Saturday, my ear clogged up again.  Do I stick something up there to fish around for that pesky piece of wax?  Do I run to the health center for a costly irrigation?  Do I go to Target for some pseudoremedy?  Nope.  I steal a 50cc syringe from lab, a plastic pipet, some olive oil (extra virgin) from the kitchen, and grab some cotton balls.  Before bed, I place a dropper full of oil in my ear, stick a cotton ball in so it doesn’t leak all over my pillow, and I sleep on my side with the troublesome ear up.  In the morning, I fill the syringe with warm water, aim my ear to the sink, and flush 50 mL of water through my ear canal, 3-4 times.  On day three of this treatment, my hearing returned as I was greeted by an inch long flake of wax in the sink (that I quickly snatched up for fear that it would go down the drain and clog my sink).  My hearing was so clear that I did the same process with the other ear, with similar disgusting results.  The world seems so loud now…

 Anyway, on to the Million Dollar Idea.  I need to package a 50cc syringe, a medicine dropper full of oil, and several cotton balls together, write up some instructions, and sell it as an ear wax removal kit that really works.  Seriously, it is dirt cheap, easy, and effective.  Who has some start-up funds?  If these hacks can sell candles (that people actually buy) that don’t do anything other than posing a fire hazard, then surely I can sell something that really works…I just need marketing ideas.  The words "soothing, organic, all-natural, essential oils, safe, herbal, green, and hormone-free" need to be worked in somehow.

 [1]  I disagree.  I suppose this is what separates the left from the right, but think about this comment from an NRO article:

Furthermore, if healthcare were a right, wouldn’t I also have the right to deny it?  The current house bill would tax me 2.5% of my income if my health insurance fails to meet a government determined standard.

 [2]  It’s not that this number doesn’t compel me to action, it’s that I don’t think it takes $1 trillion to insure 10 million or 50 million!

 [3]   Quoting this policy analysis:

 That same WHO study rates Singapore, Oman, Portugal, Colombia, Israel, and Costa Rica higher than the U.S.  I bet no citizen of those countries has ever come to the United States in search of better health care.  If your baby gets sick, would you take her to a Colombian hospital?

 [4] To quote an analysis of the same WHO report:  "To use the existing WHO rankings to justify more government involvement in health care is to engage in circular reasoning because the rankings are designed in a manner that favors greater government involvement."

 [5] Administrative costs are necessary to reduce the overall cost of health insurance.  This is addressed here:

 [6] You admit that the uninsured are getting care when they need it.  I agree that we could cover them more cheaply, but why does this have to cost $1 trillion?  We’re already paying for them.  Why do we have to spend an additional $1 trillion to keep covering them?  Additionally, what’s to say that the uninsured will all receive coverage?  The public option will still collect premiums.  Why does anyone believe that they will be willing to pay the government insurance premiums?

 [7] We have more than 2 choices.  NOBODY is proposing that we keep the existing system.  Instead of ‘replacing’ the system, reform it by encouraging competion in the free market (and not through the introduction of a government option).  There are other options.  I support Senator Tom Coburn’s proposal, briefly summarized here.  IMHO, this would achieve all that you hope for in health care reform and more, all at a much lower cost.  Why is this superior bill not up for debate?

 Anyway, thanks for the post, Dr. Miller.  I think we both agree that reform is needed, and I hope that you agree with me that our representatives should both (a) read the bill before making a vote and (b) listen to their constituents.  Anyone else?  I’ll post any other guest posts that come in, at my discretion. 

"…rumors often travel just below the surface via chain emails or through casual conversation [and blogs?].  Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov."

 Seriously?  What are you going to do with those flagged?  Can I flag the White House itself when it makes fishy claims?  I think I’m going to turn myself in to see what happens…in the meantime, I’m exercising my right to disagree with the President.

 The major argument in favor of reform focuses on the uninsured, 47 million in this country, according to 2006 census data.  LOOK at the census data.  10 million of the uninsured are non-citizens.  That means there are only 37 million uninsured Americans.  Another 18 million earn over $50,000 a year, and certainly can afford to buy their own insurance.  19 million are in the 18-34 age group, and likely choose not to purchase insurance…I know several people that make this choice, regardless of their ability to pay for insurance.  The census data includes those who are between jobs, a majority of whom are uninsured for less than 4 months.  This leaves 10-15 million Americans that are involuntarily uninsured, about 3% of the population.  Are we really getting bent out of shape for such a small fraction of the population?  I don’t think I’m a cold, heartless person, but really?  Assuming we were trying to cover all 47 million of these people, why does it have to cost over a trillion dollars?  Put $50 million in an interest bearing account, $1 million for each uninsured person.  At a 3% annual return, this gives each person $30,000 a year to spend on a private insurance plan.  There.  Problem solved, at a savings of $950 billion.

 Proponents of a public insurance option claim that it will increase competition and drive down the cost of health care.  This is flat out false.  A government option would reduce competition by driving the private sector out of business, not as a result of providing better coverage at a lower cost, but because the government is an unfair competitor in the market.  The government can hide its true costs, creating artificially low premiums.  Furthermore, the implicit guarantee of a bailout that a public option realizes would further lower costs.  Wait, didn’t Obama say this?

"No matter how we reform health care, we will keep this promise to the American people.  If you like your doctor, you will be able to keep your doctor, period.  If you like your health care plan, you’ll be able to keep your health care plan, period.  No one will take it away, no matter what."

 I find that hard to believe, given the Lewin Group estimate that 120 million Americans would be forced to move from private to public insurance.  The Associated Press says "White House officials suggest the president’s rhetoric shouldn’t be taken literally."  If adopted, a government option would very quickly become the only option by driving all other companies out of business.  Think about it:  the government is backed by the U.S. Treasury, is free of any taxes, and can increase the costs of competitors by introducing new legislation.

