So you see the Republican House is interested in politics, not in reducing the costs of healthcare

I finally have this sucker figured out. Paul Ryan, with his Republican Budget proposal, has finally become clear to me. Congressman Ryan is under the false impression that he works for the Federal Government and not the people in his Congressional District and by extension the people of the United States. Mr. Ryan's budget proposal as described in a report by the Center of Budget Policies and Priorities' Paul Van de Water is a proposal to shift healthcare costs to the patient, the patient's family and/or the business or organization that provides insurance coverage to employees and retirees. Mr. Ryan's proposal is not to reduce healthcare costs. It is a proposal to off-load payment of such insurance fees (Medicare, Medicaid, and the CHIPS program) from the government onto someone else.

The chart to the right illustrates this shift of the cost burden in one of the programs (Medicare) by moving the eligibility age from 65 to 67. During these two years of withdrawn Medicare ineligibility, the individual would continue to need medical insurance, maybe healthcare services, etc. So who pays for any services used during this period? It is either you with your insurance company's help, your employer, or if you do not have an employer plan or cannot afford a plan of your own, the kindness of your family or the generosity of the insured public who must pay. The cost has not gone away. It is shifted from the federal budget. Given enactment of Mr. Ryan's budget, the Congressman and his like minded colleagues can then crow that they have reduced the Medicare costs of the Federal Government. Makes you wonder what government is for if not to serve its constituency.

Jared Bernstein in his Cost Shifting is Not Cost Saving blog of August 24, 2011 states:

Medicare is actually a less expensive way to provide coverage to older persons relative to the alternatives.

. He goes on to quote Mr. Van de Water:

People who lost Medicare would have to seek health coverage from other sources. This would affect not only their own personal budgets but also employers’ costs, state budgets, and the premiums paid by Medicare beneficiaries and participants in the new health insurance exchanges [established by the Affordable Care Act].

Quoting from a blog posting by Ezra Klein:

As political scientists Sven Steinmo and Jon Watts concluded in “It’s the Institutions, Stupid,” their 1995 paper on health-care reform, the United States is

the only democratic country that does not have a comprehensive national health insurance system because American political institutions are structurally biased against this kind of comprehensive reform.

Passage of the Affordable Care Act last year brought us closer in line with our international peers. But not much closer. And consider the costs we continue to impose on ourselves in the interim: If the United States simply had the per-person health-care costs of Switzerland, which has the second-most expensive health-care system in the world, we would spend $3,000 less per person and save about $900 billion a year. Assuming we need to reduce deficits by about $4 trillion over the next 10 years, those savings would do the heavy lifting with about $5 trillion to spare.

In America, the only solution to our healthcare dilemma is to fix the fundamental causes of skyrocketing healthcare costs ...the delivery system clinical, administrative and management and to reform the payment system whether managed by the government, private insurance companies or a combination of both. Shifting the costs from one party to another without fundamental reform of the delivery and payment systems is a non-answer.

Other countries have used private and public healthcare and payment tools to reduce the size of their healthcare costs. I see no reason, other than politics, that prevents us from doing the same.

Politics must be a "no wimp" zone

While I disagree with the need to aggressively attack the national debt in a time when we are experiencing what the experts call a job-less recovery, the better approach would be to stimulate the economy, put people back to work on the bridges, roads, sewer and water projects, mass transportation, or other worthwhile investments in our country's future.

If the national consensus requires that the debt be worked at this time, the Democratic Party must learn that fire is best fought with fire; sometimes water helps; but you never fight fire with gasoline.

Unfortunately, Democrats enabled the Republican success in defeating the right solution for turning our economy in an upward direction. The correct approach was to look at both spending and revenue if the goal is to reign-in the deficit and the national debt.

Ezra Klein argues in his How weak Democrats enable hard-line Republicans article in his Washington Post Blog today. Mr. Klein writes in support of an article by Ross Douthat in his NY Times blog, entitled Some Advice for Democrats in which Mr. Douthat postulates that:

If Democrats expect to win political battles in an era of divided government, they need to behave as if winning those battles actually matters to them.

Mr. Klein goes further to say:

This is the reality that liberals need to face: Much of the Republican “intransigence” and “hostage-taking” and “terrorism” that they deplore is a direct consequence of the fact that Republicans assume that Democrats will always, always, cave on taxes.

Mr. Douthat concludes in his piece:

Until Democrats demonstrate a similar seriousness — until they find a way to dig in their heels and hold the economy “hostage” to tax increases the way Republicans just did with spending cuts — the G.O.P. will have no reason to take them seriously as negotiating partners. In the long run, you can’t have compromise without intransigence.

Negotiating from a position of weakness is not negotiating. It is just delaying tactics until at whatever point you make your capitulation. If the other side knows that you will not stick to your guns, but will eventually fold, you can bet that the side with the strongest will will prevail. The Republican's just proved that by their willingness to take the country into default.

Obviously, the Republican action was foolhardy from the perspective of the Country, but the Republican's are not that concerned with the failure of the country if their intransigence provides the Party a political victory.

Most people, I believe it was about 85% (most recent poll) believed that Republican obstinacy was hurting the country. Let's see what happens when the important poll (the 2012 election) does to punish the guilty party. I suspect that the spin cycle will have diluted the picture so thoroughly that many of the people who vote will have forgotten the problem, who caused it, who prolonged it and who was willing to damn the country into default for partisan reasons.

Applauding Dr. Irving Wladawsky-Berger ...

One of my favorite blogger-thinkers is Irving Wladawsky-Berger. Dr. Wladawsky-Berger is a widely recognized business and engineering leader, student of global culture, and spokesman for the interaction of these and other phenomenon. He writes extensively in his Irving Wladawsk-Berger Blog about the real world of technology, business, business strategies, operations, technology, and the effects of these and other drivers of our times. His most recent posting provides a stimulating perspective on the potential effects of entrepreneurship on the creation of jobs.

The current blog posting is must reading for those wishing to be informed about an intelligent way to proceed that may help us to become unmired from the current, all too slow and job-less recovery of American and global economies.

Dr. Wladawsky-Berger and I graduated (retired) from the same company, he from near the pinnacle, I from much further down the peak. While I barely knew him at work, I knew his reputation and was very glad to see him become a blogger.

Dr. Wladawsky-Berger demonstrates a wide set of interests in his writings. His business, academic, and public policy connections put him at the source of many of the strategies to be followed, decisions that are made and the plans that are implemented by today's global businesses and governments.

Dr. Wladawsky-Berger teaches at two major academic institutions, Imperial College of London where he is Adjunct Professor in the Innovation & Entrepreneurship Group and as a guest Lecturer at MIT's, Sloan School of Management. He participates widely in business forums, government bodies and committees, local and international technology, business, and public affairs conferences. He is known and widely acclaimed within the industry. Truly, Dr. Wladawsky-Berger is a man with something to say, a man whose writings provide a valuable source of information that will stimulate your interests. His able research complements his writing by providing documented electronic links to additional source materials.

Dr. Wladawsky-Berger's ability in connecting of the dots across the many areas for which he is knowledgeable goes unmatched. I highly recommend his blog ...check it out.