|October 28th, 2009||#101|
LRC contributor Don Cooper sent this letter to me in response to a blog I did on Sen. Al Franken’s push for universal health care.
Don Cooper here. I’m a regular contributor on LRC. Just read your blog entry on Al Franken. What an idiot. He’s dangerous to our society.
I’ve got some anecdotes for you. I lived in Europe for 10 years. I lived in 3 countries which have nationalized health care: England (1 year), Germany (3.5 years) and Romania (5.5 years). I wasn’t working for an American company but rather a German company (Siemens), so I had a German contract and was part of the European society.
I can tell you factually from first-hand experience that what the critics are saying about any sort of government-run health care systems—national or socialized—is correct. I lived there. None of these critics, including Franken, have ever lived and participated in the types of health care systems they advocate—which means they are speaking from an uneducated position; and that is irresponsible and dangerous for us.
The NHS in England is regular fodder for British comedians. I didn’t have one British colleague that had anything good to say about it. Hell, some Brits pull their own teeth because they can’t wait for an NHS dentist.
Germany was good if you needed to see the doctor for something minor. Codeine and antibiotics are sold over the counter in Germany—so you didn’t even have to go to the doctor for those things. But I had to wait 6 months for a minor operation on my arm. To this day I still have problems with it, and I have to wonder if it’s because the problem worsened while I was waiting for the operation.
|November 20th, 2009||#102|
Join Date: Jul 2007
[Women's suffrage: the reform that ended all reform.]
Mammogram Debate Shows Why Reform Will Fail
Robert Langreth and Rebecca Ruiz, 11.19.09
Why can't we control costs? Because experts who write perfectly reasonable guidelines get branded death panels.
In the midst of the debate over health care reform, we have been handed the perfect example of why America will never get health care costs under control: The furious reaction to new guidelines that recommend most women should get mammograms later in life and less frequently.
On Monday, the U.S. Preventive Services Task Force said most women should start getting mammograms at age 50 and have them every two years, a reversal from the current standard of once-yearly mammograms starting at 40. The government-sponsored panel of doctors and other health experts also said that doctors should stop teaching women to do breast self-exams.
Mammograms in younger patients save few lives, the USPSTF argument goes, but they cause huge numbers of false positives, sucking patients into the medical system and leading to unnecessary treatment. The panel isn't saying that younger women should never get mammograms, only that the benefits are murky enough that women should talk it over with their doctors first and not automatically do it. And the recommendations don't apply to women in certain high-risk groups.
But science is no match for the emotional politics of breast cancer. "It is so outrageous the word we have gotten recently on mammograms," said Senate Majority Leader Harry Reid in a press conference on health reform. "Women should be able to go get a mammogram and not have to wait until they are 50 years old." The American Cancer Society's chief medical officer, Otis Brawley, called the recommendations "a step backward in the fight against breast cancer" in an editorial in the Washington Post.
Radiologists, who are likely under ObamaCare to get hit by payment cuts for high-tech scans, are particularly upset about the guidelines. "Is this the first death panel we are seeing with mammography?" asks Long Island radiologist Eric Schnipper, whose group, Emergency Coalition to Save Cancer Imaging, opposes the guidelines. "They would rather that [cancers] just go undetected, and if you die they would accept that based on the cost savings." He darkly hints that the guidelines must have been ordered up by the top White House officials and says the timing "is no coincidence."
But focusing almost exclusively on the benefits--mammograms might help save the lives of about one in every 1,000 women in their 40s--understates the real harms of too many mammograms, including false positives that lead to unnecessary follow-up tests and biopsies. This reality has so far been overshadowed by the tales of women in their 40s whose cancers were caught early. While heartrending, those stories distract us from serious questions, says Merrill Goozner, a blogger who pays close attention to health care costs. "Everybody knows somebody who has been affected by breast cancer," he says. "Anecdotes aren't science, however, and they certainly aren't statistics."
Perhaps the biggest problem with performing too many screening tests in healthy people is a phenomenon called over-diagnosis: Screening can detect slow-growing, harmless cancers that would never have killed you. How often does this happen with breast cancer? A study in the British Medical Journal this year estimated that roughly one in three breast cancers detected by mammograms would never have caused harm if left untreated. Other studies have found somewhat lower numbers. If this figure is true, it means that mammograms are leading to a large number of unnecessary mastectomies and lumpectomies every year. "We likely create more disease through screening then we find. We likely do more harm and spend inordinate money," University of Alabama-Birmingham internist Robert Centor wrote in his blog. "But when [we] talk about breast cancer, we cannot have an objective discussion."
Dr. Kevin Pho, an internist in Nashua, N.H., thinks the rebellion indicates a larger problem with ObamaCare. "The fact that [the administration] is distancing itself from what I consider to be very robust guidelines portends a very poor future for comparative effectiveness," he says. "If they back down now, what's going to happen when a comparative effectiveness body says there's no difference between angioplasty and medical management of heart disease?"
|November 21st, 2009||#103|
Join Date: Jul 2007
Breast guidelines test American tolerance for risk
Fri Nov 20, 2009
By Julie Steenhuysen - Analysis
CHICAGO (Reuters) - The uproar over new breast cancer screening guidelines in the United States underscores the delicate balance scientists and health policy experts face in trying to convince a wary American public that less healthcare, in some cases, may be good for them.
The sweeping new guidelines released on Monday advise against routine mammograms for women in their 40s, and suggest women 50 to 74 only get a mammogram every other year instead of yearly.
U.S. breast cancer experts and advocacy groups immediately rebelled against the recommendations, saying they endangered women's lives.
Some critics said the guidelines were motivated by a desire to ration healthcare -- echoing a charge made by Republican lawmakers in attacking healthcare overhaul legislation Democrats are pushing in the U.S. Congress.
Democrats say they want to cut healthcare costs and extend coverage to millions lacking health insurance, while their critics say the overhaul would give the government a larger role in people's health.
The guidelines, issued by the U.S. Preventive Services Task Force, an influential panel of independent experts, were intended to balance the benefits of saving lives with the harms of false alarms and the cost and trouble of extra tests.
"The public has been programed to believe that doing more is better -- more screening, testing, treating -- and repeatedly we find gaps in our knowledge about making the linkage between more and better," said Dr. Harlan Krumholz of Yale University in New Haven, Connecticut.
"It seems people are not ready to have recommendations based on evidence. And politics so easily perverts efforts to bring some sense to our use of tests and procedures," he said.
"The burden of proof for doing something should be on the intervention," Krumholz said.
"We are too often assuming benefits that have no basis in fact. Medical care should be guided by good science."
GUIDELINES APPEAR CALLOUS TO SOME
But some doctors said the new breast cancer guidelines that focus strictly on science and evidence appear callous and unfeeling, especially to American doctors and patients who have trouble overcoming the intuitive belief in repeated screening.
Cynthia Ryan, an English professor at the University of Alabama at Birmingham who studies how breast cancer is portrayed in the media, said such an abrupt change follows years of aggressive communication campaigns.
"Everyone knows someone who has had breast cancer," said Ryan, who has survived two different breast cancers.
She said the new guidelines feel like a huge step backward to a generation of women who have been told they can save their lives if they do self breast exams and are vigilant about getting yearly mammograms.
"We're emotional because we're so damn confused," Ryan said.
Dr. Kyle Hogarth, who directs a lung cancer risk clinic at the University of Chicago School of Medicine, said there are no official guidelines for lung cancer screening.
"The argument against screening for lung cancer has been that when you start to order CAT scans on smokers, you find all kinds of nodules. Only a very small percentage will be malignant," Hogarth said.
He said guidelines need to balance the effectiveness of the screening with the rates of false positives.
"If I told you that you had a nodule on your lungs, are you going to be sleeping well for the next couple of months?"
But only 15 percent of patients with lung cancer survive. When a women is diagnosed with an early breast cancer, she has a very good chance of survival.
Hogarth said breast cancer is a special case.
"When you have a disease that has a strong advocacy base and you are saying on a surface that the mantra is changing, you can guarantee there is a push-back," Hogarth said.
"That also factors into guidelines, even though everyone would like to think it doesn't. Politics is everything."
(Editing by Mohammad Zargham)
|December 15th, 2009||#104|
Join Date: Jun 2009
The Growing Movement to Nullify National Health Care
Written by Michael Boldin
Saturday, 12 December 2009 10:46
"In response to what some opponents see as a Congress that doesn't represent their interests, State Legislators are looking to the nearly forgotten American political tradition of nullification as a way to reject any potential national health care program that may be coming from Washington.
In 2010, residents of Arizona will be voting on a State Constitutional Amendment that would let them effectively opt out of any proposed national health care plan.
Legislatures in Florida, Michigan, Ohio and Pennsylvania are also considering similar State Constitutional Amendments.
And now, Missouri is joining them. According to a report in The Missourian, "Rep. Cynthia Davis, R-O'Fallon, pre-filed a bill Dec. 1 that, if approved by voters, would effectively put a halt on any national health care legislation. Davis said her intent was to give voters a way to protect themselves."
FREEDOM TO PARTICIPATE
The bill, HJR48, "Proposes a constitutional amendment which would prohibit compelling a person to participate in any health care system."
"To preserve the freedom of citizens of this state to provide for their health care, no law or rule shall compel, directly or indirectly or through penalties or fines, any person, employer, or health care provider to participate in any health care system. A person or employer may pay directly for lawful health care services and shall not be required to pay penalties or fines for paying directly for lawful health care services. A health care provider may accept direct payment for lawful health care services and shall not be required to pay penalties or fines for accepting direct payment from a person or employer for lawful health care services. Subject to reasonable and necessary rules that do not substantially limit a person's options, the purchase or sale of health insurance in private health care systems shall not be prohibited by law or rule."
NULLIFICATION: A HISTORY LESSON
The principle behind such legislation is nullification, which has a long history in the American tradition. When a state 'nullifies' a federal law, it is proclaiming that the law in question is void and inoperative, or 'non-effective,' within the boundaries of that state; or, in other words, not a law as far as the state is concerned.
