Breaking Up   Leave a comment

President Trump has been in the Oval Office since January 20 and, have you heard, he hasn’t done anything substantive yet. This new Congress has been in Washington for even less time and … oh, my god, they haven’t passed a repeal-and-replacement bill for Obamacare yet, so clearly they don’t have a plan. (They do, but the one they’re going with right now is Obamacare-lite).

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President Trump has been compared to Hitler, Pot Pot, the Japanese attack on Pearl Harbor, and the 911 terrorist attacks. The New Republic is theorizing that Trump is mentally unstable because of neurosyphilis.

Establishment furor over the two-month-old Trump administration is growing. Forget that 100-day honeymoon most presidents, even President Obama, get.  Talk of removing the Trumpster through impeachment, or opposing everything he does (the progressive “Resistance”), is commonplace. Some op-ed writers and European pundits have openly hoped for his death.

The American media hate Trump with a passion, the entrenched administrative state (called “deep state” by some), the Democratic Party, progressive activities and a fair slice of the Republican Party are all freaking out about his presidency.

Trump is undisciplined and brash, a New York businessman if ever there was one. He’s not the polished (some might say “fake”) Obama and he clearly doesn’t meet the standards of the high-society ruling elite, who have dismissed him as a rude idiot who should never have been elected … and wouldn’t have been if rural rubes weren’t allowed to influence elections, by gum.

They preferred Hillary Clinton, apparently unconcerned that her election would have resulted in a Bush or a Clinton being president for 24 years of the a 32-year span. Dynasty much! Why do we think that’s a good idea on any planet, ever?

This is reminiscent of another presidential campaign. In 1828, the wild and unruly Andrew Jackson was elected president because the rapidly expanding country had tired of the pretenses of the tidewater and New York elites. The tiny coastal establishment of the 1820s perpetuated the ancestry and background of the great but waning Founding Fathers such as George Washington, John Adams, Thomas Jefferson, James Madison and James Monroe. The difficulty with this was that the Founders’ lesser successors had not earned the status they had assumed. They were the grandchildren of the Founders or grandchildren of the Founders’ friends. Jackson won by exposing their pretenses.

What got the Donald elected was a similar popular outrage that the self-described best and brightest of our time are enjoying influence and power over the rest of us without real merit or visible achievement. Trump has at least built a business empire, even if it is based on debt and serial bankruptcy. Barack Obama, Hillary Clinton and most of the members of Congress have never held real jobs (no, being a law intern and community planner does not count as a real job), let alone created an actual job for someone else in their highly-publicized lives.

But who are all these angry elitists? Conservatives refer to them a lot and someone on Facebook or Twitter recently said they didn’t actually exist, that they were bugaboos used to stir up the masses. And, these folks wonder why some of us refuse to listen to their wisdom. Clearly, you are living in a bubble if you haven’t entered elitist trolls, at least of the liberal variety, but even of the Republic flavor.

In California, state planners and legislators spent three decades focused on outlawing plastic grocery bags and not killing rodents by curtailing cutting down flammable brush while California’s roads and dams slowly fell apart. The result is crumbling infrastructure that now threatens the very safety of the public. Powerful Californians with impressive degrees also came up with the idea of nullifying federal immigration law through sanctuary cities. I’m okay with the nullification part, but not with the illegal immigrants who kill or rob American citizens within those sanctuary cities.

In the last eight years, sophisticated Washington, D.C., economists produced budgets that increased U.S. debt from $10 trillion to $20 trillion, as economic growth reached its lowest level since the Hoover administration. And, they declared that to be victory for Barack Obama.

UN Ambassador Susan Rice lied repeatedly on national television about the Benghazi debacle, apparently unaware that the Internet had the video that would show she was lying. And the media backed her up, despite the Internet having the video that proved she was lying. Is it any wonder that Americans are now deeply skeptical of the media?
Over the last year, pollsters and “expert” media pundits assured the public that Hillary Clinton would be the next president … right up until she was overwhelmed by the Electoral College landslide. Were the polls just wrong or were they lying about the polls in an attempt to sway the election?
Elitism sometimes seems predicated on being branded with the proper degrees. Universities now embrace politically correct indoctrination as a measure for these degrees, so how can anyone with a modicum of sense believe that a costly university degree guarantees knowledge or inductive reasoning? Especially, when we’ve seen these degree-holders look like idiots on public television after we’ve told them that their ideas won’t work in the real world. And, by the way, I hold an advanced degree. I just didn’t stop learning after I collected it.

