Thinking They Know Better

Since my last blog post that highlighted the murder of UnitedHealthcare CEO Brian Thompson, the suspected killer has been captured and identified as 26 year-old Luigi Mangione.

Mangione holds bachelor's and master's degrees from the University of Pennsylvania.

News reports indicate that he was motivated to allegedly kill Thompson over contempt for corporate America and frustration with the American health care system.

Mangione had several handwritten pages on him that expressed a "disdain for corporate America" and indicated "he's frustrated with the health care system in the United States," NYPD Chief of Detective Joe Kenny told ABC News' "Good Morning America" on Tuesday.

Mangione appears to have become radicalized after dealing with a painful back issue that led to what looks to have been a spinal fusion operation.

Source: https://www.thedailybeast.com/how-a-freak-accident-turned-luigi-mangione-into-vengeful-murder-suspect/

It is not clear why he took out his frustrations on UHC because the x-ray indicates that he had back surgery.

Did UHC deny the procedure and Mangione had to cover it himself?

Did Mangione have to go through too many hoops to get the surgery covered?

Is Mangione unhappy with the surgery's result and decided it is UHC's fault for approving it?

Was it something else involving a family member?

It would not be out of the ordinary for an insurance company to question the necessity of a back surgery on an otherwise healthy 25 or 26 year old.

Back surgeries are notoriously risky procedures. The intervention often does more harm than good.

The general rule I have always heard is that resorting to back surgery should be the absolute last resort for anyone dealing with back pain.

I heard an orthopedic surgeon comment that back surgeries end up helping the patient 1/3 of the time, makes no difference in 1/3 of cases and actually worsens the situation 1/3 of the time. Those are not great odds, especially for a young man.

We will hopefully get more answers about Mangione's motives in due course.

However, what is known is that Mangione was an intelligent young man from a family of money and privilege.

His family had extensive real estate interests and owned a senior living care company

He was valedictorian at a $40,000 per year private school in Baltimore.

He has two Ivy League degrees.

How could a young man with such promise go off the rails and be accused of taking the life of an innocent man on a New York City street over health insurance?

Of course, what is really revolting about all of this are the many who are making Mangione to be some sort of folk hero.

Threats have come in against the McDonald's restaurant in Altoona, PA where Mangione was captured after an employee called police about the suspicious man that looked like the NYC person of interest.

Threats have also been made against the arresting officers.

You also have former Washington Post columnist Taylor Lorenz stating that she felt "joy" on hearing about the murder of Brian Thompson.

Link: https://x.com/ianmSC/status/1866296282215842158

Lorenz goes on to claim that "tens of thousands of Americans" are being killed each year by greedy healthcare executives denying care. Therefore, it can considered that the murder of Thompson was a form of justice according to Lorenz.

What???

Does she have any idea what she is saying?

Feeling "joy" or "justice" about the murder of an innocent man?

Claiming tens of thousands are dying each year due to denial of care by health insurance companies?

Yes, there are denials from time to time. There has to be a gatekeeper or arbiter of some type of health providers or they would have free rein to do and charge almost anything they wanted to.

However, where are the "tens of thousands of deaths"?

Could there be a few legitimate cases? Yes, that undoubtedly could be true.  But tens of thousands?

Further, is Ms. Lornenz aware that 75% of the 3.1 million deaths in the United States in 2023 were of people over the age of 65 all of which are covered under Medicare?

Source: https://www.cdc.gov/mmwr/volumes/73/wr/mm7331a1.htm

Is she going to start blaming the U.S. government next for denial of care here as well?

Of course, you also have politicians like Representative Ro Khanna (D-CA) come out of the woodwork after this tragedy and start arguing that we need "Medicare for All".

Rep. Khanna believes that he knows what the country needs but he does not know the difference between REVENUES and PROFITS?

The seven largest private health insurers had $1.4 trillion in REVENUES last year, not profits.

PROFITS of the industry were $ 71 billion.

For the record. Khanna corrected his tweet after being called out for his total lack of economic or healthcare literacy.