Early nullification movements began with the Virginia and Kentucky Resolutions of 1798. These resolutions, secretly authored by Thomas Jefferson and James Madison, asserted that the people of the states, as sovereign entities, could judge for themselves whether the federal government had overstepped its constitutional bounds - to the point of ignoring federal laws.
Virginia and Kentucky passed the resolutions in response to the federal Alien and Sedition Acts, which provided, in part, for the prosecution of anyone who criticized Congress or the President of the United States.
Nullification was regularly called upon by states all over the country in response to everything from higher taxes to the fugitive slave law of 1850.
A MODERN NULLIFICATION MOVEMENT
Besides the Health Care legislation in Arizona, activists and state-legislators are pushing forward with nullification efforts all across the country - and it spans the political spectrum.
Thirteen states now have some form of medical marijuana laws - in direct contravention to federal laws which state that the plant is illegal in all circumstances. Massive state nullification of the 2005 Real ID Act has rendered the law nearly void. And, two states, Montana and Tennessee, have already passed laws nullifying federal gun laws and regulations within their states.
HOWEVER WE CHOOSE
"We (Missourians) don't like it when people try to take away our freedom," Davis told The Missourian. "We will maintain the right to purchase health care however we chose. This national health care debate is not about health care as much as it is about redistribution of the wealth. This resolution allows voters to say don't redistribute our wealth here in Missouri."
George Senate Majority Leader Chip Rogers, in an interview with the Atlanta Business Chronicle said, "Proposals to deny or limit access to the purchase of private health care are simply unacceptable. Our basic freedoms are at risk with the government-run health care proposals coming out of Washington." Legislators from Georgia recently announced that they would be introducing a similar resolution in 2010.
REAL ID AS THE BLUEPRINT?
Supporters of modern nullification efforts look to the successful rebellion by states against the Bush-era Real ID Act.
In early 2007, Maine and then Utah passed resolutions refusing to implement the federal Real ID act on grounds that the law was unconstitutional. Well-over a dozen other states followed suit in passing legislation opposing Real ID.
Instead of attempting to force the law to implementation, the federal government delayed implementation not once, but twice. And in June of this year, the Obama administration, recognizing the insurmountable task of enforcing a law in the face of such broad resistance, announced that it was looking to "repeal and replace" the controversial law.
Supporters see this as a blueprint to resist various federal laws that they see as outside the scope of the Constitution. Some say that each successful state-level resistance to federal programs will only embolden others to try the same - resulting in an eventual shift of power from the federal government to the States and the People themselves."
Michael Boldin is the founder of the Tenth Amendment Center, which you can find online at www.tenthamendmentcenter.com. He welcomes your feedback at [email protected]
|April 2nd, 2010||#105|
Join Date: Dec 2003
Location: Raleigh, North Carolina
Right now I am currently a nurse student. I am also a white racialist nursing student. In the very near future I will be getting my RN. This is ALL very upsetting to me. I went into nursing to hopefully be able to contribute something to my race as a nurse. Or, at least you would think right? Well, if you guys think things are a mess right now I really do hope that the gov is NEVER in control of the health care system. The quality of care from nurses will decrease. People think we make a lot of money, and, we do. But, when you consider the HUGE nursing shortage, due to lack of nurse educator's because jewish institutes refuse to pay them enough money to make it worh their while to become a nurse educator it is only going to get worse with gov control. Right now an RN has five to six beds to deal with per nurse and, it really should not even be that way. Gov control will only make that far worse than it currently is. Then you will be talking at least 12 patients per nurse. Not to mention the PAY. IF, the pay of an RN were to decrease with gov control quality care will also decrease. There is no doubt about that.
Myself, I'm very confused over this whole mess. Doctors and nurses constantly debate about this issue.
Right now I would rather be in the middle of a race war saving the lives of white people than to have to deal with all the crap that is going to roll down hill. Because, it's coming!!
Just walk into any Trauma center and take a good look at what you see. All kinds of brown, black, whatever. Mostly drug related, or alcohol related, or, gun shots! And, mostly ALL black! I'm not going to work for pennies to have to deal with that kind of B.S. Because, that isn't the purpose of myself to become an RN.
As a WHITE woman, I've had to deal with all kinds of B.S. in College! I've had to sit and listen to lecture after lecture for hours about how bad, evil, and you can only imagine white people are. I've had to take Anatomy and Physiology courses that never really Scientifically really want the truth out there! You can only imagine what I'm referring to in that regard.
Well, it isn't going to get better before it gets worse.
Last edited by LindaLou; April 2nd, 2010 at 08:56 AM.
|April 13th, 2010||#106|
Unfortunately we live in a society long trained to the lie. So that even simple technical matters cant be discussed rationally. If they could be, we could observe that government involvement is what messed up body repair in the first place. it is a market like any other. You should get what you pay for. A free market clears up problems quickly. "safety" and "regulations" are marketing slogans to justify the greed of the politically connected. Let people choose whatever medical care they desire, whether witch doctors, Christian Science nurse practitioners, elixir salesmen, chiropractors, MDs, DOs, dentists. It will all work out just fine - if it were allowed to. The very nature of (health) like (everything else) is that it cannot be known what will be needed - that's the whole reason for a market. No one can sit down and know beforehand how many hip or knee operations, how many flu shots, how many vials of anti-venin for brown snake bites - these are matters of chance and private decision. But the demagogues know that many people do not understand this, hence are open to manipulation through slogans and the demonization of various private entities. Public schools are where the government cultivates the demand for the kind of bullshit and "services" government provides. It is no accident that white genius flowered before public schools, and went into decline after their spread.
|April 16th, 2010||#107|
Join Date: Jun 2009
100 years of medical fascism
100 Years of US Medical Fascism
Mises Daily: Friday, April 16, 2010 by Dale Steinreich
One hundred years ago today, on April 16, 1910, Henry Pritchett, president of the Carnegie Foundation, put the finishing touches on the Flexner Report. No other document would have such a profound effect on American medicine, starting it on its path to destruction up to and beyond the recently passed (and laughably titled) Patient Protection and Affordable Care Act of 2010 (PPACA), a.k.a., "Obamacare." Flexner can only be accurately understood in the context of what led up to it.
Free-market medicine did not begin in the United States in 1776 with the Revolution. From 1830 to about 1850, licensing laws and regulations imposed during the colonial period and early America were generally repealed or ignored. This was brought about by the increasing acceptance of eclecticism (1813) and homeopathy (1825), against the mainstream medicine (allopathy) of the day that included bloodletting and high-dose injections of metal and metalloid compounds containing mercury or antimony.
Eclectics emphasized plant remedies, bed rest, and steam baths, while homeopaths emphasized a different set of medicines in small doses (letting the body heal itself as much as possible), improved diet and hygiene, and stress reduction. The worst results these treatments produced were allergic reactions to no improvement. Hence it's not surprising they began to be preferred over the ghastly bleeding and metal injections of allopathy, which killed large numbers of patients.
By 1860, there were more than 55,000 physicians practicing in the United States, one of the highest per capita numbers of doctors in the world (about 175 per 100,000). By 1870, approximately 62,000 physicians were in practice in the United States, roughly about 5,300 of which were homeopathic and about 2,700 eclectic. Schooling was plentiful and inexpensive, and entry to the most acclaimed schools was not exceedingly difficult. Most schools were privately owned. Licenses to practice were not required or enforced, and anyone could establish a practice.
Like the mythical Hollywood portrayal of the American "Wild West" as a place in which the denizens of every town were killing each other in gunfights every minute of the day, the free-market period in American medicine has also been distorted as one in which towns were mobbed by traveling quacks prescribing dangerous treatments that killed the townspeople in droves. Organized mainstream medicine concocted this myth, and as previously noted, it was they and not the homeopaths and eclectics who were killing large numbers of people via bloodletting and metal poisoning. This is why it took time and effort for any caregiver to win the widespread trust of a typical community in 19th-century America. The public en masse blindly lapping up snake oil dispensed from the dirty travel trunks of carnival-tent quacks is wild legend.
Even though they were only about 13% of physicians in practice, eclectics and homeopaths did damage to the incomes of the allopaths. The allopaths began organizing at the state level to use the coercive power of government to not only severely restrict (if not outright ban) eclectics and homeopaths, and the schools that trained them, but also restrict the number of allopaths in practice to dramatically increase their incomes and prestige.
The American Medical Association (AMA) had already been formed in 1847 by Nathan Smith Davis. Davis had been working at the Medical Society of New York with issues of licensing and education. While the pretense was always more rigorous standards toward the supposed end of effective treatments, exclusion was the reality. Hence it was no surprise that in 1870, Davis worked successfully to prohibit female and black physicians from becoming members of the AMA.
The AMA formed its Council on Medical Education in 1904 as a tool to artificially restrict education. However, the AMA's conflict of interest was too obvious. This is where Abraham Flexner and the Carnegie Foundation entered the picture. Flexner's older brother Simon was the director of the Rockefeller Institute for Medical Research and he recommended his brother Abraham for the Carnegie job. Abraham's acceptance of the role was the perfect special-interest symbiosis. Carnegie's desire was to advance secularism through higher education, thus it saw the AMA's agenda as favorable toward that end. Rockefeller's benefactors were allied with allopathic drug companies and hated for-profit schools that couldn't be controlled by the big-business, state-influenced foundations. Last of all, the AMA got an objective-appearing front in Carnegie.
Not only was Abraham Flexner not even an allopathic physician; he was not a widely known authority on education, never mind medical education, as he had never even seen the inside of a medical school before joining Carnegie. His report was already effectively written, since it was essentially the AMA's unpublished 1906 report on US medical schools. Furthermore, Flexner was accompanied on his inspection by the AMA's N.P. Colwell to insure the inspection would arrive at the preordained conclusions. Flexner then spent time at the AMA's Chicago headquarters preparing what portion of the final product was his actual work.
Regardless of these scandalous circumstances, state medical boards and legislatures used the report as a basis for closing medical schools. Around the time of Flexner, there was a high of a 166 medical schools; by the 1940s there were just 77 a 54 percent reduction. Most small rural schools were closed, and only two African-American schools were allowed to remain open. By 1963, despite advances in technology and a huge growth in demand, one effect of the report was to keep the number of doctors per 100,000 people in the United States 146 at the same level it was at in 1910. Of the approximately 375,000 physicians in practice in 1977, only about 6,300 or 1.7% were African-American.
