Obama’s Health Insurance Plan Is No Panacea
by: Gloria Vogel July 06, 2009
While US healthcare is among the best in the world, its costs are out of this world. However, the Obama plan does not directly address the cost issue. Indeed, the major focus of the Obama plan is not on how to keep costs down, but rather on how to provide coverage for those who can’t afford it now – the focus is on availability and affordability, not cost.
Need for a Fix
There is no dispute that the current health insurance system is broken and needs fixing. Over 46 million individuals are estimated to be uninsured, and those uninsured are more likely to be male, adults 25-34, children, or individuals employed by small enterprises. Those who are sick or unable to obtain any affordable coverage also account for a large pool of the uninsured. In addition, since non-elderly health insurance is largely employment-based, the growing number of unemployed account for an increasing share of the uninsured.
A few days ago, the NY Times ran an article suggesting that a House oversight subcommittee found 3 big insurers guilty of the health insurance practice known as “rescission,” in which insurance companies cancel coverage for some sick policyholders rather than pay an expensive claim. Meanwhile, the same article noted that the U.S. Senate Commerce Committee found that insurers are “imposing substantial rate increases on small businesses to prompt them to drop coverage, and are employing statistically manipulated databases to lower payments to out-of-network doctors”. Can we expect introduction of a government health insurance plan to change such activity?
Health insurance in the US is in need of repair, but not just for the reasons described above. The real source of the problem is the continuous rise in the cost of providing healthcare.
The high costs are partly due to unnecessary tests performed by physicians to avoid malpractice lawsuits. High healthcare costs are also due to the lack of coverage for preventive care that might eliminate the need for later more expensive care, as well as a population that is aging and becoming more obese. To really fix the problem, we need to address these other issues.
Public versus Private
If a government-run health insurer tries to compete with private firms, the likely outcome will be that private insurers will try to shift their worst risks onto the government, raising the costs for everyone.
Also, many jobs will be lost in the private sector as the result of mandated universal healthcare. Small employers already facing hardship in a soft economy might simply avoid hiring full time workers, unless part-timers or contract workers are included in the mandate. Taxing the benefits provided by employers will raise the costs of providing such coverage, motivating employers to cut workers or let the government provide such coverage. In many ways, the government plan will simply crowd out the private sector and raise the costs of doing business.
The government insurance program is intended to pay health-care providers at “comparable” rates to the market, with premiums paid largely by employers. But what about the growing ranks of unemployed, and what about the cost of any government plan to the taxpayers? The deficit is already in the trillions, and much more red ink will flow from introduction of a government health insurance plan.
Notably, Sen. Kennedy has proposed a plan that would assess fees on companies that don’t offer insurance. Sen. Kennedy and Sen. Chris Dodd said this revised plan would cost $611.4 billion over 10 years, down from an estimate of $1 trillion for a previous draft of legislation being considered. As noted in a Bloomberg News story last week…
“The revised plan also decreases subsidies for those with access to health-care coverage through their employer, even if employees consider that insurance to be unaffordable. The IRS would impose penalties on those who don’t have health insurance, though individuals with incomes below 150% of the federal poverty level would be exempt. Insurers would be required to cover all applicants, and couldn’t limit coverage for those with pre-existing conditions.”
Reaction:
No matter what the ultimate form of any new government plan, it will create additional costs rather than reduce existing health care costs at a time when the economy is already weak and deficits are huge. It will create new bureaucracy and force private insurers and employers to shift costs to the taxpayers. We need a fix for healthcare, but let’s first fix the cost.
First, if the plan subsidizes health insurance for the 6 to 8 million uninsured American citizens who aren't eligible for existing programs and can't afford basic catastrophic plans, the plan will cost billions. This cohort tends to be uneducated, unemployable and, most important, chronically ill. They would need a lot of attention when they first got their coverage and would cost more to insure over time than most people.
Second, if Obama's public option health plan, which I call the Government HMO (GHMO), is enacted, it would initially lower premiums in an effort to drive private insurers out of the markets. After private insurers are gone, Congress would mandate that the plan offer more benefits, raise premiums and taxes on non participating employers and the rest of us and ease initial limits on access. We'd be in an expensive, low access single-payer plan, which is Obama's objective.
Third, if Congress goes the Wal-Mart employer mandated coverage, it will mandate all kinds of benefits at the behest of lobbyists and campaign contributors and raise premiums and taxes.
