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I am not so self consumed that I think I am the only one who was speaking out against the current healthcare reform. However, I have had a perspective that most ignored or even laughed at. Well guess what? Yes, I have to say it, I've been waiting patiently for over six years. Yes, even back in the Bush era.

Click this link for some very interesting reading. Here's another one. And here's the document.

Now that you are in on their little secret, do something about it.

Welcome to my world.

As I often do, I recently attended a public meeting of our Department of Commerce and Insurance, moderated by our Commissioner. As a member of the NAIC and an appointee to their executive committee, she was very proud of the work they were doing. The feds charged them with overseeing the suggested writing of the regulations regarding the rating practices of the insurance industry. It was clear that insurance companies should expect the toughest scrutiny possible as a result of their suggested word smithing. Overlooked by the feds, and the NAIC, is the fact that most of the fraud and abuse in the healthcare system has come from the provider side - can you say HCA Medicare - including multiple doctors billing practices.

The truth is, and government will never understand it, charging more for something than it should is not a crime; unless there is a mandate and government regulation. Tote-Your-Note car dealers have been doing it for years. Your down payment is what they generally have in the car. Everything else is profit. Is that wrong? No. It is commerce. It is establishing what something is worth. How do you do that in America. I asked my son-in-law, an expert on baseball cards, how much a particular card was worth. His response, "What ever someone will pay for it." How does that apply to health care costs?

Almost no one asks a provider what something costs. Why? They know their cost, their deductible or copay. They don't need to know what it really costs. The insurance company, or actually the employer providing the benefit, pays the real cost. The provider establishes what they will charge based on what the insurance company will pay or the government in the case of federal programs like Medicare and Medicaid. Who oversees this establishment of cost? The provider community and their professional societies. Are they being overseen by the NAIC? No.

This is another argument for why it is imperative that both sides of this equation be addressed, finance and delivery, if we are to ever fix it.

Here is one of my shorter rants. Campaign financing reform has all but been lost in the wilderness of all of the other "reforms" being bantered about. It came to me in a vision the other night as I stared at my retirement account. There was a zero in the "what did I gain this month" column. That was it. That was the answer! Eureka, I have sucked the air out of the debate. Okay, here it is. After every election, all politicians have to "zero" out their fund raising accounts. What ever is left MUST be donated to a legitimate charity. They will have to start over raising funds for the next campaign. Yes, that is a lot of work. Yes, that is a hassle. Yes, if they want to stay in office as a career, they need to have these problems.

Yes, there is more. There will be a cap on what an individual can contribute to their own campaign. That will be 10% of the total amount raised. That will hinder the very wealthy from buying an office.

One last word about all of this money that is spent on campaigns. It is not all bad. Most of that money goes right back into the economy to buy printing, radio and TV air time, newspaper ads, billboards, and websites. All of that provides jobs! But in the end there is way too much spent for an office that can never pay back what it costs. In the end, successful business people, the ones we need in DC, will not consider running because they can't raise the money. Campaigns should be focused on local communities and on people who make their mark in that community through other means, not because they get a lot of money and decide to run for office. We need to get the right people running for office, not running from it.

I attended a Tennessee state department of insurance meeting this morning. It was two hours of my life that I will never see again. All of the usual players were there, Blue Cross wanting to know the new definition of certain terms included in the "minimum loss ratio" calculations, attorneys of various sorts making sure folks like myself were made to look uninformed, a representative from the American Cancer Society heralding what a grand job the Department was doing in complying with the new healthcare reform-because it was patient centered, or was that the title of the reform act? I must admit that I was encouraged when I first sat down to glance over the literature that had been supplied for the meeting. One word in particular jumped at me, transparency. Finally, my department of Insurance-sorry, Department of Commerce and Insurance- was going to demand the one thing that holds promise of fixing this healthcare cost thing. I was disappointed.

It seems that when insurance companies disclose, bear their transparent underside dealing with minimum loss ratio quotas, that they will have to list every cent that comes in and goes out. The motive for the exercise is so the state government can monitor those revenues and expenditures and make sure that they spend at least 80% to 85% (not yet determined) on claims. Also, not completely determined, is what goes in what column. Oh, here is the best part, the state will not be monitoring this or enforcing it, I know I just contradicted myself, but remember where I was. Actually all of the dirty work will fall to the IRS. Yes that is a federal bureau giving oversight and control over a state agency. Did I mention I was disappointed?

You see, for now, this only applies to fully insured insurance and only to insurance companies. Undocumented are hospitals, doctor's, ancillary medical facilities, and anyone else that is a middle-man involved in the sale and service of human pain intervention. It is like taking two fingers and carefully lifting the corner of a college students bed sheet hoping you are not embarrassed by what you find. Instead I suggest grabbing the sheet in the middle and ripping the entire piece of material off the bed exposing every unspeakable thing that has been accomplished under the cloak of satin. We can't change one corner of the bed and claim cleanliness. Everyone that is contributing to this circus has to open their records, everyone. Combine that with tempering the unrealistic expectation of the average citizen looking for their right to healthcare and we may just have a shot at doing something socialized countries have never done; run a successful healthcare program. I'll be covering a few of these bed stains in a later blog spot.

Deception is an art form, a very ancient art form. It is what a magician does when they make things appear and disappear. The art is getting you to look at the wrong thing long enough to make the other thing look believable. If some of the long-tooth politicians in DC do get their walking papers I suggest they move to Vegas and perfect their act for the casino's.

Every day some new sound bite is offered up to a gullible American audience that amazingly swallows every deceptive word as fact. Fortunately, some of us are watching the slight of hand and are chanting cat-calls from the audience. An example you ask.

How about this one from Mr. Reid, August 4, 2010 in the Washington Wire, “It’s very obvious that people have a lack of understanding of our health care reform bill,” Reid said. “The more people learn about this bill, the more they like it.” 

Like what? Do people really believe that this reform is meant to lower the cost of healthcare in this country, or do they like it because they will have access to healthcare anytime they want it, anywhere, for practically nothing, and they will not be required to do anything to change their life style? I had a meeting with a client yesterday. In that meeting was a benefits attorney, my client, his staff, and myself. We were discussing the changes that would need to take place in their written plan document to comply with the recent reform. After two hours most everyone in the room was satisfied that the more they learned about what was in the reform the more they wildly disliked it.

