I attended the White House Health Care Forum on Monday, March 23rd.  I expected it to be skewed toward universal health care, and I was not disappointed.  

A nice elderly gentleman sitting next to me wanted to ask why his efficient health insurance that gives him everything he wants with little paperwork on his part couldn’t be expanded to all.  He was of course referring to Medicare.  Many people, including those in the health care field wonder the same thing.

Medicare, in its current form, is not fiscally sustainable.  Had Medicare remained catastrophic insurance only, we could use this as a model for accessible health insurance for everyone.  However, elected officials continually expanded the benefits in order to get elected or re-elected.

The result is a system which has skewed incentives of medical students into specialities that are higher paying (in order to pay their education debts and reward the delayed gratification of 13 years in education/training without an income or retirement) and has derailed physicians from practicing in rural areas where Medicare is the predominant payer.

Prior to Medicare, physicians contracted with patients themselves for payment and accepted whatever they received.  This entire paradigm has been abolished.  Medicare at its onset was resisted by physician organizations, but we have benefitted finanically until the past 10 years.  Like most people, one can accept their salary not increasing year over year, but it is much more difficult to see it decreasing, with higher salaries paid to employees and supplies and increasing regulations, paperwork and workload.  

Physicians are increasingly dissatisfied and yet many other providers claim to be able to step in and take up the slack.  Canada has found that its nurse practitioners and physician assistants once independent do not remain in rural areas nor do they take call.  Salary caps in Canada have led to reduced working hours and physician shortages.  For the first time in 30 years, Canada is allowing a new medical school to be built.

Does this mean that we should not address our health insurance system? Not at all.  We can have a health care system that is accessible, affordable, portable and permits innovation and personal responsibility to lead healthy lifestyles if we are bold enough.  We can reinvigorate a system that allows competition focused on giving VALUE to the patient, rather than the government, employer or insurance company.

Or we can incrementally turn over our health care system to the government and “they” will mandate our exercise, food, and services we will obtain.  This is not paranoia or conspiracy.  This same government has run our school system and post office and although I have great respect for our teachers and the post office workers with whom I come into contact, I shudder to think of heath care run the same way.  

What if you are the square envelope going through a rectangular automated system?  Will you be rejected and out of luck?  You would not be able to go south for health care  as the Canadians do now.

Was Obama’s program of holding a military service person’s private health insurance responsible for wartime injuries, hospitalizations, surgeries and rehabilitation the opening salvo for government run health care?

I’ll explain this connection after first commenting on the immorality of the suggestion.  Service members of any branch of the military are guaranteed their health care as a contractual arrangement with the government in order to put up with military service, especially war.  The VA system, after military hospitals, is ideally suited to treat our returning service people because of the specific nature of the injuries incurred.  This is a debt we owe to these individuals regardless of our personal feeling regarding the validity of this war on terror.

Oops!  That was not politically correct in the new transformative era, so I will amend that to conflict and not mention military or enemy combatant.  Nevertheless, the proper role for the VA system is to treat service related disabilities.  Imagine if private health insurers knew they would have to  pay for these injuries?  They would drop coverage for these individuals.  Businesses wouldn’t hire any person in the Reserves or Guard and families would rapidly reach the maximum limits.  Lastly, premiums on everyone would increase.

Ah, the last is the hidden beauty of this plan.  Saving the paltry $560 million when we have increased the deficit to $3 trillion (accounting for the guarantees of treasury,  the Fed, Fannie/Freddie and FDIC) is secondary to passing off the cost onto the private health insurance industry, increasing premiums and causing first small businesses and then larger ones to drop health insurance for their employees.

Therein lies the connection.  The Obama administration has since recanted.  I suspect we will see a lot of back peddling and recanting from this administration as they trade populist rhetoric to achieve popularity for future credibility.  I

Finally a smart move by those in charge of revitalizing our economy without penalizing those of us who play by the rules.

Today, Ben Bernanke, chairman of the Federal Reserve, and a Bush appointee, informed us that the Fed would purchase treasuries.  This is the first expenditure with which I agree will help the housing crises, the banking crises and stimulate the economy.  You may wonder how this will help the average main streeter like you and me.

