Let's see what it'd be like if the tables were turned...
I got this and liked it so much I thought I'd post it here:
===============================
Dear Mr. President Obama, U. S. Senate and Congress:
I'm planning to move my family and extended family into Mexico for our health, and I would like to ask you to assist me. We are planning to simply walk across the border from the U.S. into Mexico , and we'll need your help to make a few arrangements..
We plan to skip all the legal stuff like visas, passports, immigration quotas and laws. I'm sure they handle those things the same way you do here.
So, would you mind telling your buddy, President Calderon, that we are on our way over? Please let him know that We will be expecting the following:
1. Free medical care for the entire family.
2. English-speaking government bureaucrats for all services we might need, whether we use them or not.
3. All Mexico government forms, printed in Spanish, need to also be printed in English.
4. I want our kids to be taught Spanish by English-speaking (bi-lingual) teachers.
5. Schools need to include classes on American culture and history.
6. I want my kids to see the American flag flying on the top of the flag pole at their school.
7. Please plan to feed my kids at school for both breakfast and lunch.
8. My husband and I will need a local Mexican driver's license so we can get easy access to government services.
9. We do plan to get a car and drive in Mexico , but, we don't plan to purchase car insurance, and we probably won't make any special effort to learn local traffic laws.
10. In case one of the Mexican police officers does not get the memo from their president to leave us alone, please be sure that every patrol car has at least one English-speaking officer.
11. I plan to fly the U.S. flag from my house top, put U S. flag decals on my car, and have a gigantic celebration on July 4th. I do not want any complaints or negative comments from the locals.
12. We would also like to have a nice job without paying any taxes, or have any labor or tax laws enforced on any business we may start.
13. Please have the president tell all the Mexican people to be extremely nice and never say a critical thing about me or my family, or about the strain we might place on their economy.
I know this is an easy request because you already do all these things for all his people who come to the U.S. from Mexico. I am sure that President Calderon won't mind returning the favor if you ask him nicely.
Thank you so much for your kind help.
Sincerely, U.S. Citizen & Taxpayer
====================================
Monday, August 31, 2009
Sunday, August 30, 2009
Are outings worth it?
Emily had only one week left off track so I thought it would be fun to take the kids to the Treehouse Museum. We spent about three hours there. That was a tough three hours!
Upon arriving Josh and Emily immediately ran to play while I paid admission. Josh went straight for the train tables. There were some new exhibits and fun things to try, Emily and Laurie really had fun doing everything. Josh would not leave the train tables. If I tried to force him he would scream. I decided that I would go around the museum with the girls and check on him every now and then. To my surprise he did leave the tables…but he left because he had peed his pants. I didn’t have anything else for him to wear and out of desperation I put one of Laurie’s diapers on him and left him in the bathroom while I tried to get help. The workers were very helpful and found me some overalls from the farm exhibit that he could wear while they put his pants in a dryer they had. He again went back to the tables after about 15 minutes in the bathroom. I kept an eye on him, and found out that he was having trouble sharing the trains. I took him screaming from the area and ended up having to put him in time out. I couldn’t believe that I paid money so that he could play with trains for three hours.
Emily and Laurie had a great time. Laurie loved the chalk and slates in the little school room. Emily loved the Art Garden, where we made sea serpents out of clay, and the western exhibit where she could sit on a horse and dress up like a cowgirl.
Friday, August 21, 2009
Destroyed In Under 10 Minutes
What happens when you put a letter/alphabet foam pad in the same room as an 18 month old toddler?
Well, curiosity gets the best of the toddler (our Laurie), and, well, take a look & see how it went...
Here's the link to the video:
http://www.youtube.com/watch?v=Jk267Z1Rq9c
Needless to say, she had the time of her life..
-Graydon
Well, curiosity gets the best of the toddler (our Laurie), and, well, take a look & see how it went...
Here's the link to the video:
http://www.youtube.com/watch?v=Jk267Z1Rq9c
Needless to say, she had the time of her life..
-Graydon
Wednesday, August 19, 2009
My Local Town Hall Meeting
I had the chance to go to a town hall meeting with my local congressman Rob Bishop.
I was really curious how it would turn out because there are so many issues currently going on in Congress. Health care reform being the biggest.
The event was held at the Layton City Council chambers in Layton, UT.
The room's maximum capacity is 190.
There were easily double that number of people that showed up.
Can you say Standing Room Only?
I was really curious to see how this one would turn out because of how others in the nation have gone. Ours was very civil, very well run, and actually ended on time. You'd think our Congressman was a school teacher in his past life, or something (he's a retired educator from Utah).
Before he started, he said, "Now, I promise not to answer my cell phone while you're asking a question." And then he said, "If you don't call me a Nazi, I won't call you a dining room table" referring to how other Congressmen had been handling some of their town hall meetings.