While physician incomes and prestige dramatically increased, so did the caregiving workload. Wolinsky and Brune (1994) report that doctors were firmly in the lower middle class at the time of the AMA's founding and made about $600 per year. This rose to about $1,000 around 1900. After Flexner, incomes began to skyrocket such that a 1928 AMA study found average annual incomes reached a whopping (for the time) $6,354. Even during the Great Depression, physicians earned four times what average workers did. A 2009 survey put family-practice doctors (on the low end of the physician income range) at a median of $197,655 and spine surgeons (at the high end) at a median of $641,728. These figures are mind boggling to ordinary Americans, even in good economic times. In addition, the cyclical unemployment that throws workers out of jobs in almost all other industries with the arrival of recessions or depressions became nonexistent among physicians after Flexner.
However, not even Flexner could repeal the laws of economics: the physician workload in certain areas became backbreaking to impossible, such that some physicians no longer accept new patients. Some primary-care physicians today are booked solid for at least two months, and unless you have some sort of connection to get in before that or pay for concierge care, your alternative for urgent care is the same as everyone else's on a weekend: the emergency room where you'll wait for hours, or a walk-in where you'll see one or two MD names posted on the building, but wait for hours for a nurse practitioner.
Of course it wouldn't make sense to restrict physician services without restricting hospitals. For-profits were the first to go, and where they were not outright prohibited, they faced a number of regulatory burdens that nonprofits escaped such as income and property taxes. Nonprofits received generous government subsidies, tax-deductible contributions, and local planning agencies working in their favor to keep for-profit competitors from expanding. This state-sponsored discrimination against for-profit hospitals took its toll: at the time of Flexner, almost 60 percent of all US hospitals were for-profit institutions. By 1968, only 11 percent were for-profit institutions with about an 8-percent share of hospital admissions.
Eliminating most for-profit medical schools and hospitals made sense for the AMA and the rest of organized mainstream medicine, since they were controlled by owners or shareholders who had the incentive to control costs in order to maximize profits. Nonprofits were free to pursue the political goals that organized mainstream medicine favored, especially the goal of a much more lengthy and costly education, which served as another barrier of entry to the profession. (Especially amusing was a 2004 article by two Dartmouth physicians arguing for maintaining restricted entry because of high costs.)
The Rise of Health "Insurance"
In the early 1900s, prepaid health plans were created for the timber and mining workers of Oregon and Washington to help offset the inherent risks of those industries. Within a free-market, for-profit insurance system, claims were closely monitored by adjusters. Fees, procedures, and exceptionally long hospital stays were monitored and subject to challenge. A physicians' group in Oregon that resented this type of scrutiny created a plan where procedures were reimbursed and fees paid with few questions asked. Plans with similar structures began dominating the market in other locations because of government-provided advantages.
By 1939 these loose-cost containment plans began to be marketed under the Blue Shield name. That same year, Blue Cross was endorsed by the American Hospital Association. Already in existence for ten years, Blue Cross had begun as a hospital insurance plan for Dallas school teachers that allowed them to pay for up to three weeks of hospital care with low monthly payments.
After this, organized mainstream medicine waged an intense war on non-Blue plans. Goodman (1980) contends that some physicians lost hospital privileges and even their licenses for accepting non-Blue plans. The Blues also gained government-supplied advantages not available to non-Blue plans. In many states, they paid no or low premium taxes and sometimes no real-estate taxes. They also weren't required to maintain minimum benefit/premium ratios and could have no or low required reserves. With government advantages, the Blues steadily came to dominate the industry. By 1950, Blue Cross held 49 percent of the hospital insurance market, while Blue Shield held 52 percent of the market for standard medical insurance. They merged in 1982 and today cover one of every three Americans.
Blues-created "insurance" was anything but true insurance.
Hospitals were paid on a cost-plus basis. Insurers paid not a sum of prices charged to patients for services but artificial "costs" that bore no necessary relationship to the prices of services performed.
Insurance of routine procedures. This converted insurance to prepaid consumption that encouraged overuse of services.
Insurance premiums based on "community rating." The word "community" meant that every person in a specific geographic area regardless of age, habits, occupation, race, or sex was charged the same premium. For example, the average 60-year-old incurs four times the medical expense of the average 25-year-old, but under community rating both pay the same premium (i.e., young people are overcharged and the elderly undercharged).
A "pay-as-you-go" system. Unlike genuine catastrophic hospital insurance that placed premiums in growing reserves to pay claims, the new Blues' "insurance" collected premiums that only covered expected costs over the following year. If a large group of policyholders became ill over several years, the premiums of all policyholders had to be raised to cover the increase in costs.
These traits spell cost-explosion disaster, so naturally they were incorporated into the federal government's Medicare and Medicaid programs when they were created in the mid-1960s to address the problem of healthcare being unaffordable for the poor and elderly a problem the state and federal governments created!
This only leaves the mystery of how health insurance became attached to employment. The answer is found two decades before Medicare and Medicaid. Wage and price controls the federal government enacted during World War II prevented large employers from competing for labor based on wage rates, so they competed based on the quality of benefits. The most effective benefit for luring labor to large employers was generous health-insurance policies.
The decision by the federal government to allow large-employer benefits to be obtained tax-free while effectively taxing plans purchased by small businesses and the self-employed created a system where medical insurance became not only perversely tied to the size of a worker's employer but to employment itself. The price of health insurance for many self-employed workers and small businesses became unaffordable.
Health Maintenance Organizations (HMOs)
Health Maintenance Organizations (HMOs) were prepaid practices that began mainly on the US West Coast in the early 1900s. Western Clinic in Tacoma (1910) and Ross-Loos in Los Angeles (1929) were among the earliest. (Ross-Loos eventually became part of Insurance Company of North America [INA], which merged into CIGNA in 1982.) Kaiser Permanente began with a clientele of shipyard workers during World War II. After the war, it had hospitals and physicians, but no more worker clientele, so it started marketing to the wider public and by the 1970s had more than 3 million enrollees in five states.
Still, HMOs had limited appeal. By 1970, Kaiser was the only major HMO in the United States, with most of its enrollees forced to join through their labor unions.
Much more about HMOs will be covered in a forthcoming review in the Quarterly Journal of Austrian Economics. The purpose here is to emphasize that, despite some assertions to the contrary, HMOs are anything but free-market firms. The Health Maintenance Organization Act of 1973 made federal grants and loans available to HMOs, removed certain state restrictions if HMOs became federally certified, and required employers with 25 or more employees who offered standard health-insurance benefits to offer federally approved HMO plans.
"Obamacare," or More Accurately, ConservativeRepublicanCare
When you actually look at the bill itself, it incorporates all sorts of Republican ideas a lot of the ideas in terms of the exchange, just being able to pool and improve the purchasing power of individuals in the insurance market, originated from the Heritage Foundation. (Barack Obama, NBC's Today Show, March 30, 2010)
The latest chapter in US healthcare is one of the most surreal. The Patient Protection and Affordable Care Act of 2010 was signed into law by Barack Obama on March 23, 2010. Among many provisions, the act includes expanded Medicaid eligibility, prohibiting denials of coverage for preexisting conditions, and a requirement to purchase federally approved health insurance or pay a fine.
While the content of the Act is summarized in myriad places, much more interesting is its conservative Republican origins. The Heritage Foundation's Stuart Butler, the intellectual behind urban enterprise zones, in Senate testimony in 2003 proposed a plan for universal healthcare coverage. Here's one surprising portion of the testimony that sounds like it was uttered by a European socialist:
In a civilized and rich country like the United States, it is reasonable for society to accept an obligation to ensure that all residents have affordable access to at least basic health care much as we accept the same obligation to assure a reasonable level of housing, education and nutrition.
Keep in mind that Butler is the conservative Heritage's current vice president of domestic and economic policy. No wonder Butler seems to have found a new admirer in New York Times columnist Paul Krugman. Butler again:
The obligations on individuals does not have to be a "hard" mandate, in the sense that failure to obtain coverage would be illegal. It could be a "soft" mandate, meaning that failure to obtain coverage could result in the loss of tax benefits and other government entitlements. In addition, if federal tax benefits or other assistance accompanied the requirement, states and localities could receive the value of the assistance forgone by the person failing to obtain coverage, in order to compensate providers who deliver services to the uninsured family.
Now "Obamacare" is certainly more than just a mandate, but the mandate is certainly what has conservatives such as Rush Limbaugh and Sean Hannity, both of whom have connections to, if not sponsorship by, the Heritage Foundation, screaming bloody murder the most. There's no doubt that these ideas influenced Mitt Romney's healthcare plan in Massachusetts.
Romney subjected himself to a recent interview by Fox News' Bill O'Reilly that can only be described as a disaster. O'Reilly dwelled on the fact that outside tax dollars funded half of the plan, and Romney agreed, adding that the funding was approved by two conservative Republican HHS secretaries, Tommy Thompson and Mike Leavitt. In response to a question, Romney admitted that he didn't know that emergency-room costs in Massachusetts had increased 17% over the last two years. He repeatedly asserted that the plan solved a problem, but he couldn't specify what it was since Massachusetts had the highest per capita costs both before the plan and after.
As far as other conservative Republicans go, former Arkansas governor Mike Huckabee has repeatedly stated that he sees "some good things" in Obamacare, especially the expanded use of Medicaid.
Voters naοve enough to think they will get a complete repeal from the Republican Party appear to be in for a major disappointment. "Obamacare," with its continuance of socialized costs for private gains in American medicine, was the treatment that the conservative Republican doctor had in mind for some time. The problem is that the Democrats were the first to implement it.
|January 17th, 2011||#108|
Join Date: Oct 2010
Two words: Drug companies.
These Drug companies have become the biggest organized crime racket in the united states. LEGAL drugs are a bigger crime racket than illegal drugs.