Elites like to believe that their ideology is defined by brilliant and proven theories and they certainly act as if that were true. Meanwhile, we’ve watched university-sired identity politics tear our country apart over the last eight years. Free speech or diversity of thought are not welcome on campuses. Progressive governments have mired most inner cities in deeper poverty.

The Western world is having a breakdown and perhaps a breakup. We’re all over the map on what the solution to our ills is. Is it socialism ala Bernie Sanders? Populism enjoys some fans as evidenced by Trump’s election, the Brexit vote and the spread of anti-European Union parties across Europe. Is the answer to be found in the total state of socialism or the total state of populism?

No! They’re remedies for symptoms, but don’t address the cause of the disease itself which stems from our false notion of elitism.

The public no longer believes that privilege and influence should be based on titles, brands and hype. They want to see demonstrable knowledge and proven character. The elites in the Beltway, Hollywood and Silicon Valley look down on the value of hard work, feeling that the 21st century culture should belong to the “experts” who live in the right zip codes and circulate in the proper social circles while garnering appropriate media admiration rather than from a demonstrable record of moral or intellectual excellence. Meanwhile, the public sees the brilliance that can be manifested in trade skills or retail sales, courage expressed by dealing with the hardship of factory work, or character found on an Indiana farm.

Donald Trump may not be one of those hard-working middle Americans, but he has tapped into the understanding that they don’t see themselves as idiots and they love him for that. It remains to be seen if he will keep his promises to them, but let’s be clear about one thing — Hillary Clinton promised to ignore them entirely … like the elitist paragon that she was. and remains.

I’m still holding out for an understanding that the elite need to be removed and not replaced. Let individuals decide for themselves what is good for us and reclaim the 19th century dynamism that truly made America prosperous. Doing that would require reclaiming the liberty that made that possible.

Can we do it? Yes, we can … if we will.

Soundtrack for a Novel   3 comments

I am not a peace-and-quiet sort of writer. I grew up in a small house where my mom operated a daycare and Brad and I lived for several years, with the kids, in a small cabin. I can write anywhere and ignore the noise level.

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But sometimes music helps to set a mood that the general chaos of living cannot. Often we remember a great movie by its soundtrack and writing a novel sometimes has the feel of writing a movie. The soundtrack is only for me, but it has its place in my art.

Daermad Cycle was inspired by songs by Enya. Makes sense, right? Celtic music inspired a Celtic-flavored novel. And when I’m feeling distracted when I’m working on Daermad Cycle, I still listen to Celtic instrumental music or songs sung in Gaelic.

Big bold instrumental music inspires battles in my imagination, so often there’s a Manheim Steamroller song behind the ringing of swords in my fantasy books. Holst’s “Mars, Bringer of War” is currently my go-to for writing a complicated naval attack scene in Fount of Wraiths. The Verdi Requiem has a similar effect as does the 2nd movement of Beethoven’s 7th Symphony.

Prokofiev’s “Death of Tybalt” is a murder scene from Romeo & Juliet) that is fraught with tension, great for scenes where I might want people to distrust one another, so it gets used a lot.

When my characters start winning battles the 1812 Overture will probably be behind it.

Other types of scenes call for jazz or blues, but I might also plug in some big band, or even zydeco. Often, I just scan through lists looking for something that matches the mood of the scene I’m trying to write. I don’t need music for every scene, but if I’m having trouble getting into it, I head over to my music lists for some inspiration.

You might have noticed — I prefer to be inspired by music that has no words. I’m not a classics snob. I LOVE contemporary music and listen to it a lot, but I don’t want the words telling me what I should think while I’m writing. That isn’t conducive to writing my own story. Enya didn’t count because she was singing in Gaelic.

