And, we're going to get 'change' if the Democrats have their way...and that seems likely.

Saxby Chambliss (R-GA) retained his seat in the senate yesterday so the Democrats will not have the magic number necessary to absolutely control the senate.  The outcome in Minnesota is still somewhat in question, but, at the rate that new votes for the Democrat candidate are being 'found', I suspect that he'll prevail.

The problem with Republicans in the senate has always been the number who have worked hard to earn the right to be called by that ugly name, "RINO"; "Republicans In Name Only".  Those people are still there and they are still beyond the ability of the Republican leadership to 'control'.  Even though the Democrats will technically be unable to override filibuster attempts, the RINOs will often tip the scales by bolting from the 'party line'.  Those three or four people tend to be more liberal in their thinking than conservative.

So, we are going to see the 'change' we voted for in November.  The only questions remaining, in my mind, are just what that 'change' will be, how quickly it will occur, and how much it will cost.

The magic "first 100 days" comes into play so far as answering the question of how quickly change will occur.

The Democrat leaders are busy shaping what they'll propose, developing the time lines for each, and determining whether or not they'll go for a few all-encompassing bills or take smaller bills up, pass those and bask in the victories during the course of those first 100 days.

The likely items include the vaunted "economic stimulus plan", a bill requiring electric utilities to be using renewable sources for at least 15% of their power by 2020, a big push on funding and hurdle-clearing for embryonic stem cell programs and increases in the funding and reach of the State Children's Health Insurance Program (SCHIP).

After the meeting between governors and the president-elect yesterday, I presume we'll also see some kind of state-directed stimulus programs proposed, possibly as part of the overall stimulus package.

Change is around the corner.  The Democrats understand that they will be gaged by what they accomplish in the coming two-year period, so far as the elections that hit two years down the road for the entire house of representatives and for one-third of the senate seats in Congress.

As always, these are interesting times in which we live.

There is more and more speculation as to the potential that we'll see a 'clean sweep' by Democratic candidates on Tuesday, November 4th at both the state and federal levels.  I hope that isn't the way it turns out, but I'm tiring of being beaten about the head and shoulders every time I read a newspaper article or watch the bulk of the television news items.  Maybe that is the intent.  If us conservatives can be sufficiently demoralized, maybe we'll just stay home.  Not this conservative!

What do I mean by 'clean sweep'?  I refer to the potential that both the Assembly and the Senate in Wisconsin will see a sufficient Democratic majority that will be able to pass anything they wish in spite of the number of Republican votes that could be massed, with assurances on most such items that those will be signed into law by the Democratic Governor Doyle.

Similarly, I refer to Democratic victories in both the U.S. House and Senate that will be Republican-proof and that will likely find favor with a Democratic President Obama.

Jay Weber has done a good job on setting forth 23 items that could be part of the triumvirate of Sen. Harry Reid (D), Rep. Nancy Pelosi (D) and a President Obama and you can find those by clicking here.  Things included on Jay's list include renegotiating NAFTA, ending secret ballots in union organizing, government-run healthcare encroachments, reintroduction of the 'Fairness Doctrine' to control conservative access to the airways, and so on.

At the state level, we could easily see state-run health care, the increase in costs of education, ever larger portions of our income going to state and local taxes,  more and more loss of personal freedoms and so.

There has been, in most of our history, a certain "check and balance" relationship in most of our governments so that not everything that was proposed was ever likely to be passed.  That 'protection' could disappear for years if we see the 'clean sweep' at the state or federal levels, or both, as the result of our national election on November 4th.  Our country tends not to flourish well under such governments regardless of party in power.

Vote your conscience next Tuesday!

Much is being written and discussed during this Presidential election period about health care reform.  Barack Obama prefers a government-run version of reform.  John McCain prefers a private market reform that would use tax law changes to accomplish nearly-universal coverage...the stated goal of both approaches.

I saw a news report this morning that serves as a great reminder of one of the things we need to be mindful of if we are going to move to government-run health care.  Here is that article:

Medco CEO argues for federally mandated end of life care protocols for Medicare patients.

CQ (9/17, Weyl) reports that in a recent speech at the National Press Club, chairman and CEO of Medco Health Inc., David B. Snow Jr., said that "the federal government should set protocols based on medical science to guide Medicare treatment for patients at the end of their lives." Snow elaborated that "30 percent of Medicare spending -- about $130 billion per year -- is spent on patients in the last year of their lives, often when recovery is no longer possible." But, nearly all of that money could be saved by establishing guidelines "of when to forgo further treatment." Snow also proposed "increasing electronic medical coordination, passing tort reform, promoting healthy lifestyles, and encouraging compliance among patients," which would save an estimated "$1 trillion per year, or half of current healthcare spending."