However, those $71 billion in profits represent only about 1.5% of the $4.5 trillion that was spent on health care in the United States in 2023.

Keep in mind that this is a guy who represents Silicon Valley in Congress, went to Yale Law School and thinks he knows better than anyone about what "we" need. 

While politicians like Khanna are so concerned about profits by private health insurance companies, they don't show the same level of concern that Medicare and Medicaid are reported to lose well over $100 billon to fraud each year. A number well in excess of any "profits" by private health insurers.

Taxpayers are losing more than $100 billion a year to Medicare and Medicaid fraud, according to estimates from the National Health Care Anti-Fraud Association.

“That’s probably a conservative number,” Pérez Aybar said. “When we think about all lines of business in Medicare and Medicaid, that’s probably a drop in the bucket.”

A big reason for this is the incentives are simply not aligned properly with a government program that is attempting to manage trillions of dollars in payments.

A trio of elites from academia. big media and politics who think they know better than anyone else but clearly don't have the slightest clue about what they are saying or doing.

Luigi Mangione.

Taylor Lorenz.

Ro Khanna.

Is it any wonder that the majority of Americans spoke up in November and signaled they have had enough of being told about what they need and what to believe from the so-called "elite" class.

Are Health Insurance Executives To Blame?

The murder of United Healthcare CEO Brian Thompson in New York City last week has gotten a lot of attention on social media.

No motive for the murder is known right now but many have speculated it was due to the fact that Thompson was the head of an "evil" insurance company that put profits ahead of people. That line of reasoning suggests that Thompson was murdered because his company denied care to either the assassin or someone close to the murderer.

When all the facts are in we may find that the killing of United Healthcare's CEO had nothing to do with this position. However, the fact that so many are citing insurance coverage and care issues as a possible motive is very, very troubling as it shows how little most people understand about the economics of health care insurance and coverage.

I oversaw employee benefits and the health insurance program for two Fortune 500 companies in my career so I know something about the system of health care coverage in the United States.

Despite the complaints that are often voiced about the US. system, there is little question it is the highest quality and most accessible health care system in the world.

A primary reason for that is that much of it is supported by the private sector.

Health insurance companies are often made to be the villains in the system but they play an important role  in balancing accessibility and affordability.

Government controlled health programs such as those in much of Europe and Canada primarily control costs by limiting accessibility. That is why it might take many months to get care for things like hip replacements in some countries if you are not denied altogether because of your age or other conditions.

It is also a fact that the United States health system could not operate without the private sector subsidizing hospital, physician and other costs that are vastly underpaid by Medicare and Medicaid.

If you doubt that compare the reimbursement rates on what Medicare and Medicaid pay on different services compared to the rates that private insurers are paying.

Almost every hospital in the United States would be forced out of business if they had to operate with the Medicare and Medicaid payment schedules.

My two employers used both Anthem Blue Cross Blue Shield and United Healthcare in the delivery of health care to our employees.

However, in that they were large employers, these companies did not provide any healthcare insurance for our employees. Both companies in which I managed the benefits function were self-insured. We only used these companies for administrative services to pay claims, provide standard medical necessity oversight and the like for which we paid a set monthly fee per employee. All the claims came back directly to the company. 

This was a surprise to most employees when they found out the reality of the insurance pool. In effect, all employees and family members were in their own insurance pool. If their fellow employee had a heart attack, was injured a major accident or had a premature baby, everyone was effectively paying a portion of the bill.

It is just one of many facts that most people do not understand about the delivery of their health care.

The other big one is how claims costs are distributed in any large health insurance pool.

The reality is that most people have very little in healthcare costs in a given year.  A handful of people will have enormous costs.  A few will have very large costs.  The majority will have almost no costs.

For example, the bottom half of a population will only consume about 3% of the costs of the group.

The top half will consume 97%.

The top 5% will consume 50% of the total health care costs.

The top 1% will consume 20% of the total costs.

This is why most people will gamble if left to their own devices if they are faced with expensive health care insurance. They will simply not part with their money today against the chance that they might get sick tomorrow. That is basic human nature.  Live for today and think about that other stuff tomorrow.