There are a handful of items in the reform that are good and could have been included in any other reform package. Those are the only things that are being blasted to the public. They are also being said in a way that is misleading and criminal. If this kind of literature was being distributed through the US Postal Service by anyone else they would be put in jail for false advertising. So what is false about their assertions?

Remember this statement, “Let me be exactly clear about what health care reform means to you,” the president told residents of the Garden State. “First of all, if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan.  Nobody is talking about taking that away from you.”  A speech in Holmdale, New Jersey, July 16, 2009 by President Obama. He left off one word at the end of that statement, "today." The reform that has been passed and the subsequent "Interim Final Rules" clearly outline the death walk of every medical plan in this country. Execution day will take place on every plan's renewal in 2014. Until that time over 90 million employees and their dependents who are covered under self funded plans have to walk a tightrope of undefined pitfalls that will cause them to lose their "grandfather" status. Eventually, in 2014 these plans will have to file a report with a government agency that certifies that they are in compliance with a standard established by the government. Those that are not self funded, but are fully insured, will lose their grandfather status for the simple act of moving to another insurance carrier, even if it is better and cheaper! The current reform has locked down the entire insurance financing mechanism for the next four years and is intentionally diverting all sources into a central stream that flows directly into the mouth of the federal government.

But, we are told, that competition will be increased by "exchanges." These are to be private concerns that will compete for everyone's business, like a bunch of small farmers at the produce market on Saturday. Sounds homey, doesn't it? Here is a definition of private you might want to consider. A private system doesn't have a set of government mandates outlining what coverage will be offered. A private system doesn't have regulations specifying what they can charge. So, if the governments sets the rules and the price, explain to me how it is private sector.

Now, explain to me how any of this has anything to do with lowering the cost of healthcare. In other areas of this site I have explained in great detail that this not a singular issue. It is not just about financing, yet every discussion gravitates back to that subject. It is all anybody knows to discuss. The "other thing," as President Kennedy so famously coined, delivery (not going to the moon) should have equal billing. How much we are paying for services and products is never touched, but just accepted that pricing is where it should be and that those who set these prices are interested only in serving mankind humanitarily. Back to the produce market. Let's say that apples are $10 a piece. Our goal then is to find a way to pay for them. How do we finance this problem? Well, we spend everything we have to buy a dozen, or we get someone else to buy them for us, or we get the government to subsidize our purchase, or as some would say, "We will just be apple-less." And as we all know, if there are those who are apple-less it will cause the cost of apples to go up for the rest of us. Or maybe, just maybe, the apples are priced too high. But, who am I to question an apple farmer?

A lot has transpired and expired over the past couple of weeks. I have not posted for a while waiting on the last shoe to drop; and I believe it will. Democrats are-some Democrats-are overwhelmed by a desire to make history; what ever the cost. They want to be known as the ones who...  Well, what we need now is to ask some very pointed questions, not make some emotional statements. Let's ask a few here by simply saying, "What happens when...

1. the 1% who pay 90% of all income tax decide to not receive a salary for a year?
2. Wal Mart is the only place you can buy anything?
3. all insurance professionals work for and everyone else buys their insurance from one company (notice I did not say government)?
4. all providers (doctors and hospitals) are in the same network?
5. we find out that there is no blank sheet of paper?
6. the only doctor you can see is a specialist?
7. all drugs are custom made according to your own genetic code?
8. Medicare goes broke in 2015?
9. federal subsidies to states for their Medicaid programs are cut off?
10. China asks for their money back?
11. America's Standard and Poor's rating drops to a "B"?
12. we find a cure for all cancer?
13. all Tea Party candidates are elected?
14. states lose all regulatory authority to the federal government?
15. obesity reaches 75% in America?
16. hospitals are all located in major metro areas?
17. other countries refuse to loan us money?
18. everyone is covered and those who already had access now have complete access?
19. we find more money to pay for healthcare?

And then my mind wanders into other areas of change sweeping our country...

"What happens when..."

1. all advertising revenue for FOX and CNN comes from ads for tax cheats and those who had the unfortunate luck to be associated with asbestos?
2. we send all illegal aliens home?
3. global warming just doesn't work?
4. the Internet is regulated and taxed by each individual nation?
5. major bridges fail and collapse due to neglect and lack of funding for infrastructure?
6. America is no longer considered a Christian nation?

And maybe the ultimate question...

"Who said the fix for healthcare was supposed to come from Washington D.C.?"

There is at least one good question in there - don't you think?

In the early 1990s Clinton health care reform died because people understood that their right to choose was going to be removed. Health Maintenance Organizations or HMOs fell from grace when people realized that their right to choose was in jeopardy. So what is different in the current debate? Why are people not frightened to death over the loss of choice in their health care decisions? Good question and one that needs to be addressed. You would think that when given the choice of receiving just the bare necessities or being offered opportunity, that the average American citizen would do what they have done since the birth of our nation; choose opportunity. One would think so.

Early in what seemed to be an endless blast of political sound bites, accusations were made that suggested our country was moving toward socialism. Those comments were met with equal force asserting that to suggest that a national health care system was socialist was ludicrous. Most Americans, comfortable in the lap of security provided by their country, accepted the retort and the thought of America sliding down the slippery slope of socialism faded into background noise. A few more attempts were made, but they to failed to arouse any passion in the heartland, or on the West Coast. The average American cannot get their head around a socialistic America. The very thought is repulsive. Really?

Let's take a brief look at the definition of socialism from Wikipedia and Mirrium-Webster.

Wikipedia - Socialism refers to various theories of economic organization advocating public or direct worker ownership and administration of the means of production and allocation of resources, and a society characterized by equal access to resources for all individuals with a method of compensation based on the amount of labor expended.

Most socialists share the view that capitalism unfairly concentrates power and wealth among a small segment of society that controls capital and derives its wealth through exploitation, creates an unequal society, does not provide equal opportunities for everyone to maximize their potentialities and does not utilize technology and resources to their maximum potential nor in the interests of the public.

Socialists inspired by the Soviet model of economic development have advocated the creation of centrally planned economies directed by a state that owns all the means of production. Others, including Yugoslavian, Hungarian, German and Chinese communist governments in the 1970s and 1980s, instituted various forms of market socialism, combining co-operative and state ownership models with the free market exchange and free price system (but not free prices for the means of production).

Notice in particular the last sentence. Do any of those terms sound familiar?

Merriam-Webster - Any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods.