Overall, I was extremely impressed with how he handled the meeting. Most of the questions obviously were around health care. His stand is that he opposes the current bill being brought for (he said there's actually 4 of them being brought forward), but did say that there's also an alternative bill by a congressman from Arizona that is slightly different. It basically gives people several more options for health care, but doesn't mandate government control over it.
One issue that he brought up that was almost chilling is the level to which the Obama administration is scrapping the US Military. He said that at current only 187 F-22 fighters are going to be approved to be built. To maintain the current needs, 254 should have been allotted and to maintain US Air Supremacy, well over 500 should have been built. At 254, that only gives our military the ability to fight a war front on a single front. Every war we've had (Korea, Iraq, Afghanistan, etc) has included multiple war fronts. So basically, if we go to war with another nation (Iran, Korea, etc) and had to fight in the air, we'll only have enough planes to fight on a single front.
Another scary thing he brought up was that the Obama administration is trying to cut back on our missile defense system. Instead of having over 100 warheads ready to help protect our nation in the event of an attack, the number has been whittled down to 44. However, the current administration wants to knock those back even further.
If we were to have an attack on the US from hostile countries, we only have 44 chances to stop incoming missiles.
Several individuals who own small businesses also spoke up and asked about the Stimulus package and how it's not actually helping them get loans or keep their businesses functioning.
One highlight of the night was when one gentleman made a comment about how the government felt a need to intervene in the housing market over the last few years by mandating that banks must issue sub-prime loans, to which the commenter replied "and we can all see how well THAT went!" His basic jist was, "Don't mess with health care right now, we saw how well the housing market turned out".
Overall, I really enjoyed seeing a town hall first hand. There were no rowdy participants nor was there any yelling or heated emotions. His biggest overriding comment was that if you have something to say, by all means contact your congressman. Write them! Email them! Call them! Just participate! If you don't like what's going on, write! It's your freedom and right to do so.
If you have a chance to participate in a meeting near you, I'd encourage you to do so. It will give you the ability to see democracy in action. I really enjoyed it.
I was really curious how it would turn out because there are so many issues currently going on in Congress. Health care reform being the biggest.
The event was held at the Layton City Council chambers in Layton, UT.
The room's maximum capacity is 190.
There were easily double that number of people that showed up.
Can you say Standing Room Only?
I was really curious to see how this one would turn out because of how others in the nation have gone. Ours was very civil, very well run, and actually ended on time. You'd think our Congressman was a school teacher in his past life, or something (he's a retired educator from Utah).
Before he started, he said, "Now, I promise not to answer my cell phone while you're asking a question." And then he said, "If you don't call me a Nazi, I won't call you a dining room table" referring to how other Congressmen had been handling some of their town hall meetings.
Overall, I was extremely impressed with how he handled the meeting. Most of the questions obviously were around health care. His stand is that he opposes the current bill being brought for (he said there's actually 4 of them being brought forward), but did say that there's also an alternative bill by a congressman from Arizona that is slightly different. It basically gives people several more options for health care, but doesn't mandate government control over it.
One issue that he brought up that was almost chilling is the level to which the Obama administration is scrapping the US Military. He said that at current only 187 F-22 fighters are going to be approved to be built. To maintain the current needs, 254 should have been allotted and to maintain US Air Supremacy, well over 500 should have been built. At 254, that only gives our military the ability to fight a war front on a single front. Every war we've had (Korea, Iraq, Afghanistan, etc) has included multiple war fronts. So basically, if we go to war with another nation (Iran, Korea, etc) and had to fight in the air, we'll only have enough planes to fight on a single front.
Another scary thing he brought up was that the Obama administration is trying to cut back on our missile defense system. Instead of having over 100 warheads ready to help protect our nation in the event of an attack, the number has been whittled down to 44. However, the current administration wants to knock those back even further.
If we were to have an attack on the US from hostile countries, we only have 44 chances to stop incoming missiles.
Several individuals who own small businesses also spoke up and asked about the Stimulus package and how it's not actually helping them get loans or keep their businesses functioning.
One highlight of the night was when one gentleman made a comment about how the government felt a need to intervene in the housing market over the last few years by mandating that banks must issue sub-prime loans, to which the commenter replied "and we can all see how well THAT went!" His basic jist was, "Don't mess with health care right now, we saw how well the housing market turned out".
Overall, I really enjoyed seeing a town hall first hand. There were no rowdy participants nor was there any yelling or heated emotions. His biggest overriding comment was that if you have something to say, by all means contact your congressman. Write them! Email them! Call them! Just participate! If you don't like what's going on, write! It's your freedom and right to do so.
