Monday, July 13, 2015

A Nation of Tolerance and Fairness

We are a nation of tolerance and fairness.

We have twice elected a black president. Black bereaved citizens of 9 blacks shot dead in a Charleston church forgave a crazed white racist. Charlestonians, in turn, took down the confederate flag from the state grounds and placed it in a museum. Before that, these same good folk of South Carolina, black and white, elected a black senator.

We are a tolerant nation. Some of us have tolerated being called bigots because we question the policies of our president. We have tolerated this dreadful practice of political correctness, that pejorative term deployed to criticize language, actions, or policies seen as being excessively calculated to not offend or disadvantage any particular group of people in society. We have tolerated attacks on our nation as a nation replete with money-grubbing groups of white supremicists, as unfair havens of privileged white people. We have tolerated being labeled an unfair nation with unequal opportunities, unequal incomes, and unequal results for every gender and every race.

But there are limits to our tolerance and our sense of fairness. These limits have been shown in our two most recent midterm elections, in the rise of the Tea Party and the number of conservative candidates for the presidency.

Fox News, sometimes unfairly and hypocritically but consistently, has capitalized on these limits with its slogan of “fair and balanced.” Fox is right. we need more balance. As a nation, we have indeed been seeking balance – between ethnic groups, the executive and legislative branches, gays and straights, men and women, domestic and foreign affairs, believers and nonbelievers in our national role and destiny, between fairness and unfairness.

President Obama has staked out “fairness” as his operative governing philosophy. All he wants , he says, is for us to be fair, to offer everyone a fair and square deal, to correct the unfairness that has been meted out to minorities, to modify the sins of capitalism with protectionist big government policies.

These are noble goals, but they have a downside, as articulated by Stephen Moore in his 2011 book Who Is the Fairest of Them All: Opportunity, Taxes, and Wealth in America.

“ President Obama has declared that the standard by which all policies and policy outcomes are judged is fairness. He declared in 2011 that ‘we've sought to ensure that every citizen can count on some basic measure of security. We do this because we recognize that no matter how responsibly we live our lives, any one of us, at any moment, might face hard times, might face bad luck, might face a crippling illness or a layoff.’ And that, he says, is why we have a social safety net. He says that returning to a standard of fairness where anyone can get ahead through hard work is the "issue of our time." And perhaps it is.”

But what is “fairness”? Fair to whom? And in the field of health care, to what group of people – patients and members of the physician and hospital communities who must supply that care/ To paraphrase Moore’s title Who Is the Fairest of Them All: Opportunity, Taxes, and Health in America. Who is the fairest of them all, a paternalistic controlling g big government or an unfettered free market capitalism?

These questions bring up other questions the answers of which depend on you whether you benefit or are harmed by health place polices,

Was it fair for Democrats to pass ObamaCare using a questionable parliamentary maneuver called reconciliation without consulting Republicans and without a single GOP vote?

If it fair that under ObamaCare 20 million uninsured patients or patients on Medicaid ( 6.25% of U.S. population received subsidies? Yes, if you’re among the subsidized. Maybe not, if you’re one of the 93.75% doing the taxpayers' subsidizing.

Is it fair that all Americans must have a health plan, whether they want one or not, or pay a mandated financial penalty?

Is it fair that small businesses, the fountain head of American prosperity, with over 50 workers must cover those workers or a pay $2000 penalty for each new worker?

Is it fair that most of us with incomes 4 times or more above the poverty line must now pay premiums of 20% to 40% more to support ObamaCare subsidies?

Is it fair for the young and healthy to cross-subsidize older and sicker patients?

Is it fair that everybody must pay for health plans containing comprehensive benefits even when they do not need these benefits? An example would be single males who have no children and who will never become pregnant.

Is it fair to when the expense and time spent complying with federal regulations (e.g. installing EMRs and using ICD-10 codes) drive physicians out of private practice into integrated health organizations who may charge twice as much for physician services?

Is it fair for the government to cap the profits of health plans, to say they can devote only 20% to marketing, and prohibit them from taking high risk patients, the main source of their financial losses?

Is it fair for taxpayers to bail out insurers for these losses?

Is it fair that ObamaCare policies promote the massive consolidation of health insurance companies and hospital-physician organizations, effectively ending free market competition?

Is it fair for that one-third of all the uninsured remain uninsured because they resent federal intrusion to their choices, of being forced to pay penalties if they do not have a plan?

Is it fair for governments to fix Medicare rates for procedures such as hip/knee replacements for hospitals, physicians, and rehab facilities when these entities may operate in radically different economic environments?

Is it fair for government to dictate what if any plans we buy, what doctors and hospitals we choose, what medicines and treatments we want, and how we lead our lives no mater how these things affect our individual freedoms, or does Big Brother know best.

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