In fact, most people will pay no more than 20% of the true cost of health insurance without showing significant resistance to its cost. It is not a coincidence that many corporate plans (and even Medicare Part B premiums) charge 20% of the full cost of premium to the enrollee.

This is why Obamacare failed to attract the young and healthy to its risk pools. The insurance costs too much (even with generous subsidies) for the young.

Some of those "dancing on the grave" of Brian Thompson suggest that this would have never happened or things would be so much better if we had "Medicare for All".

One thing is for sure---if the government is the one denying care it makes it almost impossible to complain.

What do you do if your hip replacement is denied in Canada or the government tells you that you have to wait months for a heart bypass or cancer treatment?

There is nothing you can do but find your way to the United States.

In Canada, it is against the law to even go outside the system in your own province and personally pay for a necessary procedure on your own in that nation. Some are now getting around this by traveling to another province to seek care at a private clinic.

While healthcare insurance and coverage is in the news I thought it also might be a good time to republish a blog post I wrote in 2019 to provide context on healthcare costs as well as possible paths forward to improve affordability.

Nothing has really changed regarding the substance of what I wrote over five years ago. 

However, everything has gotten a LOT more expensive.

The bottom line is this----there will be no gain in making healthcare more affordable without a lot of pain.

And the pain that the Thompson family is going through right now should not be part of any of this.

No Gain Without A Lot Of Pain

(originally published April 14, 2019)

"Medicare for All" has become a popular theme for many Democrats and that party's Presidential candidates.

Bernie Sanders introduced his proposal last week. Predictably, it is short on details and makes no mention of how it would be paid for.

It is claimed that going to a government-run single payer program will massively reduce administrative expenses and lower health care costs for the American public. In so doing, private insurance companies, and their "obscene profits", will be eliminated from the system.

I have written before how the facts about healthcare costs are often much different than is portrayed by politicians and understood by most of the public at large.

For example, one fact that is often overlooked is that the average cost per day for a hospital stay is actually higher in a non-profit hospital than in a for-profit hospital. The costs are also higher in a state/local government run hospital than a for-profit one. I wrote about this in 2013 but it is still true today.

This is exactly the opposite of what Democrats would have you believe when they argue that healthcare should be a not-for-profit government function. They argue government or non-profits are able to deliver healthcare better and cheaper as there is no profit motive adding to costs.

Here are the latest average costs per inpatient day for hospitals based on ownership according to the Kaiser Family Foundation. All of the other charts below are also from the KFF with the exception of the out-of-pocket expenditures by country comparison chart which is based on WHO data.

When you consider that hospital costs are the largest component of national health expenditures, it would seem to be a pretty significant fact that for-profit hospitals are over 20% less costly than non-profits.

Why is this? I explained in my previous post.

A big reason for the higher costs with non-profit hospitals is the lack of accountability. They are not accountable to tax collectors, shareholders, and most particularly, patients (due to our third party payment system where it is rare that the bill is paid by the person receiving the treatment).

How about another fact that most people are not aware of? Many complain about high deductible plans today, which has meant more out-of-pocket spending by patients. However, the reality is that out of pocket costs still make up only 11% of total U.S. health care expenditures in the United States. In 1970, it was 33%.

Americans are also paying less of the total share of national health expenditures in out-of-pocket expenses than other countries.

How much better can it get on this score? Would "Medicare for All" lower these "out of pocket" costs? Our out of pocket costs are already lower than in the "socialist" systems.

Let's also look at the components of U.S. national health care expenditures to determine how big the effect would be if we could reduce administrative costs (including all private insurance profits) from the system.

Here is where the $3.5 trillion in healthcare expenditures went in 2017 that represented about 18% of the entire GDP of the country.

Hospitals account for 33% of all costs. Physicians and clinics are 20%. Drugs are relatively small at 10%.

Administrative costs (included in other health costs above) make up just 7.4% of total costs. This includes all private and public plan administrative expenses and all the profits of the private insurance companies. 92.6% of healthcare costs would remain even if you removed all private insurance companies and administrators in the system.