Well, maybe things have gone a little further than those early opponents of the socialism discussion had intended. Perhaps it is time to have a very frank discussion about where all of this is headed, and in fact, where it has been headed for a very long time.

Although America is, currently, far from a socialist society, elements of socialism have been present for decades. In fact there are some things that our early forefathers envisioned that could only be accomplished by a cooperative union. Those are clearly spelled out in the Constitution, Article 1, Section 8. There are however certain things that do not fit neatly into Section 8 that we have taken for granted for decades. In fact, many seniors raise their canes in rebellion when the slightest mention of tampering with them is leaked. They are, Social Security, Medicare and Medicaid. These are social programs created by the government without a clear constitutional mandate to do so. For decades these programs have assisted seniors and the poor with funds to have what ever they desire. No, that would be be wrong. Should we say, to have just enough to get by, but enough to bolt the individual to the frame of the dependency bus? I think that would be more accurate. So have these programs been successful? The answer depends on what you call successful. If that definition includes failure to adjust and change these vehicles over time to keep up with technology and enormous advances in healthcare and drugs, then yes, it has been successful in failing to meet the need for which it was originally intended.

Today, Social Security, like our national supply of gold to back our money, is gone. It has been used to prop up other failing government programs. Those who have contributed may get back exactly what they put in to it over a life time; maybe. Chances are very good that those now in their fifties will get nothing back. Our nation is now being told that Americans should have the right to make decisions about their own health care, a hollow assertion when you consider that the same politician refuses to allow the same citizen the right to make decisions about their own retirement accounts.

Medicare was sold as having catastrophic coverage in 1965. That was a lie. The deal was sealed behind closed doors. Sound familiar? Neither Medicare nor Medicaid were structured to do what the voting public was told they would do. Neither was designed to keep up with medicine and drug advances that we enjoy today. Neither was structured to work beside commercial insurance. The cost of both over the past decades has been controlled entirely by price setting by the government at the cost of those with private health care insurance. Both of these programs are beyond repair. They can only remain afloat with massive borrowing on the part of the government.

Back to socialism, are we headed toward a socialistic America? A common man looking at the control the government already has over their life would have to conclude, yes. Recent purchases by the government, with borrowed money, in the finance and auto industry coupled with their ownership of all of the "...Mac" mortgages could only hasten the event. Shifting 20% of the gross national product (that is what health care represents) would be the straw that breaks the camels back. So what do we do?

On this website there is a tab marked "Solution." If you have not looked at it I encourage you to do so. This site is a model for a solution. You have the opportunity to participate in its creation. It is not perfect but it starts with the three layers of healthcare delivery and finance, individual responsibility, commercial insurance, and government involvement. The problem is that the third layer, the government, leaks down into every fiber of the other two. That has to be stopped and corrected. These three need to be separate entities and act on their own. Individuals need to take an active part in their cost and their health, a significant part. Commercial insurance must be reformed and transparency and competition must return. The government should be assigned a role that is appropriate. That would be the big stuff, not fixing the broken arm of an 85 year old grandmother. These three social programs need to be dumped with as much enthusiasm as when they were created. Social Security should be made a choice allowing folks to stay in if they want or transfer their money to an account they choose. Medicare and Medicaid should be completely dropped and a mechanism put in place to allow those patients to be covered under commercial insurance without intervention by the government, except when the individual reaches some predetermined catastrophic level, at which point the government program would take over (see model on Solution Tap.)

You do have a choice. You have a choice of which candidate you vote for. You have a choice of sitting on your rear end and not voting at all. You have a choice of making your voice heard by current elected officials. You have the choice of doing nothing. If you choose the latter prepare to bend over and kiss the thing you have been sitting on good by.

There is a phrase - I will leave it to your imagination - that many have heard and, several males have experienced; once. There are just some things that do not work well when facing the wind. For instance, trying to fly a kite in front of you while facing into the wind, holding the underside of an umbrella facing into the wind, and my favorite walking into the wind on Rush Street in Chicago in February without holding on to a rope. There are however some things that work well into the wind, like taking off in an airplane. What does this have to do with "Minimum Loss Ratio Requirements?" This seemingly vital piece of the proposed healthcare reform package may offer immediate relief from public opinion but it will make a mess and embarrass the ones who suggested it.

What is the intent of this section of the legislation? First, it is a lethal suggestion that all insurance companies are spending less than 85% of the money they take in on paying claims and second, suggests that the federal government is spending at least 85%, or more, of the money they take in on "pure" claims. I would debate this here except for one small detail. The whole argument is stupid. What if you just go ahead and say spend 99% of everything you take in on claims? Does that lower healthcare costs? No. It is what is not being said that should make you mad.

Nowhere in this section, or for that matter any section of this bill does the legislation simply suggest that what the 85%, 90%, 99%, or 65% of money being spent on claims, is actually paying for claims that should have been created, or more importantly that the claims that are being paid are priced correctly to begin with. In short, setting an arbitrary cap on what any company or government must pay for claims does nothing to lower the cost of healthcare! This has been my argument from day one, whenever that was, that the problem is not financing healthcare but the delivery of and the control of utilization of healthcare.

Here are the facts. A 2008 report by Price, Waterhouse, Coopers, commissioned by America's Health Plans, found that 87% of all premium dollars collected are being spent on care. The other 13% is not pure profit. This report states that in 2007 three-quarters of the increase in healthcare costs were driven by provider cost increases. Administrative costs-claims processing, consumer and provider support, taxes and profits accounted for one tenth of the total increase. This report shows the average profit to be 3%. Fortune Magazine reported last year that insurance company profits averaged 6.2% of revenue, far below other industries. There are numerous items that have to be paid out of that 13% including, in most states, setting aside a required 25% of paid claims as a reserve in case the client leaves and the company has to pay the run-out of claims incurred before the group left. It includes the administrative cost of disease management programs, staffing, processing, electronic medical record maintenance, case management, AND a mountain of compliance with GOVERNMENT regulations and taxes. Setting a minimum loss ratio has nothing to do with cutting down on utilization of services, poor life styles, eating choices, smoking, obesity, misuse of imaging for profit, preventive tests to protect the physician (which they do make money on), and a warehouse full of other cost producing items. 

The purpose of this section of the 2,500 plus pages of the bill has but one agenda, cast shame of the insurance industry and push our country toward national healthcare. It is about controlling almost 20% of our GDP. The sad part is that those pushing this current agenda are so convinced that the American public won't question this, that they can get by with it, and get re-elected. I really, really hope they are very wrong. If not, then they can continue doing it into the wind while the country does it up a rope.  

