Realistically
Feb 23, 2010
Realistically speaking, the Republicans have, as usual, ignored the consequences of their actions. Sadly, it is what they do. It is the way Republicans have always done business, and it will have to be accepted. Recently, by engaging in two questionable wars, while at the same time lowering taxes, they almost managed to destroy social security whose surpluses they usurped to pay for those wars. Destruction of the natural laws of the "marketplace" and commerce have led to a second depression and almost bankrupted the entire planet. For the last fifteen years, the Republican Party, with the help of organized labor, has devastated the manufacturing base of this country. With our nation unable to compete with the rest of the industrialized world due to the lack of any global system of health care, of any global system of freight or passenger transport, the Republican leadership's position really is "more of the same."
Unfortunately, the Democrats, furiously riding to the rescue, have forgotten to pack their saddle bags. All of the plans they have been making for some fifteen years filled with utter frustration, ironically, cannot be accomplished without the preparation that should have been done by their nearsighted opponents. High speed rail systems must be preceded by adequate local public transportation. A single payer system must be preceded by the training of an adequate bureaucracy that can handle three hundred thirty million members! It must also include elimination of hundreds of billions of dollars in graft in Medicare, most of which is the responsibility of Democrats! Entitlement programs cannot continue to represent the second largest source of graft in the history of the nation, and, sad to say, the economy will never be saved by token cuts of "discretionary spending."
Until the real problem, the Military Industrial Complex, the sacred cow of incompetent, dishonest Republicans and Democrats alike, is tackled, the country will continue to follow the same road to ruin followed by the Roman Empire. Contracts for useless, often undelivered weapon systems, illicit arms sales by U.S. companies to terrorists, and unnecessary, wasteful privatization of military functions must finally be addressed. The Armed Forces need to be increased! They are the only military resource that continually increases in value. Our men and women in uniform learn how to become better citizens, better people, educated and understanding of the value of teamwork, and when their military service is completed, they return to rebuild the communities that we, at home, have destroyed.
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Realistically II
Realistically speaking, the Republicans always seem to ignore the consequences of their actions. Sadly it is what they do. It is the way they have always done business, and it will have to be accepted. It is not the way conservatives have always done business. It started with the first Republicans, proudly getting the railroads built from coast to coast "for free." Well, almost "for free." There was the little matter of the fifty miles of land given to the railroad companies on either side of the railway. There was the little matter of upkeep of tracks and depots, costs the companies became tired of paying. Land development was much more lucrative than running railroads. Sucking their money out of railways, bankrupting mass transportation in favor of developing their "free gift" from the Republican government became entirely too tempting for most of these new real estate entrepreneurs.
You see, Republicans don't believe in taxes. Conservatives don't believe in regressive taxes. Taxes that pay for efficient mass transportation, as they do in almost every industrial country, taxes that save hundreds of billions of dollars in fuel costs, taxes that limit the destruction of our environment and cut so deeply into our dedicated support of Middle Eastern terrorists, are not regressive! They are obviously progressive. Corporate taxes are mostly regressive. They tend to retard company growth and can cost the country many jobs. Long term capital gains taxes, until lowered by President Reagan, tended to be regressive. Short term capital gains taxes, strictly regulated to prevent "short selling," if kept low, would not be regressive taxes.
Democrats, on the other hand seem to love taxes, they do not seem to differentiate between progressive and regressive taxes. You guessed it! Democrats are not immune from failure to look at the consequences of their actions either. The difference, of course, is that they are "farsighted," looking far into the future, trying to prevent catastrophes with complicated, always complicated solutions. For instance, in proposing extra taxes on better insurance plans, they are in violation of the Fourteenth Amendment, and eventually, all insurance policies will have to be taxed. In their foolish attempt to force all people to purchase inferior, poorly regulated insurance or face punishment by the government, they may lose all government mandates when the Supreme Court calls their clumsy scheme by its real name: "protection racket." The reason for this can be found in: (1) their failure to properly lay the groundwork for most of their ambitious schemes and (2) their all too obvious attempts to preserve the appropriate graft, without destroying their plan.
The health care bills in both House and Senate preserve almost all of the hundred billion dollars in illicit payments to pharmaceutical companies, durable goods and oxygen suppliers and major laboratories. They don't address the absurd, criminal payments to hospitals of seventeen thousand dollars to one institution and fifty thousand to another for the exact same procedure, under the exact same conditions. They don't address tort reform, because the CBO claims that it will not save enough money for patients. Arbitrarily cutting Medicare reimbursement for physicians by twenty percent is also "a drop in the bucket" compared to the hundreds of billions of dollars the agency loses to graft in the form of those overpayments mentioned earlier in this paragraph. Somehow, equity, honesty, and above all, common sense, are nowhere to be found in House or Senate, among Republicans or Democrats.
Without correction of the gross inequities in Medicare and Medicaid, both will be bankrupt within a few short years. With the bankruptcy of Medicaid, its two largest providers, Florida and Texas stand to go bankrupt as well, due to huge percentages of state revenue needed to service indigent patients. With the suspicious transfer of management from Humana to United Health Care, most medical historians would expect Tricare (military health insurance) to fail, in short order, as well.
Don't get me wrong. I believe in the inevitability of a single payer system. I believe in the value of a public option. I have nothing against the idea of extending Medicare. The problem is that "the people" are not yet ready for a single payer system, nor is our government's inept bureaucracy. Medicare must be thoroughly fumigated and inoculated with real competitive bidding, bogus hospital billing corrected, and Medicaid overhauled before the government can be entrusted with a public option. Legislation should, rightfully, begin with private insurance reform and regulation, including divestment of current anti-trust exemption, with portability across state lines, and the initiation of some sort of tort reform. With these changes in hand, "the people" will finally begin to feel some amount of trust in their government. If nothing else, both labor and management can benefit from immediate cuts in the cost of health care. Then, with saddlebags packed, Democrats can ride out and engage in a fair fight with Republicans over public options and single payers.
Allen Finkelstein, D.O.