First, let us understand that the reform proposal before congress is not health care.  It is medical care.  Health care is preventative; medical care is mitigative.

Controlling costs for medical care is a real concern.  Before there are trillions and trillions of dollars in obvious and behind-the-scenes costs and expenses, we’ll have to look behind Monte Hall’s three doors.  Ignoring the current problems and trying to replace the rest of the structure will give us change but not necessarily improvement.

Door #1 holds the answer to the question, “What makes American medical care so expensive?”  By choosing this door and question first instead of listening to the melody behind the songs of congress and the president, we can address the root of the problem.  The cause of the high cost is not that doctors make exorbitant salaries for their education and training.

True, they do receive an adequate compensation, considered by many to be excessive.  However, that is not the answer.  Jealous and often ignorant workers and others whose life choices do not include working hard enough, or studying hard enough, to make equivalent money tout the perceived compensation as excessive.  They cannot appreciate the hard work, study hours, rigorous testing and tremendous responsibility warranting remuneration beyond the average wage for a bookkeeper or retail store manager and certainly not above the union backed auto worker.

Repaying the loans and expenses incurred for education and training such as this takes years and thus reduces the disposable income for up to ten or perhaps twenty or even thirty years for most doctors.  It is only after repayment that doctors can realize a significant positive income over expenses.

Above the normal costs incurred to attain a degree in medicine or a certificate in health services are the insurance costs to cover malpractice or the threat of lawsuits.  Applying reasonable caps on jury awards to plaintiffs, the cost of that insurance would go down tremendously followed by fee reduction.  Law suits generally name not only the doctor directly involved, but also other attendants and the facility where the alleged malfeasance occurred.  Increased fees are necessary to overcome the cost of attorneys and outlandish awards.

Having to purchase insurance from only a local insurance carrier or limiting care provision to local clinic or hospital denies competition.  By allowing insurance companies to sell their product from one state to clients in other states, the industry would naturally self regulate and policy pricing, coverage and care would become more universal.

Door #2 settles the inquiry regarding, “Who truly benefits and who loses from restructuring the care and payment plans of today?”

Some would answer this question as follows: “The poor and middle class will have medical care like the elite and wealthy.  They are the beneficiaries.”  That, however, would be false.  The elite and wealthy will always have “more and better” opportunities (including, but not limited to, medical care) than the rest of us, just look at our elected officials.  The president and congress refuse to subject themselves and higher ranking administration officials to the same guidelines and standards they are attempting to foist upon the commoners of the country.  Also exempted are many union workers and select other groups who have lobbied to retain their current health plans, doctors, co-pay etc. without alteration.  These exclusions and exemptions beg the question “Is the reform being offered truly leveling the playing field for all?”

We now know many of whom are being exempted from the proposed changes in medical care.  We know that the exemptions and exclusions are because they are wealthy or powerful and have better plans than the offering.  Given that information, the only conclusion to be drawn is that the benefits of the plan will go to a majority of currently uninsured or underinsured individuals.  A noble goal!

Those exempted from the new plan as well as those included will be paying for it.  We all lose.  An increase in taxes must accompany the additional people covered.  There already has been, and there will be more increased taxes and new taxes.  No matter how they are disguised: as fees, tolls, surcharges, excises or duties they will be attached to virtually everything purchased, leased, used or repaired; they are taxes.  Farmers will be paying more for grain and you will be paying more for the beef that eats that grain.  Your car tires will cost more; your lawnmower repair will cost more.  Your oranges, cell phone charges, cable TV charges, gas and electric bills will also increase slightly to cover the new government expenses.  You can expect a cost of living adjustment between 3% and 15% to help keep the deficit under control.  Three to fifteen cents out of every dollar earned will be going indirectly for medical care under the current plan.

Door #3 poses the question “Why is it so important to pass legislation that almost 60% of the American public doesn’t want and 30% aren’t sure about?”  The proponents say that it will reduce medical care costs and provide better service.  Opponents claim that this is blatantly false.  Like the USPS, now negotiating a two-fold whammy by raising postage fees and reducing delivery service at the same time, this government mandate will undoubtedly provide less service at a higher cost over time.

The government wins because the passage of this bill will give the federal government more control over the citizens of the country.  Like the take over of the auto industry, the banking and financial industries, the inclusion of another 16% of the GDP will have the people at the mercy of the elites.

Who benefits?  The drug companies are spending hundreds of millions of dollars lobbying for the passage of the medical care bill.  They’re not accustomed to spending money without a positive return, so it’s safe to assume there’s a great deal of money for them in the bill.

Without tort reform, the trial lawyers will continue to receive +/- 30% of each multi-million dollar award.  It is in their best personal interest for their clients to receive the highest possible rewards.  Trial lawyers are also are pouring huge sums of money into the passage of this bill.

Of course, heavy lobbying means additional perks, benes and wallet linings for members of congress who aid companies and individuals’ long term monetary gain.  Given that fraud and wasted money are an integral and expected part of any government engagement, this program’s budget has line items for projected fraud and waste.  Thus, there is advance acceptance that anyone who has access will be able to steal a fair portion of the allocated funds.  A program of this scope generally allows for ten percent shrinkage.

President Obama’s legacy is also at stake.  For him it is a personal quest to show he can accomplish what Ted Kennedy, Hillary Clinton and many others have failed to achieve.  He knows the costs of the “reform” far outweigh the benefits to America.  It doesn’t matter to his ego, he just wants to prove that he can do it.

Additionally, some people will have a more direct access to doctors without the lengthy wait in an emergency room.  There will undoubtedly be a lengthy wait for an appointment with that doctor, as there is currently with Medicare and Medicaid patients, but the emergency room waiting times shouldn’t be as lengthy.

The losers will be people who have been contributing to a better plan for years and will now be assessed a penalty for having overpaid for unused past and future services.  Also entering the loss column are people who choose to be healthy through proper diet, exercise, vitamin and nutritional supplementation rather than mitigating maladies with synthetic pharmaceuticals.

The choice is yours.  Everybody pays the costs for a few through a system guaranteed to be mismanaged and therefore more costly than necessary.  On the other hand, we could require congress to pass laws limiting awards to a just recompense so that more people can afford required medical care.

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