I have written of the "R" word before.  Rationing is a very common practice where tax dollars are used to fund health care.  I recall the situation recently reported from Oregon where a patient with cancer was not accorded medicines that likely would prolong life, but would be accorded coverage for 'assisted suicide' since that is legal in Oregon.

 

This isn't intended as a debate on the efficacy of withholding treatment that would extend life.  It is intended to provoke some thought about the need for such decisions if we go down the government-run health care road.  There will never be enough tax money available.  We see that in the debate over a new school building, and in road repair discussions and so on.

 

When there is not enough money in a government-run health plan, the patient will pay the price.  The organizational structure won't be pared down and taxes won't be increased because it is politically unpalatable.  The weakest link in this chain is the patient who has no way to fight the decision.  A "dispassionate" board who have never met the patient will make "an informed" decision and move on to the next agenda item.

 

Medicare is government-run healthcare.  Medicaid is government-run health care.  Between the two programs, more than 50% of the people in the United States already have health care coverage provided by the government. 

 

So, we debate the question all the while that government-run health care grows essentially unchecked.  The next step in Wisconsin, by the way, after BadgerCare Plus is to be BadgerCare Connect...if the politicians on the Democrat side of the aisle in Madison have their way.

 

Incrementalism is alive and well in Wisconsin.  It reminds me of the old saw that asks how one eats an elephant?  The answer, of course is: one bite at a time.

Oregon has had government involved in health care for quite a few years.  The state electorate also approved the concept of state sanctioned suicide several years ago.

Recently, the board that reviews the medications that are approved for state residents made a determination that was controversial...in my mind if no where else.  The board, in essence, said that, given the cost of a certain medication, it would approve suicide for this patient but would not approve use of the medicine given its relative newness and the lack of convincing data as to the outcome.  It had essentially set a price on the human life involved.

Today I read the story concerning Denver Children's Hospital and heart transplants in infants that use the heart from another infant that died a 'cardiac-related death'.  This differs from a heart harvested from a brain-dead infant in which that heart is beating until removed from the donor body.  A decision has been made that the donor that has been pronounced dead and has been in that state for only 75 seconds, is a valid heart donor for purposes of this new program.  The earlier line that had existed required death be determined only after some five minutes during which time the heart did not re-start itself.  In this instance, the length of time a person had been deemed 'dead' had been reduced to assure that the harvested heart had a decent chance of functioning in the new body.  The three cases in which this approach has been employed resulted in three infants alive today.  The decisions to withdraw life support were made by the parents in all three instances.

We know so much more today than we did a decade ago.  We can do things from a medical perspective that were impossible then, and these procedures have become commonplace now.  We are, in this area, pushing the envelope as it has never before been pushed.

I know there are at least two sides to these issues.  I have good friends whose daughter lives today because of transplanted organs that were available on a timely basis.  I can't even begin to comprehend being placed in the middle of such decisions, and I earnestly hope that never befalls me.

And this leads to my general question:  Is there a line we dare not cross?  If so, where is or was that line?  Am I comfortable with an appointed board making life and death decisions about me?  Who among us can claim the right to make such a decision?  How do medical ethicists deal with these kinds of issues?

I don't profess to have the answers to these questions.  If you do, and you're willing to share, I'd appreciate your comments.

We are, by all signs, involved in an oil cost run-up driven by demand being greater than supply.  It is exacerbated for us Americans because our monetary policy has seen an intentional softening of the dollar (our money is worth less than other peoples' money, so it takes more of it to buy a barrel of crude oil).  I paid $4.20 per gallon yesterday with the price of crude oil standing at about $130 +/- per barrel.  Predictions of crude oil prices of $150 per barrel or more are seen or heard regularly now.  And, the cost of oil could well be higher than that by year-end.

How did we get to this point?  We got there by congressional law making, by presidents rolling over and signing those bills, and by our country's increasing needs/demand for gasoline and diesel fuel.  Why would we permit ourselves to become part of such a quagmire?

Politics!  Politics played by those on both sides of the aisle.  Conservatives seem to have lost their voices.  Liberals never seem to lose their voices.

Laws were re-written more than thirty years ago to make it nearly impossible for a new refinery to be built.  Those were the result of congress being rolled by the environmentalists and presidents either believing the rhetoric of the day or fearing the backlash should they stand up to the rhetoric.  This has continued to this very day.  We are forbidden from drilling within 200 miles of the California and Florida coastlines but the Chinese are already doing so as we sit on our thumbs.  We are unable to pursue the shale oil deposits that span our northern plains and southwestern states.  We have ample untapped resources that are readily available but our laws don't permit us to make use of those resources.

We see the 'global warming' group and the 'environmentalist group' driving our economy into the ground...and we have not found the moral outrage/courage to stand up to them and say "no more"!  We could easily build new refineries in any number of locations around our country but we're not permitted to do so.  We know how to drill and refine today without ruining our world.  It takes from 6 to 10 years to bring a new refinery on-line so the time to have declared a moratorium on the rules that made it impossible to build new refining capacity has come and gone.  But, the typical congressional response of "that will take ten years" should remind us that if we don't roll back those silly laws today, it'll take ten years from whenever we do roll back those silly laws.  The time to begin is now, not next week or next month.

