On Our Way to One Party
October 17, 2013

A feature common to President Obama's programs is that they grow the population of voters dependent upon or obligated to the government/Democratic Party and do so by spending borrowed money. This, together with attacks on opposition using the muscle of the IRS and Justice Department, the perpetuation of falsehhoods such as equating healthcare with health insurance and calling transfer of wealth from wealth producers to non-producers "doing their fair share", -- the selective transfer of government wealth and privileges, is leading us in the direction of a one party government.

The disillusionment with the Republican Party is not that the Country has become less conservative but that the Republican leadership is not doing their job: The foregoing, which could be fatal to the Republican Party and extremely damaging to the Country is not been exposed and addressed. Various falsehoods used by Obama supporters to move their agenda forward have not been addressed. Standing silent while the Tea Party is demonized, failing to promote cost effective alternatives to Obamacare, namely healthcare savings accounts --- and the list goes on.

On the Healthcare Debate
October 2, 2013

A. In the past (prior to 1960's), the patient-doctor conversation might have had the patient asking ---
"How much does the procedure cost? Do I really need it?"
If you had questions about the cost, you consulted friends and neighbors; got second opinions.

• Competition prevailed.
• Cost were under control at less than 6% of GDP.
• Over usage was minimal.
• Most healthcare expenses were affordable out-of-pocket.

B. Currently there is no patient-doctor conversation about cost with office staff providing no numbers but reassurance --- "Don't worry, insurance will pay for most of it."

• Competition is absent.
• Costs are out-of-control at 18% of GDP and rising.
• Over usage is common.
• Most healthcare expenses are unaffordable out-of-pocket.

How did we get from A to B? What historical events took place that brought about this unfortunate change? What lessons should that teach us that apply to today's healthcare debate?
If you don't know the answers, see our past postings here.

Conservatives, liberals and the Zimmerman-Martin Incident
July 28, 2013

Generous philanthropists in their later years, conservatives tend to be selfish during their productive years when they are generating wealth which, because of competition, is shared by all.

Liberals are good people with the best of intentions but their policies frequently produce more harm than good, truthfulness is not their strong suit and they have remarkably poor memories for mistakes of the past, the handling of the Zimmerman-Martin incident by African-American leaders being an example.

In 1965 Daniel Patrick Moynihan, distressed by poverty in the negro community, breakdown of the family unit and an illegitimacy rate of 25%, proposed a plan of assistance called "The Negro Family: The Case for National Action" also known as the Moynihan Report. Moynihan made a compelling argument for the provision of jobs, job programs, vocational training, and educational programs for the Black community.

"The report was condemned by the Rev. Jesse Jackson, and the Rev. Al Sharpton because it blamed blacks for their own troubles. In their view, it blamed the victims. The problem, as they saw it, was white racism and the solution they supported instead, in essence, was to provide compensation for the victims (1).

Compensation has been generous. "The War on Poverty" alone cost taxpayers $8.29 trillion between 1965 and 2000 (2) in addition to other programs influenced by the views of black leaders with the result today that ---

  • illegitimacy is at a staggering 73%, over two and a half times that among whites;
  • teen age pregnancy is at 47%, over twice that among whites;
  • over one in four children are high school drop outs, almost three times the rate of white children;
  • almost 1200 black teen agers die violent deaths each year mostly at the hands of other blacks, but otherwise similar to the death of Trayvon Martin, over fifteen times the white rate.
  • Clearly the programs conceived with good intentions resulted in disaster.

    Claims that Trayvon Martin was the victim in the face of compelling evidence to the contrary and the accompanying anti-white rhetoric is a continuation of positions discredited by almost 50 years of experience.

    Despite support for programs that have been devastating to African-Americans, despite opposition to programs that might have been helpful, despite the fact that this largely white country elected and reelected a black president, the anti-white rhetoric and the victim claims continue.

    Perhaps it is time to listen to accomplished Americans like Dr. Bill Cosby and Dr. Ben Carson who see matters quite differently from current self appointed leaders.

    (1) http://en.wikipedia.org/wiki/The_Negro_Family:_The_Case_for_National_Action
    (2) http://www.heritage.org/research/testimony/the-size-and-scope-of-means-tested- welfare-spending. Between 1965 and 2000 welfare spending cost taxpayers $8.29 trillion.