They drug companies bribed congress to passed a 2 trillion dollar drug benefit, 2 trillion dollars of tax money going straight into the drug companies pockets.
60% of media advertising is drug company commercials. They finance our propoganda.
Most of these drugs are just toxic chemicals that have SOME sort of effect on people, which enhances the placebo effect. Even if it's a BAD effect, if there's an effect, people will keep taking it.
Here is the method by which thalidomide was discovered, and implemented. Most drugs have a similiar sorts of originas.
|April 3rd, 2011||#109|
Join Date: Jul 2007
A Medicare problem
By Guthrie "Guff" Worth
To quote from a Washington notice: "Medicare officials say they will likely pay for a prostate cancer drug that expands life for about four months at a cost of $93,000 per patient."
The drug apparently met the criteria of "reasonable and necessary medicine." Medicare is not allowed to consider cost.
I think this is a precursor of many priority decisions that this country is going to have to face as medical care and social security problems develop.
Personally, I cannot conceive of a time when the last four months of one's life is worth an additional drug cost of $93,000 (plus the other costs of care).
I would suspect that an advanced prostate cancer victim at the end of his life would be in such shape that hospice and pain management to make the end easier and the right of self termination would be more appropriate when funding is so limited.
Perhaps when the patient being treated is a researcher who will complete the development of a cancer cure in the last four months of his life the cost is justified, but I suspect that won't happen.
I recognize that this is as much of a question of belief and of the state of mind of the patient as it is one of cost effectiveness, but the nation is going to have to consider some manner of Medicare limits if it is to maintain our present medical lifestyle.
I suspect that age, the present state of health (both mental and physical) and the potential nature and effectiveness of any proposed medical procedure and, of course, cost/benefit analysis. Not easy decisions. And the really nasty question: The recognition that all prospective patients are not equal, and the country will be benefited more by treating some patients than others when funds are limited is going to have to be faced. A lot of "bullets" are going to have to be bitten.
If our government had properly taken steps to tie in funding increases to spending forecasts in the past, we would not have this problem!
|May 24th, 2011||#110|
SMASH THE FASH
Join Date: May 2010
Hans-Herman Hoppe is essentially a neo-feudalist, an oddity even in the pseudo-anarchist school of thought called "anarcho"-capitalism.
|March 25th, 2012||#112|
California Seeks To Repress Self-Insurance
Posted by Michael S. Rozeff on March 23, 2012 11:53 AM
California insurance regulators want to stop the growth of self-insuring health care plans among smaller businesses. Yes, they want to stop this free market growth. Why? Because they want socialized (forced) medicine in which those who are better risks pay for those who are worse risks. Is it any wonder America is in deep trouble, following in the footsteps of the European bureaucratic social welfare states with high unemployment buried under unmanageable debts?
Each of us has a large impact on our own health by our life style choices, and these choices are not insensitive to price. The proponents of socialized medicine do not understand this important reality. They think that Nature deals out low blows to all those in ill health, and they think that everyone has a "right" to medical care. This mythical (nonexistent) "right" they want to be paid for by eradicating one's personal rights to one's own life, one's own liberty and one's own property.
If those who take better care of themselves must subsidize those who take worse care of themselves, the result is that fewer people take better care of themselves (since they are taxed relative to a free market solution) and more people take worse care of themselves (since they are subsidized relative to a free market solution). Socialized medicine produces worse health in the population.
|April 27th, 2012||#113|
Health and Free Trade
by Gary North
Tea Party Economist
"When they tell me I'm terminal, I'll look for a quack." ~ Murray Rothbard
For over 250 years, economists – even before they were called economists – have struggled to solve a problem: how to persuade people that trade really is positive and that restrictions on trade really are negative. This is one more attempt.
Let us assume that your physician informs you that you have cancer. The type of cancer that you have is invariably fatal. He utters those words that estate planning lawyers thrive on: "You should get your affairs in order."
You go home. After thinking about your situation, you go online in search of a solution. You come across an article on a proposed new cure. There is hope. But you find that the cure is experimental. It has not been approved by the Food and Drug Administration. The estimated cost of getting through the FDA's legal hoops is $100 million. It will take seven years.
You do not have seven years.
Do you believe in free trade in proposed cancer cures? Now you do.
What if you could sign a legal waiver taking full responsibility for your actions? What if you are willing to let the discoverer off the hook legally for any negative outcome of the treatment? Sorry, no can do. That would be illegal.
Why would it be illegal?
There is a simple reason: "Because it would reduce the power of the Food and Drug Administration." If every Tom, Dick, and Harry were willing to sign a waiver, then the FDA could not control drugs. This degree of open entry into the health care field would enable producers of health-care to get together with customers to arrange mutually agreeable solutions.
But wouldn't this open the door to quacks? Yes. Wouldn't this open the door to snake-oil salesmen? Yes. Wouldn't this expose the public to scientifically unsubstantiated claims made by profit-seeking charlatans? Yes. Then why should the government allow it? Because this allows the free flow of ideas. By "free flow" I do not mean zero-cost. I mean legally unrestricted, as in "I get to think this. I also get to share my ideas. Someone else gets to think it, too."
"Of course," says the Congress of the United States. "You may think anything you want. Just don't ask anyone to pay you for your idea. To get paid for your idea, you must be licensed by the federal government."
At every level of civil government, there are politicians who pass laws and legally tenured bureaucrats to enforce them. One purpose of these laws is to restrict the free flow of ideas. Another is to create monopolies for large corporations with teams of lawyers. These firms have the money to get through the hoops established by the bureaucrats.
Some of the senior bureaucrats then retire with full pension benefits and go to work for the corporations that are the beneficiaries of the regulations written and enforced by the bureaucracy.
This is normal. We know it's normal. We are told that this is the price the public must pay to secure safety.
Safety from what? Safety from the free flow of ideas.
Cancer cells do not have a lobby in Washington. They do not need one. But if they did have one, why would it promote laws different from what we now have?
I have presented here the basic case of free trade in ideas, which includes the implementation of these ideas in the form of products.
Am I speaking hypothetically? No. I am speaking from personal experience.
THE "BLACK BOX" (WHICH WAS GRAY)
My wife in 1987 began to suffer from an ailment. It had many names: Epstein-Barr, chronic fatigue syndrome (cfs), fibromyalgia. Whatever the name, it was widely dismissed by physicians as merely psychological. "It's all in your head." This is a code phrase for "You are desperately sick, but I have no clue as to why. Because we physicians can't define whatever it is that you have, your insurance company does not insure it. Please pay by credit card or check before you leave."
A 1987 book by a pair of husband and wife sufferers was titled Waiting to Live. It was a depressing book. My wife had many of the symptoms it described. She was in constant pain: headaches. She was constantly exhausted. She sometimes slept 16 hours a day. She could not recall anything she had just read. Driving over 15 miles an hour seemed like speeding to her. There was no relief.
I heard of a man who had a machine that seemed to cure people of numerous diseases. Her disease was one of them. He had a clinic. Officially, it was a pain clinic. Unofficially, it was a miracle clinic. As a pain clinic, it was legal. The way it reduced pain was to cure the diseases that caused the pain.
In the summer of 1988, I sent her to this clinic in California. She took three treatments, each lasting 8 hours a day. The symptoms disappeared at the end of the third treatment. They have never returned.
The man who invented the machine told me that this was the most rapid recovery from chronic fatigue syndrome that he had ever seen.
Another patient was the actor James Coburn. He had lost his career as a movie action hero. As he told me when I interviewed him, it is hard to be an action hero when it hurts too much to comb your hair. If you look at his hands when he deals cards in Maverick, you will see what he had faced. His fingers remained gnarled, but he could deal the cards.
In 1991, the U.S. government impounded the machines temporarily in his new clinic in Nevada. My wife then loaned him $10,000 to hire a lawyer. (She never got her money back.) But the Feds made a very big mistake. The impoundment order lapsed on day 30. The government's agents showed up at the clinic on day 31 to remove the machines, only to find an empty clinic. The machines wound up in England. (They are no longer in England.) I have written about all this before.
The government is hostile to any arrangement based on money transfers between a caregiver and a sufferer.
The medical establishment is equally hostile. Its above-market income has been based on government restrictions on entry by non-licensed practitioners. This 100-year arrangement is about to backfire. The government has lured the doctors into the trap. Now it is about to spring it.
Every year, the Medicare bureaucracy cuts payments to physicians and hospitals. Every year, Congress delays the implementation of these new regulations. Sometime, possibly on January 1, 2013, the new regulations will go into operation. Having made the medical establishment dependent on government regulations and Medicare money, the government will slowly take the medical establishment off life-support: government money. "Gotcha!"
I saw this coming in 1978. Now it's almost here.
ACROSS THE BORDER
Let us assume that you want to get that experimental treatment, despite the fact that the Food and Drug Administration has not yet authorized its sale to the American public. You continue to research the matter.
Lo and behold, a clinic in Mexico is offering it. So, you call the clinic and schedule an appointment. You fly there and get the treatment.
Let us say that it works. You go to your oncologist. He gives you a clean bill of health. He says it is a case of spontaneous remission. What is spontaneous remission? It's just one of those things, just one of those crazy things.
You have a choice. You can say nothing. This is the safest course of inaction. You can say you got treated in Mexico. He will think "quack." He will still attribute it to spontaneous remission. Or maybe he will decide to invest part of his pension money in the Mexican firm that produces the product. It's hard to say what he will do.
Let's go the whole nine yards. What if it's a pill? You can administer treatment yourself. Anyone can.
What if someone could buy the pills online? They would be shipped by Federal Express to his door.
What if the Food and Drug Administration finds out?
It can take remedial action. It can impose heavy penalties on anyone who buys the pills. Or maybe the FDA can say that the supplier is a Mexican drug lord. Any FedEx packages from the address will therefore be confiscated.
By whom? How? Where? How will the FDA enforce this restriction?
Can the FDA impose sanctions on the seller? No. Can it somehow block the money transfer? Maybe, but at what cost? Can it follow the money when the seller shifts banks?
