Platform for "The New Reality" Part I addressed the path to a new National Environmental Energy Infrastructure, a Science & Technology Policy for Modern America, and Social Justice for National Economic Security. These crosscutting issues profoundly affect Municipal Revenue, Criminal Law Enforcement, Foreign Assistance, Military Preparedness, and Education at both the High School and University levels.
The results of this exercise will be contributed to both the Democratic and Republican online platform development suites, and to the integrated Netroots Platform Composition System. Its objective is to propose bold innovative solutions, in a political process mired in bland conformity; it matters not which party adopts these - or other - new ideas and carries them to fruition. All we know for certain is that past approaches have been timid and suffused with failure. (more...)
A PLATFORM for "THE NEW REALITY"
We live in complex times. At their roots, few of our problems exist in isolation. Finding true solutions to the problems of the modern age requires that we think holisticly, across disciplines, in an associative and integrative mannner. Crosscuttting approaches often lead to new ways of conceptualizing old problems, with answers arising spontaneously from the chaos.
We are appalled by the manifest irrationality which pervades so many areas of public policy. In previous platform suggestions previous platform suggestions and those below, we hope to address some of the most blatant and glaring examples of national policies most directly at variance with obvious logic.
From Medical "Price Supports" to Outcomes-Based Reimbursement -
The Medicare/Medicaid system, which many demagogues propose to make universal, is the lingua franca of health care finance in the United States, and has been for decades. It so completely controls the process of medical practitioners and hospitals getting paid that virtually all private insurors adjust their policies and reimbursement formulae to synchronize with those of the federal healthcare establishment. They all use a shared code base, not unlike the airlines, which fixes a value to each procedure, just like 'body & fender' shops conducting collision repair of automobiles. This is not a coincidence, the insurance industry contributed this bit of wisdom and politicians in hock to it readily adopted it as the model for how health care would be paid for in America.
However, a medical establishment which has been so heavily subsidized by Medicare/Medicaid for so long and yet has still developed cost structures so drastically out of proportion to ambient reality is unarguably "broken", and must be fixed before the taxpayers can extend unlimited blanket coverage to another single person.
Instead of extending federal subsidies to Health Insurors or HMOs, who, after all, mend no injuries and cure no disease, any future direct universal health care benefit should be a direct reward to the actual care provider, for services successfully - and verifiably - rendered.
We propose to adopt the notion that health care is a fundamental right of American citizenship, so limited only becuase the nation cannot afford to become the "cure mecca" for every ailing person on the planet. Nevertheless, we propose that Emergency Care continue to be furnished on an unlimited basis to all patients, regardless of their ability to pay, with the indigent subscribed to through the allocation of all "Sin Tax" (Alcohol, Tobacco, Firearms, Gambling and Marijuana tax) revenues specifically to the purpose.
Even more, we would facilitate county Health Departments in the establishment of well-equipped Non-Hospital Emergency Rooms, suitable to accommodate the sum total of all urgent care requirements on an immediate and non-discriminatory basis. This can be assisted by the direct allocation of all tax revenue from Income, Capital Gains, Gifts, and Estates/Inheritence from designated Health Care Providers directly to such a deployment of free clinics. In practice, such an arrangement can then be managed to encourage Physicians and Nurses to contribute effort to these clinics, for a greater than proportionate reduction in their otherwise tax burden.
But the larger problem remains. Fundamental minimum reimbursement rates from Medicare/Medicaid, below which no provider can charge uncovered patients and still participate in the system, performs the exact same role in health care that federal price supports do in agriculture. They establish a "price floor" below which the bushel of wheat or appendectomy need not be sold, because the federal government will always pay that stipulated minimum. This is why health care is unaffordable to millions of Americans. It is anti-competitive, anti-patient, and anti-American. What's worse, these guaranteed minimum prices which protect only the earnings of health care providers are paid regardless of whether or not the treatment or care was actually effective in alleviating the suffering of the patient. It is without parallel in the economy and ensures a "black hole" down which unlimited amounts of private and public treasure may be expended.
In-hospital deaths from Iatrogenic illnesses and injuries - those actually caused by health care practitioners themselves now average more than 195,000 per year in the United States. In millions of other cases, hospital-born infections, surgical maimings, and other errors cause untold preventable suffering. Together with 'defensive medicine' - the ordering of unnecesssary scans, tests, labwork, and other procedures - practiced widely today as a precaution against malpractice claims of negligence, iatrogenic problems represent a significant portion of the inflated cost of health care in America.
Meanwhile, innovative alternative medical techniques and remedies find great difficulty entering the marketplace, much to the detriment of patients for whom conventional medicine has proven ineffective. Even non-invasive therapies, or those which have already obtained FDA approval are often slow to be adopted by a tradition oriented medical establishment. Particularly with respect to intractible fatal illnesses such as Cancer, this barrier is morally unconscionable and intolerable.
To address all of these issues affecting the cost of health care, we pledge to replace price supports in health care with an 'Outcomes-based' reimbursement schedule for Medicare/Medicaid, in which provider's financial rewards come from successful healing and cures, not merely from rendering 'treatment'.
Replace the Income Tax with A Self-Funding Tax on Debt-
Recent easy credit bubbles, the mortgage crisis, and the junk bond fiasco of years past should have indicated the opportunity for a new approach to broad based taxation.
The present Internal Revenue Code is hopelessly complex, its 40,000 pages invested with breaks and loopholes for special interests, crafted by lobbyists over decades. American businesses and individuals spend an estimated $300 Billion just in tax preparation, record keeping, and compliance; an expense to the economy with no constructive purpose. Perennially, various "flat", "fair", and "simple" tax reform plans are suggested, but all have come to no avail due to the army of lawyers, accountants, consultants, and other specialists who have a vested interest in maintaining the status quo.
Instead, we propose to replace the Income Tax with a universal tax on all personal and corporate Debt (now totalling $39.7 Trillion), at an initial rate of One Percent (1%) per annum, with the proceeds allocated exclusively to the retirement of outstanding government debt. In repurchasing or paying off U.S. Treasury Bonds, the proceeds put money back into the economy, exerting a downward pressure on interest rates in the marketplace. As a result, the net cost to borrowers is likely to decline in proportion to the new levy, in effect ameliorating any negative impact of the tax on the economy.
At the margins, the Debt Tax will encourage savings over borrowing, and equity investment over bonds, rather than discouraging incremental income as does the present system. Given a balanced federal budget, the nearly $400 Billion in annual Debt Tax revenues could set the stage for eventually retiring the $9.2 Trillion in accumulated federal debt.