My name is Thomas Eugene Krawford Jr. Disability is part of my family background and so is, either paying exorbitant health care premium costs or, in the case of both my brother's oldest son and my sister's two children as well as her husband, being denied coverage not once or even twice, but many, many times. That is what brings me to point of this open letter.
As a man with Asperger's Syndrome, a mild form of Autism characterized by a unspecified developmental forgetfulness to recognize the need for help when help is needed, I watched all six hours of the attempt at bi partisanship and more than once thought I was looking at myself, especially when I obsess on the strictness of objects, regardless of whether such strictness is called for or not.
I took notes on what almost every assembled member of the House and Senate said, as I know, some of you did as well.I watched as the President, Vice President and selected members of the House and Senate engaged in an informal mediated dialogue based on:
...where we differ and where we agree...
At times it was very interesting, particularly when the President attempted to lay out the groundwork of the discussion as an open search for an overlap: sort of a "no man's land" between the differences each side brought to the table.
Underlying the President's position was the premise that the current instability in economic growth and jobs plaguing the American Middle Class is the direct, joint and inverse result of an inherently inadequate system of health care insurance.
...state and regional exchanges where individuals and small businesses are afforded greater [freedom of] choice...through increased competition....
...subsidies for those who can't afford this...
...and the federal prohibition of preexisting conditions and arbitrary removal of coverage
Thus, I believe the President was implying that lowering cost, reforming the market so it works for all Americans is dependent on reducing long term deficits by making sure those who don't currently have coverage have access to affordable and adequate health care resources, goods and services.Yet, I wonder if anyone, Democrat or Republican ever got the message that the entire exercise, underneath all the rhetoric and reason, was ultimately designed, I feel to give both sides the opportunity ask for help in trying to understand the other.
As far as I can tell from my notes, very few Democrats and fewer Republicans, at no point thought enough to wonder whether each particular side needed help to understand the other. Or even that understanding the other side was important enough to bother with. And this is where I see myself in their actions.
In my particular kind of Autism, I have and am still learning that if I do not make every effort to question my opinions, actions and beliefs about what I feel is important, I always fall into the trap of confusing obsession with faith as if the impossibility of error, inherently was reason based solely on my interpretation of truth. Human beings who are so called normal, I have learned to call "neurotypical," do this all the time.
Aspeger's Syndrome makes this backwards kind of topsy turvy logic somewhat of a rollercoaster ride. In both cases, realizing the probability that you may be wrong in addition to subscribing to the certainty of your convictions is never as annoying and unbecoming as blindly charging forth without question or the slightest hesitation Asperger's Syndrome or no.
In the latter case, someone like me may be excused, up to a point. But in the former instance since when did never questioning one's convictions become a substitute for intelligence or even strength for that matter?
I guess I don't spend enough time in Washington D.C.
We began with Lamar Alexander who introduced the Republican argument:
...we need to start over...go step by step...get rid of the sweetheart deals...the country is too big and the problem too complex to solve all the problems at once
Lamar Alexander went on to promote insurance exchanges across state lines: state incentives to lower costs and HSA's that would reduce health care costs obviating any type of Federal regulation. It is not without some irony however, that on the one hand, the President continually made the attempt to keep the discussion focused on the areas where all could agree. On the other hand, if Mitch McConnel or John Boehner spoke you knew the only thing they were going to say was that we scrap the bill and start over and forget reconciliation. Whereas, if Nancy Pelosi or Harry Reid was speaking, you automatically knew they were going to defend reconciliation and make a point of making sure everyone in the room knew the current bill was not going to be shelved.
Take that you Republican Neanderthals.
Right back at you, Donkey Lizard Man.
This was nice especially if both Nancy Pelosi and Harry Reid are actually going to do something to back up their respective positions and yet, personally, I have to admit that whenever we got back to the President as he attempted to re-focus the discussion on what areas both sides could agree on and what areas agreement was not forthcoming, both sides found the irreconcilable an irresistible delicacy, like calimari appetizers before the moo goo gai pan.
Basically because of my disability maybe, I have never quite understood the perverse pleasure normal people who oppose each other often go out of their way to indulge in by "harping" on irreconcilable differences neither side can agree to.
Frick: take that Neanderthal Elephant!
Frack: Right back at you Pygmie donkey
...and so it often goes, on and on like a nauseating merry-go-round: but then again, like I said before, I have a disability, so maybe I'm missing something.
Some notable exceptions came when Tom Coburn remarked that
1 out every 3 dollars in these entitlement programs goes no where
implying that because of fraud, waste and abuse much of the underlying structure of the existing programs in question, don't work.
The President then readily agreed and added that:
...private market reforms...state incentives for exchanges...and preventative medicine incentive measures...
can be agreed upon and indeed are found in the current bill.
Steny Hoyer took the ball and kept going in this vein, underscoring the need for better coordination of incentives and physician best practices as well as the elimination of preexisting conditions with a built in cap for out of pocket costs.
Oddly enough, Rep Dave Camp, a Republican decidedly NOT in favor of the legislation on the table, was the only member of the either the House or Senate to have a cogent rebuttal that did not have as its centerpiece an exclusively partisan foundation.