The FDA could then contact some international regulatory agency. It could go to the World Health Organization, the source of the Codex Almentarius. This code regulates the sale of health supplements across borders. But these agencies cannot enforce anything that respective nations refuse to enforce. They have no meaningful sanctions of their own.
As the cost of communication falls due to the World Wide Web, the ability of the U.S. government to control the flow of information is collapsing.
As the cost of package delivery across borders falls, the U.S. government finds it increasingly expensive to stop the flow of goods. At some price, it can reduce the flow of products, but this price keeps rising.
Why is the price rising? Because of increased trade. The more goods that cross borders, by way of Federal Express and UPS, the more costly it is for the government to identify and intercept a single package. The haystack keeps growing. It gets easier to conceal the delivery of individual needles.
The gatekeepers cannot control the flow of ideas, goods, and digital money. The gatekeepers stand at the gates, but the walls have collapsed, like Jericho's walls.
The wife of an old friend of mine suffers from a lot of pain. He has a friend who occasionally would drive to Mexico. The person would buy the pills, bring them back, and send them to him by mail. This is no longer necessary. They buy the pills online. Bottles are delivered to their door.
Meanwhile, if you cross the Alabama border and buy a bottle of Sudafed, you can go to prison for eight years.
Here, we see political insanity in action. The idea that legislation securing a border can somehow protect people from charlatans is itself one of the most important ideas in the history of charlatanism. Politicians are the charlatans. When it comes to snake oil, can any private manufacturer rival the U.S. Congress?
DIAGNOSTICS AT WAL-MART
A computer program available to veterinarians allows them to diagnose the health of animals by doing a simple blood test. The program costs $1,000. It probably costs a lot less from some "pirate" site in China.
It is illegal for the vet to run a test on anyone in his family.
Let me write some science fiction. In a decade, you will be able to walk into a clinic at Wal-Mart and get the test for (say) $50. A licensed para-nurse will administer the test. She will make $20 an hour. This will take at most 10 minutes, most of which will be devoted to filling out a form. The digital data will be sent to a specialized diagnostic firm in India. There, a licensed physician will look at the program's analysis and offer his assessment. This will be sent to your email address.
Obviously, this is implausible. With the Federal Reserve running things, it will cost more than $50.
What is to prevent this, other than the AMA, the FDA, the FTC, the FBI, the CIA, or whatever agency or agencies assert primary jurisdiction? Take the government out of the picture, and what do we get? Better health. Cheaper health. Innovative health.
If we are talking about digits, things get cheap, fast. Things also get fast, cheap.
Why would this be bad for consumers? It wouldn't. Why would this be bad for American physicians' incomes? I don't have enough time to list the ways. I can say this: the number of medical school applications will fall. Anyway, applications to American medical schools. Tuition rates will fall due to a hundred online medical schools training people in digital medicine. Most of these schools will be located outside the USA in a room with a computer. The faculty will be all over the world.
Medical care is about to receive a shot in the arm. It will be driven by price competition. It will be available to people in clinics that will serve people too poor to buy medical care today.
Will there be quacks? Of course. Will there be genius innovators – the equivalent of Salman Khan and his Khan Academy? Of course.
Will there be concierge doctors for the rich? Yes. The price will fall, as today's licensed physicians get out of Medicare delivery and start serving only non-Medicare patients.
Will there be better living through chemistry? Count on it.
Will there be long waits in local doctors' offices – doctors who still serve Medicare patients? Yes.
Will thousands of physicians cease to take new patients because too many new patients will be on Medicare? Yes.
Start making plans to shift to the medicine of the future. It will be cross-border medicine. That is where the savings will be. That is where the innovation will be. That is where the FDA won't be.
April 28, 2012
Gary North [send him mail] is the author of Mises on Money. Visit http://www.garynorth.com. He is also the author of a free 20-volume series, An Economic Commentary on the Bible.
|May 12th, 2012||#114|
[Health care is expensive because of government involvement brought about by the socialists called progressives. The right way to go is leave decisions to individuals. Let them make such arrangements as they see fit. That really is all it takes. Coerced integration doesn't work any better in health care than in general social life.]
We should remember that the emphasis upon credentialing has not arisen because of issues of quality control or continuing trends toward more incompetence, but rather has come about through the legacy of the Progressive Era. During that time, Progressives believed that in order to create more "respectability" for various lines of work, having government set lofty requirements through licensing would mean that practitioners of the profession would be able to be trusted and competent.
Nowhere is this more apparent than in medical care, and much of the current emphasis upon using the state as a quality control device originated with the 1910 Flexner Report. Murray N. Rothbard wrote:
…the roots of the current medical crisis go back much further than the 1950s and medical insurance. Government intervention into medicine began much earlier, with a watershed in 1910 when the much celebrated Flexner Report changed the face of American medicine.
Abraham Flexner, an unemployed former owner of a prep school in Kentucky, and sporting neither a medical degree nor any other advanced degree, was commissioned by the Carnegie Foundation to write a study of American medical education. Flexner's only qualification for this job was to be the brother of the powerful Dr. Simon Flexner, indeed a physician and head of the Rockefeller Institute for Medical Research. Flexner's report was virtually written in advance by high officials of the American Medical Association, and its advice was quickly taken by every state in the Union.
The result: every medical school and hospital was subjected to licensing by the state, which would turn the power to appoint licensing boards over to the state AMA. The state was supposed to, and did, put out of business all medical schools that were proprietary and profit-making, that admitted blacks and women, and that did not specialize in orthodox, "allopathic" medicine: particu larly homeopaths, who were then a substantial part of the medical profession, and a respectable alternative to orthodox allopathy.
Thus through the Flexner Report, the AMA was able to use government to cartelize the medical profession: to push the supply curve drastically to the left (literally half the medical schools in the country were put out of business by post-Flexner state governments), and thereby to raise medical and hospital prices and doctors' incomes.
In all cases of cartels, the producers are able to replace consumers in their seats of power, and accordingly the medical establishment was now able to put competing therapies (e.g., homeopathy) out of business; to remove disliked competing groups from the supply of physicians (blacks, women, Jews); and to replace proprietary medical schools financed by student fees with university-based schools run by the faculty, and subsidized by foundations and wealthy donors.
[once who can treat people is removed from individual choice to state control it becomes a matter of politics, and those can change over time. today it's the white men who are discriminated against in medical school. the right way, again, is to get rid of the licensing and regulation and let free white men make such decisions for themselves.]
When managers such as trustees take over from owners financed by customers (students of patients), the managers become governed by the perks they can achieve rather than by service of consumers.
[this is why a doctor's appointment is like an appointment with the king. it's not at all like he's serving you, it's like he is granting you the privilege of an audience]
Hence: a skewing of the entire medical profession away from patient care to toward high-tech, high-capital investment in rare and glamorous diseases, which rebound far more to the prestige of the hospital and its medical staff than it is actually useful for the patient-consumers.
As Dale Steinreich noted, the "reforms" put into place post-Flexner severely limited individual access to medical care while at the same time enriching physicians. Not surprisingly, medical schools were able to charge higher tuition (with for-profit medical schools being legislated out of business) with the end result being that today medical schools essentially "capture" the economic profits of individual physicians, as most come out of med school carrying hundreds of thousands of dollars of debt.
Furthermore, doctors and their state-enforcement bureaus will protect their territory at all costs, even if that protection harms people who need medical care. One example was the prosecution of Jesse Maloney, the wife of a mine worker in eastern California and a licensed practical nurse. The area where the Maloneys lived was very remote and the one doctor under whose supervision she worked only came to the various towns sporadically, as he had to travel by his own private, single-engine plane.
Maloney was the person called when there were medical emergencies and she ran the doctor’s office, and at times gave "prescription" medicine to people who needed care. The people of her town thought her to be a godsend, but California authorities had her arrested and put on trial. A jury acquitted her, much to the delight of people in her community. (I suspect that today, a jury would convict because prosecutors and judges would order them to do so and everyone knows that government regulations always result in higher quality. The affair was made into a movie starring Lee Remick. Not surprisingly, the highly-Progressive Los Angeles Times, which rarely meets a government regulatory edict with disapproval, didn’t like the movie.)
Unfortunately, occupational licensing and state-ordered credentialing are not limited to medical care. Progressives long have dreamed of "professionalizing" nearly everything, which means that in order to find work that is legal, people need to impose all sorts of costs of education upon themselves.
Even the vast coercive power of Progressives, however, cannot overturn laws of economics, and even with all of the education requirements needed for modern employment, an economy in depression cannot employ people whose skills are not needed by consumers. Thus, Krugman and others of his ideological stripe have a plan: have governments "create" new positions within the bureaucracies and pay for these jobs with newly-borrowed or printed money.
At the same time, Krugman demands that taxpayers pony up to pay even for tuition for students while simultaneously funneling more tax dollars to colleges and universities. Why? Well, college costs are increasing and Krugman and others believe it is unfair that given the stratification of our economy due to various state edicts, more students cannot go to college.
[basically our enemy is, through socialist regulation, forcing people into its controlled and hugely expensive 'education' system in order to get credentials that guarantee nothing except gigantic student debt. good for ZOG, bad for Whites. regulation does not guarantee quality. regulation does not guarantee safety. but because people are stupid, they buy the lies that it does. it's very similar to dopes believing that a science fiction character called jesus can provide salvation and eternal life.]
If one finds a disconnect in the "logic," that is because there is a huge disconnect. As in medical care, third-party payments along with increased federal regulation placed upon colleges and universities have driven up costs, so Krugman essentially is claiming that the "solution" to putting out the fire is throwing more gasoline on it.
Moreover, when a highly-decorated economists believes that creating more "jobs" in the bureaucracy via the "magic" of inflation somehow is good for the economy, it tells us just how out-of-touch with reality mainstream economics has become. The U.S. economy does not need more bureaucrats; it needs fewer bureaucrats and more entrepreneurs seeking economic profits.
Instead of creating opportunity, Progressives through their forcing people to gain education that they don’t need have created a stratified society that destroys opportunity after opportunity. Such policies lay burdens upon people that are reflected in the huge post-education debts that have risen to the trillion-dollar mark.
Not only is this madness, but it is unsustainable madness at that. In the name of creating economic opportunities, Progressives like Krugman destroy the very thing they claim to be saving: our economy.