    Self-interest, Economics and Governance
    A definition of conservatism
    July 4, 2013

    Self-interest is part of the human condition. It may have been bred into us by natural selection in that those lacking this quality were not likely to have been survivors.

    This belief is referred to as Psychological egoism, "the thesis that we are always deep down motivated by what we perceive to be in our own self-interest" (1).

    For much of human history self-interest was ignored which allowed capable persons with a strong sense of self-interest to dominate others. The result was that autocracies of one form or another, with kings or emperors or war lords, became the systems of governance throughout the civilized world.

    Similarly, self-interest driven entrepreneurship flourished resulting in the accumulation of wealth in the hands of a few while much of society fared poorly.

    History clearly tells us that for the common good, self-interest must be regulated. It is the goal of enlightened conservatism to identify and promote regulatory methods that serve the balanced best interests of all.

    Arch-conservatives may shrink from the phrase "redistribution of wealth". However, this and the redistribution of power is precisely what regulations that serve the balanced best interest of all must address.

    We can also look to history, past and recent, to see what forms of regulation work well and what work poorly.

    Self-Interest and Economics
    Immediately obvious is the enormous success of self-interest restrained by competition. One need look no further than Wal-Mart, K-Mart, Target or any number of other retail establishments to see the benefit to the public at large. To be sure, government regulation dealing with anti-trust, safety, transportation, honesty in advertising etc (2) are also involved but the primary driving force producing a wide selection of affordable goods is self-interest driven entrepreneurship channeled into public-serving avenues by competition.

    An alternative to businesses regulated by competitive self-regulation are government run businesses run under government rules such as Social Security, Medicare, Medicaid, Fannie Mae, Freddie Mac, and the US Postal Service. All of these are on the brink of financial failure. A more extreme example of the failure of government run businesses is the disastrous experiment of Russian communism (3).

    History has shown that self-interest driven entrepreneurship regulated by competition is the most effective generator of wealth and that the wealth reaches all elements of society. It serves the balanced best interest of all and is therefore the regulatory mechanism supported by enlightened conservatives.

    Self-Interest and Governance
    The founders of our country sought a system of governance representing the will of the people rather than the will of a king. Recognizing self-interest both at the individual and institutional levels and the virtue of competition, they settled upon a three part government with the competition for power between the three branches controlled by checks and balances provided for in the Constitution.

    Although imperfect, enlightened conservatives believe it is the best system we know of and support it.

    There is an alternate belief to Psychological egoism, namely Psychological altruism, which holds that some have ultimately altruistic motives (1). There is a further belief that power should be entrusted to altruistic intellectuals who would make better decisions that the less knowledgeable public. This is a possibility but is subject to abuse, is far from a certainty and not something enlightened conservatives are willing to risk as an alternative to competitive self-regulation in cases where competitive self-regulation would apply.

    Current Domestic Concerns
    The cost of healthcare and the impact of lobbying are current concerns of enlightened conservatives in the economic and governance areas respectively.

    Cost of Healthcare
    Prior to WWII, the cost of healthcare was contained by competition and remained at 5 to 6 % of the Gross Domestic Product (GDP). With increasing use of health insurance, consumers erroneously believed that someone else was paying the medical bill. They lost interest in costs, competition disappeared and costs rose to the current 18% of GDP, by far the highest in the world.

    The pricing of healthcare represents a major failing of democracy and conservatism. For more than half a century the medical establishment operated with no competitive restraints with prices therefore rising. No one stepped forward to look out for the best interests of the general public, neither our elected representatives nor conservative activists who should have been pressing for competition.

    There is no lack of solutions. Another country has operated a competitively controlled healthcare system successfully since 1984 with cost steady at near 4% of GDP and healthcare quality substantially better than that of the US according to the World Health Organization.

    Instead we now have government controlled healthcare with the inefficiencies and high cost common to government business operations and subject to political influence which is always in favor of some group at the expense of the general public.

    US healthcare is excellent but its cost is a dismal example of the consequences of uncontrolled self-interest.

    Although lobbying can perform a useful function in keeping legislators informed, it is frequently used to promote the interests of groups which wish to make changes in governance that would not pass using the democratic processes the founders established. Often economic issues are involved which would give the group a bigger share of the nations wealth leaving a little less for everyone else.

    The problem is well recognized and attempts to deal with it and the closely related campaign finance issue have been made, so far with little success.

