Unsolicited Advice for President Obama

[As sent to his White House email just 10 mins ago]

Sir, I have watched with a lot of interest - and more recently a great deal of dismay - about the efforts to reform America's health care system. I have lived many years overseas where no one had to deal with the sort of indignities Americans face with their healthcare, and yet Americans somehow feel that is normal or even boast about having the best health care in the world.

Sir, I have five advice for you to explain this to the 80% of Americans who has insurance.

First, call it what it is, the US healthcare system is a well-hidden tax that goes up every year. It is a tax that is collected by insurers in cohoots with doctors, on personal income, on the economics of small businesses and on the government (state and federal). It a tax that increases at the decision of insurance companies, without anyone voting for it other than the Board and Management of insurers. Nobody gets to object to how much they pay for health care insurance - they simply see their salary increases disappear without even knowing it, small businesses simply drop coverage to stay in business. Anyone who objects to this hidden tax is welcomed to pay for it with their lives, their family's lives and their wellbeing. Sir, I cannot think of any system that is less American than the current health care system.

Second, sir, you have to remind people who has been deciding on their coverage. If it is not acceptable for governments to decide who should get treated or what treatment should be offered, Americans have been putting up with having those decisions being made by faceless boards of accountants, lawyers and management of insurers. Surely, if anyone wants to talk about "death panels" - tell them they are already in front of them. The question is whether these corporate "death panels" ought to be regulated or have minimal standards or be replaced by independent experts not beholden to insurers.

Third, sir, you have to put US$1 Trillion purported price tag for reform into perspective with what's already signed up for under the status quo, i.e. insurance companies and doctors have already decided that in 10 years, health care should cost US$1T more every year. Health care reform will cost 10% of that but in return we have a shot at taming this cost. Not while the annual impact on the federal deficit will be US$500 bn a year every year and growing. You have to contrast that what the government i.e. tax payers, are already paying every year and emphasize how much the US$1 Trillion (over 10 years) is just a fraction of the expected INCREASE. US$1 Trillion is an abstract figure unless you contrast it to what premium increases under the status quo will mean on burdens for small business and for individuals. The annual cost of reform of US$300 a year for every American should be contrasted with the US$6500 a year they are currently paying and will work out to only 10% of the expected increase in annual health care costs in 10 years.

Fourth, sir, you need to explain this for small businesses. Everyone is talking about how reform may raise taxes and suffocate small businesses. You should remind everyone that health insurance bill is one of the largest expenses for small companies. And these costs are rising faster than inflation and faster than economic growth. You should explain how rising premiums is a tax increase that kills jobs.

Fifth, sir, you should hitch the wagon of reform closer to the successful and popular Medicare. Everytime anyone talks about the public option or government-run health care, they are trying to scare people with the unknown. Tie it to what we know, call it "Medicare for everyone" instead of the public option. Tell people the federal government has been taking care of grandma for the last 40 years.

Thank you for your attention and good luck,