That “no words” goal makes it a bit more difficult to find music for contemporary pieces, but I don’t seem to need the musical inspiration so much when I’m writing in this world. As I’m moving into sadder and sadder times in Transformation Project, however, I’m starting to look for minor-key classics to inspire those scenes. Brad has suggested that I might need to find some Tchaikovsky or Mozart or zydeco or ska to lighten some scenes. He’s worried I might depress my readers, but the third book in the series, A Threatening Fragility, is about the breaking of our society, so sad and heavy is appropriate. Don’t worry. I’m not a naturally sad or depressed person, so my characters — most of them anyway — will not stay down long, but Brad is probably right that I might need some Vivaldi to lighten my writing mood when those scenes roll around.

 

Don’t Follow Pied Pipers   Leave a comment

Christianity has had its share of “Pied Pipers,”  — charismatic individuals who seem to be able to lead a group of followers anywhere they wish. We wince at the thought of Jim Jones or David Koresh and what they did to their followers, not to mention the name of Christ. Then there are some whose sins have devastated others, and at times have wrought financial havoc for Christian ministries.

Image result for image of church following pied piperIt is not just the “way out” fringes of Christianity which are plagued with leaders who have nearly total control over the lives of their followers, but whose personal lives are out of control. I’ve seen it happen in respectable churches where people should know better. One common element in these disasters is that these men who fell were so powerful and so in control that they seemed almost “unstoppable.” They had been so elevated and revered in the minds of their followers that they were considered beyond the temptations and sins of ordinary mankind. Their followers refuse to believe the evidences of sin. Even if they are guilty of known sin, no one seems to feel sufficiently qualified to attempt to rebuke or correct them.

This is precisely the problem at Corinth. Those who identified themselves with a certain leader did so in pride, confident that his (or her) message and methods was highly esteemed by the culture of that day. Paul reminded them that this was not the way they began their Christian life. He came to them in weakness, fear, and much trembling. He did not come with a “powerful” message or method of presentation, but with the simple proclamation of Christ crucified. While that message and method may not have won the praise of the lost, it was the means of their salvation (2:1-5).

Now at verse 5, Paul commenced to show the folly of exalting one leader so highly that all others are rejected. He used three analogies to illustrate his point.

First, he compares the church to God’s farm.

What is Apollos, really? Or what is Paul? Servants through whom you came to believe, and each of us in the ministry the Lord gave us. I planted,  Apollos watered, but God caused it to grow. So neither the one who plants counts for anything, nor the one who waters, but God who causes the growth. The one who plants and the one who waters work as one, but each will receive his reward according to his work. We are coworkers belonging to God. You are God’s field, God’s building. (I Corinthians 3:5-9)

Notice that Paul wrote of himself and Apollos alone, omitting Peter for the moment (compare 1:12). Paul was the first to come to Corinth with the gospel, followed later by Apollos. These were the two apostles most intimately associated with this church. I like the NET Bible’s translation here because it puts the emphasis on the position, rather than the personality, of the Corinthian leaders. The King James renders the Greek as “Who?”, but the textual critics and translaters at the NET believe “What?” is the more precise translation that focuses on the place or position to which the Corinthians’ leaders have been elevated, rather than upon the personalities of each. “To what position or place have you assigned your leader?” Paul asked.

They apparently thought their leader was above all others. Paul brought the Corinthians down to earth by basically saying “We are not heroes, to be adored; we are not gods, to be worshipped; we are not masters, to be blindly followed. We are simply servants of God, appointed by Him to speak the gospel in Corinthi.” Whatever was accomplished by their coming, it is God who accomplishes it; it is God who is Master; they are but servants. How then can the Corinthians place them on a pedestal?

God did not choose either Paul or Apollos to be the single instrument to achieve His purposes in Corinth. Each had his own task, his own calling. The ministries of Paul and Apollos were dependent upon the other. They were not competitors or rivals, but teammates, fellow-workers.

Both unity and diversity can be seen in the complementary ministries of Paul and Apollos. Both served the same Master; both were engaged in accomplishing the same task. Both were brothers in Christ, but each had his own unique calling and contribution to make to the overall task.

