Top Ten Predictions Revisited

January 20th - 2 years in the White House for President Obama. I'll mark the milestone by revisiting my Top Ten Predictions for Obama’s First Term. Here are the updates:

10. The Hip House
It didn't take long for the coolness factor to fade away. I'll concede that more young people are politically engaged, though it be through The Daily Show. Better than total apathy, perhaps.

9. The dis-armed forces
What can I say - I was wrong on this one. He's been down right bellicose. Dare I say, Obama's Nobel Peace Prize acceptance speech was a justification of the Bush Doctrine. But as a concession for the left, he's come through on his Iraq pledges. A parsimonious House will cut defense spending over the next two years, though not out of allegiance to an anti-war agenda. The erudite residents of Nob Hill won't be doing cartwheels though - they'd have liked to see the money funneled into windmills and family planning clinics.

8. Baby love
S-chip passed, so I guess I was right. I didn't know how right I'd be though inasmuch as Obama Care passed as well. If you've got a penchant for Social Justice, you've gotta be happy with this one. I mean, who cares how much debt we'll accumulate in the long run... at least we covered everyone, right?

7. America! What a country!
What made Obama think that he could gain international favor through contrition? We appear weaker to our allies and adversaries alike.

6. Roe v. Wade through 2040
If you're pro choice, so far, so good. The appointments of Sotomayor and Kagan are in keeping with Obama's position on Roe v Wade, not to mention a "Constitutional blind spot", and how to address it through the Judiciary.

5. Yo, bra’ Man! No More Excuses!
A racial quiescence imbued the first six months of Obama's presidency, until he weighed in on the Skip Gates Saga. If I were a conspiracy theorist, I'd say he commented specifically to introduce the issue. So much for a post-racial America.

4. Same deal, different century
Ding, ding, ding - I didn't exactly go out on a limb on this one though. It wasn't a secret that Obama wanted to expand entitlement programs. So what's in this New Deal? Perpetual unemployment checks, more food stamps, s-chip, and coming soon, Obama-Care. I was wrong about one thing though - it's actually quite easy to quantify... can you say "deficit spending"?


3. Will work for food (stamps)
Though the economic outlook isn't as bad as it was 2 years ago, the working man works for less, if he works at all. Despite Bush's tax cuts being extended, there's still not a lot of hiring going on out there. It looks like 9% unemployment is the new "normal".

2. Kilo-what!
Filled up lately? It's not a surprise that gas prices are going up. But there's hope... our President will lift additional restrictions on off-shore drilling in time to lower prices before for the 2012 election. Somewhat of a push on this one though. At this point, there's not enough political capital to even bring up Cap & Trade.

1. The check is in the mail
Our national debt grew by an additional three and a half trillion dollars in the past two years. If we keep spending at this rate, we won't have to worry about the impact on our grandchildren, or even our children. The price will be paid within the decade.

So two years in, we're not the "socialist republic" I thought we'd be. Why? Perhaps 235 years in, checks and balances are working. Either that, or our President is not as far to the left as I thought he was. Maybe a little of both. It'll be interesting to see if he moderates in the second half. Ah, politics... you gotta love this stuff.

Doctor, get off my back! That costs too much!

By way of example, I'll tell you the real problem with health care in America. It's got less to do with tort law and access, and more to do with who's name is in the top left corner of the check.

I took a spill about a week ago. It's a miracle that I didn't break any bones. I was in a lot of pain, and needed to see a doctor. I asked friends for recommendations, and found a chiropractor nearby. Now having medical insurance through my employer, I went to the doctor's office without batting an eyelash... "I'll probably have to make a $20 co-pay or something, $50 at the worst", I thought.

Following the initial consultation, I paid $165 out of pocket, expecting that I'd see most of that money again when my insurance provider got the bill. I instructed the receptionist, "Please verify that your services are covered by my insurance provider, or you'll never see me again." "Of course, sir. When you return in the morning, we'll have that answer for you".

Fast forward one day. I show up for my appointment, and against my better judgment, went straight back for treatment without my answer. At the end of the session, I asked the question again. "I'm sorry, sir. We have not been able to confirm that your insurance provider covers our services. That will be $125, please". Ouch! "Okay, I'll pay for the services, but you'll never see me again until you can confirm coverage". "Of course, sir. Accept my apology, and a phone call later this afternoon with confirmation. Have a nice day."

You can probably guess what happened next... you guessed it, "Not covered". So there I was. $290 lighter on the back side, still in pain and needing treatment, but unwilling to fork over $100 a pop (pun intended) for treatment. So what did I do next? I did the same thing we all do for auto insurance, groceries, housing, etc. I shopped around! I entered the marketplace and sought out a merchant that met 2 requirements: quality and price.

The ubiquitous consumer practice of shopping around is absent (or at least compromised) in health care. As things are today, I (the consumer) have no motivation to seek out an ultimately less expensive alternative (as long as the service is "covered", I generally don't care how much my provider is paying).

It gets worse. During an unrelated stream of dialogue, I asked the same doctor where he sends his blood samples for processing. "I use one of the big two - it's totally random. It depends on which form I pull out.", he said. "Are their rates comparable?", I asked. "I don't know. Most of the time, the patient's insurance covers the cost, so it doesn't matter to me", he replied.

So there you have it. A system in which purchasing decisions are made on both ends by individuals with no pecuniary responsibility! It is a run-away train that needs to be derailed, or we're all doomed to spend ourselves into poorer health.

But changed to what? Changed for the sake of change? Changed to something that will exacerbate the problem? "But at least we did something". Are you kidding me?!

Adding a so called public option will not control costs. To the contrary, it seems obvious to me that it will increase costs. It seems obvious that the public option will destabilize the last remnants of market competition, a force that we all know controls costs (though not to a proper degree in this case because it's not a true market).

Is the United States Postal Service (USPS) as efficient as FedEx or UPS? Does the USPS drive down the cost of parcel transfer? Of course not. So if we see that logic, why on earth would we believe that government provided health care could reduce the cost of seeing the doctor, let alone cost less (as is being touted by President Obama and some members of Congress).

I could refute ethical arguments justifying public health care. I could get into the ideology and politics of forced compassion. Here, I have done neither. I've only attempted to demonstrate the lunacy in believing that a public option could or will improve our collective financial position with respect to health care. It's laughable.

I welcome your comments and dialogue.