The literature is beginning to show what I've been saying for years. Most expensive preventive care is covered by insurers because the states mandate that coverage at the behest of providers who support politicians' election campaigns with contributions. Only a small part of preventive care cuts costs for the long term, and very little if any cuts costs for the long term.
Because preventive care contributors have the attention of members of Congress and presidential candidates, it's like ethanol, basically an expensive scam.
I've been writing and blogging on health care and health insurance businesses and economics for years at businessword.com.
It is amazing that people who claim to be health insurance experts continue to say there are 46 to 50 million uninsured. That's a number inflated by the government officials who believe in health care reform and publish it to help providers turn a small problem into a crisis. Their gambit worked and will give politicians and some providers' trade associations much more power, but it will cost everyone under 65 trillions.
Monday, July 06, 2009
The Health Care Debate Continues ... a sobering view of the future...
Medicaid and Medicare for All
How Obama would ration health care for all Americans.
By Peter Ferrara
National-health-insurance schemes always start by promising health care for everyone. But they always end up establishing powerful bureaucracies whose purpose is to deny people health care through rationing. That is because in a government-run health system, centralized rationing is the only way to control costs.
Enough is known about the details of the health-care bills taking shape in Congress, with Obama’s support, to give a clear picture of how the president’s national-health-care system would work. Indeed, a revealing report from Obama’s Council of Economic Advisors (CEA), The Economic Case for Health Care Reform, which Obama has touted as showing how he would reduce costs, specifies in detail how thoroughly the new system would be government-run and how it would ration health care for all Americans.
We can start by looking at the mega health-care programs already run by government, Medicaid and Medicare. Medicaid has long severely underpaid doctors and hospitals for the care they provide under the program. As a result, 40 percent of doctors and hospitals will no longer accept Medicaid patients. This restricts access to health care for the poor, as they have to scramble for short and hurried appointments with available doctors, or wait for available hospital care. The result is worse health outcomes for the poor, including more and earlier deaths from heart disease and cancer.
Medicare is headed in the same direction, with lower and lower payments to doctors and hospitals. Doctors are already dropping out of Medicare, and government bureaucrats are already restricting what drugs doctors can prescribe under the program. Average face time with a doctor for a Medicare appointment is now down to a mere 13 minutes. Payments to doctors and hospitals are scheduled to be reduced again next year, by more than 20 percent, which would greatly worsen the problem.
Any new “public option” government health-insurance program of the type Obama vigorously supports would undoubtedly follow these same policies of sharply restricted payments to doctors and hospitals. This is exactly how Obama would follow through on his promises to reduce health-care costs through his reforms. That would result in cost-shifting to patients with private insurance, as has already occurred because of Medicaid and Medicare underpayments, raising private premiums even more sharply.
Obama has said over and over that if you like your current health insurance, you can keep it under his plan. But in the case of employer-provided insurance, it won’t be your choice. It will be up to your employer, who will likely choose to dump you into the public plan, which will cost less because of the restricted doctor and hospital payments — not to mention possible taxpayer subsidies — while private premiums soar because of the cost-shifting. Indeed, even those paying for their insurance themselves may be seduced into the public system because of the savings resulting from its greater power to stiff doctors and hospitals. Private insurers may well adopt the same compensation policies as the government in order to survive. Consequently, doctors, hospitals, and other health-care providers will see themselves subject across the board to the same restricted compensation they receive from Medicaid and Medicare today.
This reduced compensation in turn is going to reduce the supply of health-care services. In this environment, investors are not going to pony up the funds for health clinics and hospitals; new ones will not be built, and existing ones will just deteriorate over time. Investors will not be interested in funding the development and adoption of high-tech medical equipment like MRIs and CAT scans, or the development of biotech or genetic therapies. Drug companies will sharply cut back on investment in the development of new, cutting-edge miracle drugs.
Along with financial capital, human capital will flee health care. Experienced doctors will retire early and seek more remunerative post-retirement employment. Young talent will seek other, more promising professions. Some clinics and hospitals will just go out of business. It is not by accident that Great Britain’s socialized health-care system has such a high proportion of doctors coming from developing countries like India and Pakistan.