    Seeing how well competitive self-regulation works one might consider applying this restraint mechanism to lobbying by requiring that registration for lobbying be done in pairs with applicants having competing interests. Legilators would more likely be exposed to both sides of an issue and would be better prepared to make decisions that favor the balanced best interests of the population at large.

    Happy Independence Day!


    (1) http://www.iep.utm.edu/psychego/

    (2) Sometimes referred to as "police powers", defined by
    as "measures to preserve and protect the safety, health, Welfare, and morals of the community" and guaranteed by the Tenth Amendment to the U.S. Constitution. Enlightened conservatives strongly support government regulations that have demonstrated over time the successful performance of these essential services and not encroached unnecessarily on individual freedom.

    (3) Improvement in the human condition through governmental regulation was a goal of Karl Marx which was implemented in communist Russia. The net result was replacement of the then existing aristocracy with an aristocracy of communist party officials while the suffering of the country as a whole became much worse.

    Conservatism In Crisis
    Success of the Democrats "Win Machine"

    March 1, 2013


    As seen by Rush Limbaugh

    "The left has beaten us. (They have) control of the education system, control of the pop culture, movies, TVs, books, music. We’ve just been outnumbered.” (1)

    As seen by Bill O'Reilly

    Slightly less pessimistic, “We are now in a struggle to define America. The left has powerful agents in the media and pop culture --- the country is changing quickly into an entitlement society." (1)


    For the 2012 election, the Democrats developed highly sophisticated communication techniques for winning public support, herein called the "win machine".

    As described by Newt Gingrich

    1."Democrats had 54 data analysts (working) ---"
    That big a staff suggests that the target population was broken down into a far larger group of subsets than current practice providing more detailed and more accurate information regarding voter decision processes.

    2. "(they) were hiring PhD's in advanced math because they were using the most advanced decision processes (programs) in the country. They were bringing in behavioral scientists."
    Never-before-used high tech analysis and methodology developed for "winning".

    3. Commenting on the obsolescence of our current practices --- "None of our consultants would have imagined hiring 54 people in the decision area, none of them would have imagined having 24 people (do) nothing full time except e-mails and then blind tested the best e-mails to see which ones worked. ---- they are a Super Bowl team --- we are currently a midlevel college team floundering around" (2)

    As seen in use

    1. Controlling permissble political dialogue with "Political Correctness".

    2. Character Assassination
    Examples are successful campaigns to damage the credibility of Sarah Palin, Michelle Bachman, the Tea Party , among others.

    3. Criticizing actions of the opposition that they also engage in, counting on an ineffectual opposition not to challenge it. See "Smarts Needed", below.


    As seen by Bill O'Reilly

    "The key to changing this malaise in American society is a charismatic conservative leader who can fight off the media jackals. That person can turn the country to the right because America is inherently a place of achievement. We’ve always been that. --- once the nanny-state victimization mentality begins to get hammered in an effective way, it will quickly fall apart — as fair-minded, hard-working Americans will reject it. Therefore, the left has not won in America, --- not yet.” (1)

    As seen by Hans

    Amen to Bill O'Reillys comments with a prime candidate for the needed leader being Dr. Ben Carson.


    The assumption of the plan is that the very recent successes of the left are due to use of the "win machine" and that these can be neutralized by effectively addressing that device. Some things to consider include ---

    1. Learning in great detail what comprises the "win machine";
    2. identifying elements thereof that are generally viewed as improper/immoral and
    3. attacking the left for use of those element.
    4. Conservatives need to come of age by developing their own "win machine" minus the improper/immoral elements and use it as effectively as the left has (nothing wrong with copying what works from the opposition)
    5. Encourage Dr. Ben Carson to lead the crusade to restore America to its former greatness.