May 12, 2012
William L. Anderson, Ph.D. [send him mail], teaches economics at Frostburg State University in Maryland, and is an adjunct scholar of the Ludwig von Mises Institute. He also is a consultant with American Economic Services. Visit his blog.
Last edited by Alex Linder; May 12th, 2012 at 09:55 AM.
|May 24th, 2012||#115|
Millions in Equipment Missing From Indian Health Service
The numbers and details are staggering: Over the course of four fiscal years, at least 5,000 pieces of property, including computers, all-terrain vehicles, and digital cameras worth about $15.8 million, were lost or stolen from the Indian Health Service (IHS), a division of the Department of Health and Human Services (HHS). Following a whistleblower’s tip in June 2007, Government Accountability Office (GAO) investigators began looking into the IHS, which is meant to provide personal and public health services to American Indians. They found a division plagued by a “weak internal control environment,” which demanded little accountability for property and held little regard for protecting personal data. Some of the electronics that went missing were used to store personal information. For instance, a computer containing a database of uranium miners’ names, along with their Social Security numbers and medical histories, was carried out of an IHS hospital in New Mexico. Though IHS attempted to contact the miners, the agency didn’t issue a press release. And throughout the course of the investigation, “IHS made a concerted effort to obstruct our work,” GAO investigators reported, including lying to investigators claiming that IHS had recovered about 800 of the items reported missing. In addition to the waste of taxpayer money, the loss and theft of property denied the recipients access to critical items, like Jaws of Life equipment that can save lives after automobile and other accidents, Jacqueline L. Pata, the executive director of the National Congress of American Indians, told The Washington Post. An IHS spokesman refused to comment beyond reactions the agency provided to the GAO, which are documented in the report.
The GAO released its report documenting rampant IHS mismanagement in July 2008. The GAO made 10 recommendations to IHS, including investigating “circumstances surrounding missing or stolen property, instead of writing off losses without holding anyone accountable.” HHS disagreed with the recommendation to track all sensitive equipment that went missing, even if it falls under a certain value threshold or contained sensitive information.
|August 4th, 2012||#118|
The Impending Collapse of American Medicine
by Paul Craig Roberts
Just as is every issue in the US, Obamacare and the wider question of the state of American health care are obscured by propaganda and disinformation. In the article below, Dr. Robert S. Dobson looks back on a lifetime of medical practice and provides facts and insights that might help us to understand our situation.
The US medical system is the most expensive on earth without being the best and without providing full coverage. One-sixth of the American population has no medical coverage.
There are two main reasons that US medicine is so expensive. One is that profits are piled upon profits. In addition to wages and salaries for doctors, nurses, and medical personnel, the American health care system has to provide profits for private hospitals, diagnostic centers, insurance companies, and for the accountants, attorneys and management consultants made necessary by the enormous litigation and regulatory compliance cost. American medicine is the most regulated in the world and the most criminalized.
What “Obamacare” does is to divert Medicare and Medicaid monies to the profits of private insurance companies. Instead of providing medical care to those in need, the taxpayers’ money will provide bonuses for insurance executives and profits for their shareholders. It is the height of folly for Obama worshipers to defend a law written by the private insurance companies that uses public revenues to provide insurers with 50 million more customers and to add yet another layer of profits to the cost of American medicine.
Reflections on a Medical Career
Robert S. Dotson, M.D.
All lovely things will have an ending, All lovely things will fade and die; And youth, that’s now so bravely spending, Will beg a penny by and by.
~ Conrad Aiken (“Disenchantment IV” – 1916)
Thirty years have passed since a much younger physician opened his ophthalmology practice in East Tennessee. A lifetime of hopes and expectations, intermingled with the usual collection of fears and uncertainties, has sped past at blinding speed. Children came, grew up, and moved on to their own lives. Parents and grandparents, aunts and uncles, many friends and colleagues have returned to dust in advance of their fading photos.
Patients and their parents and children and grandchildren have moved in and out of this world, too, inextricably woven into the fabric of my life. Sadly, a few may have been hurt by lapses in judgment or the arrogance of youthful physician pride and overconfidence. But, at the end of the day, most were helped. I was fortunate to be recognized as a “doctor’s doctor” early on and, though there was no attendant reward other than the respect of peers, that was a sufficiently gratifying laurel to carry.
As in any human story, joy and pain, love and sorrow, have marked these same years. The Millstone of Time has also worn away foolish aspirations and vainglorious pretensions. There is no one left to impress, no accolades to seek, no rank to which to aspire. Consequently, I feel freed to offer some end-of-life reflections on my profession and career.
Any thinking American knows that there is something terribly wrong with the health care system in this country. Throughout my career, the political ruling elite has been enacting piecemeal a version of “universal” healthcare coverage to satisfy the demands of an increasingly vocal, but also increasingly disenfranchised citizenry. Our overlords, of course, have been more motivated by enhancing corporate bottom lines and enriching themselves, than in genuinely helping the peasantry.
Every U.S. President since Kennedy in 1962 has dealt with the issue in one way or another – by policy statement or passage of legislation. LBJ oversaw the creation of Medicare and Medicaid in 1965. Nixon oversaw the passage of the HMO Act (Health Maintenance Organization) in 1973 and ERISA (Employee Retirement Income Security Act) in 1974. Amazingly, he also introduced CHIA (Comprehensive Health Insurance Act) in 1974. Even more incredible was the spectacle of Ted Kennedy working to ensure its defeat. Doubtless, Kennedy regretted that in future years. Following the untimely departure of the 37th President, Gerald Ford signed ERISA into law in 1974 on his behalf, thereby introducing some minimal regulations to ensure that separated employees could maintain benefits, such as health insurance, for a limited time.
Carter campaigned in favor of National Health Insurance, but failed to pass anything similar during his time in office. He cited Kennedy’s opposition to CHIA and to his own proposals as the main reason for failure. Reagan’s era witnessed the passage of EMTALA (Emergency Medical Treatment and Active Labor Act) and COBRA (Consolidated Omnibus Budget Reconciliation Act) in 1986 that, among other things, provided for emergency medical treatment coverage for anyone who could drag themselves into an emergency room (of course, such a visit might bankrupt them unless they were lucky enough to be an illegal alien). Medical labs and imaging centers (and, the providers staffing them) were given “special attention” under CLIA (1988).
The first President Bush had little time for national health care issues, as he was primarily focused on launching the NWO. Poppy’s “Thousand Points of Light” degenerated into in-coming tracers from the illuminated Angel of Death – simply more “peace, freedom and liberty” being delivered to millions of innocents across Battlefield Earth. It seems so trivial now, but Bush was unseated after reneging on his pledge of “no new taxes,” not for offshoring the US economy or taking the first step toward turning US foreign policy into the pursuit of world hegemony.
The Clinton administration tried to force through “Hillarycare” in 1993, but met with stiff opposition from their Republican opponents (of course, the opposition was due to perceived threats to corporate profit margins). Nonetheless, Team Clinton was able to push through HIPAA (1996) (Health Insurance Portability and Accountability Act) and SCHIP (1997) (State Children’s Health Insurance Program) which, contrary to the titles of the acts, neither improved health insurance portability or accountability nor improved the health of children.
The Clinton White House had more important fish to fry: war in the Balkans; the liberal distribution of depleted uranium and cruise missiles across the globe; test wars on Americans at places like Ruby Ridge, Waco, and Oklahoma City (OKC); the appearance of numerous “Arkan-cide” victims whose mortal remains seemed to be discovered at the most inconvenient times; and, a semen-stained blue dress. The first versions of the Patriot Act were trotted out in response to the false flag event of OKC, but Congress and even the Imperial Senate balked at moving so precipitously toward the New Amerikan Security State.
The ascension of son Bush and his neoconservative cabal turned the government to the drive toward world hegemony. The serendipitous events of 9/11 opened the door for passage of the neocon’s PATRIOT Act and for the still on-going implementation of their Project for the New American Century (PNAC). New alphabet agencies like DHS and TSA were created to augment existing departments and agencies (FDA, DHHS, IRS, FTC, FCC, EPA, FEMA, DEA, BATF, FBI, NSA, CIA, and DOD) charged with dominating the nation and the planet beyond. Orwell’s dystopia, 1984, became reality: “War is Peace. Freedom is Slavery, Ignorance is Strength.” President Bush modeled Big Brother’s third slogan for an admiring populace more concerned with Harry Potter and Janet Jackson’s nipple than with the deadly machinations of the psychopath in charge.
It seems likely that steps toward the Third World War were taken during Bush II’s reign with “war, war, WAR” being unconstitutionally declared against the nebulous (some might say, non-existent) terrorists lurking under every bed and in every closet, cave, and country on the planet. In spite of a premature proclamation of “Mission Accomplished” from a flag-festooned carrier in 2003 by the Decider-In-Chief, the killings have continued with little pause up to this day. The Great Decider used the opportunity of “victory” abroad, however, to turn his attention to the healthcare needs of his subjects.
What could be a better bone to throw to the peasants than the expansion of pharmaceutical coverage for those under Medicare? And, what could be a better pay-off for corporate buddies than massive new government wealth transfers of taxpayers’ dollars to Big Pharma via such a plan? It was a perfect “win-win” for the oligarchs at the top of the pyramid and a “lose-lose” for the peons at the bottom. To the great joy of Big Pharma, the Medicare Prescription Drug, Improvement and Modernization Act (Medicare, Part D) was launched in 2003 to insure unimaginable profits for its corporate members and more expense for the common people it was alleged to help. As in any casino, our healthcare croupiers are well trained to leave no dollar on the table.
President Obama, a corporate stooge par excellence, was able to ram through “universal healthcare” with the help of a Howdy Doody smile, his corporate sponsors, and the slavish devotion of an ever-delusional, pseudo-Left. It mattered not that the legislation was written by the insurance companies who had been profiting from the misery of patients for decades.
