From the first breath of life to the last, and all of them during the interim, things ARE going to change big-time and the initial costs are going to be even bigger. Everyone has an absolute moral obligation to educate themselves on the topic. Everyone also have a moral obligation to enter the fray.

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STEP 1. Take a deeeeep breath, then exhale v-e-r-y slowly. Think “calm.”

First ‘scrap’: A special prosecutor to investigate the Bush administration. To disclosure, if I were Emperor of the US, I’d order a baker’s dozen of them up yesterday, January 20, 2001. Although a dozen would have been woefully insufficient, given all the thuggery that gang of thugs perpetrated, twelve might be as many as even an emperor would have been able to get away with.

But it just ain’t gonna happen; not yesterday, not today, not tomorrow. Ken Starr was GOP payback for Nixon, and that Nixon was both warranted and necessary, while Starr was exclusively what I just iterated, is irrelevant to the practical politics of the game.

One: Sans the SP, the Obama team is riding high, and the only horizon in view looks downhill. Insistence on or reference to such plans would be spun by all the talking heads on the Right, by much of the public and almost every Republican in Congress as vengeful hardball partisan politics. Any hope Dems might have of pushing through programs would be dashed in the 60-vote necessary Senate. 

Two. Both the administration and Congress have more stuff that’s w-a-a-y overstuffed to deal with right NOW that any prosecutorial diversion into territory with very little political upside just will not garner more than lip service.

The tally. No one would like to see George & Friends doing the perp-walk more than I. But, as I’m also capable of recognizing political reality, and as I can’t find the beneficial use of a head-against-a-brick-wall brain injury, I’m prepared to direct my wrath in areas more promising, and I urge others to do as well.

Second ‘scrap’: Healthcare reform. (C-SPAN video of Obama’s March 5 Healthcare Summit: http://www.cspan.org/Watch/watch.aspx?MediaId=HP-R-16093)

Because everyone — every individual, every small business owner, every CEO of every conglomerate, and every government employee — has a huge stake in this one, I strongly urge everyone to stop by C-SPAN’s website and have a look-see.

The United States has the world’s very worst healthcare delivery system. Let me explain that, it’s sort of a mathematical look. By gross (word used both ways) expenditures, this country exponentially outspends every other nation on the earth. On a per capita basis we outspend every other nation, except Switzerland, at least twice. We still spend more than the Swiss, just not twice as much. But what we get for the beaucoup bucks is pretty nearly abject failure. We’re 41st in life expectancy, and never reach above 20th for any health standard.

Unless you’re going to be at least close to equally miserable for capital outlay, your business plan has to be judged an abject disaster. (It’d be like trading A-Rod and a hundred mil, for a 3d-string minor league player, to be named later.)

So, everyone is on board the Need-An-Overhaul Express. At least all the attendees at the summit were so full of evangelistic bonhomie esprit de corps that you could be forgiven for committing fun-house errors of perception. The hang-ups are in the myriad of details, and I’m concerned that those will prompt many to hang the idea out to dry.

Here is where I’m going to interject a couple facts, then an opinion concerning those facts. (Disclosure: For 15 years, prior to my retirement, I was a licensed, appointed life and health insurance rep, authorized to transact contracts on behalf of every major insurer.) The fact: 30 - 33¢ of EVERY private insurance premium dollar, whether it’s paid by the individual or the employer, goes not to 1¢ of healthcare, but to administrative and profit.

The Blues president, Scott Serota, last year earned multiples of $1,000,000, while at the same time subscribers were receiving premium increases above 15%. The only two functions served by insurance company administration is to separate the good-wheat healthiest from the not so perfect chaff and to DENY BENEFITS! The opinion I’d like someone, anyone to counter: Private health insurance companies serve no beneficial social function whatsoever, certainly not one worth 30% of what they’re being paid. Medicare’s administrative costs run less than 5%, and have no one on the payroll knocking down the kind of bucks that are de rigueur in the private for-profit health insurance industry. Granted, in a system where everyone is in, government admin costs will be higher than 5%, but in no case will they reach the wasteful stratosphere that’s today’s rule. Counter?

Like it or not, no matter your philosophical bent, medical care is being rationed now (See above paragraph at “DENY”.) and will be in the future.

Like it or not, no matter your philosophical bent, you already have “socialized medicine.” The uninsured and under-insured wait until there is no option but to refer to the ER. If the patient is covered by Medicaid, you pay. If the patient is not covered by Medicaid, you still pay; this time via higher premiums that get passed on to you in the form of reduced potential wages or reduced coverage.

