Contrast the national median income for a family of four -- $55,775 -- against the average bureaucrat or congressional or presidential staffer, who earns twice what the average American family does (members of Congress earn 3.2 times their average constituent), and the picture becomes clear. They can't possibly understand the daily life of the average American. In this context, the GOP proposal to "repeal and replace Obamacare" makes perfect sense. From their cushy perch -- $16000 a year for health insurance is not such a big number.
The people who are coming to town halls have a point. Their justifiable anxiety (some of it sparked by politicians and the news media) stands in the way of a down-payment on reforming Obamacare in short run and reforming our health care delivery system in the medium to long term. These vocal town hall participants are part of the 1 percent of the USA population that incur 23 percent of the cost of health care in the United States. Here's how we can help these people without raising insurance premiums for the other 95 percent!
It is an axiom of American politics that Americans reject a public health care option. Rhetoric to the contrary: 49.6 percent of the American people get their health care paid for by a government-run insurance program. The dictionary definition of a public option! Instead of railing against it -- why not seize the opportunity?
Recently my allergy doctor suggested a vapor treatment for my pollen-driven tightened chest. I said okay. It never occurred to me to ask how much does the treatment cost because I won't get a bill. The charge will merely be an object of curiosity when the insurance company sends me an explanation of benefits they paid. If the insurer is required to pay – no questions asked – for tests and treatments, our profit-making health care eco-system is going to prescribe more at a higher cost each. That leads directly to rising insurance premiums. If I had to pay the bill for that treatment, I would have asked more questions about the cost and efficacy.
By the time I had printed out a copy of the just released Congressional Budget Office (CBO) cost estimate of the GOP proposal to "repeal and replace Obamacare" my inbox had filled up with draconian headlines. A complete reading of the 27 page report paints a more complicated picture but does urge caution as the House of Representatives moves to debate. But, if we examine the CBO's underlying assumptions, their analysis, itself, is complicated and more conjecture than fact.
Healthcare is 20 percent of the United States economy. It impacts each and every American. It's a huge problem and it can only be solved through a bi-partisan debate in full view of the American people. The GOP bill does nothing to address the health care affordable crisis: It does nothing to reduce the cost of health insurance because it does nothing to change the underlying healthcare cost crisis. It does nothing to reduce the employer-based premium increases triggered by Centers of Medicare and Medicaid (CMS) Obamacare mandates.
If we want good healthcare coverage with reasonable insurance premiums, Americans must become active consumers. We must advocate for a system without hidden costs. If we want the impending debate in Congress to conclude with a better outcome than just "Obamacare2.0", we, the people, are going to have to hold our representatives' feet to the fire! We must insist they begin with a comprehensive investigation of the underlying costs of healthcare.
The specific issues at Veterans Administration boil down to one simple fact: The VA duplicates services other government departments provide more efficiently to the general population!
To get effective, efficient government we must improve the capability and capacity of government information technology teams at every level of government.
There is a troubling juxtaposition between the President pictured in the Situation Room during the Bin Laden raid and the absence of any evidence the President and his health care policy and technology team ever conducted an ACA milestone review. In the former, the President had no control over the roll-out and the latter he had absolute control of the roll-out