthy discussion and analysis, a suggestion was made in 1999 that a new bridge span would be better than just retrofitting the old one. Keeping the new bridge design simple would not increase the cost too much; the life expectancy of the new span would be 2-3 times longer than the old one; and maintenance costs would decrease. Sounded good.

Unfortunately, some people thought the simple design was not distinctive or dramatic enough and a committee was appointed.

The bridge span is still not finished; the cost is up around six billion dollars; tolls have continued to increase; the cost has continued to increase; a major crack was found and repaired in September; and this repair recently failed and had to be re-repaired earlier this month.

Mary Theroux’s other question: “How much faith do you have that a politically appointed committee in Washington, D.C., can determine what’s best?”

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The Dalai Lama Snub And Israel

President Obama decided not to meet with the Dalai Lama when the exiled Tibetan leader visited Washington earlier this month. What does that mean for Israel?  See previous post

Dennis Prager wrote, “According to the Jerusalem Post, as recently as six weeks ago, just 4 percent of the Jews of Israel regarded President Obama as pro-Israel. Even if exaggerated, it is likely the most negative Israeli view of an American president since Israel’s creation.” (Jewish World Review 10/20/09)

The snubbing of the Dali Lama “is particularly troubling to Israelis because it means that an American president is placing appeasement of strong dictators above America’s traditional defense of embattled small countries….The line between selling out Tibetans and selling out Israelis is a direct one.”

“Those who worry about good and evil know that if America decides that the world’s approval is important, evil will increase exponentially. Only an America willing to be disliked, even hated, will consistently support the smaller good guys against the bigger bad guys.”

“And if America now values getting along well with everyone above moral considerations, the days of strong American support for Israel are numbered.” And the Israelis know it.

Is this the change that the Obama campaign was talking about?

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Noticing The Dalai Lama Snub

The world took note when President Obama decided not to meet with the Dalai Lama when the exiled Tibetan leader visited the U.S. earlier this month. The administration tried to pacify China by not receiving this distinguished Nobel Peace Prize recipient. See previous post

Alison Smale noted in the New York Times (10/14/09) that when interviewing Vaclav Havel, a leader in the non-violent overthrow of communism in Czechoslavakia, he had a question for her. “Was it true, he wanted to know, that President Barack Obama had refused to meet the Dalai Lama in Washington?”

Ms. Smale told the former Czech president that President Obama would meet with the Dalai Lama after the President’s visit to China. His response? “It is only a minor compromise….But exactly with these minor compromises start the big and dangerous ones, the real problems.”

Maureen Dowd, also of The Times, weighed in with this: “The tyro American president got the Nobel for the mere anticipation that he would provide bold moral leadership for the world at the very moment he was caving to Chinese dictators. Awkward.”

Awkward, indeed. The Dalai Lama, the Nobel Peace Prize, and human rights were forced to take a backseat to a dictatorship. And that’s what the world noticed.

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Dangers Of The Dalai Lama Snub

The Dalai Lama visited the U.S. earlier this month. Unfortunately, the Obama administration needlessly postponed the president’s meeting with this exiled Tibetan head-of-state and fellow Nobel Peace Prize recipient. Will this be used by the Chinese to further disparage the Dalai Lama? See Previous Post

Several people are concerned that this put-off could set a precedent and increase China’s arrogance. It could also make it more difficult for the Dalai Lama to have meetings with leaders of other countries. China has already put pressure on other leaders not to have the Dalai Lama visit their countries.

The Dalai Lama’s meetings with past presidents were usually private visits. But President Bush in 2007 met publicly with the Dalai Lama who was being honored with the Congressional Gold Medal, Congress’ highest civilian award. The postponement by President Obama could easily be described as a rejection of the Tibetan leader.

This administration may have emboldened the Chinese by snubbing the Dalai Lama but it won’t secure a better relationship with them. It has just placed the U.S. in a position of being viewed as a country led by a weak and compromising and easily manipulated administration.

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The Dalai Lama Snub

The Dalai Lama visited the United States earlier this month and was snubbed by the President. The exiled Tibetan spiritual leader, who fled China in 1959, has visited the U.S. ten times since 1991. This was the first time he has not met with the president during his visit.