    (1) http://www.newsmax.com/Newsfront/oreilly-limbaugh-left-action/2013/02/25/id/491969
    (2) http://abcnews.go.com/ThisWeek/video/week-roundtable-ii-week-politics-18524314?tab=9482930§ion=1206874&playlist=18524923

    Ben Carson for President?
    February 18, 2013

    Just as we sadly reflected on the lack of effective conservative spokespersons (see Smarts Needed, below), along comes Dr. Ben Carson, whose February 7, 2013 National Prayer Breakfast talk resulted in a February 8 Wall Street Journal headline ---

    "Ben Carson for President"
    and subhead,
    "The Johns Hopkins neurosurgeon has two big ideas for America"

    Actually Dr. Carson presented at least four big ideas for America:
    1. To restore our first amendment right to free speech lost through "Political Correctness";
    2. Restore educational excellence lost through "dumbing-down" (by federal programs?);
    3. Fiscal responsibility and a proportionate tax system;
    4. Healthcare reform through healthcare savings accounts --- and not Obamacare;
    and a return to Judeo-Christian ethics from the current "anything to win" morality --- or lack thereof.

    Political Correctness
    The left has largely won control over what we are allowed speak through "Political Correctness". Criticize Obama's programs and you are likely to be called an anti-black racial bigot --- with the media supporting the criticism. Tea Party people, mostly older, better educated citizens, because of their conservative views can be diminished as "tea-baggers" , their representatives as uncompromising extremists --- and the media are silent or participants.

    In Dr. Carson's words, "Political Correctness is dangerous". "It put a muzzle on (people)". "It keeps people from discussing important issues while the fabric of this society is being changed." (Would he have said "eroded" if Obama weren't sitting there?)

    Related to this are speech issues raised by Newt Gingrich on This Week with George Stephanopoulos, February 17 where he says ---

    "Democrats had 54 data analysts and were hiring Ph.Ds in advanced math because they were using the most advanced decision processes (programs) in the country. They were bringing in behavioral scientists. They were trying to figure out how you talk to 311 million people and do so in a way that you can survive 8 percent unemployment and get re-elected and it worked. ----
    None of our consultants would have imagined hiring 54 people in the decision area, none of them would have imagined having 24 people (do) nothing full time except e-mails and then blind tested the best e-mails to see which ones worked. I mean, this -- they are a Super Bowl team that we ought to respect deeply. And we are currently a midlevel college team floundering around"
    ---- consistent with "Smarts Needed", below.

    Language and speech are being increasingly used as vehicles for high tech deception and Republicans and conservatives, so far, have been unable to respond effectively.

    Dr. Carson devoted most of his speech to education pointing out that ---
    -- when Alexis de Tocqueville visited the US in 1831 he found 2nd graders completely literate;
    -- 6th grade exit exams from the 1800's were at a level challenging to todays college graduates;
    -- in a recent international survey of 8th graders' ability to solve math and science problems the US came out 21st of 22.

    He talks about his beginings in poverty in a one parent family, mother one of 24 children, married at age 13 and now divorced from a bigamous drug addicted father; how this remarkable woman disciplined him to read and the liberating effect of literature which ultimately led to his impressive accomplishments in neorosurgery. The implied message is that education and hard work is a far better path forward than welfare.

    Fiscal Resposibility
    Dr. Carson draws a parallel to powerful Rome which destroyed itself through moral decay and fiscal irresponsibility. To demonstrate the magnitude of the US 16 trillion dollar deficit he points out that counting to 16 trillion would take 507,000 years. Displeasure with Obama's class warfare is expressed through a belt-tightening example where some are excluded and even rewarded.

    He proposes a flat income tax referring to tithing as a biblical recomendation thereof. This is one of the two issues focussed upon by the Wall Street Journal. Graduated income taxes have been part of our culture, on and off, going back to the Civil War. This issue is unlikely to gain traction in this writers opinion.

    Healthcare savings accounts which bring the good economic judgement of the American consumer back into the healthcare cost equation have been advocated in these pages repeatedly and it is a great pleasure to see that the good doctor advocates these. This is the other WSJ "big idea" and we agree.

    This man appears to be a Reagan-type conservative, articulate, charismatic. The Republican Party would be making a huge mistake if he were not vetted for a significant leadership position.

    Smarts Needed
    February 10, 2013

    Conservatives in the House have been labeled as uncompromising extremists, a label that has stuck. This is a major victory for Obama advisors and reveals a major lack of smarts on the part of conservative leaders.

    The reality is that ---
    --- those who want a larger government are willing to compromise on how much larger;
    --- those who want a smaller government are willing to compromise on how much smaller;
    --- neither group is willing to switch sides.

    What has happened is that the pot called the kettle black and the kettle is standing there tongue-tied. To make matters worse the kettle (conservatives) has positions far more in line with the sentiments of most Americans--- but has not been able to articulate them persuasively.