We witnessed the ridiculous 'hearings' held by congress in the past few weeks.  We watched as Sen. Herb Kohl embarrassed himself by chiding the 'big bad oil companies' for making a profit.  He is a former businessman who certainly understands that profit must be derived in order for businesses to exist and grow.  He knew how that worked when he ran Kohl's Food Stores.  He certainly must have some comprehension as the owner of the Milwaukee Bucks.  His statement to the oil company executives that their profits didn't seem fair gives one a lot of insight.  He knows better but he will play/pander to the crowd he favors.  He 'feels' as do most liberals.  He doesn't necessarily reason.  He has his millions, so he can set out to control everyone else who aspires to similar success.

Sen. Kohl is but one of the 535 members of congress.  Too many of those men and women are too intent on keeping their offices to actually vote the way they probably know they should.  You have probably heard the old phrase that states you must "go along to get along".  That should be inscribed over the doorways leading to the House and the Senate chambers since it is the rule that is followed by the vast majority of people who walk through those portals.  That is true on the national stage, the state stage and the local stage.

The people who go to Washington and who do not give in and play by the Washingtonian rules are few and very far between.

Whose fault is this dilemma in the final analysis?  Yours and mine. 

We're the men and women who have permitted this to happen.  We don't vote in the House or the Senate, but we do elect those who do...and we do not seem to unelect people very often once they've gotten into office.  Rep. Steve Kagen (D) from the Appleton area stands for re-election this November.  He is at his most defeatable point historically.  If he survives the first re-election campaign and keeps his seat, he is likely to be in that seat for so long as he desires without regard to how he votes or doesn't vote.

We're so unconcerned about our vote, it seems, that we don't even think voting is sacrosanct enough to require valid photo identification before we're permitted to cast a ballot. 

So, all this angst has been brought to us by us.  Remember that the next time you buy gasoline or diesel fuel.  Remember that the next time you go to the grocery store and try to make your food budget stretch.  Remember that when you ponder whether or not you'll be able to take a vacation this year, or buy new school clothing for your children, or go out for a fish fry.  Remember that when you try to stretch your retirement income to cover your basic needs.

And, when you've gotten yourself all 'cranked up', if that happens, make a resolution to get involved and stay involved and to talk with your elected representatives at every level of government and let them know what you think and what you want them to do on your behalf.  And, if they fail you, fire them with your vote at the polling place.

Had you and I done that two decades ago instead of simply going with the flow, maybe we'd not be in the situation we find ourselves in today.

The Center on Wisconsin Strategy and the Wisconsin Council on Children & Families, both found in Madison, have released a report that reaches the startling conclusion you see in the headline above.

Wow!  What a surprise!  Further into the article in today's Journal Sentinel that discussed this amazing statistic, we find out that Wisconsin actually ranks quite well so far as this measurement is concerned...but apparently not well enough to make these groups comfortable.  The report shows that the gap in Wisconsin is actually smaller than on average across the country.  The report found that Wisconsin actually ranks 11th out of the 50 states in this regard, and that means the gap between top and bottom fifths of the population are lesser.

But, there are the usual suggestions made to 'correct' this terrible situation:

• Increase the minimum wage and then index it to inflation.
• Improve worker skills and education.
• Expand subsidized childcare and health care for low-income workers.
• 'Update' unemployment insurance.
• Make taxes 'more progressive'.

This 'minimum wage' canard is so old and tiresome but it just keeps coming back.  There are positions in the workforce that do not command more than the current minimum wage.  Every time the minimum wage is increased, it displaces workers at the bottom end of society because the jobs simply go away. The majority of minimum wage jobs are held on a part-time basis by students and homemakers, and not be sole bread winners.

Improving worker skills and education is a noble undertaking, it is one that we are engaged in already, and it speaks to the need to get MPS working since it seems intent on not graduating 53% of its students thus relegating them to those minimum wage jobs and/or welfare programs (except that you have to read for many of those, so I guess that is out).

I don't know where the people have been who built this study, but every time we turn around, we are expanding childcare and health care for low-income workers.  Look at BadgerCare and BadgerCare Plus.  Listen to the radio commercials begging people to come in to sign up for welfare programs.

Apparently unemployment insurance should be 'updated' (read increased) so the people who are unable to hold jobs get more money until the benefit runs out.  Maybe a better tax climate in our wonderful state would prompt the creation of more jobs and remove the increasing need for the unemployment insurance program 'update'.

