My concern is that the US spends entirely too much money on health care. We spend twice as much as any other country on earth, 19% of our GNP. For spending twice as much, the health in the US is no better than any other country. In short we spend twice as much and get less than other countries.
Health care does not create wealth, it consumes it. Health care spending does not produce goods or services than can be sold, exported, or consumed. The US cannot compete against foreign countries when US products bear a 19% markup to pay for the workers health care, and our foreign competitors only pay 10%. Manufacturing is "outsourcing", moving overseas, in order to avoid ruinous US health care costs.
Why is US health care so expensive? Simple. For the majority who have health insurance, it's all paid for. The providers, facing cost increases, merely raise their fees. The patients don't care, they don't have to pay for it, that's what insurance is for. So why not do that extra CAT scan, just to be sure, do that extra doctor's office visit, do some extra blood work, it's all paid for. I remember Uncle Remus, where Brer Rabbit claimed to be making a dollar a minute. My doctor does better. My last yearly office visit cost my insurance company $500 for fifty minutes. That's ten dollars a minute.
If patients had to pay for health care out of pocket, a lot less money would be spent. Insurance is needed to cover the big stuff, because the big stuff can cost more than a house, and few people have that kind of money. But the routine stuff, yearly physicals, children's earaches and sore throats, a few stitches here or there, most of us can handle out of pocket. You used to be able to buy "hospitalization only" policies for $3000 a year, as opposed to "everything is covered" policies that cost $12000 a year. With the $9000 savings you can do a lot of routine stuff. And, since it's your money, you will bargain for fees less than ten dollars a minute. Obamacare outlawed those, all that is legal now is the $12000 covers everything policy.
Competition would bring down the price of health insurance. If insurance companies were allowed to sell policies nationwide, policies would cost less. Up here in the northwoods there are only TWO health insurance companies selling policies. If we could buy our insurance from any company in the US of A, we could find better prices out of state.
Competition would bring down the cost of medines. We ought to be able to buy pills from any decent first world country, like Canada, England, Japan, or pick your favorite. We can't because US drug companies have wined and dined the FDA into forbidding imports, so that they can charge ridiculous prices ($2 a pill) to US patients.
Too bad none of these made the Wall St Journal 's list of "crucial" health care issues.
Tuesday, January 24, 2012
Monday, January 23, 2012
Health Care according to the WSJ
Special six page section in today's Wall St Journal devoted to "six crucial health care issues" with pro and con articles on each one. Somehow the Journal's six crucial issues" are not my crucial issued. The Journal lists:
1. Should everyone be required to have health insurance?
Of course the medics love this one, it would ease their burden of indigent care. Doctor's have to treat all patients, it looks really bad should they pitch someone out on the street 'cause they don't have any money. If everyone is required to buy health insurance, that problem goes away.
2. Should healthy people take cholesterol lowering drugs to prevent heart disease?
Jeeze, you'd think this question should have a solid statistical answer, you know compare life expectancy of people taking cholesterol lowering drugs with those that don't. Apparently this hasn't happened or the Journal was able to find some doctors who don't believe cholesterol lowering drugs actually do much. The drugs are pretty cheap, the one I'm on, Simvastatin, is only $4 a month from Walmart. Lipitor is coming off patent and should get cheap soon.
3. Should we create a medical ID number to tag patient's electronic medical records with?
This is a crucial question? Once your medical records are computerized, hackers will get them and sell them to employers, political enemies, nosy neighbors, the cops, and a whole bunch of people you would rather not see them. A special "unique" ID number won't make much difference.
4. Should doctors use email to communicate with patients?
I think they are trying to say that doctor's could cut back on office visits if they accepted and answered email queries from patients. This is crucial? In actual fact, the doctor is always going to say, "Why don't you come in and we'll have a look".
5. Should drug patents be extended?
That's obvious. The drug companies will say "Yes" and the rest of us will say "No".