In other words, you could eliminate all the administrative costs that are being paid for by all the private insurance plans, Medicare and Medicaid and you would only save about one year of health care inflation.

Granted, there are internal administrative costs in the costs of each hospital and medical provider but it strains credulity to believe that this alone is going to significantly lower healthcare costs in the United States.

Total expenditures per capita have increased 30-fold since 1970. Adjusted for inflation, costs have increased 6-fold!

What can be done? There is no easy answer despite what glib politicians might tell you. In fact, as I have written before in my post "Why Is Health Care So Expensive", everything suggests that the problem will get even worse no matter what the policymakers do. Every factor is trending against controlling health care costs.

More and more medical technology becomes available everyday. Americans have rebelled against every attempt to limit choice in selecting doctors, hospitals, etc. Americans are getting older. Americans are not getting any healthier and the United States still has more money to spend on healthcare than any other country. Attempts to control costs are akin to trying to change course heading into a Category 5 hurricane.

How could health care costs take a smaller bite of our economy and household budgets?

There are only three options.

1. Hospitals, doctors and other providers have to make less money.

2. Patients need to see their care rationed or limited in some way.

3. We all need to get a lot healthier.

"Medicare for All" sounds great as a theory. 56% in a recent poll stated they favored the idea. They liked the idea of guaranteed health insurance (71% favor) and eliminating health insurance premiums and reduced out of pocket expenses (67%),

However, support collapses when people hear exactly how the plan would have to work--eliminate private health insurance (37%), require most people to pay taxes (37%), threaten current Medicare (32%) and delays in getting medical tests and treatments (26%).

The bottom line is this.

There will be no gains in controlling healthcare costs without a lot of pain on someone...and most likely, everyone.

Don't let any politician convince you otherwise.

If you want to actually consider a system of healthcare that might work at controlling costs, while serving the American people better, read my previous blog post "Revolutionary Replacement".

Pardon My Hypocrisy And Dishonesty

I am not sure we have ever had a President that has displayed the amount of hypocrisy and dishonesty that Joe Biden has during his four years in office.

He is capping it off with the pardon of his son Hunter Biden for not only the crimes he has already been convicted of (gun charges and tax evasion) but any other crimes he might have committed back to 2014.

The pardon was given despite the fact that Joe Biden repeatedly stated that he would not pardon or reduce his son's sentence.

Source: https://www.yahoo.com/news/fact-check-biden-repeatedly-said-210800273.html

Of course, Joe Biden previously told us that his son Hunter was "the smartest man that I know."

Biden was also adamant that Hunter "never did anything wrong" when asked about his son's questionable activities.

Hunter ultimately was convicted of a federal gun charge in a jury trial in June and pled guilty to tax evasion and fraud charges in September.

Hunter Biden was scheduled to be sentenced on both charges in the next two weeks which would undoubtedly have resulted in prison time.

Joe Biden must have determined he had to pardon his son now rather than wait until January 19, 2025 in order to insure his son did not spend even one day in prison.

Right after Hunter pled guilty to the tax evasion and fraud charges as the the trial was about to begin I predicted that you could count on a pardon being given to Biden's son.

The timing of the sentencing in the two cases is interesting coming after the election in both cases.

If Kamala wins, Joe will probably stand by his statement but a deal will have been made so that she has to do the dirty work when she takes office

If Trump wins, Joe will forget he ever made the statement. He is not going to allow the smartest man he knows to be put in a prison cell.

It goes without saying that it has been a very bad ending for both Joe and Hunter over the last several months.

Of course, the beginning of the bad ending began when Joe Biden dropped out of the Presidential race in July after claiming earlier that month that only the "Lord Almighty" could convince him to quit.

We are not sure to this day whether "the Lord Almighty" was Barack Obama, Nancy Pelosi, Chuck Schumer of a combination of the three.

Source: https://www.bbc.com/news/articles/cl5y8n5d09qo

However, it is hard to not also consider many of the statements made by Biden going back over four years ago for other examples of hypocrisy and untruths.

How about this one?