Finally, the ultimate liberal solution for every ill to be found in society:  let's take more money away (tax increases) from 'the rich' and give it to the poor.  This class warfare shot is being heard all too often in the current presidential campaign, and it fails to define just who the 'rich' are; be careful middle class; you may be rich.  We don't need to resort to the use of this class warfare tactic in Wisconsin.  In case the 'ruling class' hasn't figured it out, our taxes are already too progressive.

These studies drive me nuts (as is plainly seen from this Blog).  Lower our taxes as Texas has done for its citizens and employers, and watch what happens to unemployment, etc.

What a surprise.  The rich get richer faster than the poor.  The real surprise is that liberals have yet to figure out how cause and effect function in this equation!

I had the 'pleasure' of meeting with one of Congressman Obey's staff members, Paul Carver, on Super Tuesday in the Congressman's absence.  Obey is the Congressman who represents Wausau and the surrounding area, and who is the 'Big Dog' so far as appropriations go in the new world controlled by the Democrats.  Congressman Obey has the reputation of a 'pit bull' and it appears that he hires in his own image.  The staff person, Paul Carver, is a native of England and had an attitude that was apparent from the very moment he walked out of his area and stated that ours weren't the names he had been expecting.  We had the pleasure of Mr. Carver's presence since the House of Representatives isn't in session this week.  I have no idea if the Congressman would've been more hospitable, less hospitable or about the same.

We were representing the National Association of Health Underwriters, a well-respected association in Washington,D.C.  NAHU represents 20,000 insurance agents and brokers who collectively handle the health care insurance coverage for some 150 million citizens.  We wanted to discuss the legislation that we expect which will affect health insurance for every citizen of the United States.

Mr. Carver proceeded to rant about how great socialized medicine was, how rotten insurance companies were, and berated us when we said we hadn't watched the so-called 'documentary' Sicko that had been advanced by Michael Moore.  Then he decided it would be more fun if he elicited comments from us that he could flame.  As we each became aware that this man was all about bullying and had no interest in learning anything, since he obviously knew everything, we ended our meeting as graciously as was possible.

During the rant, however, he did say that he believed in socialized health care for the United States, just like that in his old home, England.  We tried to offer information for his consideration, but he had no interest.  It was as if he were saying, "Don't confuse me with facts because my mind is made up."  He based much of his argument on the Michael Moore 'documentary' "Sicko".  He 'knew' that Cuba had better health care than the U.S., as did England, the Netherlands, Canada and a few other countries that flew out in his diatribe too quickly to be noted.

This is but one example of the 'ruling elite' that populate our nation's capitol.  The concept of these people being employed by we voters is simply a concept so foreign as to be laughable from their perspectives.  In defense of most of the 'staffers', they are well-educated, courteous and only too happy to meet with any citizens.  Some, unfortunately, are like Paul Carver.  I hope he is a citizen, but I don't know that for sure.  It certainly seemed that he'd be much happier back in his homeland of England.

We went to Washington. D.C., the capitol of our country, to meet with and discuss health care with our elected representatives.  We were not well-received by Mr. Carver who represented Congressman Obey.  We were actually treated with a rudeness that I've not experienced since my encounter with a former Congressman from the South Side of Milwaukee whose name was Jerry.

These are the Democrats, the very officials who supposedly represent the 'underdog'.  They turn my stomach.  They don't represent, so much as they misrepresent, the down-trodden.  So long as they are able to maintain their personal positions of power, it seems they're very satisfied.  And, we electors seem so gullible that we continue to re-elect these elitists.

Seemingly everytime we pick up a newspaper or periodical we see that health care costs have risen again.  The only real question anymore is 'How Much?'.  Of course, if we still have health insurance, the premium rates continue to go up and up.  What in the world can we do about this?  Would statewide mandatory insurance coverage do the trick?  Can we somehow legislate lower insurance premiums?  Are the drug companies really the culprits?  Maybe we simply need to move to Canada or Europe.

Recent studies show that our national health care spending increased in 2006 by 6.7% to $2.1 trillion.  That means that one out of every six dollars spent in our national economy goes for health care.  The 'good news' in this staggering number is that this is actually slower growth than we saw for 2005.  Apparently we're going in the right direction, even if too slowly.

Another amazing fact, to me at least, is the amount of 'out-of-pocket' spending each of us averages after insurance premiums, etc.  In 2006, we spent, on average, 12% out-of-pocket for our health care expenses.  Know what we spent out-of-pocket in 1960?  We spent 47% out-of-pocket for health care expenses. 

That means that we are shielded to a much greater degree today from our real health care costs than we were in 1960.  Our out-of-pocket costs have decreased steadily since 1960.  We are often at the point today where we think of the cost of health care as being the $10 or $20 co-pay we have to come up with when we go to see the doctor.  Or, the $20 or $30 dollars we have to cough up for medicines.  Those amounts are very small percentages of the total costs.