 What about efficiency and profits?  After all, private insurers are driven by profits and lack the efficiency of the government, right?  (When have the words ‘government’ and ‘efficiency’ ever been synonymous?)  The Congressional Budget Office reported that less than 3% of premiums go toward profit for the insurer.  Albiet small, this profit motive drives efficiency.  Without this incentive for efficiency, a public option will stray in the direction of inefficiency.  A couple examples:  (1) It took Medicare 30 years longer than the private sector to include prescription drug coverage into benefit packages.  30 years!  (2) Bear with me.  Medical errors add a huge amount of expense to the price of health care.  Private insurance started forcing providers to pay for costs resulting from medical errors as early as 1929.  Medicare didn’t begin this practice until 2008, and STILL reimburses providers for the cost of medical errors in some cases.  The U.S. government is thus rewarding providers for committing medical errors.  That’s efficient?  Only 23% of Americans actually believe that costs will go down with a government option.

 A public option will discourage innovation.  Take this example:

"Park Nicollet Health Services, a hospital and clinic system based in St. Louis Park, Minn…started…spending as much as $750,000 annually on more nurses and on sophisticated software to track heart failure patients after they left the hospital.  It reduced readmissions for such patients to only 1 in 25, down from nearly 1 in 6.  But the reduction has been a losing proposition.  Although the effort saved Medicare roughly $5 million a year, Park Nicollet is not paid to provide the follow-up care.  Meanwhile, fewer returning hospital patients mean lower revenue for Park Nicollet.  "We’ve kept it up out of a sense of moral obligation to these patients, but we’re getting killed," said David K. Wessner, chief executive of Park Nicollet.  "We will totally run out of gas.""

 Profit incentive from the private sector drives innovation.  Competition drives innovation.  A government health insurance option will kill the private sector, competition, and innovation, all at a huge price to taxpayers.  If any of you still disagree with me, write a coherent post with links to references explaining why free-market proposals will be more harmful to health care in the U.S. than the current legislation up for debate in congress.  I will post it on this blog for all to see.  Just so you know, I’m not the only one against this:

(1) The government is encouraging people to borrow money.  Awesome…it’s not like this recession was caused by too much borrowing and spending, right?

(2) Car sales are up, helping out a flailing auto industry.  Didn’t we just bail out the auto industry?  This sounds like another bailout to me, but you claim its for the environment, so I guess that’s ok.

(3) All clunkers "will be crushed or shredded within such period and in such manner as the Secretary prescribes."  Yeah, lets get all of those gas guzzlers off the road and destroy the used car and parts industry.  Wait…people can’t afford new cars right now, why would we destroy perfectly good used cars?  Oh yeah, because they hurt the environment…gotcha.

(4) What’s a billion dollars anyway…after all, it will last until November.  What?  The billion dollars was used up in 4 days?  Oh well, throw another $2 billion at the program.  We can spend our way out of a recession.  I’m willing to help out those who can afford to take advantage of this program.  It’s only $21.74 out of my pocket.

 All sarcasm aside, stop spending my money on this.  Can I also point out how awesome our government is at budgeting money?  I mean, how can one honestly predict that $1 billion will last 4 months when instead it is all promised out in 4 days?  You expect me to believe your predictions on the cost of health care after this?

Notice that recovery.gov is #4 on the list.

 (a) Get rid of employer sponsored coverage.  Workers that receive coverage through their employers are getting government subsidized health care that puts the rest of us at a disadvantage when shopping for health insurance with our taxed dollars.  Drop the benefits and add the money saved onto worker’s (taxed) salaries.  Better yet, the government could offer an income tax refund on money spent on health insurance.  Sound familiar?  This gives everyone the same purchasing power and puts consumers in charge of their insurance.  Once consumers are paying their own premiums they may think twice about visiting the doctor for a cold.  Employers don’t cover homeowner or auto insurance, why should they fund health insurance?

 (b) Promote competition.  This can largely be accomplished by removing restrictions that prohibit us from purchasing insurance across state lines.  Premiums could drop as much as 15% as a result.

 Two ideas that don’t cost any money and would go a long way to reform health care.  ObamaCare, on the other hand, would cost $1-2 trillion in the midst of a recession, and promises to save money?  Obama proposes to fund the new plan in part with $500+ billion in savings from reducing waste in the Medicare system.  If you can find $500 billion in waste in one government run program, why the hell would you start a new, broader one?

 “That is why those who are betting against this happening this year are badly mistaken," Obama said. "We are going to get this done. We will reform health care. It will happen this year. I’m absolutely convinced of that.”

 President Obama, I’m betting against you.

 In May 2008, I received a $600 check from Uncle Sam.  This stimulus plan received much ridicule, even from me.  After all, what is $600 going to do to stimulate the economy?  Despite it’s downfalls, the plan did put money in to people’s pockets.  Back to me.  I spent my stimulus check entirely on my first professional dSLR camera.  A few months later, I helped start a small business that would not have been possible without that purchase, made possible by the stimulus bill.  Today, just over a year after I received my check, the business has 8 clients (and counting) and is spending revenue on website hosting, a photo management site, print and book ordering, business cards, membership dues to a local business group, local and federal taxes, et cetera.  I have purchased a second camera body, lens, and lighting equipment for the sole purpose of improving the quality of the service that the business offers.  Not to mention the fact that we are offering affordable photography services to couples who can spend the money they save on booking us as their wedding photographers elsewhere.  I accept that I am a unique and rare example, but how’s that for stimulating the f’ing economy?

 EDIT:  I just did the math.  Obama’s $787 billion plan comes to $5,703 per U.S. taxpayer.  I could do a lot of stimulating with $5,703 in my pocket.