Trillion

My 3 year old daughter used the word "trillion" last night. "Did she just say 'trillion'?" I astoundedly asked my wife. Yes, she had. Apparently earlier in the day my little one had asked her mommy what "the biggest number" was, and my wife told her "trillion."

When I was 3, the word "trillion" was not part of the normal vocabulary. When I was just 6, Ronald Reagan spoke eloquently about the word "billion", trying to explain just how big a number that is. Now "billion" is nothing.

So thirty years ago, "trillion" was a number that just never came up in conversations related to government spending. Now "trillion" is simply one Congressional bill. In fact, it's entirely possible that we will have two Congressional bills in this year alone, that both come close to or eclipse the "trillion" dollar absurdity.

Here's to hoping that my grandchildren, or great grandchildren, never have the word "quadrillion" become part of their normal vocabulary.

The Constitution wasn't meant to just be a "suggestion"

Congress continues to run roughshod over the Constitution. I have long argued that the health care reform being considered in Congress is unconstitutional simply because the United States Constitution does not authorize the federal government to regulate this area of our lives. All Congressional powers are clearly delineated in Article 1, Section 8, and regulating health care is not one of them. The Tenth Amendment further clarifies and enforces that "all powers not delegated to the United States by this Constitution, nor prohibited to it by the states, are reserved to the states respectively, or to the people."

The current bill being considered in the Senate further ignores Article 1, Section 7 of the Constitution which states that "all bills for raising Revenue shall originate in the House of Representatives." As we all likely know by now, the Senate bill is chock full of new taxes and fees - in other words, it is a bill originating in the Senate that raises revenue.

From the assumption of powers that do not exist, to procedural arrogance, Congress continues to completely ignore the Constitution to which they have all been sworn to uphold.

Health Care Wasted Spending

I read an interesting piece in Forbes tonight about the wasteful spending endemic in our health care system. It only further entrenched in me my already strong belief that as long as consumers continue to have health "insurance" that covers every medical expense, paid for by a third party, with high premiums and low co-pays, we will continue to see this upwards spiral of cost increases.

Procedures, tests, and drugs are all taken and prescribed, even though there may be little to no benefit for the patient. Yet the patient does not have to bear much, if any, of the cost of these activities. There is therefore no incentive not to utilize every available remedy their doctor may be willing to prescribe.

High deductible, low premium, catastrophic loss true health insurance policies, coupled with health savings accounts where the consumer controls the majority of first costs for health care coverage, would eliminate a lot of the waste described below. "Waste" facts highlighted in the article included:

• In 2008, the consultant firm McKinsey found $650 billion in excess medical costs.
• A Dartmouth Medical School study estimates that 20% or more of all health care costs could be eliminated without harming anyone.
• At least 40% of all specialist visits and 25% of all hospital stays are unnecessary.
• We now do 70 million CT scans per year, compared with just 3 million in 1980, all at a cost of $200 or more per scan. The number of scans has doubled in this decade alone (from 35 million to 70 million). Scans are frequently done when not needed, just to be safe, or when other symptoms and factors would otherwise indicate that one is not needed.
• Over the past 5 years, spending on antipsychotic drugs has increased 50%. One doctor states these drugs are prescribed "a little wantonly." Another says their wide use is "one of the reasons we haven't been able to control health care costs" and that the wide use is "without scientific justification."
• Spending on back and neck pain treatments increased 65% (after inflation) between 1997 and 2005, to $86 billion. Yet the Journal of the American Medical Association found no evidence that the increased spending was making people feel any better.
• Surgeries to put in artery-widening stents cost more than $12,000. But studies find many people who get them didn't really need them. Drugs that cost less than $1000 lead to outcomes almost as good as $12,000 stents (only a 1/2 percent difference in the odds of suffering a heart attack using drugs over stents).
• From 1996 to 2006, knee arthroscopy procedures increased over 50%, to 956,000 annually - many to help patients with arhritis of the knee. Yet two vigorous trials show that this $5000 procedure doesn't actually help patients with arthritis of the knee (granted, not all of the yearly arthroscopies performed were solely on patients w/ arthritis). One doctor says "This is one of the most frequently performed procedures in medicine, and we don't know whether it works."

There is much that can be done to help bring down health care costs (and thus insure more people), but clearly one of them is to have a system where patients have more skin in the game, and control the majority of first dollars spent. Only then will consumers begin to ask themselves "Do I really need this?" and in doing so create some cost containment. Until then, as long as a third party is paying, the only words you'll hear will be "Where do I sign?"