Why is this important?  It is important because we need to think about what we're spending if we're ever going to be able to bring this cost spiral under control.  If we come to understand that the real cost of the doctor visit is in the range of $125 to $150 or more, we can begin to understand that maybe we shouldn't be running to the doctor everytime we have a runny nose or a cough.

Another very interesting fact is this:  more than 50% of all health care claims costs in America today are to cover lifestyle-related illnesses.  Those are the things that you and I can control to one degree or another.  But, we can't control them if we don't know about it or if we choose not to do anything about it.  What are 'lifestyle' issues?  Smoking, alcohol use, obesity and simply laying around doing no exercise.

Does this apply to us?  Here are the most current facts:  One in every four Americans eat fast food every day!  Six of ten Americans do not exercise or seldom exercise!  Two of every three Americans are classified as either overweight or obese!

This is the real source of our health care cost crisis.  We have met the enemy and it is us!

No mandatory state programs, or profit controls on drug companies or anything else is going to solve this problem.  The simple truth is that this is up to us.  All the rest of these proposals are simply pablum calculated to make us feel good.

That is why this 'stuff' is flowing from the mouths of politicans.  And it does nothing to solve the problem!

Let your politicians know that you understand this.  If they really want to help us, they'll begin an educational program using some of the 'smoker money' to get the true message out.  And, be sure to tell them we do not want laws banning fast food or drinking or smoking.  We need to take responsibility for ourselves.  No one else can do that for us.  The marketplace will make its own corrections just as you've begun to see with the menu changes going on in the world of fast foods, for example.

Maybe if insurance companies were permitted to charge people what we deserve to be charged based on our lifestyle habits, we'd begin to see these changes occur.  If I smoke, I pay more.  If I'm overweight, I pay a surcharge.  Make me feel my wallet lightening up if I don't take personal responsibility (just don't think this is your new way to raise taxes). 

Don't just continue to blame big health, or big drugs or big insurance!  You are doing nothing but pandering when you resort to this, and we're on to you!

As we've all known for some time would occur, a couple of significant mergers, for us at least, have now been made complete.

Aurora and Advanced Health Care are now one entity.  And, ProHealth Care and Medical Associates are now one.  We've heard and read the assurances but we all know that things will change.  If things were not going to change, then why would each of the two acquirers have acquired?

First, duplication, if any, will be eliminated.  And there is almost always duplication.  People will lose their jobs.  Payroll services, for example will probably be consolidated.  Second, patient flow, the primary driver for both acquirers, will ultimately be affected.  We all will be subjected to the changing scene called health care.  Our doctors may practice in different buildings, we may be admitted to different hospitals, and our employers' health plans (if we're still fortunate enough to have one of those) may not include all the providers they have in the past.

We still have the remaining major hospital groups that have been in negotiations for some time.  The word is that these deals will mature in the not-too-distant future and that they are pending the approval of the Archbishop since catholic healthcare would be merging with non-catholic healthcare.  There are some obvious wrinkles in such a deal that would need to be smoothed sufficiently so as to permit that coming together.

Another key will be what Synergy determines its future will be as it makes its way to January 31st, the date by which it has stated it will decide from amongst the three or so proposals they've received from interested acquirers.  Many of the doctors in that equation have categorically stated that they want no part of Aurora.  Had they not opposed the deal, I suspect that Synergy would already be owned by Aurora.  And, maybe, Aurora has submitted a sweetened deal that will be more appealing to the doctors.  We have no way of knowing, but the one thing we do know is this: Aurora should never ever be discounted as a deal-maker.  They've made more deals and built more buildings over the past few years than all the others combined.

Our predictions for 2008 and beyond are beginning to prove out.  You'll recall that one of those predictions was an increase in the overall cost of healthcare traceable directly to this vertical integration and the resulting building boom.  I'd love to be proved wrong, but I'm really skeptical that cost will not be driven upward as the direct result.

The key in all this is massing sufficient patient populations so as to be a major player.  It is the patient (and the politician), after all, that creates the bills...and the employers, the insurers, the taxpayers, etc. who pay those bills.  If we follow the patient, we're also following the money! 

I have not smoked a cigarette since July 5, 1985 but smoked three packs per day at the time I quit...for the last time.  With that disclaimer stated, if I were still a cigarette smoker, I'd be looking for alternatives. 

What are the alternatives?  The first, and the one I finally chose after numerous failed attempts, is to quit using cigarettes.  Another, is to cut back on the amount of cigarettes smoked.  Yet another is to find someplace where cigarettes are still 'affordable'. 

What jumps out as I look at this issue is that all the alternatives will reduce the amount of taxes collected by Wisconsin and will cause some businesses difficulty, yet the uses for those tax dollars will continue to exist, and to grow if they behave like anything else our government does.  Does this make sense to you?  If so, I'd love to have it explained because I can't find anything sensible about it other than for the people who, like me, will have finally 'kicked the habit'.