It is no accident – and would be comical, if it were not so serious – that there will be no true, equitable national health care system under the Patient Protection and Affordable Care Act of 2010 (aka, “Romneycare II” or “Obamacare” or, lately, “Robertscare” in homage to a Supreme Court judge) and its accompanying legislation, the Health Care and Education Reconciliation Act. No Single Payer. No mutual insurance system that provides a basic level of healthcare for the proles of this collapsing Security State. Instead, we are witnessing the imposition of a system that will further enslave and impoverish the peasants here in Gulag Amerika. How poetic that a self-identifying “black man” is the front for resurrecting a 21st century version of chattel slavery in the twilight years of Empire.
Obama was positively beaming in his many photo-ops with the sponsoring corporatist representatives of Corporate Medicine, Big Insurance, Big Pharma, and Big Government who enabled the Prince of Change to achieve this milestone deception of America. The very fact that this “wonderful” new system – lauded by supporters as “revolutionary” – is to be enforced by a projected army of 16,500 new IRS agents should give us pause.
Notwithstanding passage of the legislation, decades of bad healthcare policy and corporatist plunder are finally taking their toll. The collapse of the ill-conceived US health care system might be near.
Ever more intrusive regulations are driving up the cost of medical care, and the practice of medicine is being criminalized. Even with all of their flaws, Medicare and Medicaid have provided a safety net for the elderly and disadvantaged since their inception. Those systems’ days are numbered, however, as they are being gutted to turn health care into profits not for doctors and hospitals but for insurance companies and Big Pharma. For starters, large sums have been ear-marked to be taken from Medicare and Medicaid to help fund PPACA (Patient Protection and Affordable Care Act). Is looting Social Security and Medicare “change one can believe in”?
If this system is bad for patients, what does it mean for doctors? It means falling reimbursement rates and rising overhead costs for providers, onerous government mandates and regulations, and institutionalized, legalized larceny by Big Pharma, Big Insurance and Corporate Medicine. As an example of how time and circumstance have affected my own profession of ophthalmology, one need only look at Medicare approved reimbursement rates for cataract surgery.
In reflecting back over my many years in the field of ophthalmology (as of this writing, I am 63 years old and feeling pretty shop-worn), I am staggered by the changes that have occurred. When I opened my practice in 1982, Medicare approved surgical fees for cataract and implant surgery were near $1200. By 2012, that approved charge had dropped to about $570 in Tennessee. (There is some variance within states based on rural versus metro areas and between states where some are declared to have higher costs of doing business.)
Additionally, the US dollar has declined in value an average of almost 2.5% per year over the past 30 year period. Needless to say, overhead operating costs – salary, rent, insurance, personnel costs, taxes, and normal business expenses – have exploded during this same 30 year period. My office rent was raised 20% in the Fall of 2011, for instance.
To further illustrate the absurdity of the situation, it is worth recounting an anecdote. Several years ago, a patient excitedly told me of the vision restoring cataract surgery that her poodle had received at the local veterinary college. It “only cost $2600 for both eyes!” At the time, Medicare was paying about $1400 for two eyes in a human – including work up, surgical fee, post-op care for 90 days, and the very real liability associated with being a physician in a litigious society.
I do not begrudge my animal doctor friends their success, but surely the worth of human care should at least approximate that for a poodle. Although I know veterinarians who are struggling in their own practices due to the economic recession, at least they do not have to deal with government fee-setting and the liability and costs associated with treating humans. They are able to price their services sufficiently to keep their practices open and to provide for their own health care and retirement.
In my own practice, the amount of “write off” on charges for legitimate services rendered began to climb as we entered the 21st Century. For years, the “disallowed” charges by Medicare and private insurers resulted in “discounts” of 20-25%. As the economic upheaval of 2008 rolled around, those fee adjustments (actually theft of labor from providers) began to climb – 30%, 32%, 35%, and in my last year of practice over 60%! For years, I had been able to subsidize my Medicare (cataract) side of the practice by offering elective refractive surgery procedures (LASIK, PRK, etc.) to my patients. As these were private pay cases, they offset the draconian cuts in Medicare and insurance fee “adjustments.” The economic collapse of 2008, however, reduced that income stream for many ophthalmologists and, subsequently, led to the closing of many practices throughout the country.
Most general ophthalmologists are, by definition, primarily cataract surgeons. Many people – including Medicare recipients – do not realize that the fees paid to their physician are fixed by the U.S. Government after consultation with its many corporate sponsors within Big Insurance, Big Pharma, and Corporate Medicine. Patients also do not realize that those reimbursement levels are set by central planners at below-cost levels.
Medicare issues cut across all specialties, and ophthalmology has not been alone in experiencing cutbacks. Primary care physicians have increasingly become “piece good workers” – managed by corporate pencil pushers to see a patient every 6-8 minutes while being forced to carry all the liability and manage all the data and coding previously done by insurers. Who can diagnose, much less treat a patient in 6-8 minutes?
My own solo cardiologist was forced to close his practice last Fall and seek employment with an area hospital, due to declining reimbursement levels. More than 51% of cardiologists in the U.S. are now hospital employees. One of my medical school classmates, a successful internal medicine specialist, has recently given up the fight and has plans to enter some other line of work. Several friends in Radiology have seen their incomes decline as more and more work is “outsourced” to tele-docs in Asia. Still other long-time friends who are general surgeons are struggling to survive (a surgical fee for incisional cholecystectomy, for instance, is now under $400). Several have retired prematurely and others are looking for other work to do. As a final example, another of my friends is one of five physicians in a busy urology practice (2 offices and 26 employees) and they are now borrowing from the bank to make payroll. A recent article from CNN, “Doctors Going Broke,” confirms the growing problem.
As income reductions are being imposed on private practice, costs are being driven up by exploding regulations. In addition, the plethora of new mandates and laws have increasingly criminalized every aspect of the practice of medicine and created vast new armies of armed bureaucrats whose sole aim is to impose civil and criminal penalties on any provider unlucky enough to be singled out for attention. The old Soviet dictum attributed to Lavrenti Beria (Stalin’s NKVD chief), “Show me the man and I’ll find you the crime,” is in full force in Amerika.
The present puppet in the White House has completed the work begun by his predecessors in moving the nation into a police state. The NDAA passed in the Fall of 2011 was the final nail in the coffin of personal freedoms guaranteed by the US Constitution. By suspending habeas corpus and even trial by judge or jury, the Act has made certain that no person is safe from being violated by a power-mad Security State. At the mere movement of the Unitary Executive’s pen, it is now permissible to “disappear” or even execute anyone on the planet – all on the whim of the unaccountable psychopath in charge. Judge Andrew P. Napolitano, has reported that our present Unitary Exec spends every Tuesday morning reviewing and signing off on a kill list supplied by his loyal minions. Nobel Peace Prize worthy stuff, indeed!
One is presumed guilty now in Amerika until proven otherwise and nowhere has this been more demonstrated than in the policing of medicine. Heaven help the poor provider who is targeted by the Medicare Police – or now, one supposes, by the new IRS Medical Special Branch. If targeted, his or her practice will be shut down without due process. His or her assets will be seized without due process (assuring the inability to even defend oneself). Finally, the unlucky guilty-until-proved-innocent physician will be permanently discredited (libeled) in his or her community with the ready help of the Government’s countless propaganda organs – press, radio, and TV – all before any day in court is seen.
New restrictions, rules, and regulations on healthcare – on providers and patients alike – have imposed legal constraints with which full compliance is impossible. Medicare rules and regs alone fill tens of thousands of pages, and ignorance of any of them is no defense for the unlucky. The original HIPAA legislation has been amplified with many additions since its inception in 1996: FERPA, HITECH, ARRA (2009). Each additional act or regulation has further criminalized the practice of medicine.
Finally, the entire health care system is being forced to switch to electronic health records (EHRs) and, soon, to a completely new coding system (from ICD-9 to ICD-10). Failure to comply with these mandates will result in further reductions in provider payments with every year that they remain unimplemented. For a solo physician practice, it is estimated that each mandate will cost as much as $80,000 to implement initially and, then, $10-15,000 annually to maintain. For multi-physician practices, costs run as high as three times (or more) that of a single provider practice. Of course, the purpose behind all of this is to make each person’s most private and personal information available to government bureaucrats and regulators while also ensuring its accessibility to the Security State’s many law enforcement tentacles and to all the corporate members of the Medical-Industrial complex.
Unfettered access to this information will ensure that the Corporate State can maximize its profits, largely avoid all risk and liability, and eliminate any potential competition (such as, often cheaper and more effective alternative medicine providers and therapies, non-GMO whole foods, and nutritional supplements). It will also ensure that medicine is practiced/delivered within strict cookbook guidelines that are carefully written by non-physician bureaucrats to maintain corporate profits and government power. All of this is well along in implementation.
A recent article, “Efforts to implement Obamacare law raise concerns of massive government expansion” from Fox News, 5 July 2012, informs us that lawyers have already “drafted more than 13,000 pages of Obamacare regulations and that this number will increase further over coming months. In addition, we are told that DHHS (Department of Health and Human Services) has been given more than one billion dollars to date in order to begin oversight of this mess and that more than 180 “commissions, boards, and bureaus” within the Agency are already hard at work implementing the final destruction of American medicine.
Widespread vaccination of the population with untested “stabs” will be mandated and enforced. As long predicted by Tin Hatters around the planet, this will permit biometric “nano-chipping” of the citizenry without the unpleasant need to ask their permission.
Vast sums will be committed to “preventive” medicine which will prevent nothing and will only expand the reach of the Medical-Industrial complex into every nook and cranny of a person’s life – and, into every wallet. Certain corporate profit-driven diets and treatment regimens will be mandated and enforced; access to nutritional supplements and alternative medicine practices will be limited or banned altogether; behavior patterns of all types will be monitored and carefully scripted and controlled (what we see, hear, read, do, eat, drink, and breathe – where and how we work, play, and live) under the guise of State Security concerns and its new companion, Public Health or Public Good; and, finally, the Corporate State will deploy “death panels” to decide when a person has outlived his or her economic usefulness to the State. In spite of Obama’s denials that such bodies exist and Palin’s diversionary, hysterical rantings at Tea Party rallies, there is clear provision in the Act for bureaucratic decision-making bodies which will make end-of-life decisions for us all. These entities are already being formed and deployed across the land. Our Anglo cousins in the UK are showing us the way by withholding food and fluids from as many as 29% of their hospital patients now who are judged to be living beyond their government-dictated “use-by” dates (pragmatically justified “to free up beds” – oh, those Brits and their refined sense of humor).
