Obamacare

On myriad levels, Obamacare is a good plan, and ultimately I am in favor of seeing it fully implemented. But if we eliminate emotion and politics, it’s fair to say Obamacare is only half of what is required.

Affordable? Maybe not. Necessary? Likely so.
Part 6 (of 8) of the Off The Reservation special election series in the Long Island Press

It has been said that death and taxes are the two irrefutable realities of our existence. By declaring the act that seeks to prolong death for every American to be a tax, the U.S. Supreme Court has neatly fused them together, making the debate surrounding Obamacare an inescapable reality unto itself.

My election series of columns has thus far made clear arguments in favor of re-electing Barack Obama with respect to the stimulus, deregulation, foreign policy and appointing justices to the Court, with Obama winning three of the four topics convincingly and a split decision on Wall Street regulation. When it comes to healthcare, I must admit that I am struggling a bit. Perhaps you can help.

Intellectually, I am a fan of a single-payer healthcare system. In America, this would essentially mean Medicare for all, with no option for private health insurance. The administrative cost and paperwork associated with patient care would be a fraction of what they are today and with the advent of electronic medical records an argument can be made that there are significant efficiencies to come. Practically, however, this is essentially the Canadian system and it is far from perfect.

My family is originally from Canada and most of my relatives still live there. While there is no question that general care is indeed more affordable, available and efficient, critical care is a problem. My aunt died prematurely due to the ridiculous lengths she had to go through to receive a proper and thorough diagnosis. But this painful anecdote belies statistics that suggest the mortality rate from disease in the US and Canada is nearly identical.

Doctors in the United States are compensated much higher than doctors in Canada; but this applies mostly to specialists and not general practitioners. Therefore, in Canada there are far more general practitioners per capita than in the United States. Perhaps this implies that although critical care is less available, greater access to preventive care mitigates the severity and incidence of diseases that require critical care. Frankly, I don’t know. But I do know, just looking at Long Island for example, that we have universal healthcare because the emergency room at Nassau University Medical Center is just about the busiest place on the Island. This is why I am in favor of an attempt to cover every individual in the United States and, for the most part, a proponent of the Affordable Care Act, or “Obamacare.”


When I began working for my father 18 years ago, we covered 100 percent of healthcare costs for our employees. Now, we can only afford to cover half. Moreover, this “half” is far more expensive than the entire amount was almost two decades ago even on an adjusted basis. It’s why I find it insulting when people suggest that Obamacare is crushing small businesses already. The fact is, Obamacare hasn’t been fully implemented yet, but this is the first year that two very significant things happened to our business:

  1. We were reimbursed several thousand dollars by our insurance company because they had failed to meet the minimum standards under Obamacare for the amount of money that must be allocated to actual care, and not administrative costs.
  2. This is the first year the insurance company didn’t attempt to raise our premiums by double-digits.

So, as a small business owner, I have already benefitted from a plan that hasn’t even been fully implemented. Moreover, it puts my business on a level playing field with other small businesses I know that skirt the rules by paying their people as independent contractors simply to avoid offering them health insurance.

There are other great parts of this legislation such as extending dependent care, outlawing the practice of declining coverage for anyone with a pre-existing condition, closing the Medicare “donut” hole for seniors, mandating electronic records, and identifying best practices across the nation. But I have heard time and again that Obamacare will ultimately result in a massive decrease in reimbursements for physicians— forcing them to see more patients to sustain current income levels—thus jeopardizing the quality of care.

This is a practical sentiment that I can sympathize with, but many of my friends who are physicians have been complaining about this for years. This isn’t an “Obamacare” phenomenon; this is a “healthcare-as-it-currently-is” phenomenon. And while I agree that adding millions of additional people to the insurance pool is beneficial for insurance companies and detrimental to the earning potential of physicians, access to preventive care and wellness visits is undoubtedly a positive step for America. I’m hoping my physician friends weigh in on this to express their viewpoints because I know many of them are tired of being businesspeople and accountants and simply want to get back to caring for patients and growing as doctors.

The politics surrounding Obamacare have drowned out any and all reasonable debate surrounding this issue. The mere fact that the GOP vehemently opposes this plan that was originally crafted by a conservative think tank, touted by Republican legislators and actually adopted fully by a Republican governor now running for president should indicate how toxic our politics are. On myriad levels, Obamacare is a good plan, and ultimately I am in favor of seeing it fully implemented. But if we eliminate emotion and politics, it’s fair to say Obamacare is only half of what is required. The real drivers of cost in the system are the high-cost liability insurance, rampant pharmaceutical dependence encouraged by advertising that is unnecessary and unethical, an overly-litigious culture that forces physicians to order unnecessary tests simply to thwart potential claims, paying doctors and hospitals per procedure instead of paying for the care the patient requires, and the extraordinary cost of end-of-life care. If over the next decade, Obamacare is married with serious attempts to tackle these issues, then it has a shot at not just succeeding but being a model system. If not, it will likely lumber along as a quasi-failure but no worse than had we done nothing at all.