All of this is why patients under national health plans end up on long waiting lists to see their own doctor or a specialist, or for access to diagnostic equipment, or for hospital space for surgery. This is why socialized-medicine systems end up with deteriorated, outdated facilities. This is how Canada got to the point where a hospital room could not be found in British Columbia for a mother experiencing accelerating birth contractions; she had to be flown over the Rockies to the next province, Alberta, in the midst of giving birth.
In other words, a reduced supply of health care in response to reduced compensation means rationing. Indeed, former Senate Majority Leader Tom Daschle, whom Obama originally picked as Health and Human Services secretary because he liked Daschle’s policies, explains the new rationing system in great detail in his book Critical: What We Can Do about the Health-Care Crisis. In that book, Daschle expressly advocates the severe rationing of the British socialized-medicine plan as the model for America.
The CEA report says 30 percent of American health care is waste, which will be eliminated under Obama’s health reforms. What is the difference between waste and health care you want? Answer: a government bureaucrat.
The CEA explains exactly how this is going to work. Under Obama’s health reforms, the government is going to sharply reduce health costs by looking systematically at what works and what doesn’t in order to provide more high-value care and less care that is of low value. For many types of medical conditions, a patient may have a choice of several methods or treatments, each having different benefits or risks. Systematic examinations of the merits of different treatments and dissemination of the results of these examinations to patients and providers is one mechanism for promoting high value care.
In other words, it will no longer be you and your doctor who decide what health care works and what doesn’t, and what is high-value care and low-value care. It will be a centralized bureaucracy in Washington. Of course, this bureaucracy will not even know you or your medical condition the way your doctor does. But like all good socialist central planners, the CEA and Obama effectively assume that the government is omniscient.
The CEA also explains how the government will enforce these decisions:
Reorienting the financial incentives of providers toward value rather than volume. Payment systems . . . should reward providers who deliver care that adheres to evidence based guidelines and should not pay for preventable medical errors.
This is supposed to solve a problem identified earlier in the report as provider incentives. Most provider payment systems are fee-for-service, which creates financial incentives for doctors and hospitals to focus on the volume of services that they deliver rather than the quality, cost, or efficiency of care delivery. In general, payment systems do not reward higher quality and value.
In other words, the government will enforce its decisions as to what works and what doesn’t through the payment system for doctors and hospitals. Those who follow the government’s decisions get paid well, and those who don’t don’t. They will be lucky to get paid at all.
But a remote, centralized government bureaucracy in Washington doesn’t, can’t, and won’t know what works and what doesn’t for every individual in the country; what are the right prices for each that will provide exactly the right incentives to eliminate precisely and only the 30 percent of health care spending that is waste; and what exactly is waste, rather than the health-care services you need and want. And this is all before politics gets involved, and the bureaucrats start answering the phone calls from congressmen who want an explanation as to the pitiful payments the government is providing to such-and-such doctors and hospitals in their districts.
Nevertheless, despite the government’s severe lack of knowledge, those doctors and hospitals that don’t follow the government’s decisions will get formally labeled as “lower quality,” losing out to those who win high-quality labels by slavishly following the government’s health-care diktats. This is found in another CEA cost-control measure:
Expanding performance measurement and provider feedbacks. Performance measurement includes collecting and summarizing information about clinical quality, consumer satisfaction, and resource use of provider practices. . . . One potential way to increase efficiency is to facilitate the development of a set of performance measures that all providers would adopt and report. . . . Additionally, new efforts could be made to generate risk-adjusted provider performance profiles to encourage quality improvement and to inform consumer decision-making around quality.
The omniscient central health-care bureaucracy, of course, will know exactly how to measure the performance of every doctor and every hospital in the country for every health-care service. And there won’t be any politics in this, either.
But the CEA has still more bright cost-control ideas:
Rewarding high-value technology creation that reduces morbidity, mortality, and total spending over the lifetime. In most fields, technological progress is generally cost-reducing as individuals discover more effective ways of accomplishing things that were already being done. In medicine, however, technological progress in recent decades has been almost exclusively cost-increasing, without generating a commensurate increase in value. Undoubtedly, provider incentives, which largely reward finding an expensive way of treating a previously untreated condition rather than finding a less costly alternative to an existing treatment, contribute to this trend.
This is meant to address a problem earlier identified in the report as:
Providers also have strong financial incentives to compete on the basis of technology adoption rather than price, leading to an excess supply of high technology equipment and services (for example, MRI machines and minimally invasive vascular diagnostic and procedure suites) and accelerated replacement of hospital beds in local markets. In turn, this can lead to higher rates of utilization and costs.