6. Can "Accountable Care Organizations" (ACOs) raise quality and reduce costs?
Who knows? But this sounds like Health Maintenance Organizations (HMOs) all over again.
1. Should everyone be required to have health insurance?
Of course the medics love this one, it would ease their burden of indigent care. Doctor's have to treat all patients, it looks really bad should they pitch someone out on the street 'cause they don't have any money. If everyone is required to buy health insurance, that problem goes away.
2. Should healthy people take cholesterol lowering drugs to prevent heart disease?
Jeeze, you'd think this question should have a solid statistical answer, you know compare life expectancy of people taking cholesterol lowering drugs with those that don't. Apparently this hasn't happened or the Journal was able to find some doctors who don't believe cholesterol lowering drugs actually do much. The drugs are pretty cheap, the one I'm on, Simvastatin, is only $4 a month from Walmart. Lipitor is coming off patent and should get cheap soon.
3. Should we create a medical ID number to tag patient's electronic medical records with?
This is a crucial question? Once your medical records are computerized, hackers will get them and sell them to employers, political enemies, nosy neighbors, the cops, and a whole bunch of people you would rather not see them. A special "unique" ID number won't make much difference.
4. Should doctors use email to communicate with patients?
I think they are trying to say that doctor's could cut back on office visits if they accepted and answered email queries from patients. This is crucial? In actual fact, the doctor is always going to say, "Why don't you come in and we'll have a look".
5. Should drug patents be extended?
That's obvious. The drug companies will say "Yes" and the rest of us will say "No".
6. Can "Accountable Care Organizations" (ACOs) raise quality and reduce costs?
Who knows? But this sounds like Health Maintenance Organizations (HMOs) all over again.
Sunday, January 22, 2012
Newt!
Well, Newt came thru like gangbusters and the GOP nomination is still open. And we still haven't killed off Ron Paul or Rick Santorum. But it surely looks like a showdown between Newt and Mitt.
The real question is who has the best chance of beating Obama? Both Newt and Mitt have some baggage that doesn't help. Newt has a long history of supporting and defending damn near everything under the sun. So does Mitt. Newt has two exwives and two ugly divorces. Mitt is a rich man who pays capital gains rates.
In my estimation Mitt should have handled the Bain Capital attacks. He had his supporters, Chris Christy and the Wall St Journal step up with solid defenses, but Mitt said nothing. Mitt should have said "At Bain I invested money into [list of winner companies]. Those companies are doing well today and employ [pick a good defensible number] people, who would be on unemployment today except for my investments in their companies. "
Mitt never came forward with a tax overhaul plan. 9-9-9 might not be fiscally possible but it was clear and simple and we voters had no trouble figuring out what it would mean to us. I have no idea what a Romney administration would mean to my taxes. Mitt has learned the lesson of the media too well, don't say anything at all because whatever you say gains you enemies, never friends. He has been very adroit at coming out four square for motherhood and apple pie and never saying anything of substance. We voters notice. Particularly from a man who has stood on both sides of abortion, single payer health care, gun control, tax hikes, and many other things. If you look at Mitt's record, you can't tell where he is coming from, and waffling on the debate platform doesn't help him.
Gingrich sounds very good on the debate stage, and we love to hear him raking newsies over the coals. He figures the newsies will never give him any decent coverage so why not let 'em have it, right between the eyes? It's a good show, and there are enough obnoxious newsies out there to furnish a target rich environment right up to November. Gingrich sounds feisty and we voters want someone to go to Washington, take names and kick ass. Gingrich puts on a good show, although a thoughtful voter might think that trashing Congressmen the way he did poor Juan Williams could be counterproductive.
But, who can win against Obama? Up til last night, I would have said "Mitt". Now I am not so sure. I want a candidate who can win because four more years of Obama will wreck the country, even worse than it is now. I am not yet convinced that Newt is electable. And we have endless primaries yet to go.
