AFP Health Reviews

Mr. President:

I know that you are a very busy man so I will try to keep my questions about health care reform and the recently passed legislation as short and simple as possible.

– I could ask you why you think this is a good piece of legislation even though I truly believe that it will be a failure and will come very close to bankrupting the country. The basis for my conclusion has nothing to do with political partisanship (in fact, I have never voted for a Republican for national office in my life.) From my perspective, “Obama Care” never effectively addressed the root causes of our escalating health care costs: Americans eat too much of the wrong kinds of food, they exercise far too little, they are overweight, they smoke too much, and they are getting older. This legislation does not address these causes, it just raises taxes and moves money around within the bureaucracy. I could ask you about this but I will not.

– I could ask you why you have not stepped forward and denounced those in your party that have likened Americans like myself, i.e. those that have legitimate and honest concerns about this health care reform bill, to the racists who fought against the civil rights movement from the 1960s. I thought that we lived in a free country where citizens could freely address their elected representatives without being slurred in the most debasing way possible, just for having a different opinion. Your lack of fortitude to oppose those Democrats who frequently use the term “racist” to malign myself and those Americans expressing their honest opposition, cheapens the bravery and contributions of those from long ago that fought actual racism. I could ask you about this but I will not.

– I could ask you why you felt it necessary to pass this legislation by the back door called reconciliation. This is a major, major issue in the country that will affect every American for decades to come. Sneaking it in the back door, without using the traditional, time honored method of passing laws in his country, belittles the approach and makes it look like it was forced through without the full weight of the democratic process behind it. I could ask you about this but I will not.

Here is what I will ask you about. But first, some background facts:

– Let me reiterate that both my wife and myself have never voted for a Republican for national office in our lives.

– We both spent several decades of our lives working hard for AT&T, retiring several years ago, secure in our thinking that AT&T’s promise of health care benefits and coverage for our long years of service was a good bet.

– We both try to eat well, we exercise at our local YMCA on an almost daily basis, neither of us smoke, and we rarely drink. In other words, we take personal responsibility for our health and our health care.
One reason for our personal responsibility behavior is that we are on a high deductible insurance plan with AT&T. We are each responsible for the first $1,200 of our annual health care costs before we get any insurance coverage at all. However, for this personal responsibility, we also pay nothing in annual premiums.

– During the debate leading up to the passage of health care reform, you reiterated more than once that those of us that currently had health care coverage would be able to keep it. However, in a recent article in Fortune magazine, the CEO of AT&T, Randall Stephenson, was interviewed (several pages of the article are attached). Towards the end of the interview, he was explicitly asked whether AT&T would consider dropping health care insurance coverage for its employees and retirees. His response made it clear that this was a very viable option for two reasons. First, from a business profitability perspective, under the new health care reform law, “you’re better off paying the government a fine and dropping health care coverage for your employees”, improving AT&Ts bottom line. Second, he talks about “economic gravity” which appears to be code words for “if others in his industry do it, AT&T will have no choice but to do it also.”

Thus, a few quick questions for you:

1) Were you just naive when you made the comments that we could all keep our current health care insurance, not realizing the simple fact that companies are in business to make money and if this bill makes it easier for them to make more money by not insuring their workforce, that is what they will do? Or were you being disingenuous, knowing that this would happen and deliberately misinforming the country to help get your health care reform bill passed? Naive or disingenuous, in either case you will be making millions of American voters unhappy in November and in 2012 when we are forced out of our current health care coverage and will blame you for either ignorance or arrogance in this situation.

2) I am 57 years old and my wife is 56 years old and if Mr. Stephenson does decide to terminate AT&T’s health care coverage for employees and retirees, where do you suggest that my wife and I get coverage? What insurance company is going to want to pick us up, and millions of other older Americans who lost their coverage, at our ages even though we are both healthy and taking personal responsibility for our continued good health?