According to a U.S. Geological Survey there is no scientific definition of the volume of a faucet drip, but after measuring a number of kitchen and bathroom sink faucets, the volume seems to be between 1/5th and 1/3rd of a milliliter (mL). Drips from bathroom tubs come in a bit more, though, at about 1/2 mL. So, for our calculations below (numbers are rounded), we are going to use 1/4 mL as the volume of a faucet drip. So, by these drip estimates:One gallon: 15,140 drips, One liter: 4,000 drips.

Looking at it this way, it seems like that drop of water down the drain is pretty insignificant. But, as you can see by the following estimates assuming one home with three dripping faucets leaking at 60 drops a minute, all those drops flowing in "real time" can really add up to a flood.

259,200 drips per day, or 17 gallons per day, or 6,248 gallons per year, or 124 baths per year. And that is just one house. Speaking of houses, in the U.S. House of Representatives there 435 leaks. This number is currently fixed by the Reapportionment Act of 1929. There are an additional 100 dripping leaks in the U.S. Senate. Granted, some are leaking worse than others, but there is very little intention of calling a plumber.

The current march to healthcare reform is a slow, steady drum beat. It is just slow enough to avoid serious attention by the owner of the House, the American public, but persistent enough to cause a flood of Biblical proportions. Yes, there will be reform, of some sort. It really doesn't matter what reform, just something. This is stated in a way that makes it seem harmless. It is being called watered-down, unacceptable to the right and the left. Do you hear the soft music in the background?

WAKE UP AMERICA!!!!

The media reports would have you believe that all they were doing behind closed doors was writing this 2,500 plus page bill. Yes, that was done early in the process. The rest of the time was spent planning how this would be eased through the American bias against actually finding out the truth. The plan, the entire plan, has already been set and is being implemented; right now. There is only one thing that can stop it; YOU, your vote. It doesn't take a doctorate in political science to understand what is going on. A casual understanding of the bill in both the House and the Senate uncovers the real agenda; a socialized healthcare system. Under both the House and the Senate bills, and the Republican bill, healthcare financing cannot survive as we know it. It will become impotent and the only hope will be for the government to step in save the world, while bankrupting our country. We are not only going to have government run healthcare, we are going to have a healthcare system owned and operated by our U.S. Bank - China.

You have to vote these people out of office at your first opportunity and send people to Washington that have no intention of making it a career. We have uncovered an array of ideas on this website that can address the real problems and offer a sound solution. The problem is getting past the need of congress and the media for self-sustaining, self-promotion.

Speak up at every opportunity and keep it short and simple. Something like this:

We cannot afford the current solution. There are not enough primary care doctors to give access to everyone. The government cannot do healthcare cost effectively. The problem ain't financing, it is delivery and utilization. I am doing something about the high cost of healthcare; I am changing my lifestyle and eating habits. Oops, that last one just slipped out.

If simple doesn't seem to work try the ones listed by the National Association of Health Underwriters. Some of the most serious concerns in HB 3590 are:

• A minimum loss ratio requirement that applies to all fully insured plans, including grandfathered plans, as of January 1, 2011.
• A completely ineffective individual mandate requirement that will make it more financially advantageous for many healthy Americans to forgo coverage until they are sick and then utilize the guaranteed-issue protections to temporarily obtain coverage and then drop it again.
• Strict modified community premium rating requirements (including age bands of 3:1) that now apply to all fully insured plans.
• State-based exchanges that create costly and confusing layers of dual regulation.
• New employee voucher provisions to allow choice between employer coverage and the exchange, which could actually hurt participation in employer-based health insurance plans.
• An expansion of the federal Medicaid program to individuals up to 133% of the Federal Poverty Level (FPL).
• The creation of a huge new federal long-term care program that threatens the private long-term care insurance market and is inadequately financed.
• Financing mechanisms that would significantly, and negatively, impact the health care industry, consumers, employers and our overall economy.  
• New annual health insurance premium taxes of over $6 billion per year to be enforced on 2010 contracts that have already been priced and sold prior to the enactment of the bill and taxes.
• The 40% federal excise tax on high-cost health plans ($8,500 for individuals and $23,000 for families) is not properly indexed for inflation, and this bill does so little to control the medical care costs that are the true drivers of health insurance premiums, eventually all plans may fall under this excise tax umbrella.
• Massive proposed cuts in funding to Medicare, particularly the Medicare Advantage program.

Well, there you have it. Now, start making plans to call the plumber. Better yet, become one.

Lost, or maybe assumed, in this current debate about healthcare costs is that the key reason to defeat the democratic proposal-healthcare reform du jour-is to allow the republican proposal to come to the front of the pack. There is one small problem with that strategy; the republican bill is no better and is based on the same mis-information as the democratic nightmare on Pennsylvania Avenue.

The Patient's Choice Act would assure essential health coverage and health care to every U.S. citizen, without increased federal spending and taxes, and without the federal government taking over health care. The key to the bill is that it shifts the tax benefits for employer provided health insurance from corporations to all workers. As a result, every citizen not retired on Medicare will get a refundable tax credit of $2,300 per year for individual health insurance or $5,700 per year for family coverage. For workers who don't have insurance now or who pay for their own insurance, that is thousands of dollars a year they don't have today to help pay for health insurance. Workers with employer-provided coverage can keep that or use these credits to purchase their own preferred insurance instead.

Under the bill, each state would set up their own Health Insurance Exchange, where insurers could compete to offer coverage to everyone in the state. All insurance offered on the Exchange would have to provide coverage meeting the same standards as the insurance offered to federal employees and members of Congress under the Federal Employee Health Benefits System. The bill would also enable employers to devote a specified amount toward health coverage for each worker each month, with the worker to then use those funds to buy the health plan of his choice on the state Exchange, or outside the Exchange. States could join with others to form regional Health Insurance Exchanges that would expand insurance options. Consumers in each state in a regional Exchange would be free to purchase health insurance from any other state in the Exchange.

Do you understand what you just read? Are you shaking your head, as you should be, and asking what is so different about this approach when laid along-side the democratic version? The republican approach makes some fatal catastrophic assumptions; bigger is cheaper, buying insurance across state lines will not make the cheaper insurance become more expensive, individuals know better what to buy than their employers, and that a Health Insurance Exchange is somehow not "insurance." Remember, insurance companies are cheats and greedy corporate robbers of helpless American citizens. Let's look at each of these assumptions.