The real question is who has the best chance of beating Obama? Both Newt and Mitt have some baggage that doesn't help. Newt has a long history of supporting and defending damn near everything under the sun. So does Mitt. Newt has two exwives and two ugly divorces. Mitt is a rich man who pays capital gains rates.
In my estimation Mitt should have handled the Bain Capital attacks. He had his supporters, Chris Christy and the Wall St Journal step up with solid defenses, but Mitt said nothing. Mitt should have said "At Bain I invested money into [list of winner companies]. Those companies are doing well today and employ [pick a good defensible number] people, who would be on unemployment today except for my investments in their companies. "
Mitt never came forward with a tax overhaul plan. 9-9-9 might not be fiscally possible but it was clear and simple and we voters had no trouble figuring out what it would mean to us. I have no idea what a Romney administration would mean to my taxes. Mitt has learned the lesson of the media too well, don't say anything at all because whatever you say gains you enemies, never friends. He has been very adroit at coming out four square for motherhood and apple pie and never saying anything of substance. We voters notice. Particularly from a man who has stood on both sides of abortion, single payer health care, gun control, tax hikes, and many other things. If you look at Mitt's record, you can't tell where he is coming from, and waffling on the debate platform doesn't help him.
Gingrich sounds very good on the debate stage, and we love to hear him raking newsies over the coals. He figures the newsies will never give him any decent coverage so why not let 'em have it, right between the eyes? It's a good show, and there are enough obnoxious newsies out there to furnish a target rich environment right up to November. Gingrich sounds feisty and we voters want someone to go to Washington, take names and kick ass. Gingrich puts on a good show, although a thoughtful voter might think that trashing Congressmen the way he did poor Juan Williams could be counterproductive.
But, who can win against Obama? Up til last night, I would have said "Mitt". Now I am not so sure. I want a candidate who can win because four more years of Obama will wreck the country, even worse than it is now. I am not yet convinced that Newt is electable. And we have endless primaries yet to go.
Saturday, January 21, 2012
Mitt's tax return
Actually, we don't need Mitt's tax return. When he said he paid only 15% he did himself a lot of damage. And I'm sure Mitt has that right. He makes his money by selling stock or cashing in stock options, rather than taking a salary. And selling stock is perfectly legitimate capital gains. I ought to know, I spent plenty of time in the past figuring capital gains on my stock sales. A guy like Mitt shouldn't be paying more than capital gains rate (15%) unless his tax accountant is brain dead.
Mitt would have done better to just release his tax returns without comment. Few newsies are intelligent enough to read a form 1040 or schedule D and they might not have noticed that most (perhaps all) of Mitt's income was from capital gains.
A better public debate would be about having capital gains at all. Why not tax money made by playing the stock market the same as money made any other way?
Mitt would have done better to just release his tax returns without comment. Few newsies are intelligent enough to read a form 1040 or schedule D and they might not have noticed that most (perhaps all) of Mitt's income was from capital gains.
A better public debate would be about having capital gains at all. Why not tax money made by playing the stock market the same as money made any other way?
Heard on NPR
"Or perhaps the voters won't accept anything (Newt Gingrich's ex wife trashing him on ABC) from sources that they don't like. "
"Don't like" isn't the issue. "Don't Trust" is the real issue. I was surprised to hear that staid old NPR has finally realised that the MSM has a credibility problem. Dawn over Marblehead.
"Don't like" isn't the issue. "Don't Trust" is the real issue. I was surprised to hear that staid old NPR has finally realised that the MSM has a credibility problem. Dawn over Marblehead.
Friday, January 20, 2012
Looks like SOPA/PIPA is dead
Or at least seriously wounded. We should not allow injured animals to suffer, we need to follow the bloodtrail and finish them off.
Then we could have another go on copyright revision. The last copyright law extended the life of copyright to "life of the author plus seventy years" which is forever for all practical purposes. We ought to set copyright to a flat 17 years. All the serious money that is going to be made is made in the first 17 years. Stretching copyright beyond 17 years is welfare for lawyers, and red tape to overcome for libraries, websites, and people who need one more copy of an out of print work.
