Medical Reformatories and Drinking out of old worn-out boots…
The Politics of Theft, Medical System Style
See: 15 U.S. Code § 13 – Discrimination in price, services, or facilities
This column demands a response, so here you go.
There is nothing more we can do here. We tried everything else, and now it’s time to do the right thing (ed: Single Payer). It’s the American way.
Well, let’s see. I count three lies in three sentences, four if you call “Single Payer” the American Way.
Let’s start with the first: There is nothing we can do here. Sure there is. We could start with my one sentence extortion-stopping bill. We could then follow up with the linked bill outline from that article, which you can read here. That has a link to the implementation of same, and what it would look like — read that too.
None of this has been tried, so to say that there is “nothing more we can do here”, or “we tried everything else” is a flat-out lie.
It is in fact worse than a lie; it’s a knowing fraud put together by someone who advocates for and sells “medicine as a business”, of course, with a focus on, in her own words, “obtain(ing) better reimbursement” (read: “more moolah!”)
But let’s rewind that article and go back to the start, with the claim that we have a $3 trillion annual “healthcare pot” to spend. That’s a lie too. You see, the Federal Government runs huge deficits. That is, we don’t have a $3 trillion annual “pot” of money because we’re borrowing a huge percentage of it. This is akin to saying that if you make $30,000 a year, but spend $50,000 because you charge up the credit cards by $20 large your “pot” to spend is $50,000.
No, it isn’t. It’s $30,000. You can for a while spend the $50, but not forever. In the case of the government the form of “not forever” doesn’t come the same way it does for you. When you try this you eventually get a declined back at the store on your plastic.
When governments do it they destroy productivity in the economy and cap GDP expansion. We have done this serially for 30 years and it has now caught up with us, which is why we haven’t had an actual “recovery” since the 2008 crash, being capped off under 2% GDP.
What has happened since the 1970s is that medical spending has gone from ~5% of GDP to almost 20%, a four-fold increase in percentage terms.
What’s just as bad, however, is that the much-vaunted “Medicare” and “Medicaid” (single-payer, basically) that this chick likes to argue for has seen a roughly 9% compounded rate of increase in spend for the last 30 years.
Obamacare managed to buy one year of decreased spending — exactly one.
On this trajectory the Federal Government will try to spend $2 trillion dollars by the time Trump’s first term ends, nearly $800 billion more than it spends now.
There is utterly no possible way to do that.
I remind you again: Medicare and Medicaid are single-payer.
The author also tries to present military procurement as a “success model.” Oh really? Exactly how much over budget and behind schedule was the new Ford aircraft carrier? Let me count that up for you — it’s over $2.4 billion above the “accepted bid cost” and the carrier was roughly 18 months behind schedule for completion as well; it was supposed to be finished in September of 2015! Worse, while it’s currently in the water and running on its own power it won’t actually be operational until at least 2020.
Would you like to talk about something even more-simple? How about pistols? The military recently decided to have a “competition” for the next-generation military sidearm. That ought to be quite simple; there are literally hundreds of sidearms currently available in the marketplace. Let them compete, pick one, negotiate a volume discount, done.
No, that’s not what they did. Go look that one up for yourself as it’s enough to make you want to throw up. What the military wound up with was a bespoke variant of an existing design at materially increased cost.
We run our entire government this way — and this is the model for health care we should adopt?
If you think that perhaps the states or cities can do better may I direct you to a bathroom in New York, in a public park. It’s a public restroom. It has stalls, urinals, sinks. It’s not especially large and might be able to accommodate a dozen people doing their business at once. It cost $2 million dollars and took several years to build. In the same neighborhood you can buy an entire house for under $700,000 and a new one can be built in six months, more or less.
Again, this is the model you wish to apply to health care?
The math presented is reasonably clear — $3 trillion and change divided by 330 million people is about 10 large a person, annually. The problem is that this is two to three times the cost per-person in all other developed nations and essentially all of those are socialist medical systems — that is, single payer.
I think American medicine is the best in the whole world. Not because it’s expensive and not due to the corrupt ways in which it’s being financed, but in spite of these things.
Oh, so we’re back to what people think? See, when you can’t argue facts (because they say you’re full of crap) you argue feelings and this of course leaves you open to charge anyone who disagrees with bigotry and, if you’re a woman, you can claim sexism as well.
Arithmetic and statistics, of course, don’t care about your feelings or what you think. The facts are that we spend 2-3x as much per-person on health care as any other developed nation and yet we’re nowhere near the top of the list among developed nations on any of the objective measures of success in health outcomes: Mortality, morbidity, longevity, infant deaths, obesity, diabetes, high blood pressure, coronary disease, strokes and more.
More to the point we have 100+ years of history in economic outcomes comparing socialism .vs. capitalism across the world. There has never been a case where socialism has “won” on an objective basis — real GDP growth per capita, technological advancement, objective measures of personal wealth, economic upward mobility and more.
No matter what objective metric you care to use as a yardstick socialist systems consistently and persistently underperform.