Bigger is cheaper. No, bigger, to a point, offers more choices for administration and flexibility of plan design and for the formation of a self-funded model (preferred.) There is no, did catch that, no empirical data that proves bigger is cheaper. Buying insurance across state lines will not make the cheaper insurance become more expensive. Why, you should be asking, is insurance in Tennessee cheaper than in New Jersey? Why is anything cheaper? It cost less to make. Insurance costs in Tennessee are based on the regional costs for medical care; e.g. hospitals, doctors, and what drug stores can get by with in pricing. If someone in New Jersey buys a policy based on Tennessee rates, those rates will eventually go up. Why? Because the person in New Jersey is going to use New Jersey healthcare...which is...more expensive. Get it? 

Individuals know better what to buy than their employers. Really? Why do over half of the people who have insurance depend entirely on their employers to offer benefit plans designed for their group? The same reason why individual sales of health insurance have lagged behind for years, people don't understand insurance. They don't want to understand insurance. If it is left to an individual they will buy based on cost alone. This is not in conflict with the earlier statement that bigger is not cheaper. Remember I said there were limits. Finally, that a Health Insurance Exchange is somehow not "insurance."  Several years ago this was offered and defeated as "Association Health Plans." It was the same concept. It wouldn't work then because it was so restrictive. It will only work if it is set up correctly, self insured, reinsured and restraints are placed on members who wish to withdraw for the wrong reasons. Again, an exchange will work, not because it will be cheaper, but because it will offer choices not available otherwise.

In the end, this republican alternative still has at it's core the destruction of the current financing system. Why is that important? Simple, there is nothing wrong with the financing side that a few tweaks within the industry will not cure. The problem is delivery, and over utilization by a society that prides itself in finishing everything on their plate; so starving children in India won't be mad at them. The only hope we have to fix this problem is to take a step back - politicians please take a hundred steps back and stay there - take a deep breath, and then look around for some folks who know what they are doing. Those folks need to fix this one step at a time, not reinvent the things that do work. The current approaches on both sides resemble touching up a Rembrandt with a four inch paint brush that has be dipped all the way to the bottom of the can. One would hope that many in the current Congress would take their retirement and stay home after the next election. Any statesmen, I'm sorry, statesperson out there that would like to run for office. Send me your credentials.

I have only watched HBO Poker for a few minutes but it was clear to me that the folks playing had each developed their own unique style of not letting their opponents see them sweat. I have both C-Span channels running on two TV's in the background. Legislators on both sides of the isle have told their story so many times that you can almost mouth the words with them. And, they do it with a straight face. The difference between the HBO players and congress is money; ours. Here is what is being said with a straight face.

The Associated Press reported that negotiators scrapped a public plan in favor of an insurance program run by private companies, but supervised by the federal agency that oversees health insurance for federal employees – the Office of Personnel Management. That was after a ten member closed door meeting to hammer out a compromise Tuesday night December 8th. Then Senate Majority Leader Harry Reid, D-Nev., said the emerging compromise "includes a public option and will help ensure the American people win in two ways: one, insurance companies will face more competition, and two, the American people will have more choices." Reid declined, in this impromptu news conference, to provide any additional details about the agreement. He said it with a straight face. He really believes this stuff. So did people who swore that the earth was flat. Like Reid, they had only the details they wanted to have. Even if the ten member group and Reid are both right, they are wrong. Why? If the government oversees a non-profit, sets the rates, and dictates the eligibility, the fact that the program is administered by a private entity doesn't make it a private plan.  It is still a public plan. 

The basis of a public plan is that it creates competition and thereby lowers cost. Kind of like Wal-Mart. I said that with a happy face. I couldn't keep a straight face. The government is going to lower what they pay doctors, hospitals, states, pharmaceuticals, and others and that is going to make "insurance" cheaper. First it is not insurance, insurance is simply a transfer of risk. Congress confuses sound risk principles with their own terminology. Like what is usually said about poking a balloon and it pokes out the other side, they are flat wrong. But they say it in such a way that the public believes it. After all they elected them, surely they know what they are talking about. Let's consider sound science. If you poke your finger in a balloon it doesn't form a bump on the other side, the entire balloon gets bigger. The space doesn't go away it just rearranges. Same with mandating lower costs for goods and services. If the government is paying less for something, one of two things happens. One, somebody else pays the difference, or two, the one providing the service or product goes away. That is enough railing on poker face politicians. Instead, let's again spend some quality time discussing, with a straight face, what will work; how you actually make the balloon smaller.

In other sections of this website I have clearly and with documentation explained who the contributors are to this problem. Let's review the major players; insurance companies, doctors, hospitals, lawyers, politicians, employers, pharmaceutical companies, and consumers. If these are truly the players in the problem then there is absolutely no way to fix the problem without offending all of those on this list. It is also prudent to assume that the only way to fix the problem is to do just that; offend them - with a straight face. Insurance companies enjoy cash flow, agents have to have something to sell, doctors, while running preventive tests to make sure they have evidence if they get sued also enjoy the profits coming from the extra testing, hospitals complain about treating patients with no insurance but enjoy the DSH payments they receive from the government that offsets a significant portion of that loss, trial attorneys suck blood from all sectors of the industry with a very straight face, politicians enjoy a rich, permanent retirement benefit, not because they do something right or worthwhile, but because they were elected, employers have enjoyed ignoring a problem that should have been recognizable a decade ago, pharmaceutical companies enjoy a very bright future since medicine will inevitably move in their direction with the discovery of tailor made drugs based on genetics, and consumers still don't have any significant skin in this game, they can still abuse their bodies and expect someone else to pay the bulk of the cost. Any viable solution must impose on everyone of these enjoyed abuses. Every piece of current legislation is designed to have as little impact on those enjoyed benefits as possible. If that can be done with an agreement from both sides of the isle, with a straight face, America will be saved from economic implosion.

Here is the answer. Click here and enjoy the abuse. 
 