If we limited copyright to 17 years, then most music downloading would become legal. I never hear anything but "goldy oldies" on the radio. Few of my children's CD's have any artist that wasn't popular when I was in high school. Most of what is downloaded is older than 17 years, because stuff younger than 17 years mostly sucks.
Then we could look at the Constitution which only empowers Congress "To Promote the progress of Science and the Useful Arts by securing for limited Times to Authors and Inventors exclusive Right to their respective Writings and Discoveries". Not a word about music. Music is not one of the useful arts, it's a fine art. And it certainly isn't a science. In short, the plain language of the Constitution does not allow copyright on music at all.
Losing copyright on music would infuriate the RIAA and the labels, but it wouldn't make much difference to the artists, who mostly survive by doing live gigs for cash. Few of them get much royalties from the labels. In fact the labels have been suffocating the artists, which is why there is so little good new music out there. We would have more good new music if we didn't have the labels.
Then we could have another go on copyright revision. The last copyright law extended the life of copyright to "life of the author plus seventy years" which is forever for all practical purposes. We ought to set copyright to a flat 17 years. All the serious money that is going to be made is made in the first 17 years. Stretching copyright beyond 17 years is welfare for lawyers, and red tape to overcome for libraries, websites, and people who need one more copy of an out of print work.
If we limited copyright to 17 years, then most music downloading would become legal. I never hear anything but "goldy oldies" on the radio. Few of my children's CD's have any artist that wasn't popular when I was in high school. Most of what is downloaded is older than 17 years, because stuff younger than 17 years mostly sucks.
Then we could look at the Constitution which only empowers Congress "To Promote the progress of Science and the Useful Arts by securing for limited Times to Authors and Inventors exclusive Right to their respective Writings and Discoveries". Not a word about music. Music is not one of the useful arts, it's a fine art. And it certainly isn't a science. In short, the plain language of the Constitution does not allow copyright on music at all.
Losing copyright on music would infuriate the RIAA and the labels, but it wouldn't make much difference to the artists, who mostly survive by doing live gigs for cash. Few of them get much royalties from the labels. In fact the labels have been suffocating the artists, which is why there is so little good new music out there. We would have more good new music if we didn't have the labels.
Thursday, January 19, 2012
Maybe we can get union guys to vote Republican?
Obama put the kibosh on the Keystone XL pipe line yesterday. This was a privately financed shovel ready big project that would employ thousands of dues paying union members, give us oil from a friendly neighboring country, and keep the price of my furnace oil down.
Obama claims he needed more time to "evaluate" the project. The paper work has been in for two years already. Then he claimed that a piece of Nebraska prairie was "ecologically sensitive". This bit of prairie already has 25,000 miles of pipe buried in it, but for Obama a few more miles was unthinkable. Pipelines are the cleanest, safest, most accident free way of bringing in the oil that fuels the country. Without the pipeline, the same oil comes in by tanker, and tanker accidents are really messy. There has never been a pipeline accident as bad as Exxon Valdez.
In a way, this might help elect a Republican president. Union guys have been known to vote Republican now and then. Where as the lefty greenies who want to stop the pipeline would cut off their fingers before pulling the voting machine lever for anything but Democrats.
Obama claims he needed more time to "evaluate" the project. The paper work has been in for two years already. Then he claimed that a piece of Nebraska prairie was "ecologically sensitive". This bit of prairie already has 25,000 miles of pipe buried in it, but for Obama a few more miles was unthinkable. Pipelines are the cleanest, safest, most accident free way of bringing in the oil that fuels the country. Without the pipeline, the same oil comes in by tanker, and tanker accidents are really messy. There has never been a pipeline accident as bad as Exxon Valdez.
In a way, this might help elect a Republican president. Union guys have been known to vote Republican now and then. Where as the lefty greenies who want to stop the pipeline would cut off their fingers before pulling the voting machine lever for anything but Democrats.
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