What’s worse is that there are myriad cases in which socialist societies have literally collapsed upon themselves leading to violence, civil unrest, coups, and even civil war.
What “single payer” boils down to, in short, is attempting to protect the medical scam.
And yes, it’s a scam.
I can cite specific Medicaid issues in this regard, and some Medicare ones as well. They’re outrageous. We’re talking about situations where people are cut up to fix something ignoring severe, even life-threatening co-morbidity problems that could be at least in part alleviated first. Not doing so means greatly increasing the risk of severely-extended hospital convalescence for which the hospital gets paid, of course. Never mind the fact that this “decision path” also comes with a materially-increased risk of the person in question dying. And finally, if you alleviated those co-morbidity issues the original operation might not have been required at all and that would mean they make far less money.
The medical industry doesn’t want to talk about this sort of thing just like they don’t want to talk about what they do now when it comes to billing in general, which is bilk you. And I do mean bilk. I have here in my hand a hernia repair bill sent to me by someone who had the procedure recently done. It’s roughly $20,000, of which the “insurance company” paid $3,500 and the customer paid $150.
Note that if said “customer” had a $6,000 deductible they would have paid the entire $6,000 which is close to double what the insurance company actually paid. This, despite the fact that the customer got the exact same surgery and exact same result. The only difference was whether he elected to pay for a “catastrophic” plan or not.
This pretty-much fits the description of extortion to a “T”. The message is clear: Buy a low-cost insurance plan for a catastrophic event and for a non-catastrophic but still serious event you will be billed double or more.
Incidentally extortion is illegal — at least it’s supposed to be. Further, refusing to quote a price and other similar games are illegal under long-standing consumer protection laws, and colluding to fix prices is a felony under 100+ year old law (15 USC Chapter 1.)
Exactly how many prosecutions are brought over this? Zero.
Or shall we talk about the two recent lawsuits brought against pharmacy chains (of which there are now only a handful, and thus there is effective monopoly power) alleging that people with insurance are paying more than a cash customer for medications? Those allegations look pretty solid, seeing as they’re easily backed up. Exactly what justification can you raise for someone to pay $23 after they buy “insurance” when a cash customer can walk in and buy the exact same medication for $10? I remind you that Robinson-Patman, part of that 100 year old 15 USC Chapter 1 law, makes illegal the charging of differential prices for physical goods that travel in interstate commerce (that would be basically all drugs), where it tends to reduce or destroy competition, between customers of like kind and quantity.
You want to put this all under “single payer”? Where is the evidence that any of the above would be helped by doing so? And as for the claim that “we’ve tried everything else” would you please point out when and where your definition of everything else involved enforcing existing, 100+ year old law — when it’s quite clear that doing so would collapse cost by at least 50% and probably something more like 70-80%!
Then there is the plethora of evidence that morbidity and mortality is intentionally stoked by Medicare and Medicaid existing in the first place.
Leaving aside the financial impact we are talking about people being screwed physically and perhaps dying unnecessarily as a consequence, all so the medical scam machine can make an even more-obscene profit.
Now you might actually get me on board if we had “tried everything else” first.
But we haven’t and any such assertion, as I noted, isn’t just a mistake — it’s a lie.
Right at the top of this article are two links. They take you to a one-sentence bill that would instantly stop the extortion game played on people who have high-deductible insurance plans by requiring that a person who either has no insurance or is underinsured for the event (e.g. they have a deductible to satisfy) is not billed more than a person on Medicare is billed for the exact same procedure.
This instantly ends the medical extortion and cost-shifting game.
The second link restores competition by (1) forcing the posting of prices and agreement, when possible, to actual charges before they are incurred, (2) enforces 100+ year old law that does apply to the medical industry across-the-board, (3) aligns the interest of customers and providers in stopping infections transmitted by poor procedure or “mistakes” in clinical practice by refusing to allow said firms to bill you for that which they do to you as a result of said failures, (4) enforces “most-favored nation” status for the US on drugs, devices and supplies, preventing US consumers from being forced to fund the entire world’s medical system at gunpoint, (5) allows anyone to obtain any non-invasive and non-dangerous diagnostic on their own, for cash, without a doctor’s order should they so choose, (6) requires the provision of medical records in readable form to you at the time of service, and confirms your sole ownership of same, (7) ends, permanently, the provision of government-funded care to illegal invaders in this nation and (8) for the indigent dramatically increases both their options for medical care and drives down cost by enforcing anti-trust law, thereby bringing competition into the game for everyone.
If we try all of that and fail with it then I might be open to debate about single-payer. But we won’t fail if we do that. What we will do is take that $3 trillion current spend and cut it to $1 trillion. This will not only permanently fix the budget deficit it will make America the place in the industrialized world to start and operate a business on a cost-competitive basis.
But until all that happens any such statement that we’ve tried everything else is simply a bald-faced, self-interested lie by those who have ripped off Americans for more than 30 years, all of whom should be staring down an indictment right here and now.
[Byline Karl Denninger]
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