Thursday, February 25, 2016

An open letter to the GOP Front Runner




As I listen to and see different reports about the current GOP front runner's position seeming to change, depending on the interpretation, regarding the future of Health Insurance as it relates to the Federal Government's role, should he be elected… It occurs to me that if I were a moderately successful Real Estate Developer... Or if I were a known philanthropist... or if I were Donald J. Trump this would be, by far the easiest of all my policy ideas to explain.
Yet, as he seems to struggle a bit more than is comfortable, for some, I thought I'd take this opportunity to break it down, the way I'd explain it.

First, I'd stop, immediately, using the phrase "Repeal and Replace".. Too often when the current administration and the democrat-controlled legislature were debating the inevitable passage of "Obamacare" Frequently the GOP members were heard saying that they approved of every single aspect of the bill, but wanted to pass it in pieces and parts.. The counter was obvious, "why?" If you agree with something as it is, why tear it apart and pass it piece by piece..? That made zero sense.
This has become a matter which concerns many Americans. If the same GOP which has previously admitted they liked the 'parts' of the current policy, do somehow manage to repeal it.. what then, will they replace it with..? Something that looks, feels and operates Exactly like the system that already exists..?? Probably.
So, right away I'd stop using the "and replace" part of that ever-so-catchy phrase.
Instead I'd start explaining the four basic steps that would be taken, concurrent to the repeal process.
1st. Removing the imaginary border restrictions from insurance companies, allowing them to compete across those lines as well as giving the insured more options to find the plan that best suits their needs.

2nd. Creating a regulatory requirement that all insurance companies Must provide coverage to anyone with a pre-existing condition in order to maintain their charter. The cost to the consumer must be no greater than the median of their current policies.

3rd. Declaring that anyone issued an ID card by the Department of Veteran's Administration, who is non-active duty, will be able to use their accompanying benefits at any hospital and any doctor, of their choosing and their care will be covered.

4th. Those who are collecting unemployment benefits will be granted access to a medicare-type of program for the duration of their benefit period. The health insurance will continue after their unemployment benefits run out, until such time as they become employed, at which point they can opt to keep that coverage, should their employer not offer insurance or the offering be too expensive, however there will be a slight fee to maintain the coverage.

That seems simple enough, but what about everyone else..? How do we drive down the costs..??
As a moderately successful real estate developer, I believe I would understand better than those who have worked in and around Government that there are steps that Must be taken before a major project begins. Very often, one of the earliest steps is having a scale model rendering of the project constructed.
Whether it be a Memorial…








Or a Luxury Hotel…










Or even a Shopping Mall...






These models often times cost tens or even hundreds of thousands of dollars to build. That's a lot of money, for sure.. But before the first shovel breaks ground on a construction site, to begin the process of building a multi-million dollar structure, these scale models are a necessity.

Once built, the model can be measured and adjusted according to whatever regulations and zoning requirements may be in effect.. or change as the process begins. Most people don't see or know that before the first shovel breaks ground, the many different inspectors come in and make certain that the curbs are a specific distance from the sidewalks, that there is adequate lighting in the parking lot.. the positions of drains and locations of load-bearing walls as well as fire-retention walls.. There are Many, Many details that have to be figured out and much of that is done with the scale model. Once the model meets all of the requirements and is Approved, only then can the actual building begin. Sometimes there are major adjustments that have to be made to the model, for instance a fire lane might have too sharp of a turn.. or the location of a dumpster access might be too close to air conditioning.. Little things, many people don't think about, must be absolutely correct Before the actual ground is broken.
Government, generally, does Not operate the same way. Government will come up with a policy, which will cost tens or hundreds of billions of dollars.. Then they allocate the money - usually right out of thin air - and they design the program with so many hoops, bells and whistles that they inevitably go over their previous budget assessment.. and institute the program anyways.
They never start on a smaller scale and work out the kinks and bugs and make the pilot program a success before going into the full scale… This is a major reason why so many Government-run programs fail.
So, what would I 'replace' Obamacare with..? Nothing.
I would, instead look at the Existing Scale Model of Government-run healthcare, the one that's literally been stuffed in a closet on Capitol Hill, collecting dust and been ignored for the last several decades. It's time to bring it back into daylight, dust it off, knock down the cobwebs and make it Perfect, by current standards. Then we can begin to look forward.
If I were a moderately successful developer, or even somewhat of a philanthropist, I might know key people at facilities like The Cleveland Clinic - where they already use cutting edge, next generation automation; or John's Hopkins where new techniques are taught and research is constantly practiced, or both. I would reach out to these people, from every sector, Administrators as well as Doctors, Nurses and Specialists. I would effectively hire them for 120 days. I would have the administrators go over the filing processes and 'administrative' aspects and determine what the best course forward would be.. and what that would cost. I would have the doctors, nurses and Specialists visit the existing locations to evaluate the conditions top to bottom. Is the current equipment up to today's standard..? Do the windows leak..? Are the beds sufficiently comfortable..? Every detail, in every location would be evaluated and a report returned, along with an estimate of the actual cost to bring the entire program up to today's standards.
Of course, this Scale Model I'm referring to is the Department of Veteran's Administration.
No one, and I do mean No One in our country deserves better care than our Veterans. It's time we focus on fixing that. Once we make the V.A. perfect - which will cost a fraction of a nationwide health care/insurance program - Then we can begin to look at what it will actually take to bring this to the whole country.. But I suspect, we won't have to.
The market is a wonderful proving ground. Supply and Demand Always creates newer and better options and competition. One need only look back as far as Apple's first generation of iPhone technology. At it's inception the iPhone was cutting edge. It was able to do things no phone had ever done before - but it was limited to one carrier. That exclusive deal with AT&T was 'Yuuuge' for both companies.. Many users dumped their current carriers and switched, just to get the newest and greatest phone of its time. Unfortunately AT&T did not always have the best coverage area, compared to some of its competitors and this diminished the user's ability to use many of the iPhone's features. People began to demand alternatives, which brought about newer and more competitive Android phones, Windows phones and eventually even Blackberry developed a smarter smart phone. All of which were available through the competition carriers.
I believe the same will be true with health care. As the Veteran's care becomes better and becomes more cutting edge, while being available exclusively to Veterans.. The market will demand the same. It will demand the same coverage from their insurers. It will demand the same technological advances from hospitals. And it will demand the same, elevated quality of care from its practitioners.
The private market will see that, once past the initial investment for machines, beds, sealed windows, etc. The cost of maintenance for the Veterans hospitals and clinics will go down dramatically. As those costs go down, those savings will be passed on to the veterans themselves, through alternative treatments, etc… The market will demand their own costs decreased as the private hospitals and clinics also see decreases in their overhead. Perhaps the Government's role will be to provide grants to these hospitals to upgrade their equipment or automate some of their systems. These grants will still cost less than the hundreds of billions the Government is currently spending for services that are consistently over budget.
If I were the GOP front runner.. I believe I could explain that our Veterans, who's care has been overlooked and nearly forgotten would be the highest priority to my administration, should I be elected. And while it is important to do something for the American people as a whole, to improve their care while making the costs more affordable - No Government run program has ever worked, not here, not anywhere - nor will a new one, unless it is first built on a smaller scale and perfected there. Then and only then will it be suitable to expand.. which will likely happen privately, before the Government even needs to create any additional bureaucracies.

But, alas.. I am not a moderately successful real estate developer. Nor am I much of a philanthropist.. I'm certainly not Donald J.Trump ..if only someone like that existed, though…