Credit: https://x.com/DefiantLs/status/1863329697263693897

Or these?

"The Hunter laptop is fake Russian disinformation."

"If you get the vaccine you will not get Covid".

"The Afghanistan withdrawal was a success".

"Inflation is transitory."

"The border is secure."

"Bidenomics is working".

"No one is above the law."

 Law Professor Jonathan Turley weighs in on X on what he thinks about Biden and the pardon.

All he sees are lies and denials with Biden.

As noted above, Biden's pardon of Hunter does not just involve the gun charge conviction and the tax evasion and fraud guilty plea.

It includes any other crimes that Hunter has committed or may have committed all the way back to January 1, 2014---a 11 year span.

Why is that significant?

First, Hunter became involved with Ukraine in early 2014.

Second, the general statute of limitations for most federal crimes is five years.

Why would Hunter need a general pardon going back ten years?

It is interesting to consider the federal crimes in which there is no statute of limitations.

Crimes that do not have a federal statute of limitations include capital murder, treason, espionage and sexual offenses against minors. Charges for these serious offenses can be filed at any time, regardless of when the crime occurred.

For context, in the long history of the United States there has never been a pardon given that was so broad and far-reaching. The only one that was even close was Gerald Ford's pardon of Richard Nixon but that pardon spanned only five years.

There are a few other interesting side notes in all of this.

Donald Trump was impeached by the Democrats for asking whether Ukraine had looked into investigating any potential crimes. Joe Biden just pardoned Hunter for any of those potential crimes.

Impeaching Trump for asking questions about Ukraine makes a lot more sense now when we see just how big the stakes were for Joe and Hunter Biden..

Perhaps we will one day find out exactly what really went on between Ukraine, the Bidens and other D.C. elites. And the cozy relationship Hunter (and Joe?) had with China.

Now that Hunter has been pardoned he cannot plead the 5th amendment if called to testify about his dealings in Ukraine, China and other places.  He may personally be immune from prosecution but others may be at risk. If Hunter is called to testify to Congress, or in a court of law about any of his dealings, he will be compelled to testify or be considered to be in contempt.

Will we see other pardons handed out by Biden in the last days of his Presidency?

Joe Biden's brother Jim might be high on that list. Who else will Biden protect? Will Biden pardon himself?

The Hunter Biden pardon and any other possible pardons given by Joe Biden are also going to make it much easier for Donald Trump to exercise the pardon power for January 6th protestors and any associates ( Roger Stone, Steve Bannon, Peter Navarro etc.) who were targeted by the Democrat lawfare machine. The difference---these people already had to serve their time.

I believe most people can understand why a father would want to do everything in his power to try to protect his son.

However, as I wrote in an earlier blog post, if Joe Biden was really a caring and compassionate father, who really wanted to protect his son, he never should have run for President in 2020 knowing what he did about his son's addiction issues and shady dealings.

Biden was selfish in running for President in 2020 putting himself ahead of his son.

Biden was just as selfish running for re-election in 2024 considering the nation's problems and his evident weaknesses in mind and body.

It is hard to believe that Nancy Pelosi was promoting the idea in August that Joe Biden should be added to Mount Rushmore as his legacy.

Source: https://nbcmontana.com/news/nation-world/pelosi-wants-biden-added-to-mount-rushmore-

It was a laughable idea then. It is an incomprehensibly idiotic statement when viewed today.

The reality is that Biden's legacy will be defined by the astonishing amounts of hypocrisy and dishonesty during his term as President.

Alas, there is no pardon for hypocrisy and dishonesty.

Not Everyone Needs To Be Deported

There is no way that Donald Trump would have been elected President in 2016 without his strong stance on illegal immigration.

It separated Trump from the pack of 17 other GOP candidates during the 2016 primary and his call to build a wall on the southern border was a defining issue during the general election that year.

Frustration with illegal immigration by the American public reached even greater heights with the open border policy of the Biden administration.

The Biden administration attempted to justify that the millions of migrants coming to the United States were merely seeking asylum.