Verse 9 plays a critical role in this passage by serving as a transition from the analogy of the “farm” to that of “construction.” When Paul wrote “For we are God’s fellow-workers; you are God’s field, God’s building,” he told us two very important things:

  • All the saints belong to God, and none of them belongs to any apostle.
  • He distinguished himself and Apollos, as apostles, from all the rest of the saints in Corinth. He and Apollos are apostles; the rest are not.

The apostles played a unique role in the founding of the church, a role not to be duplicated by any other. In a unique way, the apostles did “labor together with God” in their intimate contact with Him, and in being witnesses of His resurrection, but especially in the “laying of the foundation of the church” by being the human authors of the New Testament Scriptures.  (See Ephesians 2:19-22; Hebrews 1:1-3; Hebrews 2:1-4; 2 Corinthians 12:11-12 for supporting passages).

According to the grace of God given to me, like a skilled master-builder I laid a foundation, but someone else builds on it. And each one must be careful how he builds. For no one can lay any foundation other than what is being laid, which is Jesus Christ. If anyone builds on the foundation with gold, silver, precious stones, wood, hay, or straweach builder’s work will be plainly seen, for the Day will make it clear, because it will be revealed by fire. And the fire will test what kind of work each has done. If what someone has built survives, he will receive a reward. If someone’s work is burned up, he will suffer loss. He himself will be saved, but only as through fire. (1 Corinthians 3:10-15)

In this passage, the church is likened to a building which is under construction. Paul called himself a “wise master builder,” who had laid the foundation on which others built. When Paul referred to himself as a wise master builder, it was with a very deliberate goal in mind. The Corinthians thought themselves wise, and they considered Paul and the other apostles simple, foolish, and weak. Their thinking was wrong! Paul was wise whether or not the Corinthians (or we in modern times) believed it to be so.

Paul distinguished himself from Apollos in this passage. In the prior paragraph, Paul was the one who planted; Apollos was the one who later watered. Now, Paul alone is the foundation-layer in Corinth, and others like Apollos built upon that foundation. Apollos was a powerful and eloquent speaker, a man mighty in the Scriptures (Acts 18:24), but also a man who built upon the foundation Paul laid in Corinth. Apollos was trained in the gospel by Priscilla and Aquila, who were students of Paul, therefore, Apollos learned the gospel second-hand from Paul. He built on Paul’s foundation. Paul’s work of “foundation laying” is represented as a finished work, as a work which is not to be repeated.

Paul looked upon his mission of laying the foundation for the Corinthian church as complete. What remains was for the saints at Corinth (and elsewhere) to completing the construction. The proper function of each worker is Paul’s primary focus.

Paul was not talking about salvation here. This is not a proof-text for the doctrine of purgatory. Paul was saying that a Christian’s works may be burned up by the fire of divine judgment, but not the believer. The believer will be saved, but only by the “skin of his teeth.”

Some argue that Paul’s words encourage the “carnal Christian” to live a careless, self-indulgent life, knowing he will get to heaven regardless. A very few Christians think that they can get the “best of both worlds”, free to sin and yet be forgiven and saved. How foolish and dangerous! Paul’s next words are aimed right at those who might try to pervert his teaching in practice, so that a life of sinful self-indulgence is based on the “comfort” of his words in verse 15.

Do you not know that you are God’s temple and that God’s Spirit lives in you? If someone destroys God’s temple, God will destroy him. For God’s temple is holy, which is what you are. (1 Corhinthians 3:16-17)

The Corinthians thought they were very smart and yet Paul demanded “Don’t you know …?” The building described by Paul as under construction in verses 10-15 was “God’s building”. Paul now explains that the church is God’s temple, His dwelling place. While elsewhere Paul spoke of each individual believer as God’s dwelling place (1 Corinthians 6:19), here he spoke of the whole church as God’s dwelling. We are not the temple, but we are a temple, a place where God dwells. Because God dwells there, the temple is holy, and it must remain holy.

We should understand the seriousness of defiling God’s temple. When we live godly lives, in obedience to His Word through the power of the Spirit, we display God’s glory (1 Peter 2:9). We are good workers, building up the church in accordance with our calling. But when a Christian fails to fulfill their mission, then they become a detriment to the church. In the symbolic terminology of Paul, we “destroy” (NASB) or “defile” (KJV) the temple of God when we are not building well.