There are several frustrations in my life but one of the most profound is sitting in a meeting where some one is explaining why something is not working because "they" said...  It is always they, them, those people, the other party, them and us, on-and-on infinitum. We have developed a problem over the past 233 years; a party system. No, I did not say a two-party system, a party system. Two has nothing to do with it. We have had two or so parties since before the bell cracked in Philly. What has evolved over the past six or seven decades is a "them and us" mentality. To overcome that we now hear everything prefaced with, "it is a bi-partisan effort," as if that makes it pure and holy. It makes it impure and sacrosanct from those who would like to actually just...work together for the good of the people. Nothing can be accomplished today unless it is bi-partisan. What the hell happened to "by the people?"

This also bleeds over into the other class of intellectual curiosity, Hollywood. CSI Miami used to be a great show to watch. I can't anymore. Every episode has dialog that accuses the immoral insurance companies of being the sole villain in the healthcare crisis. Oh, and rich CEO's who will not provide a policy for their employees that will cover a $200 knee brace! A recent episode revealed that an undesirable rich, greedy, CEO was taking out life insurance policies on his employees and then knocking them off one at a time to collect the life insurance proceeds. They must have had their understanding of insurance a little out of phase. That is exactly what could happen under a federal, government run program that cannot stop billions of dollars in fraudulent claims. The facts are that if such a thing were to happen the private insurance company would have been all over the second claim, not Horacio Cain.

Here is the sad news. Many Americans believe what they hear from politicians and actors, and other famous people, most of which also now have a book to sell. If you have not sold your soul to politics, Hollywood, any cable news network, or accomplished daring-do in a sports arena your opinion and facts are pretty much toast. Not because the networks and others don't want to share you with the world, but because the public don't want to hear it. Why? It is not believable or repeated enough to be a redundant fact (otherwise known as a sound-bite.)

How do we fix it? Depends on who is reading this blog. If you are already out front, which I doubt you are or you wouldn't have time to read this, you will do nothing because it is not in your best interest. What is important to you is what is happening right now, being the first to report it as though that makes it relevant. If you are one of the majority of people in this country who would like to change your perception, the choice is yours. To the first group I would say get all the gusto you can get. You're going to need the memories. To the second, it's your move. Actually you were raised better. Demand the truth, not opinion. Demand facts and details, not outlines and promises. Ask questions like...who are they anyway?

Recently my wife and I took a cruise to Norway to celebrate our 40th wedding anniversary. Norway is the home of her grandparents and she wanted to see were they came from. A trip like that requires that you stay on a very large boat for several days, eventually agreeing to attend some of the entertainment venues offered on-board. One of those opportunities was to see a magician. He didn't have any rabbits and he didn't wear a top hat, but he did do something with a couple of attractive ladies heads. As intently as I tried not to be distracted and allow myself the opportunity to tell my wife how he "did it", I was tricked into believing that he actually swapped the ladies heads. The guy was good. So are politicians.

Did you see it? There it goes again. The healthcare bill and its debate just disappeared! It is no longer a healthcare bill, it is an abortion bill. No, now it is a stimulus bill, no,no, what it is is an opportunity to work together and pass something we can all agree on. You know, when the rabbit disappears into the top hat you know in your heart of hearts that the animal is somewhere eating a carrot in a cage. You know it didn't disappear, but you were entertained. Well, congratulations, the greatest show on earth just marched up Pennsylvania Ave.

Aren't you wondering what else can be added to this already massively overstated, mistaken solution to the wrong problem? Don't be fooled by the current distractions, the best move was at the beginning of the show when we were told that the problem was all within healthcare financing. You know, the evil, immoral insurance companies. Then it was Medicare Advantage and all those greedy seniors who were taking advantage by paying extra premium for an Advantage program. Then it was an endless list of things highlighted by every special interest group that could afford a bus ticket to Washington.

In reality we are so very far astray from our target because the initial definition of the problem was so far off course at the beginning that our final destination will be light-years away from a true solution. Everything that has happened since is noting more than a distraction to keep us from waking up and realizing that we were fooled during the opening monologue. It is like a good card trick, the card was exchanged at the very beginning of the trick. Everything else is just show to help us forget what happened at the beginning. The only way to get back to stage one is to burn the current proposals, on both sides of the isle. This solution must be based on the original, real problem, and it must be designed from the ground up by those who are at ground zero, not in the flight tower.

Very little, if any, discussion about the healthcare crisis has highlighted the self funded market. Why? Very few understand it and politicians have never heard of it. Why is it important? Because it is the perfect laboratory for dissecting the frog and looking inside to see how it works.

Simply diagramed, a self funded plan consists of two things; fixed costs and claims. Fixed costs are about 15% to 20% of the total expenditure and the rest is pure claims. Yes, pure, transparent claims. Or, as transparent as providers want them to be. The other reason to look at a self funded plan, other than the fact that over half or the people insured today are in these arrangements, is that it takes the evil insurance companies out of the discussion. On second thought, maybe that is why politicians don't want to discuss self-funded; it removes their only target and turns the discussion back to where it should be - delivery.

It is not unusual for a self funded group to get a 20% to 40% increase in expected costs for the coming year. Here is where that is different when compared to a fully insured group (see defining stuff for an explanation.) If a fully insured group gets a 40% increase, that is 40% on the entire premium. If that original premium was $1,000,000 it would go to $1,400,000. The insurance company's cash flow for investment income would also increase and the agent's commission. If there is a 40% increase on a self funded plan that would be a 40% increase on 15% to 20% of the total cost or $1,000,000 X .20 = $200,000 X .40 = $80,000 increase, not $400,000. That is because the increase on the self funded plan is only on the fixed cost and not the claims portion. Does that mean that the claims will not also increase? Certainly they will, and that is the point. The claims will increase, not the insurance premium. The claims went up because the group is spending money at providers and drug stores, not because the evil insurance company is charging immoral prices for their coverage. In reality, that is also why the fully insured premium went up - claims. You just don't see it on a fully insured group.  That is why self funded is transparent and why we should be focusing on these groups to clearly see the problem. The problem is us, you and me. I won't go into that here because there are plenty of other pieces on this site that address the issue.

We are not in Kansas any more and there is no yellow brick road. There is however a very large tornado and it is sitting right over Washington DC. It will stay there and continue to destroy our ability to fix this problem unless someone seeds the clouds or changes the pressure in the atmosphere to allow it to move along. You my friend have the ability to do this. Step one, get this message out. Step two, let your elected official know that if they don't start listening to reason that you will not vote for them and will in fact campaign for the opponent in the next election. Step three, lose weight and begin a rational exercise program. Step four, get a check up with blood work and take proactive action once you get the results. Yes, it is that simple.