However, under the law, refugees should be seeking asylum from political or religious persecution. During the Obama and Biden years more and more people were granted asylum for stating they were escaping gang violence, domestic violence and other forms of criminal behavior.

Further, under U.S. law, refugees are supposed to show that the government of the country they were leaving were complicit in the persecution or were unable to control the conduct of private actors. This was all ignored by Biden/Harris.

To show how badly abused the asylum policy has been over the years, a recent U.S. government study found that 86% of asylum claimants between 2008-2019 were not legitimate asylum seekers under the law.

Credit: https://x.com/fentasyl/status/1860525163571257715

The percentage is undoubtedly much higher today considering what occurred during the Biden years.

Illegal immigration is a powerful issue because most Americans see it as fundamentally unfair. Americans are not anti-immigrant. However, they care about the rule of law, and most importantly, they believe in an even playing field. Both the rule of law and fairness have been ignored by every Presidential administration over the last 40 years with the exception of the first Trump administration.

In response to the total failure by Biden/Harris to enforce the immigration laws, Trump responded with a call to not only secure the border but to deport all illegal immigrants as well if elected to a second term

A CBS poll conducted after the election shows that policy is supported by 57% of American voters.

That policy is even supported by 48% of Hispanics.

I can't say that I believed that such a hard line policy would have received such strong support if I was asked a few years ago.

It remains to be seen whether Trump can maintain that popular support for deportations when the media starts playing images of the illegals (and their families) being loaded onto buses or airplanes and sent out of the country.

Rounding up those with criminal records in their home countries or with violent records in the United States will have broad support. 

It will be tougher to deport the illegal who is mowing your yard, cleaning your house or picking strawberries in California.

Over a decade ago I proposed that the immigration laws should be amended to add a Red Card to supplement the Green Card.

The Green Card is the term used to signify an individual that has been granted permanent residence and authority to work in the United States. It is also the pathway for citizenship under the law. The general rule is that someone with a Green Card can apply for citizenship after five years.

A Red Card would be granted to someone who had entered the country illegally but who had otherwise not committed any other crimes while in the United States and was also gainfully employed. Red Card holders would not be able to apply for citizenship. In effect, they would be allowed to stay in the country as guest workers with no opportunity for citizenship.

The Red Card policy that I outlined in 2013 could be useful as a blueprint for  Trump's deportation policy in that it would provide an alternative for law-abiding, gainfully employed illegal immigrants to avoid deportation as long as they identified themselves, received Red Card status, and adhered to the rules of the program.

Those rules would include paying all required taxes, not being able to collect Social Security, Medicare, Medicaid and other public welfare programs and being placed at the end of the list behind all other applicants for Green Cards who had followed the legal process.

Red Card holders would also be required to leave the country in the future if they lost employment or were convicted of a crime.

Illegal immigrants who did not come forward and register for the Red Card during the initial registration period would be subject to removal from the country and banned from ever entering the United States during their lifetime.

The original proposal I outlined in 2013 follows below.

Not everyone needs to be deported if we were to adopt this common sense proposal.

Is there a chance that common sense might finally prevail in dealing with illegal immigration?

Donald Trump as President gives us a better opportunity to curb illegal immigration and pass common sense immigration reform than ever before.

Do We Need A Red Card And A Green Card?
(originally published June 17, 2013) ( edited for length and clarity)

I have long been in favor of some form of immigration reform.  There is little question that our current immigration laws have not been effective and are in need of reform.  The United States is a nation of immigrants and it needs a rational, practical, balanced and equitable set of immigration laws for the 21st Century.

The most explosive issue in the immigration debate, especially among conservatives, involves amnesty. Simply stated, are we going to allow people who violated our laws by entering our country illegally the rights and privileges of legalized status?

What about the millions of people who want to come to our country, obeyed the law and have waited patiently in line for their turn?  For example, in 2012 there were almost 15 million people who applied for the green card diversity lottery for just 50,000 openings hoping to come to the United States from underrepresented countries!  How is it fair and equitable to reward those who broke the law and deny others who play by the rules?  More importantly, what precedent does that establish for the future?