The consequences for such defilement are severe, because we are defaming the reputation of God by defiling His temple. Those who would do damage to God’s dwelling place should expect severe consequences. Paul did not mince words when he warned, “If any man destroys the temple of God, God will destroy him, for the temple of God is holy, and that is what you are” (verse 17).

We know from the preceding verses (especially verses 13-15) that a Christian will not lose his salvation, but that he will lose his reward. Lest one feel too smug and secure in sin, however, let him ponder the meaning of the word “destroy” in verse 17. Paul did not seek to comfort any Christian who sins willfully. This passage cannot be construed to encourage a sinful, carnal, lifestyle, for Paul’s words of warning are clear.

We today live in a consumer age. A lot of the church growth movement caters to members, or seekers, as consumers. It’s like a marketing program that finds out the kind of church people want to attend, and then seeks to provide that kind of church. Consequently, some churches may have many of their pews filled, but with people who expect, even demand, to get what they want from the church in terms of services, at little or no cost to themselves. They want to get much and give little.

Paul knew nothing of this kind of church. Paul knew only of the kind of church where every member is a worker, and where there is no such thing as a shirker. Paul’s words have a very clear inference. He assumed we know that we have an obligation to build the temple, to play an active role in the building up of the church as the body of Christ. Why then in most churches do a few members give much, some members give a little, and many to most members do not give at all? Why does the church have so much trouble getting volunteers to teach in Sunday School, and to help with the many tasks in the church? It is simply because many consider themselves a part of the church (rightly or wrongly), but fail to grasp the fact that God requires every member of it to be a working member, contributing to the growth and ministry of the church.

Not only are we obliged to be an active contributor to the construction of God’s temple, we are to build upon the foundation of the apostles. While in those days, the churches had to remember Paul’s words or perhaps refer to a letter, we have the New Testament. To build well, we must know the foundation well, for all of our building must conform to “the code” the Bible sets down. Some people seem to think that “working hard” in the church is enough. Paul wouldn’t agree. We are to work hard, but only in compliance with, and in submission to, His Word, the Bible. For the builder who would work so as to please God and to obtain His approval and reward, he or she must build in accordance with sound doctrine as taught by the apostles.

Doctrine is therefore important to every Christian, and not just for the theologians, because it is foundational. Sound doctrine is not required just for those who teach; it is required as the basis for each and every ministry which takes place in the church. Those who show mercy should do so in accordance with sound doctrine. Those who give must give in accordance with sound doctrine. For example, they must not give to the support of those who are false teachers (2 John 7-11). Those who serve should serve in accordance with sound doctrine. Those who “love” must love within the confines of sound doctrine (Philippians 1:9-11).

Sound doctrine is the basis for all ministry. We dare not seek to serve God apart from sound doctrine.

Divisions, often the result of following a particular leader and rejecting all others, are a very serious offense. For saints to be divided and opposing one another is a tearing down of the church, not a building up of the temple of God. Let us see the evil of divisions, and also the serious consequences which it brings to us personally.

How Could They Make It Worse   Leave a comment

So when Rick and I started our series, we didn’t yet know what Congress was going to propose for certain, but they came out with the House plan now (March 8), so we decided to write up our impressions.

The draft House health insurance bill fails to correct the features of Obamacare that drove up health insurance and medical care costs and mainly just tweaks Obamacare’s financing and subsidy structure.

The bill focuses on protecting those who gained subsidized coverage through the law’s exchange subsidies and Medicaid expansion, while failing to correct Obamacare’s misguided insurance regulations that drove up premiums for Americans buying coverage without government subsidies.

 

The draft bill leaves Obamacare’s costly insurance regulations in place and attempts to offset those costs with the same basic approach.

Approximately 22 million individuals currently receive subsidized health insurance coverage through the exchanges (8 million) and the Medicaid expansion (14 million). For them, Obamacare’s higher insurance costs are offset by the law’s subsidies.