WEEK 6 goes once again to the POTUS.

PHOTO: Barack Obama signs the Affordable Care Act into law, March 23rd, 2010. The act is the most sweeping healthcare reform since Medicare and based largely on initiatives created by conservative think tanks. (AP Photo/Charles Dharapak)

Why Is Oil So High? Crude: Part II

Former Morgan CEO John Mack and His Love Pump

Greetings all. With oil prices rising and likely topping $100 per barrel in the New Year, I revisited a favorite subject in the Long Island Press this week. This week’s Off The Reservation is an update to a cover story penned two years ago about the oil speculation scandal in 2008 that artificially drove prices through the roof.

Returning to the subject, I found that not much had changed. A couple of the players, perhaps, but the speculation scheme is alive and well. So when you read projections from “industry analysts” who see crude oil prices rising due to a weak dollar and surging demand, you’ll know the real deal. Don’t get me wrong, these are key drivers of crude oil but are far from the entire picture. There are those who believe that pricing for the last several years is anywhere between 60% and 70% as a result of speculation; the remainder is due to market forces.

So when you’re at the pump cursing the Saudi’s, China, Obama, the Fed – whatever your poison – the biggest ass f#$*ing is still coming from Wall Street.

What’s In A Name?

The racial insensitivity of the phrase “Off the Reservation” rarely, if ever, occurs to non-Indians. But for Indians, it’s as intolerant as having an Indian as the mascot for a sports team. It would seem crazy to root for the New York Jews, Indianapolis Caucasians or Washington Negroes, but we’ve got the Braves, Indians and Redskins.

Over the past two weeks, my inbox has been jammed with comments related to an “Off the Reservation” column regarding the Republican Party. One of the more humorous e-mails begins with “off the reservation doesn’t begin to describe where you are.” Some pose the question as to the origin of the column title, which I have yet to fully explain within these pages. A little clarification is in order.

The eagle soars with the American, Iroquois and Canadian flags at Akwesasne

The majority of the observations in this column are political or environmental and Long Island-centric. But a personal mission is to highlight and, when necessary, advocate for issues related to American Indians. The title “Off the Reservation” refers to the land mass located outside of reservation territory, or if you prefer, the United States of America. As a true American mutt, the most significant percentage of my heritage is Mohawk and I have found the Indian cultural perspective an interesting lens through which to view the world, our nation and this little Island of ours.

Predictably, most of the pushback regarding the title comes from Indians who happen across the column online and take issue with the derogatory nature of the phrase. Once explained, they are extremely forthcoming in expressing their frustration at how the “white media” covers Indian issues. It’s hard to disagree. Much of what I read about Indian life in non-native publications is woefully devoid of context. Virtually nothing is straightforward in Indian country, no matter where the territory is located. Every tribe, every reserve and every generation is different, complicated. To get inside the heads of America’s indigenous population is a perspective-altering experience that opens the mind to how insane our world has become.

Perhaps this is due to the keen understanding they have of their past and current circumstances. While our culture moves in nanoseconds, Indian culture is stubbornly and beautifully rooted in tradition; a tradition that presupposes land is free to roam on, Earth provides all we need for life and embraces us again in death. The notion that we are not independent of our environment but merely a small part of the ecosystem is the only prevailing thread I have discovered among the tribes I have met with. It is why there is little wonder most Indians have gotten on terribly in so-called modern life. They are confounded by restrictive borders and an increasingly poisoned Mother.

The racial insensitivity of the phrase “Off the Reservation” rarely, if ever, occurs to non-Indians. But for Indians, it’s as intolerant as having an Indian as the mascot for a sports team. It would seem crazy to root for the New York Jews, Indianapolis Caucasians or Washington Negroes, but we’ve got the Braves, Indians and Redskins. There’s probably a few pissed-off Swedes and Danes out there that think new grandfather Brett Favre isn’t much of a Viking either.

I’m of two minds about the wave of political correctness that has washed over us. On one hand, 10 years in the catering/restaurant business taught me to celebrate diversity and that stereotypes exist for one profound reason—they tend to be partially accurate. But elaborating on cultural idiosyncrasies is only safe in the purview of comedians. On the other hand, if uttering a particular word or phrase requires you first look over your shoulder, you probably shouldn’t. Still, I’m amazed at how flip most people are when referring to Indians.

Last weekend my wife and I met up with friends from New Jersey and two other couples we had never met. At some point over dinner the conversation turned to someone they know who was acquitted from shooting and killing an Indian near a reservation in New Jersey. None of them looked over their shoulders when declaring “there are no real Indians,” “they’re all black these days” and “they live like animals anyway.” None of them looked over their shoulders when uniformly concluding, when it comes to protecting reservation territory, “those people are crazy.”

They’re funny that way. At least that’s the way it seems over here. You know, off the reservation.