I have thought a lot about what I could do to get the attention of a practical person in Washington, DC. Someone who has the resources and the desire to fix this healthcare cost mess. Someone who was not absorbed by their own popularity, selling their book, and commercials to support their TV programing. Someone who would be willing to shut out every thing that was going on just long enough to consider something different, something fresh, something that required everyone giving up something. Well, it doesn't seem like such a person exists.

Having come to that conclusion most would just say, oh well, and fade away. Not a chance. I will keep writing on this site until someone finds something of value and starts to move forward with a new banner, a real solution.

Aren't you tired of hearing what is wrong with the current proposals? Do you really have any desire to fix the proposals instead of fixing the problem? Here is the deal. A bunch of politicians got together, with the help of their aides and lobbyists and those who have influence and financial means, and drafted a set of legislative band aides. Those were put forward over an acceptable period of time, changed, amended, debated, and eventually passed by the House, without the first thought that it was totally wrong. That it was more important to fix the legislation than the problem. That it was more important to get bipartisan agreement than pass something meaningful.

Well, back to me and few others like myself who have to stand in the crowd and scream because we do not have a voice in the debate, other than our persistence and self-supported websites. We are the frozen-few who do have answers. Getting those to an uninformed and sometimes uncaring public is a problem.

So, if you are out there and have an audience and the financial backing to make something different a reality, we'll be right here. Just in case no one responds, we will keep on writing and talking to whoever will listen. That would be you, if you read this blog. Thanks.

Nancy Pelosi has stated that insurance company's are making "immoral profits" on the backs of people who are being denied coverage.  Click HERE to hear a pod cast.

"Keeping the status quo may be what the insurance industry wants, their premiums have more than doubled in the last decade and their profits have skyrocketed." Maryland Rep. Chris Van Hollen, member of the Democratic leadership.

"Health insurance companies are willing to let the bodies pile up as long as their profits are safe." A MoveOn.org ad.

MY WAY, WASHINGTON (AP), By CALVIN WOODWARD, Oct 25, 8:37 AM (ET)
"Quick quiz: What do these enterprises have in common? Farm and construction machinery, Tupperware, the railroads, Hershey sweets, Yum food brands and Yahoo? Answer: They're all more profitable than the health insurance industry...Ledgers tell a different reality. Health insurance profit margins typically run about 6 percent, give or take a point or two. That's anemic compared with other forms of insurance and a broad array of industries, even some beleaguered ones. Profits barely exceeded 2 percent of revenues in the latest annual measure. This partly explains why the credit ratings of some of the largest insurers were downgraded to negative from stable heading into this year, as investors were warned of a stagnant if not shrinking market for private plans."

Why do politicians do this? The answer is simple but my response may surprise some. The answer is that it is easy, and most politicians are either lazy, or smart, or both. Using terrorist jargon, insurance companies are soft targets. They are low hanging fruit, and all of the other clichés you can think of regarding easy money. Insurance companies actions are often questionable in the eyes of the ordinary citizen who goes to work every day and earns an honest living. Why not shoot at the fat cat? The American public gives politicians the right to make these accusations.

My response however is that the insurance industry, in particular the largest carriers are to blame. Not for their profits, but because they are so damn arrogant. That statement comes from a life in this industry that has been frustrated on countless occasions listening to endless chatter from various insurance company department heads about their cost control procedures. Here is what they say, "We have the tools to lower your cost Mr. and Ms. Customer." "We have wellness programs, disease management programs, lifestyle programs, smoking cessation programs," and my all time favorite, "health risk assessment programs." Oh, and they also have "predictive modeling" programs. All of this is designed, and the cost included in your premium - sometimes, to lower your health care cost or at a minimum stabilize them. So where is the rub? They don't work. And there is no body of data or evidence that they do.

These programs are ineffective for one reason, there is no incentive or motivation to get the majority of people to take ownership of the programs. I said there was one reason, well, there are actually a couple of more. An insurance program is only good, if it even works, as long as you are with that company. Once you change companies you have to start over - assuming the new company has one - because everything will be different. In addition, these programs only work on people who have actually had a claim. It is proven that early detection saves lives and dollars. It is also true that lab work is 80% of detecting early prevention and management of disease. As an example it is more likely that a diabetic will find out that they have the disease after collapsing and being rushed to an emergency room than through a simple blood test. The same is true with high blood pressure and cholesterol, and a score of other diseases. HRA's or health risk assessments taken on-line with an insurance company do very little to identify detection and even less to motivate the patient to take action.

There are powerful on-site clinic models available that have proven time and again that they overcome all of these negative problems. They are owned by the client so it doesn't matter if they change carriers, they are revenue neutral for self-funded employers, they are personal and convenient so they are used and manage an illness after a serious diagnosis is discovered. The best way to make this work is to get the "big" carrier to furnish data and cooperate with the client, including giving proper credit for costs that they do not incur because the patient never files a claim. When confronted with this solution the carrier, more times than not, says, "The data is proprietary and confidential." Or they say their systems will not communicate. Or, "We are the ones who should be providing this service so you can't leave us." Arrogance. How did they get this way?

It isn't their profits, it is their size. And, the unholy union with providers through a thing called managed care, discounts, networks, CPT codes, and a host of other mechanisms that allow them to dominate the scene, continue to consolidate, and drive competition away. How do you get arrogance to go away? Through a humbling experience. How do you create more competition in the insurance industry? Not through a Public Option or any government run health care, but by replacing managed care with total transparency and restricting growth of these mega beasts. Big may work for Wal-Mart but the health care industry isn't selling clothes and greeting cards. Big has the opposite effect on cost in the health care arena. No, Ms. Pelosi, the problem is not immoral profits, it is pious arrogance.

For a long time there have been ads running on TV and in publications offering a Medicare Supplement policy to their membership. From those ads many would assume that this is a special deal just for AARP members. Well, there is the fine print. That sounds strange when you are offering something to a generation, myself included, that already have a hard time reading the large print edition of the family menu at Red Lobster. Yes, there is fine print. Some ads may even say it out loud. Here's the kicker - "You do not have to be a member of AARP to purchase this product." This offering is what many associations call "affinity programs" or "sponsorship programs." See this article published by L A L Association Membership Services out of Ontario, Canada.

These programs have been popular for years because they offset association administrative costs and are an additional source of revenue to membership dues. In itself there is nothing wrong with this arrangement, except, occasionally members are left to form their own opinions about what the product is, it's value to them, and why the association offers the benefit. All associations should be required to make a full disclosure regarding these issues.

