Bottoms Up to Health Care Reform

A primary reason that GOP failed with Repeal and Replace was that the GOP was trying fix health care from the top down.

A top down approach inevitably benefits the people at the top while depriving health care to the people on the bottom.

Real Health care is about our daily lives.

The best approach to health care reform is to start at the bottom and work up.

The great thing about open source design is that the open methodology allows for a bottom up approach.

The open source proposal is that a group of people get together to talk about free market health care reform. The group would start an open source project to create an alternative to group health insurance.

The plan would include the creation of a distributed database to hold health care data. It would also include the creation of a new business plan to fund health care.

The business model is a real business model with a real profit potential.

The Open Source Project would lead to a detailed discussion of the mathematics of funding health care.

The business model I propose requires a different set of regulations than insurance. The creation of this new business model ends up highlighting the problems created by ObamaCare, TrumpCare, RomneyCare and related efforts at health care reform.

I live in Salt Lake City. I am willing to travel, but I would need a guarantee that there would be people willing to dedicated several afternoons to the discussion of the health care before I travel.

Conclusion: The Open Source program that I propose would create a bottoms up approach to health care reform. Essentially the program creates a network of small businesses to take on big insurance. This bottoms up approach to health care reform would provide people with more and better care than the top down approaches to health care reform that come from Washington DC.

An Open Source Project

The Senate's "Skinny Repeal" failed and it appears that the GOP's plan to Repeal and Replace PPACA has gone down in flames.

IMHO, the GOP's efforts failed because the GOP did not have a compelling alternative to PPACA.

The GOP did not have a compelling alternative to PPACA because conservatives have failed to discuss health care in detail.

For the last eight years I have contended that group of people could radically change the health care debate if they sat down and discussed health care.

An interesting way to start a conversation is to start an Open Source Project.


The current health care debate holds is premised on the idea that group health insurance is the only possible way to fund health care. If insurance is the only way to fund health care, then we must have a public policy to force people to buy insurance.

NOTE: Single payer health care is group insurance with a single provider. Single Payer is insurance made totalitarian.

I hold that the way to radically change the health care debate is to create an alternative to centralized insurance.

So, I propose launching an Open Source Project to create an alternative to insurance. I will tweet about the idea using the hashtag #OSHCR.

Insurance companies use intrusive centralized database to track health care. They use massive centralized pools to fund care.

These centralized databases and centralized pools lead to a concentration in wealth and power.

The Open Source Health Care Reform would use a distributed database and distributed pools to fund care.

The goal of the project isn't to create a single business. The goal is to create a network of small businesses. The project would create business models for these small businesses.

The project would create a new position called a "Health Care Advocate" to replace the insurance agents, medical transcriptionists and claims adjusters in insurance.

The Open Source Project is not just about writing computer code. The project will create new businesses.


Anyone who participates in the Open Source Project would be on the inside track to starting a business in a very lucrative field.

I have already thrown in several thousand hours into creating a market based alternative to insurance.

My analysis has shown that breaking up huge insurance pools into a distributed network would do several things. The program would restore the pricing mechanism in health care: Giving people more care for less. It would create a model that promotes maintaining health over the current model that just treats sickness. The program would create thousands of new businesses. The program would reduce the gap between rich and poor.

Above all, the program would be fun.

My claims aren't just pie in the sky. The claims are based on common sense.

Putting all of our health care dollars in centralized pools controlled by a ruling elite has the predictable effect of concentrating wealth.

This is basic common sense. If we put all of our health care dollars in centralized pools. The people who control these pools will get immensely wealthy while everyone sees the financial condition deteriorate.

Conversely, if we broke huge centralized pools into smaller accounts, we would see a more equitable distribution of wealth.

The really fun thing about an Open Source Project is that such a project would get people to talk about the foundations of health care.


The failure of the GOP to pass a Repeal and Replace bill shows that groups that fail to discuss health care will never be able to create a compelling health care reform plan.

Anyway, I will start tweeting using the hashtag #OSHCR (my apologies to the Occupational Safety and Health Registry of Ireland for taking your tag).

The goal of this Open Source Project is to reverse engineer a centralized health pool into smaller businesses and individual accounts.


The project would create a business model for a network of small businesses. It would create a distributed database to be hosted in the cloud and it would create a new profession called a Health Care Advocate.

I contend that this Open Source Project would have a positive affect on the debate and is likely to have a positive effect on the health care debate.

I will tweet with the hashtag OSHCR. If there is interest in the idea, I will run either an Indiegogo or Kickstarter campaign to raise funds to have a meeting a publish a book about the effort.

Anyone interested in helping write a book would get title credit on the book.

The Constitution and Health Care

Republicans tend hold the separation of powers held by the US Constitution in high esteem.

The Constitution did not give the US Congress the powers to regulate health care.

I have a great deal of respect for traditional Republicans who balk at this process of writing a Federal Health Care bill.

The US Congress is not the correct venue for setting health care policy.

The problem we face right now is that the PPACA passed by the Democrats undermined the health care market and created an environment where insurance companies are collapsing under unreasonable regulations.


The PPACA created a regulatory environment where one cannot simply repeal PPACA because the insurance market would collapse after its repeal.

People are depending on their insurance companies for their health care.


The "Repeal and Replace" argument started with the realization that repealing would harm the American public.