When the Fed buys treasuries, this will lower yields and incent individuals to look elsewhere to park their money.  It will lower interest rates both on banking loans and mortgage loans, which will help the housing sector and stabilize housing prices without penalizing those of us who made down payments and  have paid our mortgages on time despite declining prices.  We will be able to refinance with the possibility that mortgage interest rates could fall to as low as 4%.  This has the potential to get the bystanders off the sidelines and snap up houses at lower prices than a year ago and at lower interest rates.  When the glut of houses is reduced, contractors can begin building again.

Credit card interest rates may decline as well, but individuals may have to change to another card to get the best rates.  You can access information on credit card interest rates at www.bankrates.com.  There will also be more funds available for business investment with stabilization of the banking sector and at a lower interest rate.  This scenario is much better than rescuing some irresponsible homeowners (punishing those who were stalwart) and further bailing out Wall Street banks.

As I had stated last summer, temporarily stabilizing mark-to-market accounting would also firm up the banking sector.  Another thought would be to utilize mark-to-market for disclosure, but not for regulatory purposes (which began after the Enron collapse and was mandated by Sarbanes-Oxley).

Finally, the business sector could be helped immensely by decreasing the corporate tax rate to 20%, and for those who hate lowering tax rates, this could be done while concurrently reducing deductions or loopholes.  Sweden reduced its’ corporate tax rate from 39% to 20% last year specifically to spur growth and productivity.   Allowing multinational companies to repatriate revenue from overseas at a reduced tax rate if invested in worker salaries or capital investment would make tremendous strides in decreasing uncertainty which paralyzes companies into inaction.

Instead of the platitudes toward small business by both parties of the political class, true action should evolve.  Waive the FICA tax for 6 months for small businesses.  This helps the average worker by lowering their tax burden, and the small business owner who pays the entire 12.4%.  Rethink cap and trade which unfairly taxes small business, but continue to promote and incent environmentally friendly practices.  

The marketplace will take us where Obama wants to go environmentally, without the taxpayer subsidizing industries that the consumer doesn’t want to purchase.  Revoke the Carter administration ban on reusing spent fuel rods and nuclear energy with ZERO carbon emissions will accelerate and provide cheaper energy per kilowatt hour than wind and solar.  Natural gas vehicles are a better alternative until we have an electrical infrastructure in place for electrical vehicles, but the stimulus pushes federal purchase of electric vehicles.  A more thoughtful proposal would have been to stipulate fuel efficiency of 40 mpg, however it is proper to question if this should have been in a stimulus bill at all.

All of this to say BRAVO to Bernanke for a thoughtful move.  It is obvious he has studied the great depression and the best book (to me) on this topic is John Kenneth Galbraith’s book “The Great Crash, 1929″.  It is an easy read and reinforces the old adage that those who don’t know history often repeat it!

While driving back from North Carolina, my wonderful husband stopped at this huge outlet mall in Indiana.  I was thinking I could get some great deals on upcoming presents for birthdays and baby’s birth.

I thought the traffic would be light and the weather was phenomenal, so we ventured off the interstate.  Imagine my surprise to find no parking spaces, and long lines in the store!

Maybe it is because of pent up demand or people sticking with their budgets.  All I know is that you couldn’t guess it was a recession by the number of people shopping!  Needless to say, I bought some luggage that I had been scoping out for 3 years, waiting on the best deals.  You know the kind with the spinning wheels so you don’t tip it over while pulling it through the airport.  I got a bargain (80% discounted) and was delighted with the red color which will be easily visible.

I purchased a cashmere sweater for a mere $21 for one of my sister’s birthday, and a summer dress for my daughter for $23.  My husband, well I will leave that story for another day–he hates shopping!

Alright, so I am a bit cranky driving cross country to go to North Carolina, and losing an hour of sleep in addition to moving ahead an hour for eastern standard time.

Why do we move our clocks ahead or behind an hour?  We have credible evidence that this practice does not lead to any reduction in electrical use, especially now with 24 hour TV and internet capability through computers.

So if there is no “green” advantage, we should just leave the time alone.  It saves us from getting out the instruction manual of our automobiles to figure how to reset the clock, and we wouldn’t have to get out a step stool to reach the kitchen clock (at least some of us wouldn’t).  It would be easier when making international calls and we would adapt to more light in  the morning and  perhaps get up earlier and jog or walk the dog or ourselves.

I think the entire process of changing the clocks disrupts our biorhythms and is illogical.  With a new hip president and administration, one can always hope for change!