President Obama did not want to meet with the Dalai Lama until after the president’s visit to China in November. John Pomfret reported in the Washington Post (Oct. 5, 2009) that the decision to postpone the meeting “appears to be a part of a strategy to improve ties with China that also includes soft-pedaling criticism of China’s human rights and financial policies.”

But according to Pomfret, the Chinese had already concluded that the meeting would take place in October and were interested only in how the president would receive the Dalai Lama: would it be a private or public visit. Thus, Obama officials needlessly postponed the president’s very important meeting with the exiled leader.

"’We’ve got the classic case of a Western government yet again conceding to Chinese pressure that is imaginary long after that Chinese pressure has ceased to exist,’ said Robert Barnett, a Tibetan expert at Columbia University. ‘The Chinese must be falling over themselves with astonishment at what Western diplomats will give them without being asked.’”

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The Free Market And Health Care – Part 3

  “What Is the Free-Market Approach to Health Care Reform?” This is an article published on The CATO Institute on Health Care Reform. http://healthcare.cato.org/     The article lists seven reforms; we have reviewed the first four and will now look at the last three. See Part 2

Reform 5. “We also need to rethink medical licensing laws to encourage greater competition among providers.” Examining the history of enabling legislation in the health care system causes many people to conclude that much of the legislation was enacted to protect the profession and not the patient. See The Four-Party Health Care System series

Reform 6. “Congress should give Medicare enrollees a voucher, let them choose any health plan on the market, and let them keep the savings if they choose an economical plan. Medicare could even give larger vouchers to the poor and sick to ensure they could afford coverage.” This may encourage a healthier lifestyle in the elderly while improving competition among insurers.

Reform 7. “The expansion of ‘health status insurance’ would protect many of those with preexisting conditions.” (See the February 18, 2009 Policy Analysis by John H. Cochrane on the topic of health status insurance at http://cato.org/ )

There have been good health care reforms proposed by a number of people and organizations. Many of these reforms would not be costly. But, are Congress and the President listening?

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The Free Market And Health Care – Part 2

“What Is the Free-Market Approach to Health Care Reform?” is an article published by the Cato Institute. http://healthcare.cato.org/ The article lists seven reforms to our health care system that would improve health care access, quality, and cost.

Cato Institute’s mission states that the organization promotes policies based on limited government, free markets, individual liberty, and peace. The Cato philosophy supports “a uniquely American solution, one that builds on free markets, competition, and choice.”

We will continue our look at each proposed reform. See Part 1

Reform 3. “Changing from employer to individual insurance requires changing the tax treatment of health insurance.” Employer-provided insurance gives the employed a significant tax advantage over the self-employed. The health insurance of the former is not taxable income while that of the latter is. This is not fair and must be changed. The article recommends that “[w]orkers should receive a standard deduction, a tax credit, or, better still, large Health Savings Accounts (HSAs) for the purchase of health insurance, regardless of whether they receive it through their jobs or purchase it on their own.”

Reform 4. “We need to increase competition among both insurers and health providers. People should be allowed to purchase health insurance across state lines.”

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The Free Market And Health Care – Part 1

The CATO Institute on Health Care Reform published the article “What Is the Free-Market Approach to Health Care Reform?” The article agrees that our health care system is in need of reform: “It costs too much. Too many people lack health insurance. And quality can be uneven.”

“But a government takeover of the health care system, as proposed by the president and some in Congress, would be a step in the wrong direction. Instead, we should pursue a uniquely American solution, one that builds on free markets, competition, and choice.”

The proposed solution lists seven reforms. We will look at each.

Reform 1. “Let individuals control their health care dollars, and free them to choose from a wide variety of health care plans and providers.” This would entail dismantling the huge amount of government legislation (both state and federal) that has denied individuals access to certain insurance providers and vice versa.

Reform 2. “Move away from a health care system dominated by employer-provided health insurance.” As the article asserts, health insurance “should be personal and portable” and not controlled by governments or employers. Under our employer-based system, the true cost of health care is hidden from employees, employee choice of health care policies is limited, the self-employed are at a costly disadvantage, and if employees lose employment, they may become uninsured.  See The Four-Party Health Care System series

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