Instead of spending the effort to develop a replacement. A large number of conservative candidates (including Donald Trump) began using "Repeal and Replace" as a slogan.

Conservative candidates ran on the slogan "Repeal and Replace" without taking the time to develop a replacement.

While I respect traditional candidates who simply want the Federal Government out of health care. I am livid with those candidates who campaigned on "Repeal and Replace" without taking the time to create a replacement. Campaigning on Repeal and Replace without a replacement in mind did a great deal of harm to our nation.

Of course, all is not lost. I still contend that if a group of people sat down and spoke about free market health care reform that that group could revolutionize the health care sector and restore our health freedom.

Choking on Health Care

I am delighted that, after eight years of mindless posturing, conservatives have finally started to debate health care.


Unfortunately, the debate in the Senate simply shows that conservatives do not have a positive health care plan. The sad result is that the Republican Party is choking.

In the last eight years, conservatives had ample time to devise an alternative approach to health care.

Rather than taking the high road. Conservatives did nothing but posture on the issue while attacking their enemies.

Health care is the most important issue of our generation. Unfortunately, there is no way to develop a health care bill without discussing health care.

Right now, the Senate is having the most important debate of the Trump presidency.

What do conservatives do?

Since they are choking on health care. Conservatives return to their culture war playbook.

To divert attention from health care, President Trump issued a provocative tweet about transgendered members in the military. The Trump administration also issued a major initiative against MS13.

Once again, Conservatives show that they have no interest in delivering better health. Conservatives simply want to play culture war and divert attention from the most important debate.

Sorry, but Mr. Trump is the Liar Here

Sorry Mr. President, but the campaign slogan of "Repeal and Replace" was a lie.

Donald Trump's slogan of Repeal and Replace was a fake promise.

The slogan implied that Trump had a great plan to replace the PPACA in the works. People voted for Trump believing that he had a plan.

The pathetic health care debate that just unfolded in the House and Senate indicates clearly that neither Trump nor the GOP had a plan for replacing PPACA in mind. The conservatives in Congress simply had hollow words.

A person who says that they are going to do something without having a plan to carry the action through is engaged in a lie.

The current effort at health care reform is not salvageable.

The best path forward is to scrub the current fiasco. The GOP needs to go back to the drawing board. Debate health care and develop a good plan for replacing the PPACA.

Fake Promise

Donald Trump loves to complain about "fake news."

As it turns out, Donald Trump did something far worse. Trump campaigned on the promise that he would "Repeal and Replace ObamaCare" when did not have a substantive plan for replacing the bill.

Of course, Trump was not the only conservative to use use the slogan "Repeal and Replace" without first engaging in a substantive debate about alternatives.

So, I decided to pen a few posts with the absurd hash tag #FakePromise on the horrible job that conservatives have done on the cause of advancing liberty.

Technically a "Fake Promise" is a promise that is not really a promise. A better word is "False Promise." A hash tag is like a trademark and does not need to make sense.

While my hashtag is absurd the issue of health care is serious.

Conservatives had eight years to work on a replacement for ObamaCare.

What happened during these years is that conservatives positioned themselves as champions of the free market while actively suppressing debates about free market reforms.

I know for a fact that conservatives actively suppress discussions of free market reform.

As you see, I have several thousand hours developing a framework for enacting free market reforms.

I gave this framework for discussing health care reform the campy name "The Medical Savings and Loan."

The Medical Savings and Loan is a model for funding health care that uses a combination of savings accounts, a loan reserve and a generously funded system of grants to fund health care.

I worked for a half decade in a state run insurance company writing programs to track claims and calculate insurance premiums. I discovered that the insurance model created predictable inequities and that the industry as a whole created a market that favored the extremely wealthy and upper middle class over the working poor and small business.

I created a mathematical model that replaced centralized insurance pools with a combination of savings accounts, a loan reserve and generously funded grants. The plan creates a new position called "The Health Care Advocate." The simulations I ran indicated that such a model would dramatically improve the health care of the working poor and small businesses.

I gave this model the campy name "The Medical Savings and Loan." The name is a reference to the movie "It's a Wonderful Life" in which George Bailey's Savings and Loan stands against big finance represented by the curmudgeon Henry Potter.

To contribute to the health care debate, I developed a presentation in which I develop the Medical Savings and Loan as a business model then argue that it serves people better than big insurance.

The presentation takes about two hours.

The presentation leads immediately to action items and possible ideas about enacting free market health care reform.

What consistently happens is that, when I bring this presentation to conservatives, they immediately shut down debate when I question big insurance.

Personally, I believe that the path I am following with the Medical Savings and Loan could lead directly to better health care legislation.

I understand that my belief is my belief. I understand that my beliefs might be wrong.

What I've discovered in these last three decades is that both progressives and conservatives systematically shut down debate when ideas are put forward.

Donald Trump's fake promise to repeal and replace ObamaCare was just one lie in a long string of lies put forward by conservatives to stifle debate.

So, I figured that, while Trump tries to push a corrupt health care plan on the nation, I would call Trump out as the liar that he is.

Trump campaigned on a fake promise that he had a great plan to replace PPACA, when he did not have such a plan. By pushing a fake promise, Trump contributed to an environment which suppressed the discussion of ideas. The result is that the GOP does not have a decent health care plan.

The American people are suffering because Donald Trump made a #FakePromise.