A Confession: I’m a 14- to 15- cigarettes-a-day smoker, and have been for about 50 years. It doesn’t matter that I don’t engage the addiction anywhere indoors or in the midst of non-smokers, I realize I’m now more of a social pariah than someone with an evident infectious skin rash. Nor do I do anything but condemn the practice — strange word selection, I think I have it down now to a highly honed pastime — and counsel one and all to never, ever take that first puff. One of the cost-offsetting ideas advanced in the video-recorded breakout was to increase the federal tax to $2.00 per pack. I support that, but only on the proviso within the next paragraph.

The preceding duly noted, and in no manner rationalized, smokers no longer compose the greatest health risk to the common weal. That ignominious prize has now been seized by the obese among us; truly a growing population. They’re in your family. They’re your coworkers (provided you’re so fortunate to have a job), they’re next door to you. However the NIH prefers to call it an epidemic, as a pariah myself, I prefer “plague.” The health costs, from all related illnesses, that these folks are exacting are excruciating to the fiscal health of this nation. So, if the second-tier assaulters can be expected to pay a hefty surtax because of their behavior, why should the well-rounded first-tier members not also pay a heavy price for their . . . heft? And why should they not also — once again — be looked upon with disgust and disdain, “Ugh, you’re sooo _____”? 

Where more healthcare dollars are spent than anywhere else: End of life procedures that are intended not to just relieve pain and suffering, but to toss that desperate Hail Mary pass. Grab a few more months on the arms of “Whatever it takes, Doc — money’s no object.” This issue was raised in the breakout, almost apologetically, almost in a whisper. But it’s a serious money-eating monster that has to be thought about, thoughtfully; by all of us. I’m not asking anyone to decide what he or she would decide for him- or her self, but, when the family is gathered around grandma’s hospital bed, or that of a child. Let’s not pretend this is ever going to be easy. Perhaps if you considered the matter this way: If YOU had a secret ballot, would you vote to spend tens of thousands of dollars, a portion of which was YOUR money, on a long-bet procedure that might — only “might” — buy a couple more weeks or months for me?

End of life also goes to the highly troublesome death with dignity and assisted suicide controversies. The Church and numerous other religious sects have taken their stands four square. However, there are two aspects to this that are deserving of consideration and open discussion. On the premise that dignity is an essential component in that which defines the individual, shouldn’t the individual have the ultimate say over his or her life and death decision, not any other individual or institution? The other question pertains to the definition of humane treatment. We regard it so extremely inhumane that we have codified sanctions against forcing an animal to suffer in a painful state. How then can we rationalize forcing a person to endure excruciating pain to the very last breath, when the end is known? It’s your money, and your conscience.

Other issues raised included rehabilitative care; who says “yes”, who says “no”, who decides what’s efficacious and what’s wasteful and what’s in between, for how long, how much to spend.

All agreed that preventive care — education on behalf of healthy lifestyle choices — has to be a major part of any plan. Whether that is a mandate for mandatory physical education, with no excuses save for actual physical disabilities, in the schools was hinted at. That Americans in general partake quite unhealthy diets is a fact. But truly healthy diets are unobtainable to those who are in poverty, who have lost their incomes. Then, it’s what fills the stomach.

Lastly, for now, EVERYONE agree that EVERYONE would have to be included, regardless what scheme might be settled upon. Healthy folks could not be permitted to remain aloof and only buy in once they fell ill or injured. While you might have some choice as to which plan, you would have no choice whether to be in some plan.

As with a publicly financed education system or a freeway system or a national electric grid or a broadband network, the up front costs are going to be astronomical. And that is going to be a political hurdle no politician looks forward to with anything but dread. Setting it aside, for someone else in some future generation to grapple with will only serve to exacerbate to economy crushing weight a circumstance that is already crushing individuals and individual families and business and government. Doesn’t matter, however: viewing the video of the breakout was an eye-opener as to just how inordinately complex and difficult this is going to be.

From the first breath of life to the last, and all of them during the interim, things ARE going to change big-time and the initial costs are going to be even bigger. Everyone has an absolute moral obligation to educate themselves on the topic. Everyone also have a moral obligation to enter the fray. I strongly urge the beginning of that education be a reference to the video of the Washington summit, and not rely on spun or un-spun sound-bites, or what you heard from someone you know.    

Authors Bio:
An "Old Army Vet" and liberal, qua liberal, with a passion for open inquiry in a neverending quest for truth unpoisoned by religious superstitions. Per Voltaire: "He who can lead you to believe an absurdity can lead you to commit an atrocity."