What can be done about the failing American health care system and the wider collapse of the economy and civil liberty? Frankly, very little. The system is rigged against the people as it has always been, only now one can be “black-bagged” and disappeared at any time. Protest too loudly and one is liable to literally see a grim Reaper overhead with one’s personal biometrics programmed into its fire control system. Like every other institution within the United States, the medical system is totally and completely broken. It can no longer be fixed by “voting” for the lesser of evils, by printing bales of fiat currency, or even by deploying fleets of obsolete aircraft carriers across the planet.
If as it seems we are arriving at the end of an age, if we can survive the end, something better might arise from the ashes. The prospect of collapse turns one’s thoughts to escape and survival. Can you do either? Volumes have been written about preparedness in a time of chaos, so I will spare readers a rehash. But, a few comments about healthcare, in particular, might be in order.
In a perfect world, it is my opinion that we should have some form of single payer healthcare system and divorce ourselves from corporate medicine. In my opinion, this will not happen without the complete collapse of the present system. Since that is unlikely to occur before more seasons of national election fraud are imposed on us, a few “in-the-meantime” suggestions follow:
Avoid contact with the existing health care system as far as possible. Yes, emergencies arise that require the help of physicians, but by and large one can learn to care for one’s own minor issues. Though it is flawed, the internet has been an information leveler for the masses and permits each person to be his or her own physician to a large degree. Take advantage of it! Educate yourself about your own body and learn to fuel and maintain it as you would an expensive auto or a pet poodle. One does not need a medical degree to:
1. avoid excessive use of tobacco or alcohol or, for that matter, caffeine;
2. avoid poisons like fluoride, aspartame, high fructose corn syrup, and addictive drugs (legal or illicit);
3. avoid unnecessary and potentially lethal imaging studies (TSA’s radiation pornbooths, excessive mammography, repetitive CT scans – exposure to all significantly increases cancer risk);
4. avoid excessive cell phone use and exposure to other forms of EMR pollution where possible (the NSA is recording everything you say and text anyway);
5. avoid daily fast food use and abuse (remember: pink slime and silicone) ;
6. avoid untested GM foods (do you really want to become “Roundup Ready?”):
7. avoid most vaccinations and pharmaceutical agents promoted by the establishment;
8. avoid risky behaviors (and, we do not need a bunch of Nanny State bureaucrats to define and police these);
9. exercise moderately;
10. get plenty of sleep;
11. drink plenty of good quality water (buy a decent water filter to remove fluoride, chloride, and heavy metals);
12. wear protective gear at work and play where appropriate (helmets, eye-shields, knee and elbow pads, etc.):
13. seek out locally-grown, whole, organic foods and support your local food producers;
14. take appropriate nutritional supplements (multi-vitamins, Vitamin C, Vitamin D3);
15. switch off the TV and the mainstream media it represents;
16. educate yourself while you can;
17. QUESTION AUTHORITY!
Doing these simple, common-sense things will add healthy years to a person’s life and help one avoid most medical encounters during his or her allotted time on earth.
Finally, we have a responsibility to our neighbors and our families. We need to reach out to those around us – talk to them, listen to them – sympathize and empathize. Take time especially to listen to those who are in pain and are suffering and to help them by being humane. If you do this, you will discover that we have more in common with each other than the ruling elite wants us to believe. Governments obtain power and control by taking advantage of divisions along religious, ethnic, class, economic, ideological, and nationalistic lines. We must awaken to this fact if the 99% are to prevail against the 1%.
As for me, I was finally forced to close my practice earlier this year. Nearly two years of consulting with multiple attorneys, accountants, practice management consultants, and bankers, and expending most of my resources in a vain effort to keep operating, were simply not enough. It seemed only poetic that April Fool’s Day 2012 should be chosen for turning out the lights and ringing down the curtain. Patients and employees and suppliers were notified of the end. Many had been with me for my entire career and leaving them was and remains painful. More than nine thousand active charts were transferred to the care of a younger ophthalmologist still trying to stay afloat.
I share the heartache of many physicians forced out of medicine by the high cost of practicing it. As the health system is stripped of medical care in behalf of corporate profits, its exploitative character will become clear to all. In the meantime, don’t give in or give up. Plan for something better on the other side of chaos.
I wanted a perfect ending. Now I’ve learned, the hard way, that some poems don’t rhyme, and some stories don’t have a clear beginning, middle and end. -Gilda Radner
Glossary of Terms:
ARRA American Recovery and Reinvestment Act of 2009
CHIA Comprehensive Health Insurance Act
CIA Central Intelligence Agency
CLIA Clinical Laboratory Improvement Amendments of 1988 – administered by CMS
CMS Centers for Medicare and Medicaid Services
COBRA Consolidated Omnibus Budget Reconciliation Act of 1985
DHHS Department of Health and Human Services
DHS Department of Homeland Security
DOD Department of Defense
EMR Electromagnetic radiation
EMTALA Emergency Medical Treatment and Active Labor Act – part of COBRA1986
EPA Environmental Protection Agency
ERISA Employee Retirement Income Security Act
FEMA Federal Emergency Management Agency
FBI Federal Bureau of Investigation
FDA Food and Drug Administration
FERPA Family Educational Rights and Privacy Act (1974 original legislation)
GM Genetically modified
HCERA Health Care and Education Reconciliation Act of 2010 – supplement to PPACA
HIPAA Health Insurance Portability and Accountability Act
HITECH Health Information Technology for Economic and Clinical Health Act (2009)
HMO Health Maintenance Organization
ICD-10 International Statistical Classification of Diseases and Related Health Problems 10th Revision
IRS Internal Revenue Service
NDAA National Defense Authorization Act
NSA National Security Agency
NWO New World Order
PPACA Patient Protection and Affordable Care Act
SCHIP State Children’s Health Insurance Program
TSA Transportation Security Administration
USAPA Unifying and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism – aka, The Patriot Act
August 4, 2012
Paul Craig Roberts, a former Assistant Secretary of the US Treasury and former associate editor of the Wall Street Journal, has been reporting shocking cases of prosecutorial abuse for two decades. A new edition of his book, The Tyranny of Good Intentions, co-authored with Lawrence Stratton, a documented account of how americans lost the protection of law, has been released by Random House. Visit his website.
|August 8th, 2012||#119|
How 'No Coverage' Means More Care
Posted by Lew Rockwell on August 8, 2012 09:10 AM
Writes G. Keith Smith, MD:
My mother called me this morning to tell me that a 76-year old friend of hers had gone to her doctor to get a B12 shot. She was told her insurance (Medicare) didn’t cover that any more. Her friend was incensed and left without getting the shot.
What are the lessons here? First, my mother’s friend doesn’t understand what incredibly great news this is. She will understand soon enough that the only care available to her might be only those things that Medicare doesn’t cover. Care subject to price controls will be…ok..if you said “scarce” you get a gold star. Care outside of the “system” will be controlled somewhat by market forces, with prices free to adjust and send appropriate scarcity signals to producers who then rationally respond. If my mother’s friend really needs her B12 (as opposed to those patients that obtain this injection simply because it is free or priced below its value) it will be available.
But here’s the rub. She will have to pay for her B12. All of it. So many people are conditioned to follow the “orders” of the third parties, including government payers.
“The pharmacist will only fill 30 days at a time of my medicine because that’s all Medicare will pay for.” I don’t know how many times I have heard that.
“How much would it be for you to pay for a 6-month supply out of your pocket,” I ask?
“Didn’t think about asking.”
Did my mother’s friend have difficulty thinking outside of her usual box or did she not really need the injection? I don’t know. Maybe a little of both.
What has happened to the price of Lasik surgery and plastic surgery over the years? What has happened to the quality? Poor results in this field are simply not tolerated. Too high a price? That surgeon’s waiting room is empty. Why would anyone think that the rest of health care is any different? Indeed, what is it about the medical economics of Lasik surgery and plastic surgery that results in reasonable pricing and great results? Could it be the absence of the distorting influence of third parties? Could it be the market at work? What do you think will happen to the price and availability of B12 shots once “insurance” is no longer part of the picture? What will happen to the demand of the unnecessary B12 shots? What will happen to the incidence of B12 shots reported given that were never given but billed for?
How long will it take for patients to learn to pay for their hernia repair out of their pocket rather than wait years in a line like the Canadians have been trained to do? Will people in the U.S. be intolerant of this treatment? We’ll see.
I always learn something when I talk to my mom.
|August 13th, 2012||#120|
[good example of one problem of socialist medicine: someone other than you decides what treatments you are allowed to get. under a market system, you decide what you want, and pay for it. under socialism, you get whatever the powers that be decide to give you, which can often by nothing]
They've sentenced me to blindness: Army wife loses NHS appeal for eye injections
South Staffordshire PCT have turned down Mrs Thomas' appeal
'I feel all hope is gone. The health chiefs are heartless'
By Claire Bates
13 August 2012
Dawn Thomas: They've reduced my quality of life but don't care
A soldier’s wife says she has been condemned to losing her sight after local health chiefs denied her access to eye injections available elsewhere on the NHS.
Dawn Thomas had hoped that an appeal - backed by a national charity might sway managers to allow her drug that can save her sight from a rare disease.
But South Staffordshire Primary Care Trust confirmed its initial decision to deny the 44-year-old the medication.
The treatment for her rare degenerative eye condition would involve several injections which can cost up to £800 each.
She now fears having to give up her job and driving - and that her family may even be forced to sell its house to fund private treatment.
But wait. I thought under socialism everybody got FREE HEALTHCARE. What's going on here? This woman pays taxes, but gets denied treatment.
Hey, here's an idea: maybe there's no such thing as "free" healthcare. Maybe it's the kind of thing that, you know, like almost everything else, is better left to the individual.
|#1, health, health care, medicine|