3) If we are forced out onto the market for health care insurance coverage, our new coverage is likely going to be much more expensive. Our annual health care costs will go from a maximum of $1,200 each to a minimum of several thousand dollars each. Is this how you planned to reduce health care costs for middle class America? Is so, then you need to explain the math to me. Maximum of $1,200 to a minimum of several thousand dollars, does not make sense out here in the real world. How does this reduce the escalating health care costs for the 90% of Americans that already had health care insurance prior to the passage of this bill?

Thus, I am not going to ask you about why you and the rest of Congress did not address the root causes of high health care costs in your legislating process. I am not going to ask why you have sat back and been silent while those Americans with legitimate and honest dissent against this bill have been likened to racists by members of your party. I thought you represented all Americans, not just those that agreed with your policies. I will not ask you about why you did not have the courage and guts to pass this legislation the right way, through the front door like every other piece of legislation, but instead snuck it through the back door of reconciliation.

However, I will ask you or your staff to contact me and explain where and how I can get health care coverage at my age if AT&T and the rest of corporate America decides it is a better economic choice to pay a government fine than to cover their employees and retirees with health insurance. I will ask you to explain whether you were naive or disingenuous when explaining that we would be able to keep our current health insurance coverage. And finally, please explain how paying no more than $1,200 a year under my current coverage (with many years paying nothing for coverage during healthy years) is a better deal then finding new coverage at my age and paying several thousand dollars a year for the privilege.

Although I have written to the White House many times, I have never received any answer to my questions on a wide variety of topics even though you promised to have the most open and responsive administration of all time. That has not happened yet. However, in this case I do require, in fact I demand specific answers to my three questions above. For your political sake I hope to receive those answers before early November and certainly before 2012.

Thank you for your time,

Walter “Bruno” Korschek

[Follow up note: a month after sending this to the White House, no answers to the questions have been received or even a simple confirmation that this letter was received has been forthcoming from the Obama adminstration.]

It has always been the view of many thoughtful Americans that Obama Care and the politicians that wrote the voluminous and unreadable 2000+ page legislation got it all wrong. They assumed that the problem was escalating health care costs and then wrote legislation to treat this symptom, not the underlying root causes. High costs are an outcome because of other factors.

It is as if the political class is treating a cough but do not understand whether the cough is caused by allergies, the flu, bronchitis, pneumonia, cancer, strep throat, etc. Unless you know what the underlying disease is, if you treat only the symptom, in this case high and escalating health care costs, the chances of success are quite low.

If you look at the literature on the health state of most Americans, you find a consistent pattern:

– Americans smoke too much.

– Americans eat too much.

– Americans eat too much of the wrong kind of foods.

– Americans do not get enough exercise.

– Americans in general are getting older.

The first four items in this list are modifiable behaviors. They are the key to getting health care costs under control. Obama, Reid, Pelosi, et al never understood this. They raised taxes and implemented new taxes and fees, they created an untold number of new government agencies, they will criminalize millions of Americans for not bowing down to Obama Care and buying mandatory health insurance for themselves, etc. They treated the symptom of high health care costs as a tax, control, and bureaucracy problem, not a behavior and aging problem. Their chances of success are very small, assuming the legislation ever gets fully implemented and is not declared unconstitutional.

They also did not understand that forcing a human being to do something is never the best way to get something done. If you can make someone want to and like to do something from a behavior perspective, they are 1) more likely to do it, 2 ) do it with more conviction and 3) do it for a longer period of time. Forcing an American to do anything just gets their ire up and robs them of the freedom of choice, something a government should rarely, if ever, do in a democracy.

This is where some creativity and originality may have been a much better approach, in conjunction with modifying behavior relative to good health habits. We got none of this creative thinking from those in charge of Obama Care, it was the same old overbearing, freedom robbing, inefficient government control approach. Maybe they should have looked at a specific YouTube video for some of that refreshing new thinking. this video can be viewed by going to the YouTube website and searching for “odenplan, sweden, stairs, escalator, piano.”