Where can one go to avoid the heavy taxation?  Almost anywhere.  Neighboring states would be one place.  Tribal land would probably be another although I've not any idea of what those prices will look like with this market aberration.  The Internet is another place, although Wisconsin says it has that taken care of through laws passed requiring those U.S.-based merchants to pass information back to the taxing authorities.

If you take a moment to 'Google' the word 'cigarettes' as I did this morning, you'll see something on the order of 31 million hits.  The second one on the first page told me how I could buy a carton of Marlboros for $12.40 from what appears to be a Mexican-based company that states categorically that it doesn't report anything to the United States.

Now, if you decided to continue to smoke, which so far is your choice (except for location), would you rather pay $12.40 plus shipping costs or would you prefer to drive to your local emporium and spend $52.70 for the same carton of cigarettes?  I think I know your answer.

So, the bottom line as I am seeing it is this:

People are going to continue smoking except for the 10% to 15% who manage to quit each year, while the same or greater amount of people take up the habit.  People are going to find other places to buy their cigarettes.  Wisconsin merchants will suffer.  Foreign merchants will love us even more than yesterday, and our other taxes will go up to offset the loss of tax revenue already spent by the state.  Our healthcare costs will continue to climb as will lost time costs.

New Jersey has the distinction of being the state that taxes cigarettes the most at about $2.58 per pack.  Wisconsin has, today, risen to the status of the twelfth highest taxing state at $1.77 per pack ($2.02 per pack if you count the sales tax).  New Jersey found that its cigarette tax collection rate dropped by nearly 50% when it reached its current tax threshold.  How much will Wisconsin's tax collection rate drop?  We'll be able to figure that out come next year and the year after, because our other taxes will be going up so that the programs can be continued.

For a legal product, cigarettes are sure unpopular.  Milwaukee County just closed the smoking lounge at Mitchell Airport even though the only people who went inside were smokers, and even though there was no semblance of smoke outside the lounge.  The various bills that are sure to be introduced and re-introduced in the coming months will seek to ban them almost everywhere other than in one's own home...and that is even on the target now in California.

The stench of hypocrisy is much more offensive to me than the occasional whiff of cigarette smoke.

Maybe bold is a bit overdramatic; these things are almost certainly going to occur during the next twelve months...and probably during the next twelve months after that.

HEALTHCARE COSTS CONTINUE TO RISE...Of course that will happen as it has been happening for a long, long time now. 

We'll know what our healthcare delivery landscape will look like as we move through 2008.  We will be in the process of building too many facilities and that will ultimately drive costs up at an even greater pace.  We'll see the consolidation wave cresting and then we'll effectively have a couple of behemoths.  And that will ultimately drive health care costs up at an even greater pace.  We'll have continuing debate over the governmental control of our healthcare; and that holds within it forebodings for us all if we take the seemingly 'easy' pathway to universal coverage.  Government will continue to blame health insurance companies while it meddles in the free marketplace to the detriment of us all.  Will we be able to work our way through this coming year in healthcare?

TAXES WILL CONTINUE INCREASING...Again, of course this will happen as surely as the sun rises in the morning.

Our governmental bodies from village to state to federal continue to spend at a pace that simply cannot be sustained without damaging the economy.  Programs once instituted never die.  If funding channels go away (read cigarette taxes), the programs are simply shifted to using 'general purpose funds'.  And, as if the idea of never killing off useless tax-funded programs isn't bad enough by itself, our various government bodies add new tax-funded programs willy-nilly.  Our state budget just approved carries with it unfunded future obligations of something in the range of a billion dollars for the next biennium.  Our federal budget carries within it the same type of mischief.  Our politicos are absolutely addicted to 'earmarks' and those infect state budgets as well as federal budgets.

EDUCATION WILL CONTINUE TO BE DEBATED...And this, too, is a virtual given.

The primary state teacher's union, WEAC, has still not extracted its payback for the massive support provided to the Governor and many elected representatives.  Look for the QEO provision to be attacked and possibly thrown out if Democrats gain control of the Assembly in addition to the Senate and Governor's mansion.  Milwaukee's system will continue to move in precisely the wrong direction so far as numbers of graduates, test scores and almost every other measurable area.  Germantown's petition to move from MATC to another technical college district will be heard by the state technical college board, and only a miracle will see that petition granted.  We will have been accorded our 'due process' but come to realize that appointed boards do not provide 'due process'.  Virtual schooling will continue to be assailed by the teachers' unions...even though union member teachers are employed in those programs.  Why you ask?  Competition seems to be a great idea in everything but education, where the establishment simply cannot tolerate the possibility that we'll come to realize the king has no clothes.  There will be more referenda, and those that are properly presented will be voted on their merits from the electorates' perspective.  'Properly presented' means that the referenda are scheduled during an existing election, and not on some obscure date calculated to bring out only the 'right' voters.  'Properly presented' means that teachers and administrators are not employing taxpayer money to make their case, and that all the facts are presented well in advance to permit reasoned public debate.