Obama’s budget czar, Peter Orszag, spills the beans even more obviously in saying, “Future increases in spending could be moderated if costly new medical services were adopted more selectively in the future than they have been in the past, and if the diffusion of existing costly services was slowed.” In other words, the government is going to reduce costs by delaying implementation of technological innovations, discouraging investment in the development of new technology, and leaving patients suffering as they wait for the latest diagnostics and treatment. This will only further discourage investment in the development and adoption of new, advanced medical technologies and drugs, as discussed above.
Implementing all of these cost-control measures will involve the government’s controlling our health care in great detail. Remote government bureaucrats, rather than you and your doctor, will be deciding what health care you will get and when. They will be deciding what health-care advances will be adopted and when. All of this involves pervasive and detailed central economic planning, which experience teaches us will not work. In other words, Obama’s cost controls involve government rationing of your health care, just as in all those foreign countries with socialized medicine that the CEA admires in its report.
— Peter Ferrara serves as director of entitlement and budget policy for the Institute for Policy Innovation, and general counsel of the American Civil Rights Union. He formerly served in the administrations of President Reagan and the first President Bush.
How Obama would ration health care for all Americans.
By Peter Ferrara
National-health-insurance schemes always start by promising health care for everyone. But they always end up establishing powerful bureaucracies whose purpose is to deny people health care through rationing. That is because in a government-run health system, centralized rationing is the only way to control costs.
Enough is known about the details of the health-care bills taking shape in Congress, with Obama’s support, to give a clear picture of how the president’s national-health-care system would work. Indeed, a revealing report from Obama’s Council of Economic Advisors (CEA), The Economic Case for Health Care Reform, which Obama has touted as showing how he would reduce costs, specifies in detail how thoroughly the new system would be government-run and how it would ration health care for all Americans.
We can start by looking at the mega health-care programs already run by government, Medicaid and Medicare. Medicaid has long severely underpaid doctors and hospitals for the care they provide under the program. As a result, 40 percent of doctors and hospitals will no longer accept Medicaid patients. This restricts access to health care for the poor, as they have to scramble for short and hurried appointments with available doctors, or wait for available hospital care. The result is worse health outcomes for the poor, including more and earlier deaths from heart disease and cancer.
Medicare is headed in the same direction, with lower and lower payments to doctors and hospitals. Doctors are already dropping out of Medicare, and government bureaucrats are already restricting what drugs doctors can prescribe under the program. Average face time with a doctor for a Medicare appointment is now down to a mere 13 minutes. Payments to doctors and hospitals are scheduled to be reduced again next year, by more than 20 percent, which would greatly worsen the problem.
Any new “public option” government health-insurance program of the type Obama vigorously supports would undoubtedly follow these same policies of sharply restricted payments to doctors and hospitals. This is exactly how Obama would follow through on his promises to reduce health-care costs through his reforms. That would result in cost-shifting to patients with private insurance, as has already occurred because of Medicaid and Medicare underpayments, raising private premiums even more sharply.
Obama has said over and over that if you like your current health insurance, you can keep it under his plan. But in the case of employer-provided insurance, it won’t be your choice. It will be up to your employer, who will likely choose to dump you into the public plan, which will cost less because of the restricted doctor and hospital payments — not to mention possible taxpayer subsidies — while private premiums soar because of the cost-shifting. Indeed, even those paying for their insurance themselves may be seduced into the public system because of the savings resulting from its greater power to stiff doctors and hospitals. Private insurers may well adopt the same compensation policies as the government in order to survive. Consequently, doctors, hospitals, and other health-care providers will see themselves subject across the board to the same restricted compensation they receive from Medicaid and Medicare today.
This reduced compensation in turn is going to reduce the supply of health-care services. In this environment, investors are not going to pony up the funds for health clinics and hospitals; new ones will not be built, and existing ones will just deteriorate over time. Investors will not be interested in funding the development and adoption of high-tech medical equipment like MRIs and CAT scans, or the development of biotech or genetic therapies. Drug companies will sharply cut back on investment in the development of new, cutting-edge miracle drugs.
Along with financial capital, human capital will flee health care. Experienced doctors will retire early and seek more remunerative post-retirement employment. Young talent will seek other, more promising professions. Some clinics and hospitals will just go out of business. It is not by accident that Great Britain’s socialized health-care system has such a high proportion of doctors coming from developing countries like India and Pakistan.