This video covers an interesting experiment that was done in Odenplan, Sweden. The video opens with a shot of what looks like a subway area with abutting stairs and an “Up” escalator. In the first part of the video, the overwhelming percentage of travelers take the escalator to get up to street level, very few take the 20-30 stairs up. It is then that a bunch of engineers and others get involved. They transform the stairs into a simulated piano keyboard, with both black and white keys. When someone steps on the stairs, a piano note is generated so that by walking up the stairs it is as if you are playing the piano.

After the installation of the musical steps are completed, the majority of travelers opt now for the keyboard stairs and not the easier escalator. According to the video, the usage of the steps increased 66%. Using the steps is obviously a better health option but a healthier option that people chose of their own free will, not one forced on them.

If Obama, Reid, and Pelosi were in charge of the situation, they would have shut down the escalator, forced people to use the stairs, written a 2,000 page manual on the proper way to use steps and charged citizens a fee or tax to do so. The stairs would not make any sound since the government bureaucracy in charge of implementing the musical stairs would have been bogged down in red tape and never got around to the job.

Now, is it feasible to convert every set of steps in the country to musical steps? Obviously not. However, in a whimsical sort of way it would be cool to do so. Americans would gladly use the musical steps even though it was healthier for them, they would still be free to chose but by using some creativity, the right behavior would occur without new government regulations, without a loss of freedom, without coercion, and without new taxes.

This would have been such a refreshingly new approach: guide, not force, people to the right behavior to address and eliminate the underlying causes of high health care costs. If you reduce the demand for health care services because of musical steps or other innovative behavior modification, simple economics would drive down the costs, assuming the supply of medical services was constant.

That is why when you correctly view the issue of high health care costs as a behavior modification issue and not a government bureaucracy and tax issue you see that the solution should be executed from a public health viewpoint. How can you find a way to make good health behavior the right and freely chosen behavior to do? That would have been the creative, innovative, and liberty-wise right approach. It is not the type of behavior we can expect from our political class. We have not had our political class solve any issue from a creative, innovative, or freedom perspective for a very long time.

How might this positive public health approach be accomplished? On way would be to put together a panel of very smart Americans, sans politicians and lobbyists, in the mode of the successful Manhattan Project, the Apollo space program, the Military Base Closing Commission, and the Grace Commission on reducing government costs. Let the experts go about defining the true underlying causes to the problem and let the smart members of the panel come up with piano steps-like public health initiatives that modify behavior, address the underlying root causes, allow us to not lose our freedom of choice, not create mega-new bureaucracies, and not waste our tax dollars.

Now, as mentioned above, even if you modify all of the bad American eating and exercising habits, you are still left with the simple fact that Americans are getting older and in all likelihood will need more health care. We need to funnel resources into solving some of the biggest cancer killers of our time and vigorously attack the problem of dementia and Alzheimer’s disease. These are the health care cost causers that will cripple the nation’s financial viability unless we can find a way to solve these health issues.

Over time, better eating and exercise habits might mitigate the cancer and Alzheimer’s impact but that would happen down the road. With thousands of Baby Boomers turning 65 every day, we must find a way to attack and conquer these diseases to mitigate the impact on health care costs. Obama Care does not make this approach a priority, which is a shame because if you do not solve these aging disease factors, it does not matter what you do from a taxation, government control, and bureaucracy perspective. The sheer number of Baby Boomers will overwhelm the system from a cancer and dementia perspective.

Thus, as you go through your day, think about using the stairs once in a while and imagine a piano playing every time you take a step. It will invigorate your body with the healthy stair option and maybe invigorate your mind, possibly staving off dementia, if you can imagine the piano steps playing a song as you go up. This will certainly make a bigger contribution to a healthy America than anything in the Obama Care legislation.

As the video says, “Fun can obviously change behavior for the better.”