About 25 million Americans with unsubsidized individual-market coverage (10 million people) or small-employer plans (15+ million people) are the ones who most need relief from Obamacare that can only be supplied by repeal, and they probably don’t care about or for replacement. Their experience of Obamacare has basically been “all pain, no gain,” as they have been subjected to significant premium increases and coverage dislocations with no offsetting subsidies.

Unfortunately, the draft House bill provides no meaningful relief for that group of middle-class Americans who are most adversely affected by Obamacare and are most supportive of repeal.

The draft bill leaves Obamacare’s costly insurance regulations in place and attempts to offset those costs with even more subsidies.

The draft bill’s new Patient and State Stability Fund is particularly problematic. It would provide grants to states of up to a total of $100 billion over the nine years, 2018-2026. What are the significant problems with this new program? They’re substantial.

  • It substitutes new funding for old Obamacare funding without adequately addressing the misguided Obamacare insurance market rules and subsidy design that made the exchanges a magnet for high-cost patients. Those Obamacare mistakes created an insupportable burden on the individual insurance market by concentrating expensive patients in only that small portion of the total market.
  • Like Obamacare, it doesn’t actually reduce premiums, but rather uses subsidies to mask the effects of Obamacare provisions that drove up premiums in the first place.
  • It creates a new entitlement for states.

Furthermore, without a resulting reduction in unsubsidized premium levels, future Congresses will likely face pressure from states and constituents to extend and expand the program. It will become a creeping Medicaid-like drain on resources that will destroy medical care access in this country. Under the Medicaid expansion, the federal government reimbursed states 100 percent of the cost of expanding Medicaid to able-bodied adults, with federal support eventually declining to 90 percent. These are able-bodied people who earn a living (in Alaska, up to $52,000 a year for a family of four) and their medical care is paid for by the taxpayers.

Yet, states continue to receive significantly less federal assistance (50 percent to 75 percent, depending on the state) for covering the more vulnerable populations (such as poor children and the disabled) that the program was intended for. That policy was both inequitable and unaffordable.

The draft bill does not correct that inequity, but rather reduces the enhanced match rate from 95 percent to 80 percent. The better approach would be to allow states to immediately cap expansion population enrollment, while also setting federal reimbursement for any new expansion enrollees at normal state match rates.

Such changes would likely limit the addition of new individuals to the program, and also substantially reduce the size of the federal revenue loss that expansion states will incur when the program terminates. That is because a significant share of current enrollees can be expected to leave the program for other coverage during the transition period.

Yet another policy mistake is the failure to take the first step toward providing more equitable tax treatment of health insurance.

The House version drops a proposed cap on the unlimited tax exclusion on employment-based health insurance contained in an earlier version, while retaining the so-called “Cadillac tax”—the 40 percent excise tax on so-called “high-cost plans”—and delaying its implementation until 2025.

Congress should kill this punitive excise tax and replace it with a cap on pre-tax funding so as to encourage employers & workers to evaluate the trade-off between higher health care spending and higher cash wages, to rethink how much of total employee compensation should be devoted to health benefits.

While the Cadillac tax would force employers to alter the health benefit plans that they provide their workers, no such effect would result from the cap on the exclusion. It would instead limit the amount of employer health benefits that constitute pre-tax income to workers, which would make the tax treatment of employer-sponsored health benefits consistent with the tax treatment of other benefits (such as retirement savings plans, group life insurance, and dependent care) offered by employers.

Workers would still be able to use after-tax income to purchase additional coverage, just as they can with other employer benefits, and the employer would still be able to offer a plan whose value exceeds the level of the cap on pre-tax funding.

This bill misses the mark primarily because it fails to correct the features of Obamacare that drove up health care costs. Congress should continue to focus on first repealing the failed policy of Obamacare and then act to offer patient-centered, market-based replacement reforms. Stop making patients into a group where things are done to them and put them back in control of their own health care.

Primary Care Clinics Another Option   Leave a comment

The United States medical care crisis has been a long time coming.

Image result for image of medical careIn 1910, the physician oligopoly was started during the Republican administration of William Taft. The American Medical Association lobbied the states to strengthen the regulation of medical licensure and allow their state AMA offices to oversee the closure or merger of nearly half of medical schools and also the reduction of class sizes.  Those restrictions remain in place today, severely curtailing the number of doctors who can enter the market because the bar is very high to get into medical school.