All of this is why patients under national health plans end up on long waiting lists to see their own doctor or a specialist, or for access to diagnostic equipment, or for hospital space for surgery. This is why socialized-medicine systems end up with deteriorated, outdated facilities. This is how Canada got to the point where a hospital room could not be found in British Columbia for a mother experiencing accelerating birth contractions; she had to be flown over the Rockies to the next province, Alberta, in the midst of giving birth.
In other words, a reduced supply of health care in response to reduced compensation means rationing. Indeed, former Senate Majority Leader Tom Daschle, whom Obama originally picked as Health and Human Services secretary because he liked Daschle’s policies, explains the new rationing system in great detail in his book Critical: What We Can Do about the Health-Care Crisis. In that book, Daschle expressly advocates the severe rationing of the British socialized-medicine plan as the model for America.
The CEA report says 30 percent of American health care is waste, which will be eliminated under Obama’s health reforms. What is the difference between waste and health care you want? Answer: a government bureaucrat.
The CEA explains exactly how this is going to work. Under Obama’s health reforms, the government is going to sharply reduce health costs by looking systematically at what works and what doesn’t in order to provide more high-value care and less care that is of low value. For many types of medical conditions, a patient may have a choice of several methods or treatments, each having different benefits or risks. Systematic examinations of the merits of different treatments and dissemination of the results of these examinations to patients and providers is one mechanism for promoting high value care.
In other words, it will no longer be you and your doctor who decide what health care works and what doesn’t, and what is high-value care and low-value care. It will be a centralized bureaucracy in Washington. Of course, this bureaucracy will not even know you or your medical condition the way your doctor does. But like all good socialist central planners, the CEA and Obama effectively assume that the government is omniscient.
The CEA also explains how the government will enforce these decisions:
Reorienting the financial incentives of providers toward value rather than volume. Payment systems . . . should reward providers who deliver care that adheres to evidence based guidelines and should not pay for preventable medical errors.
This is supposed to solve a problem identified earlier in the report as provider incentives. Most provider payment systems are fee-for-service, which creates financial incentives for doctors and hospitals to focus on the volume of services that they deliver rather than the quality, cost, or efficiency of care delivery. In general, payment systems do not reward higher quality and value.
In other words, the government will enforce its decisions as to what works and what doesn’t through the payment system for doctors and hospitals. Those who follow the government’s decisions get paid well, and those who don’t don’t. They will be lucky to get paid at all.
But a remote, centralized government bureaucracy in Washington doesn’t, can’t, and won’t know what works and what doesn’t for every individual in the country; what are the right prices for each that will provide exactly the right incentives to eliminate precisely and only the 30 percent of health care spending that is waste; and what exactly is waste, rather than the health-care services you need and want. And this is all before politics gets involved, and the bureaucrats start answering the phone calls from congressmen who want an explanation as to the pitiful payments the government is providing to such-and-such doctors and hospitals in their districts.
Nevertheless, despite the government’s severe lack of knowledge, those doctors and hospitals that don’t follow the government’s decisions will get formally labeled as “lower quality,” losing out to those who win high-quality labels by slavishly following the government’s health-care diktats. This is found in another CEA cost-control measure:
Expanding performance measurement and provider feedbacks. Performance measurement includes collecting and summarizing information about clinical quality, consumer satisfaction, and resource use of provider practices. . . . One potential way to increase efficiency is to facilitate the development of a set of performance measures that all providers would adopt and report. . . . Additionally, new efforts could be made to generate risk-adjusted provider performance profiles to encourage quality improvement and to inform consumer decision-making around quality.
The omniscient central health-care bureaucracy, of course, will know exactly how to measure the performance of every doctor and every hospital in the country for every health-care service. And there won’t be any politics in this, either.
But the CEA has still more bright cost-control ideas:
Rewarding high-value technology creation that reduces morbidity, mortality, and total spending over the lifetime. In most fields, technological progress is generally cost-reducing as individuals discover more effective ways of accomplishing things that were already being done. In medicine, however, technological progress in recent decades has been almost exclusively cost-increasing, without generating a commensurate increase in value. Undoubtedly, provider incentives, which largely reward finding an expensive way of treating a previously untreated condition rather than finding a less costly alternative to an existing treatment, contribute to this trend.