ELECTIONS WILL DETERMINE THE WILL OF THE PEOPLE...And that is truly the hallmark of our country.

Our state government will be re-shaped and a Democrat sweep, should that occur, will virtually assure the we'll have universal health care called 'Healthy Wisconsin Two', higher taxes across the board, and fewer freedoms as government sucks up more of the available air.  We'll have more tax and spend programs that will take on lives of their own, and conservatives will trudge through the political wilderness for another decade or two.  Our Governor, who promised this would be his last term, has apparently decided that we need him for another term of four years.  Of course we expected that since other promises like 'no tax increases' have been conveniently forgotten, as well.

The federal scene holds a similar scenario.  People will need to evolve beyond the still-controversial 'hanging chad' feelings.  There was no Supreme Court fiat involved in the Florida race; that was a contrived attempt by the loser to fan the flames and get into office because he 'deserved it'.  So, he then went on to exploit the 'global warming' thing instead, while emitting more pollution that a thousand or more normal folks.  We'll have a new President-Elect by year-end.  The Iraq war seems to be less and less an issue as the press finally tells a more positive story...that has been going on for much longer than has been told.  The attempt to convince people that we're in a recession seems to be failing, but Congress still tries to make that happen with tax legislation.  For the first time since 1952, we have a wide-open race on both sides of the aisle.  What will happen if a strong third party candidate 'suddenly' emerges...like the 'sudden' emergence of Mayor Bloomberg of New York (as has been rumored for months now)?  That will throw everything into the proverbial 'cocked hat' on both the Democrat and Republican sides.  Yet another reason why congressional seats are so important.

2008 promises to be a very exciting and rewarding year, just as all the other years I remember have held great promise coupled with the aura of excitement...if we can but sieze those opportunities.

May you and yours enjoy a most healthy, happy and prosperous 2008...no matter your politics!

Wisconsin has had a program called BadgerCare in place for some time now.  It is the Wisconsin version of the federal SCHIP (State Children's Health Insurance Plan) program that was recently funded for another year+.  As we've discussed, somewhere between two-thirds and three-quarters of all premium dollars in that program in Wisconsin are spent on ADULTS.  Some 40,000 children who are eligible have never been enrolled.

Here comes BadgerCare Plus effective on and after February 1, 2008.  The goal is that this will assure that 98% of all children in Wisconsin will be covered.  That is a noble cause and no one disputes that.  I am troubled that those administering the current plan have been unable to reach out to the families of those 40,000 kids that have not been enrolled. I am wondering how we're going to be able to get to 98% with BadgerCare Plus if we were so unsuccessful with the current plan.  I take major exception with what this new program does cover, however.

It is available to all children regardless of the income of their parents.  Some parents with incomes too high to qualify for 'free' coverage will have to pay a monthly premium of as much as $68.00 for each child covered.  It has been established in the current program that for every two children enrolled in BadgerCare, one is dropped from private insurance coverage already being paid for by employers and/or parents.  Your tax dollars are actually causing people already covered to disenroll in order to get this better deal, and that is increasing the cost of these programs; a cycle that cannot go on forever.

BadgerCare Plus will cover all pregnant women with incomes of up to 300% of the Federal Poverty Level (FPL) or an amount equal to $51,510 for a family of three.  BadgerCare Plus will now be available to farmers and other self-employed people.  BadgerCare Plus will be available to parents and caretakers who earn up to 200% of FPL, or $34,340 for a family of three.

The Standard Plan is the same as the current coverage and features copayments from $0.50 to $3.00 based upon the services provided.  Those amounts are insufficient to cause anyone to think about the need before presenting for services.  That drives the overall costs higher and higher. 

A new Benchmark Plan is going to be available.  That will feature copayments of from $5.00 for prescriptions to $100 for in-patient stays.  Again, these copayments are insufficient to cause anyone to think about need.  Emergency cases are the exception, of course.  The Benchmark plan is available to families with higher incomes as well as to self-employed families.  The list goes on.

BadgerCare Plus is but another example of the incremental movement by those who think government is the answer to everything.  A program called the "Childrens Health Insurance" plan is being used to cover more and more adults.  It is being used even though disenrollment from private insurance coverage is being caused.  It is being expanded to cover more and more people.  The Federal Poverty Level number is being very conveniently multiplied by 2 or 3 times in order to be made available to more people with every iteration.