    The left talks about helping the underprivileged, weaving a safety net. The reality is that the safety net was established decades ago; we are now dealing with a "safety hammock" (a term used by the late Jack Kemp) providing unaffordable cushiony pillows to be paid for by our kids and grandkids.

    Until we get smarter, more articulate conservative leaders we will continue this slide away from traditional values --- and none seem to be in sight.

    Bad Agreement
    January 1, 2013, 11 am

    The Senate Fiscal Cliff agreement supports the President's aim to rapidly change the country into a more complete welfare state. So far, through Obamacare, he provided essentially free health insurance for the 30 million people at the bottom of the economic ladder. He continues by providing a path to the middle class for these folks, not by encouraging productivity but by transferring wealth to them through expanded welfare programs paid for by increasing taxes and increasing the nations debt.

    This program is strongly supported by the beneficiaries, resisted by the few conservatives who recognize what is happening while much of the country seems confounded and somewhat persuaded by the vicious attacks on the resistance by the President's supporters. An inept Republican party seems to be unable to make the case that replacing our economic system, which made us the most prosperous nation in the world, by a European style system is leading us in the wrong direction.

    On the Fiscal Cliff
    December 22, 2012

    On leaving for vacation the President presented a "modest" proposal that increases taxes, increases spending and provides for zero spending cuts, deferring consideration of these for the future. If a balanced proposal of revenue increases and spending cuts were 50 on a scale of 0 to 100, he offers zero and claims it's a 50. How do you negotiate with someone who tries to persuade you that you are getting 50 when he's handing you zero?

    The 200+ point panic selloff Thursday night should have sent the message to the President that reaction to his overreach could be catastrophic to his presidency and his place in history. Contrary to the views of most pundits, the courageous action of conservative house members in sticking to principles weakened and not strengthened the Presidents position who now has something additional to worry about. If there is a market crash on his watch, he owns it!

    On Taxation and Scott Walker's Victory
    June 7, 2012

    Taxation to fund essential services is necessary. No reasonable person will argue that. However, the reality is that taxation transfers control of money from earners to politicians. Are you or a politician the better manager of your money?

    There shouldn't be much argument about that either because --- politicians have incentive to direct public money to friends that help keep them in office. Not all politician engage in this practice but many do.

    The practice began in the U.S. in 1828 with President Andrew Jackson. It was called the spoil system ("to the victor belong the spoils") and it's continued ever since. "Patronage appointments", some "earmarks" and "sweetheart deals" between legislators and public employee unions are current examples.

    The latter has resulted in government employees earning 44 % more that private industry workers for comparable work and with 69 % greater benefits (1). This has placed a back breaking burden on tax payers in some communities such as San Diego where payments to the city's retirement fund soared from $43 million in 1999 to $231.2 million this year (2) almost 4 times the increase in the consumer price index over that period (3). San Diego tax payers voted for pension reforms on Tuesday similar to those instituted by Governor Walker.

    Governor Walkers reforms are being called "union busting" by the liberal media and even some conservative commentators. What Governor Walker did was to replace unsustainable abusive excesses with a reasonable, sustainable alternative --- hardly "union busting".

    Thank you Governor for showing the country what can be done with common sense conservative management.

    On Wisconsin !

    Hans Borchardt, U of Wisconsin, PhD '56
    Local Organizer, Delaware Tea Party Patriots

    (1) http://reason.org/news/show/public-sector-private-sector-salary

    According to the most recent Employer Costs for Employee Compensation survey from the U.S. Bureau of Labor Statistics, as of December 2009, state and local government employees earned total compensation of $39.60 an hour, compared to $27.42 an hour for private industry workers-a difference of over 44 percent. This includes 35 percent higher wages and nearly 69 percent greater benefit

    (2) http://www.foxnews.com/politics/2012/06/06/2-major-california-cities-approve-pension-cuts-for-city-workers/

    "San Diego's payments to the city's retirement fund soared from $43 million in 1999 to $231.2 million this year, equal to 20 percent of the city's general fund budget, which pays for day-to-day operations."

    (3) CPI 1999 164.3, 2012 226.7. (4) CPI increase 138%. 231.2/43 = 5.37 or 537%. 537/138 = 3.89 or appx 4x.