This is meant to address a problem earlier identified in the report as:
Providers also have strong financial incentives to compete on the basis of technology adoption rather than price, leading to an excess supply of high technology equipment and services (for example, MRI machines and minimally invasive vascular diagnostic and procedure suites) and accelerated replacement of hospital beds in local markets. In turn, this can lead to higher rates of utilization and costs.
Obama’s budget czar, Peter Orszag, spills the beans even more obviously in saying, “Future increases in spending could be moderated if costly new medical services were adopted more selectively in the future than they have been in the past, and if the diffusion of existing costly services was slowed.” In other words, the government is going to reduce costs by delaying implementation of technological innovations, discouraging investment in the development of new technology, and leaving patients suffering as they wait for the latest diagnostics and treatment. This will only further discourage investment in the development and adoption of new, advanced medical technologies and drugs, as discussed above.
Implementing all of these cost-control measures will involve the government’s controlling our health care in great detail. Remote government bureaucrats, rather than you and your doctor, will be deciding what health care you will get and when. They will be deciding what health-care advances will be adopted and when. All of this involves pervasive and detailed central economic planning, which experience teaches us will not work. In other words, Obama’s cost controls involve government rationing of your health care, just as in all those foreign countries with socialized medicine that the CEA admires in its report.
— Peter Ferrara serves as director of entitlement and budget policy for the Institute for Policy Innovation, and general counsel of the American Civil Rights Union. He formerly served in the administrations of President Reagan and the first President Bush.
Long Weekend, July 1-5, 2009
It was a great holiday weekend. The weather was perfect and I spent time in both Milwaukee and Door County.
The weekend kicked off with dinner at the Riverfront Grill, followed by the Willie Nelson/Bob Dylan concert at Summerfest on Wednesday night. Willie was fine, Dylan was kind of flat. I wish Dylan would have played more stuff I knew.
On Thursday, I headed up to Door County in my "new" car, a 2008 Chevy Malibu V6. It's fun to drive and much too fast for me, but has the power when I need it. I spent the day hanging around in Fish Creek, going for a long run, and catching up with my dad, who arrived last week for the summer. We dined at Mr. Helsinki and had a nightcap at the C&C and Bayside before calling it a night.
On Friday, I had a nice run in Peninsula State Park, ran some errands and hung out with some friends in Fish Creek. I ate in at home and then went out for one or two before heading home early.
On Saturday, I spent the day down in Egg Harbor at Bielefeld's house for their annual friends get-together. We watched the 4th of July parade, then headed out by boat to Chambers Island for the rest of the afternoon. I then went down to Shawn's boat and hung out with her for the annual fireworks in Fish Creek. Beautiful.
On Sunday, I got up really early and drove back to Milwaukee. Upon arrival, I went for a run, then hopped on my bike and rode down to the beach for a little while, then biked around for another hour or so. The weather was so perfect. I had my usual dinner at Flannery's then biked around my neighborhood for a little while before heading home to bed.
It will be sad when summer is over. It just doesn't get any better than this.
The weekend kicked off with dinner at the Riverfront Grill, followed by the Willie Nelson/Bob Dylan concert at Summerfest on Wednesday night. Willie was fine, Dylan was kind of flat. I wish Dylan would have played more stuff I knew.
On Thursday, I headed up to Door County in my "new" car, a 2008 Chevy Malibu V6. It's fun to drive and much too fast for me, but has the power when I need it. I spent the day hanging around in Fish Creek, going for a long run, and catching up with my dad, who arrived last week for the summer. We dined at Mr. Helsinki and had a nightcap at the C&C and Bayside before calling it a night.
On Friday, I had a nice run in Peninsula State Park, ran some errands and hung out with some friends in Fish Creek. I ate in at home and then went out for one or two before heading home early.
On Saturday, I spent the day down in Egg Harbor at Bielefeld's house for their annual friends get-together. We watched the 4th of July parade, then headed out by boat to Chambers Island for the rest of the afternoon. I then went down to Shawn's boat and hung out with her for the annual fireworks in Fish Creek. Beautiful.
On Sunday, I got up really early and drove back to Milwaukee. Upon arrival, I went for a run, then hopped on my bike and rode down to the beach for a little while, then biked around for another hour or so. The weather was so perfect. I had my usual dinner at Flannery's then biked around my neighborhood for a little while before heading home to bed.
It will be sad when summer is over. It just doesn't get any better than this.
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