If you have a chance to participate in a meeting near you, I'd encourage you to do so. It will give you the ability to see democracy in action. I really enjoyed it.
Thursday, August 13, 2009
Laurie's Antics
Laurie loves to play in my silverware. She makes such a mess, that sometimes I have to re-wash everything. Most of the time everything ends up on the counter, but she also carries them everywhere in the house. This day, if you'll excuse the clutter, I was preserving tomatoes and was able to grab this video clip. It is a little long, but cute.
Wednesday, August 12, 2009
New Glasses

Monday we received a notice from the school that Emily had failed the eye exam and needed to see an eye doctor. She went to the eye doctor that afternoon and now has a new pair of glasses.
She was very excited. Her prescription was a -2, we had no idea that her eyes were that bad. She now carries the case with her everywhere in case she needs/wants to take them off (which she has done a lot today).
Thursday, July 30, 2009
More details on health care...(Fortune Magazine)
This was from Fortune magazine on 7/27/2009
===========
5 Freedoms You'd Lose in Health Care Reform
by Shawn Tully
Monday, July 27, 2009provided byFortuneonCNNMoney.com
If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.
In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.
A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy's Health committee, contradict the President's assurances. To be sure, it isn't easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.
If you prize choosing your own cardiologist or urologist under your company's Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.
In short, the Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have. It's a revolution, all right, but in the wrong direction.
Let's explore the five freedoms that Americans would lose under Obamacare:
1. Freedom to choose what's in your plan
The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.
Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.
The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.
2. Freedom to be rewarded for healthy living, or pay your real costs
As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.
Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.
Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.
Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.
3. Freedom to choose high-deductible coverage
The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.
Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.
The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."
4. Freedom to keep your existing plan
This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.
The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs and Time Warners and most other big companies.
The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.
But read on.
The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.
The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.
The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.
5. Freedom to choose your doctors
The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.
Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.
The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.
In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.
Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.
The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that's strictly taboo in the bills). I'll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.
========================
My thoughts, if you value the current health care system, write your congressman today!
===========
5 Freedoms You'd Lose in Health Care Reform
by Shawn Tully
Monday, July 27, 2009provided byFortuneonCNNMoney.com
If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.
In promoting his health-care agenda, President Obama has repeatedly reassured Americans that they can keep their existing health plans -- and that the benefits and access they prize will be enhanced through reform.
A close reading of the two main bills, one backed by Democrats in the House and the other issued by Sen. Edward Kennedy's Health committee, contradict the President's assurances. To be sure, it isn't easy to comb through their 2,000 pages of tortured legal language. But page by page, the bills reveal a web of restrictions, fines, and mandates that would radically change your health-care coverage.
If you prize choosing your own cardiologist or urologist under your company's Preferred Provider Organization plan (PPO), if your employer rewards your non-smoking, healthy lifestyle with reduced premiums, if you love the bargain Health Savings Account (HSA) that insures you just for the essentials, or if you simply take comfort in the freedom to spend your own money for a policy that covers the newest drugs and diagnostic tests -- you may be shocked to learn that you could lose all of those good things under the rules proposed in the two bills that herald a health-care revolution.
In short, the Obama platform would mandate extremely full, expensive, and highly subsidized coverage -- including a lot of benefits people would never pay for with their own money -- but deliver it through a highly restrictive, HMO-style plan that will determine what care and tests you can and can't have. It's a revolution, all right, but in the wrong direction.
Let's explore the five freedoms that Americans would lose under Obamacare:
1. Freedom to choose what's in your plan
The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.
Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.
The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure "children" until the age of 26. That's just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn't even know what's in their plans and what they're required to pay for, directly or indirectly, until after the bills become law.
2. Freedom to be rewarded for healthy living, or pay your real costs
As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.
Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.
Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.
Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.
3. Freedom to choose high-deductible coverage
The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.
Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.
The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."
4. Freedom to keep your existing plan
This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.
The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don't have real insurance. Those are the GEs and Time Warners and most other big companies.
The House bill states that employees covered by ERISA plans are "grandfathered." Under ERISA, the plans can do pretty much what they want -- they're exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.
But read on.
The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the "qualified" policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we've already discussed. So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.
The outlook is worse for the second group. It encompasses employees who aren't under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only "qualified" plans to new customers, via the exchanges.
The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.
5. Freedom to choose your doctors
The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.
Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.
The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.
In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.
Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren't covered by their employers. It won't happen right away -- large companies must wait a couple of years before they opt out. But it will happen, since it's likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they'll be lobbying Washington to keep the tax under control in the righteous name of job creation.
The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that's strictly taboo in the bills). I'll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.
========================
My thoughts, if you value the current health care system, write your congressman today!
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