This is pure, unvarnished "Universal Health Care" in the early stages.  Surely we remember the parable of the frog and the increasing temperature of the water, don't we?  The frog eventually was boiled to death but made no attempt to leave the kettle.  While we citizens anguished over the failed 'Healthy Wisconsin' plan (which is coming back for another run), BadgerCare Plus was brought into existence with barely a whisper!  Our state officials proposed the relaxation of rules to the federal administrators, who love to be all important to everybody; the rules were relaxed for Wisconsin; and, BadgerCare Plus results.  And now the liberals who watched this happen are touting Wisconsin as the newest 'shining beacon' for healthcare.

That is what incrementalism is all about.  It has worked down through the centuries.  People eventually become accustomed to one level of entitlement, and then the next level gradually appears.  People get used to that level, and another is brought into being...until the frog is boiled to death.

That was the title of an article by Jeffrey Schmidt that appeared in the American Thinker publication on November 27th discussing the funding debates that are taking place in Washington over the Medicare program.  Then, today's Boston Globe carried an article that discusses the problems in the Massachusetts Connector healthcare program.  Both articles should chill you to the bone...and they should convince you that politically-driven healthcare is simply a bad idea.

The Medicare funding process gives us keen insight into what happens once politicians get to decide how much and what sort of healthcare participants receive.  There is some $390 billion available for coverage of the 40 million seniors and other beneficiaries of the Medicare programs.  The discussion involves everything from possible changes (reimbursement reductions) to the very successful Medicare Advantage programs, to reducing physician's fees to reimbursement amounts for various treatments and therapies, etc.

What has been absent in all this debate is this:  the process has not been about the best healthcare for Medicare recipients. 

It has been about the political process with political ends uppermost in the minds of the participants.  The politicans directly involved are worrying more about currying favor with some special interests, placating other special interests and punishing, yes punishing, other others.

Now, the other example:  the Massachusetts Connector healthcare program.  This program is run by the state politicians (they appointed the Board that actually holds the meetings, but we all understand that appointed boards are political organs).  It requires that every citizen, save a few, must have healthcare coverage by December 31st or risk penalties that include confiscating their tax return dollars.  Among other things, this mandate overwhelmed the system established by the state, truly a surprise :)

During the initial set-up of plans, the Connector board had to go back and browbeat the insurers to extract artifical premium reductions.  That hen has come back to roost.  The Connector staff has estimated that premiums for the several plans they designed will go up from 4% to 14% based on actuarial reviews given the costs that insurers have seen during this year.

However, the Connector can't afford this for fear it'll cause the program to fail.  So what to do, what to do?  They have an idea; let's go back and mandate premium increases of no more than 5%.  What'll this do?  Well, for starters, it is going to prove to the insurers that they were right all along, and that maybe they should think seriously about getting out of Massachusetts.  Golly, if we can't mandate more losses for the insurers, then we can either increase premiums (since no tax money is currently involved) or we can reduce benefits.  Can you spell R-A-T-I-O-N-I-N-G? 

These are two classic examples of what happens when we entrust our healthcare to politicians.  These are two excellent examples of what we can expect when "Healthy Wisconsin" is brought back to life next year as has been promised by the Democrats.  These plans simply invite trouble for us participants.  How is it that we can still insist on repeating the mistakes from which we should have learned our lessons?

Because the politicians see in this that which might well be the ultimate political control tool.  There are too many politicians who believe they are the solution to everything when, in fact, they're more often the problem.

Will we remember the lesson, or will the promise of universal healthcare win us over?  Will we trust the politicians with our healthcare future?   I hope the answer to that question is NO.

 

We need simply look at the gyrations occurring in Congress as the “great debate” over SCHIP and Medicare Advantage takes place to see exactly where we’ll be if Healthy Wisconsin were to become the law in Badgerland.

SCHIP is being re-engineered to bring in more and more adults and to permit families of four earning over $80,000 per year to join. This is a very obvious expansion of government-run healthcare.

Medicare Advantage funding is being threatened because it represents an incursion of the private sector into the world of government-run healthcare (Medicare) that is a threat to all those whose goal is just that…government-run healthcare.

Doctors in Medicare would be favored by much of the money freed up by the reductions in Medicare Advantage while SCHIP would get the rest plus the huge increase in tobacco taxes at the federal level. Why is this happening? Because there simply isn’t enough money to go around to do everything the politicans want to do. Medicare Advantage could disappear as the direct result of this move. In this instance, oldsters who had selected Medicare Advantage would be forced back into Medicare parts A & B with lesser benefits available to them at higher costs. This subtle form of rationing should give us all pause. Future forms of rationing promise to be far less subtle.

Politicians running healthcare is oxymoronic. They will be unable to resist the temptations of all that power…and you and I will suffer…just as those on Medicare Advantage programs are about to suffer. What will it be next? Will it be mandatory health prevention as suggested by one presidential aspirant? What will happen with all that data that is collected? And then where will healthcare go? Will we ultimately see consciously controlled death rates since death is less expensive than living with and treating a disease? That happens in single payer countries around the world today. What makes us think that it wouldn’t happen here as well?