    (4) ftp://ftp.bls.gov/pub/special.requests/cpi/cpiai.txt

    Presentation by Clare Gray, M.D.
    March 22, 2012

    Dr. Gray, President of Physicians for Reform, made a presentation to TPP Local Coordinators on March 22 on "The Battle for Our Health Care".

    Dr. Gray is an inspired speaker and thinker. He put the health care issue into the broader context of preeminence of the individual versus preeminence of the state, going back to the philosophies of Hippocrates and Plato. Hippocrates, father of western medicine, believed in the sanctity of the individual as did the writers of the US constitution and, today, members of groups such as the TPP. Plato and Nietzsche believed that the individual was subservient to the state and Obama's advisors appear to share that view.

    This is brought out in Dr. Gray's analysis of section 3403 of the Patient Protection and Affordable Care Act (Obamacare) which creates and spells out the purposes of an appointed Independent Payment Advisory Board (IPAB) whose ruling are practically impossible to overturn by the elected Congress.

    Dr. Gray presents a list of 9 Primary Reforms and 8 Secondary Reforms none of which conservatives can take exception to. They all make good sense. However, they are qualitative. When viewing some healthcare issues quantitatively, a somewhat different path to solutions becomes visible.

    Dr. Gray points out that our current 3d party payer system is wasteful but does not quantify this.

    The key fact is that the US healthcare system is extremely wasteful. If this waste is reduced, many of the problems with healthcare would disappear.

    Depending upon the test, the waste factor can be 2, 3 or 4.

    Singapore test. Factor of 4
    In Singapore, where consumer oversight is in place with health care savings accounts, the current cost is about 4 % of Gross Domestic Product (GDP), less than 1/4 our cost of 18% of GDP, with a healthcare system rated better than the US system by the World Health Organization.

    US cost prior to 3d party payer test. Factor of 3
    Prior to WWII, health insurance was a rarity in the US with about 5 % of the population so insured. The consumer had to manage health care expenses and, under this management, health care costs remained at less than 6 % of GDP through 1966, 1/3 our current cost of 18%. (Recall that Medicare started in 1965.)

    Compared to other Industrialized nation test. Factor of >2
    US health care cost as % of GDP is the highest in world, almost twice the average cost of other industrialized nations --- who also have aging populations and have their own waste problems.

    Personal observation test. Factor of >2
    I'm 82 with a host of medical problems that has me in and out of hospitals where waste due to over usage by at least a factor of 2 can be seen at almost any time.

    With US health care cost near $ 2.5 trillion/year, even with the most conservative waste factor of 2, the saving of over a trillion dollars per year would preclude the need to cut physicians reimbursement, restricting services at both end of the age curve and the other cost reduction proposals of Obamacare.

    To contain cost by service and fair compensation reduction and ignore waste, much of it due to governmental mismanagement, makes the Obamacare concept seem insane.

    On Health Care Costs
    October 12, 2011

    Health care (HC) costs have the nation near bankruptcy. We consumers today are making the erroneous assumption that "insurance is paying for it" and so ignore the actual cost. We can't afford to keep making this mistake.

    Here is how we got into this mess.

    Prior to WWII, health insurance was a rarity in the US with about 5 % of the population so insured. The consumer had to manage HC expenses and, under this management, HC costs remained at less than 6 % of Gross Domestic Product (GDP) through 1966.

    After group health insurance became tax deductible in 1943, use of health insurance gradually expanded to current levels and along with it, the erroneous notion that health care was free to the consumer: "insurance was paying the bill". Consumer oversight was lost and health care costs increased to the current 18% of GDP. In Singapore where consumer oversight is in place with health care savings accounts, the current cost is about 4 % of GDP with a HC system rated better than the US system by the World Health Organization.

    The foregoing suggest that, with consumer oversight, 4 to 6 % of GDP should be the norm in HC costs. This is admittedly an over simplification. However, comparing these numbers to the current 18 % suggests that there is something very wrong with US HC costs that might be significantly improved by having the good judgment of the American consumer again be part of the HC cost equation.

    This concern is further compounded by the fact that US HC cost as % of GDP is the highest in world, almost twice the average cost of other industrialized nations --- who also have aging populations. If US costs were in line with that of others as % of GDP, US cost would be lower by over a trillion dollars per year.

    It is time that our elected officials demonstrate leadership by initiating programs that encourage consumer involvement in HC cost decision making.