...HSA's and FSA's [under certain conditions] can save money...under the current legislation...in question...too much authority is given to the bureaucracy
On the other hand, I can't forget Senator Tom Harkin's surprising appeal to the rest of his colleagues that high risk pools with caps will certainly NOT stabilize costs while expanding coverage incrementally without destabilizing the existing health care insurance system. His main point was to paraphrase:
[regrading the incremental approach]...everyone needs to be in a general[primary] pool in order to ...establish a risk management model scenario of the greatest common general accessibility to affordable health care coverage...which will in turn drive down costs by jointly, directly and inversely fostering more broad based competition... "you can't pick one out...its a package deal..."
Sen Harkin went on to draw the analogy between racial and gender discrimination and health care discrimination, implying that the result of marginalization is the product of a fundamental flaw in the prevailing reasoning many of his Republican colleagues continue to hang on to.
Overall, however, both sides took the position that their side was right and the other side was wrong, period. And this kind of single-minded approach by either side is puzzling, especially considering the position of the Democratic leaders whom I have supported all along and yet whose wisdom I must question.
For instance, Vice President Biden who spoke after Marsha Blackburn's good but somewhat partisan tinged remarks regarding freeing up the ultimate goal of Entitlement Overhaul versus real Competition Enhancement at state, regional and district levels (i.e. American Somoa, Native America perhaps?) actually opened up the floor, albeit briefly, to an honest two way dialogue that none of the other democratic leaders noticed or picked up on. Although, Rep. Beccera did hold Rep. Ryan's feet to the fire on the issue of the Congressional Budget Office figures regarding the "actual" cost of the proposed legislation.
It may be my inherently circuitous way of looking at almost everything, but I interpreted the Vice President's modest remarks regarding bending the cost curve as a proposal to deconstruct the curve, proportional to existing state, federal and regional Medicare and Medicaid Allocation trends ultimately going a long way towards streamlining some of the fraud, waste an abuse characteristic in the frequent overpayment of insurance companies and the subsequent Medicare Advantage SNAFU currently swallowing tax payer dollars.
I thought I saw and heard the idea to break up the concept of health care insurance risk integration as that central concept relates to any given general state, federal or regional pool according to 1) basic needs 2)high risk pools and 3)catastrophic health care concerns.
I thought I heard that Basic Needs Coverage would be compulsory, in so far as, the general pool for every state, region and or district would constitute the General Public Health Care market facilitated through baseline guided coverage, purchased across state lines by way of state and federal regulated exchanges. Preexisting conditions would thus be ruled out because of interstate law regarding full faith and credit statute pertaining to interstate commerce.
Basic needs coverage in this sense would directly involve market based approaches with respect to the uninsured and those priced out of the existing health care market.
This would allow small businesses as well as individuals the necessary level health care playing field 30 million Americans currently do not yet enjoy according to the idea of the right to life, liberty and pursuit of happiness. At least, that's what I thought I heard.
Most small businesses get revenue share because of the improvements in structural and procedural reforms regarding health care delivery across the board.
On the other hand, High Risk Health Care Issues, phased in incrementally into the concept of interstate compacts as adjunctive risk management projections in the State and Regional Exchange System Fiscal outlay programs would afford the adequate Structural Consumer Protection guidelines crucial as a counter integration of any scenario of projected Kitchen Table Hardship at the State level specifically.
Catastrophic Health Care, Special Needs Medicare and Medicaid as mandated along these lines, would in turn be adequately and affordably implemented if and only if the core of the 2700 page bill is integrated into the framework of state, regional and district authority.
Thereby spreading the cost, strengthening the power of grass roots choice specifically regarding health care insurance reform in general common balance and increasing the overall confidence in the fundamental (middle class: $29,000 to $67,000 per year)health care consumer market. The subsequent contingent basic larger market of American goods and services relative to all the existing risk management models pertaining to health care insurance would thus stabilize based on market value driven by fair and equitable competition based on the underlying general principle.
Look at health care insurance reform as a direct, joint and inverse (and thus balanced) incentive to overall economic reform and American Gross economic revitalization, because, essentially in the strictest terms dictated by the laws of human nature to which we all adhere, that is indeed what it MUST be.
Finally a word of caution to the ladies and gentlemen in both the House and Senate whom I respect and admire.
As a body, you have spent an awful lot of time on this one piece of legislation. I'm Autistic, but none of you are. My point is, there's more to America than Health Care Insurance Reform. Jobs, Wall Street regulation and the Environment notwithstanding, Lesbian,Gay Bisexual and Transgendered Americans who are increasingly growing frustrated about the status of their human rights in relation to the Constitution's delineation between naturally inherent and civil statute, for example just may become an issue. Some of them just may decide to sue the lot of you for the right to be formally recognized as full fledged citizens of the United States of America.
Juxtapose this possibility with the increasing International unease regarding Iran and the Middle East and Afghanistan, and I would estimate your plate is rather full whether many of you realize that fact yet or not.
In other words, in my limited opinion you are wasting time by obsessing on things that should be a "no brainer." Much like someone with Asperger's Syndrome trying in vain to explain the value of Socrates' or Democritus' Electromagnetic Field Harmonic Response to a Police Officer about to give you a ticket for speeding.
But what do I know. I'm just a cab diver here in the Ann Arbor Michigan with a mild case of Asperger's Syndrome who often forgets when to shut up.