In 1925, prescription drug monopolies begun after the federal government (under Republican President Calvin Coolidge) started allowing the patenting of drugs, essentially creating monopolies.

In 1945, buyer monopolization begun after the McCarran-Ferguson Act led by the Roosevelt Administration exempted the business of medical insurance from most federal regulation, including antitrust laws.  (States have also more recently contributed to the monopolization by requiring health care plans to meet standards for coverage.)

In 1946, institutional provider monopolization begun after favored hospitals received federal subsidies in the form of matching grants and loans provided under the Hospital Survey and Construction Act, passed during the Truman Administration.

In 1951, employers started to become the dominant third-party insurance buyer during the Truman Administration after the Internal Revenue Service declared group premiums tax-deductible.

In 1965, nationalization was started with a government buyer monopoly after the Johnson Administration-led passage of Medicare and Medicaid which provided government-provided health insurance for the elderly and poor, respectively.

In 1972, institutional provider monopolization was strengthened after the Nixon Administration restricted the supply of hospitals by requiring federal certificates-of-need for the construction of medical facilities.

In 1974, buyer monopolization was strengthened during the Nixon Administration after the Employee Retirement Income Security Act exempted employee health benefit plans offered by large employers (e.g., HMOs) from state regulations and lawsuits (e.g., brought by people denied coverage).

In 1984, prescription drug monopolies were strengthened during the Reagan Administration after the Drug Price Competition and Patent Term Restoration Act permitted the extension of patents beyond 20 years.  The government has also allowed pharmaceuticals companies to bribe physicians to prescribe more expensive drugs.

In 2003, prescription drug monopolies were strengthened during the Bush Administration after the Medicare Prescription Drug, Improvement, and Modernization Act provided subsidies to the elderly for drugs.

In 2014, nationalization was further strengthened after the Patient Protection and Affordable Care Act of 2010 (“Obamacare”) provided mandates, subsidies and insurance exchanges, and the expansion of Medicaid.

 

With each new law or set of new regulations, restrictions on the medical care market went further, until, at some point in the 1980s, people began to notice the cost of medical care had skyrocketed … soon to be followed by the cost of medical insurance.

As regulators allowed special interests to help design policy, everything from medical education to drugs became dominated by virtual monopolies that wouldn’t have existed if not for government’s notion that intervening in people’s lives is part of their job.

We started meddling in 1910, but costs didn’t go up immediately and that causes a lot of short-sighted people to think the regulation is not related to the increased costs. They’re wrong, but some regulation was more harmful than other regulation.

In 1972 President Nixon restricted the supply of hospitals and clinics by requiring institutions to provide a certificate-of-need, then in 1974, the president strengthened unions for hospital workers by boosting pension protections, which increased the cost for hospitals. This move began to force doctors who once owned and ran their own hospitals to merge into provider monopolies. These, in turn, are often only able to keep their doors open with the help of government subsidies, so increasing costs to taxpayers..

As the number of hospitals and clinics became further restricted and the medical care industry became obsessed with simple compliance, patients were the first to feel abandoned. According to Business Insider, the average doctor has thousands of patients, and each visit lasts less than 30 minutes. As many in my parents’ generation can attest, doctors listened to their patients prior to the government’s slow but absolute control of medical care, doctors listened to the patients and medical care was easily affordable. Now, doctors can hardly recall the conversations they have with the people they are supposed to be looking after.

Insurance is not the same thing as medical care, but President Barack Obama pushed further restrictions on the insurance industry by touting the Affordable Care Act as a piece of legislation that would make insurance more affordable. That didn’t work out. Insurance had already been increasingly slowly over the years, but since the passage of the ACA, there’s been an average increase of 153% in premiums. And as a result, a new group of independent medical care professionals ignited one of the most liberating revolutions in recent U.S. history. As ACA became increasingly suffocating to patients and providers, many doctors ditched the system altogether while others went into the primary care business.