In AARP's case the plot thickens. (See related article HERE) If you do a little research you will note that AARP, not necessarily all their members, support the current health insurance reform coming out of the house and the senate. The main element of that proposals funding comes from a significant cut in the Medicare Advantage program. This is a different benefit than that used for regular Medicare. Medicare Advantage has co-pays for most procedures instead of large deductibles and it includes drug coverage without the "dough-nut hole." But you say, the United Health Care Medicare Supplement does not offer a Medicare Advantage product. You would be correct...enter SecureHorizons.

Here is a copy of their offer on one of the AARP web links.

"AARP^® MedicareComplete^® plans are SecureHorizons^® Medicare Advantage plans insured or covered by an affiliate of United Healthcare, Medicare Advantage Organizations with a Medicare contract. These health plans may provide all of the benefits covered under Original Medicare and more. Our plans have no limitations for pre-existing conditions for enrollment, and they do not require a physical exam."

Okay, why is this such a big deal? AARP supports a bill that cuts a new program they are just unveiling. Is it bad timing? Is it calculated? Oh, and here is another piece of information from the above mentioned site.

"The AARP^® MedicareComplete^® plans are SecureHorizons^® Medicare Advantage plans insured or covered by an affiliate of United Healthcare, an MA organization with a Medicare contract. AARP is not an insurer. United Healthcare pays a fee to AARP and its affiliate for use of the AARP trademark and other services. Amounts paid are used for the general purposes of AARP and its members. The AARP MedicareComplete plans are available to all eligible Medicare beneficiaries, including both members and nonmembers of AARP. AARP and the AARP logo are trademarks or registered trademarks of AARP. The SecureHorizons and MedicareComplete marks are trademarks or registered trademarks of United Healthcare Alliance, LLC and its affiliates.

AARP does not make health plan recommendations for individuals. You are strongly encouraged to evaluate your needs before choosing a health plan."

Note the last statement fellow senior, you are to "evaluate" your needs before making the plunge. Your Association is not permitted to help you with that - they are not licensed agents.

Here is the summary. Very few things we see on TV, read in the paper, see on a billboard, or hear on the radio are what they seem. That would also be true of noise coming out of Washington DC. If AARP really wanted to endorse the current health care reform efforts by the majority shouldn't they get out of the Medicare Advantage business?

10-13-09 5:10 PM CST

Well, it is official. No one knows what they are talking about. I have been watching interview after interview on both the left and the right leaning cable networks and the overwhelming result is pure ignorance. If it wasn't clear that those in Washington making a living out of lifetime politics didn't have a clue before, it will soon be evident that they don't have the slightest chance of understanding the problem...much less crafting a solution.

Now it is about molding all of the committee bills into a lean, mean cost saving machine. The only thing more important is that both sides agree and that there is a solid bill that will announce to everyone that their local elected official did the right thing. Why is that important? There is an election next year.  A very big election. They will be able to stand in front of a camera and say that they did something, but, when pressed about what they did, they will all say the same thing..."we provided health INSURANCE to half of the 50 thousand/30 thousand/25 thousand, what ever the number that is popular at the time. In reality what they did is...nothing.  And for that, everyone of them, of both stripes, should be sent home.

Washington is not the brain trust of fresh, new, entrepreneurial ideas. Be honest, congressmen, I mean, congresspersons, are trained by their staff. You need to actually go to Washington - if you have not shame on you - and meet some of these folks. You will be impressed by their manners, their intense enthusiasm, and their total misunderstanding of this issue. They believe what they are told. By whom? Which ever group has an appointment that day. And, by every lobby group in town. That would be four to one if you are keeping score.

So, where are we on October 13, 2009? Legislatively congress is at their best. They have flushed a fox out of the bush and they are all on their horses riding in what ever direction the dog is barking. For the news media it is ratings time. This will sell soap or whatever an attorney is selling at the moment, protecting you because you haven't paid taxes in years, you worked with asbestos 20 years ago and now have mesothelioma, you've been in a car wreck...you know the ads. Insurance companies? Well they got pretty beat up. Probably justified. This was their problem to fix ten years ago and they turned away. Hospitals and doctors? Depends on which ones you ask. Employers? The smart ones are freezing employment and studying their benefit plans. Joe the plumber? There are two camps, one that still believes in Santa Claus and that the federal government can fix everything, the other, the ones with common sense are looking into different ways of cutting back on everything they have to buy so they can pay for what is coming. The first group is about to find out what the rest of the country already knows. War is hell and the ones who can't see past their desire to have the wealth shared is about to go even deeper into despair. The second group, I hope, is gearing up to send home as many politicians next year as possible.

What I heard today from most every congressperson is that they don't think the American public will recoil at their decisions. They really believe they are untouchable. They believe that special interest groups will keep them in office and that they can continue to borrow this country into failure. I really, really, hope it has not come to that. I hope that America will raise their silent voices at the voting booth next year. I really hope this country has had enough. 

Every media sound bite will contain several references to the fact that certain parts of bills and amendments are "bipartisan", meaning that both parties agree on that aspect. There seems to be much joy and excitement when this occurs. Actually, nothing is ever said about whether the aspect of the bill or amendment has any validity, just that both sides agree. It is as though the mere fact that both sides agree, makes it valid. Being bipartisan has become more important than being for the right thing.

Is that to say that both sides have never agreed on something that could help with the current healthcare cost crisis? No, in fact there are a few things that both agree on that should be put into play immediately. What neither side agrees on is who gets credit for those items.

Here's the problem. The things on which both sides agree are so common sense that neither should take credit for their passage. Both sides want to pass a large, all encompassing bill with their name on it so they can point to it and say, "We did that! Re-elect us because we care for the folks who cannot get insurance." How? "We came up with more money". How? "We borrowed it." How will you repay it? "We will print more money. We will increase taxes. We will make those who are not currently paying into the system wish they did." Did that fix it? "Well, no." Why? "Because we financed a solution that we thought would get us re-elected. We knew better, but it was worth the shot."

It is possible that the federal legislature is so broken that it cannot be fixed. It may be true that the only fix will come from the common person who understands how things really work, or don't work. At the end of this debate maybe the best outcome would be for the word bipartisan to drop out of the English language and be replaced with, bythepeople.

Bob G. Shupe - Director, SCHCR