I watched your presentation to the joint houses of Congress last week. I was surprised by the action of Congressman Wilson when he shouted, "you lie", but I understand his frustration. I would not say that you lied, but more to the point you did not tell the entire truth. Permit me to site an example. You faced the camera and said if you like the health insurance you have, you'll be able to keep it.

That is NOT entirely true.

The bills written by your democratic colleagues comes with a condition and expiration date. Existing plans will be grandfathered in, but no new enrollees are permitted and after 5 years all plans have to conform to new federal requirements yet to be determined. So did you lie, well in lawyer talk no, but you also did not tell the entire truth. This is the action of a "con artist", not the action of the President of The United States. You ran on a campaign of honesty and transparency; I do not see you following through on your campaign promises. And I am beginning to doubt your credibility and your trust value is showing serious cracks.

Permit me to explore another half-truth. The public option. You claim it will compete on a level playing field with the private sector. How is that possible? The private sector must make a profit to stay in business, the Government does not. As the Government offers coverage at a lower premium cost it will slowly put the private sector out of business eventually leading to a single payer plan. The Government does not have to make a profit because it can subsidize the plan with IOU's similar to Social Security, print more money, or as usual raise taxes.

Mr. President, let's step back and look at other businesses the Government has operated, Post Office (bankrupt), Amtrak (bankrupt), Freddie Mac (bankrupt), Fanny Mae (bankrupt), Social Security going bankrupt, and Medicare heading to bankruptcy. Do you really want to entrust 1/6 of our economy to the holder of this track record of failures?

One last point. I have difficulty understanding how you will be able to expand health care coverage without adding to the deficit or curtailing services. I hear some of the avenues of opportunity include:

-Cutting Doctors fees, this will only serve to reduce the number of doctors available to serve the public. Not a good direction.

-Reward providers for quality care, what exactly does that mean? Who establishes the criteria? What are the criteria? How do you measure it and claim success? Who checks the system?

-Reduce waste, what is the standard for measurement? How do you know what is waste unless you establish some cost benefit analysis? Who establishes the criteria-the government or the doctors? And how often do you measure it?

-Reducing fraud, do you mean to tell me after all the years Medicare has been in force that we are just now looking at fraud. Please tell me this is not true. What new checks will be implemented to check for fraud? What government agency will be responsible to monitor for fraud? What are the penalties if caught committing fraud?

So, just how much do these savings add up to? Do they really pay for the system and make health care deficit neutral?

You are saying what the public wants to hear, but just how do you intend to deliver? What are the details of the plan?  How will it be measured and at what cost to administer? None of this important information is explained, so how can I in good conscience go along with a program of this magnitude and expense without knowing the details of the plan.

Mr. President, I do agree with some of your points, namely, people should not be turned down for pre-existing conditions. I agree health insurance should be portable. I also think cost could be better controlled by allowing insurance companies to compete across state lines. And I believe malpractice suits need to be reviewed for reasonableness. I realize you are not in favor of this last approach as it would affect your lawyer lobby and they would not be pleased with your action. But perhaps it is time for you to look at ALL the possibilities of paying for your health care reform.

As a means of paying for your program I offer a suggestion. Presently, all legal citizens under the poverty level can receive health coverage under Medicaid. However, if a person improves his earnings slightly above the poverty line, they lose coverage. Why not reward their initiative and have them be accepted into Medicaid II. In this plan, because they are doing better financially, have them retain their Medicaid coverage but pay a higher deductible or a small monthly premium. This approach provides people with an incentive to do better, it covers some of the cost of the program, and you still get health coverage for all legal citizens. It will still need to be subsidized but at a lower cost to the taxpayer. As the person continues to do well they will eventually work themselves out of Medicaid II and afford the full coverage of a private company.

Mr. President, I would appreciate it if someone on your staff would take the time and address my questions. I believe my concerns are legitimate and a response is only common courtesy.
 
Very truly yours,


Sal La Rocca
Cave Creek, AZ

Dear Mr. President,