After all, we have already been down this road once before in 1986 when 3 million undocumented immigrants were granted amnesty and provided legal status in this country.  How has that worked out? Not real well. We now have at least 11 million undocumented immigrants.  It is also estimated that those 11 million have another 4.5 million children that were born in this country.

If we were to enforce the law it is clear that those 11 million should be required to pack up and return to their home countries.  However, the practical reality is that is not going to happen. This is particularly true in light of the parents who have minor children that were born in this country and are legal citizens under the law. The Democrats therefore argue that we should legalize all of these undocumented aliens, since they are here and they are not going anywhere, and get them on the path to citizenship with a green card.

The green card is the term used to signify an individual that has been granted permanent residence in the United States.  The general rule is that someone with a green card can apply for citizenship after five years. In my mind there is no way that this existing legal grant of residency should be granted to anyone who entered this country illegally.

However, we also must recognize the practical reality that the undocumented illegal immigrants are not going home and it is to everyone's benefit that they come out of the shadows and have some status under the law.

My solution is to create what I call the "Red Card".  Of course, this assumes that the border is secure and we don't have to worry about doing this all over again. Nothing is going to work if we don't prevent future illegal immigration.  We will be an even worse position in another ten years.

The Red Card would be available to anyone who is in the country currently that does not have proper documentation. Application for the card would have to be made within 90 days of the enactment of the law.  Holders of the Red Card would be granted conditional residency as long as they were gainfully employed and contributing to the economy of the United States.  After all, we should encourage people who want to work and contribute to our society in a positive manner. The Red Card would permit the individual to stay in the United States as long as they remained employed, paid all taxes and committed no crimes.

The Red Card would also be used in the future to grant status for temporary guest workers in situations and job sectors where it was necessary. Red Cards would be issued where job shortages exist and our Immigration Service would institute a system by which available jobs would be matched with qualified immigrants willing to do that work.

If a holder of a Red Card should lose their employment status, they would be given a grace period of 120 days to find other employment. If they could not find employment in that period they would have to leave the country within the next 60 days.

The Red Card will also be allowed to be extended to a spouse (if minor children 12 or under) and dependent children 18 and under). However, if the primary Red Card holder loses job status all family members also lose their status.

Holders of Red Cards would be entitled to no government benefits currently (welfare, Medicaid) or in the future (Social Security and Medicare). They must pay all required income and other taxes in the United States while here. They must carry health care insurance. They must commit no crimes. Any violations will result in immediate deportation and the loss of the right to future entry into the United States for their lifetimes.

All immigrants would be required to have their green or red card in their possession at all times. Beginning 90 days after enactment if someone does not have proper documentation, is here illegally, has overstayed a visa, or violated the terms of the Red Card status, they will be deported and will never be entitled to return to the United States. This may sound harsh but without a strong provision like this you have little hope in insuring compliance with the law and getting everyone to register and comply with it going forward.

Holders of Red Cards could apply for Green Cards by getting in the back of the line for their respective category under the law.

What does this accomplish?  It provides a method by which we can provide a method for allowing hard working people to stay in this country if they are contributing to the economy and are positive forces in the community.  However, it establishes a clear delineation between people who came to this country legally and those who did so illegally.

It also insures that those here illegally will not benefit from our government programs and have no path to citizenship and no amnesty.  They are free to work to make a living for themselves and their family. They will not be allowed to take advantage of the taxpayer or get an unfair advantage over legal immigrants. They are not allowed to vote. Proof that they voted in a U.S election will also be grounds for immediate deportation and a lifetime ban from ever entering the U.S again.

I see this as a common sense compromise to bridge the liberal and conservative divide on the issue. Common sense should also be determining all of the decisions on immigration reform.

Why have an immigration policy at all?  Why do we let anyone in? The only logical reason is to improve your country by importing human talent that will provide a benefit to the nation.  This is the thinking that drove our immigration policy for most of our history.  

Immigrants with illness or who could not support themselves and their families were turned away. Often this was at Ellis Island after they had already faced an arduous journey here by ship. Those who were willing to work and contribute were welcomed. Why should it be any different today?