On average, members of these direct primary care clinics pay as little as $60 per month, with couples paying about $150, which is a lot less than the cost of full medical insurance.  Without having to handle heavily regulated middlemen, patients have a clearer picture of how much they spend on their health by being members of such practices. They also enjoy the peace of mind of knowing their doctor.

Studies have already demonstrated that when there is good communication between doctors and patients, treatments are more efficient. This is not simply because doctors are giving patients attention, but also because they are able to tailor a certain treatment to that patient’s lifestyle, health, and activities.

What many people don’t understand about government-run medical care is that government bureaucrats apply a one-size-fits-all mentality to everything, but what bureaucrats fail to understand is that they do not possess all the answers. Only a doctor who is paying attention will be better able to help the individual patient. Those needs cannot be addressed by a few thousand new regulations under either the ACA or the AHCA.

What this growing movement seems to suggest is that, even if doctors and patients are unaware of the interventionist forces driving the cost of doing business and receiving medical attention, they’re still driven into the open arms of the free market at some point or another.

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Posted March 24, 2017 by aurorawatcherak in Uncategorized

Removing Barriers to Medical Care   Leave a comment

I believe that we all have a right to medical care, but not in the way the progressives want us to believe. My belief is similar to the belief I have in the right of free speech and the press. You have a right to write and publish and to gain access to the tools to do so, but you don’t have a right to compel others do do it for you. So, if the local newspaper doesn’t want to run your article, it doesn’t have to, but if you pay for a blog or your own printing press, nobody has a right to stop you from publishing.

Image result for image of medical care as open marketI have the same belief in the right to medical care. You have a right to access care that you pay for, but you don’t have a right to compel others to provide it for you.

Sadly, the United States government at both the state and federal level have erected barriers that limit your access to medical care. The steepest of those barriers are the licensing laws. Removing those barriers should lower costs while improving quality.

 

Both of my children and two of Rick’s grandchildren were delivered by direct-entry midwives, but barriers against such practitioners in many states limit access, driving up prices and, if you compare US outcomes to European outcomes, endangering the lives of mothers and their children. 

Regarding the different classifications of midwives, the regulations vary from state to state. Nurse-Midwives are legal nationwide but different states have different regulations that cover what they may do, if they can work independently of a doctor, or if they must be supervised by one.

Certified Professional Midwives (CPMs) have been to a school for training but are not nurses. Twenty-six states allow CPMs to practice with some variations in what they legally can do.

Direct entry midwives typically study as an apprentice under someone else before beginning their individual practice, and their practice varies from state to state. Their legal standing is not clear in some states.

Since Medicaid pays for almost 50% of all births, midwives offer the nation an opportunity to save tax dollars while providing mothers with another choice. Europe uses direct entry midwives for 80% of their deliveries, nurse-midwives for most all of the others and their mortality rate for mother and child are much much lower.

It isn’t just the barriers to midwives that have created problems for patients. Other workers have seen their professions restricted as well, and with that comes physical and financial harm to patients. Nurse practitioners should be at the top of any list of professionals allowed to work without restrictions nationwide.

Nurse practitioners are an often overlooked source of health care and, according to Kaiser Family Foundation, can “manage 80-90% of care provided by primary care physicians.” Research shows that patients are just as satisfied with the quality of care provided by nurse practitioners as by primary care physicians.

An Institute of Medicine Report, from 2011, The Future of Nursing: Leading Change, Advancing Health, states that “what nurse practitioners can do once they graduate varies widely for reasons that are related not to their ability, education or training, or safety concerns, but to the political decisions of the state in which they work.”

Twenty states allow nurse practitioners to work independently of physicians to diagnose and treat patients. Twelve states require physicians to supervise nurse practitioners. Nineteen states allow them to practice as long as they have an agreement to work in collaboration with a physician. Other laws limit their scope of practice by not allowing practitioners to prescribe drugs.

With the aging of society, we will see an increase in the need for medical care, but layer upon layer of regulations makes it hard for practitioners to enter the field and thereby makes care expensive, complex and frequently unavailable.

 

 

Removing these barriers is key to improving access to medical care and lowering costs. Obamacare made those barriers even higher, but now we have an opportunity to remove the barriers entirely and allow the open market to work as it should. Let’s lead the way!

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