What’s news today?
First we go to Oklahoma, for a good display of patient centered healthcare.
And no, it ain’t nothing like ObamaCare. This will actually work.
“What Free-Market Healthcare Looks Like”
From Reason.com
But we get this nonsense instead.
From HotAir
“Embedded within the shadowy depths of the Patient Protection and Affordable Care Act (sometimes, I like to use its official name just to re-appreciate the irony of “patient protection” and “affordable”) is a 2.3 percent excise tax on the sale of taxable medical devices by the manufacturer/importer — and it’s no small thing. Happening now:
Medical device executives will descend on Capitol Hill today to press members of Congress to address the 2.3% medical device tax before it takes effect in January. …
“Without action from Congress, implementation of the medical device tax will cost our economy thousands of high paying jobs,” MITA executive director Gail Rodriguez said in prepared remarks. “These job losses will directly impact patient access to the most advanced, life-saving medical technologies available.” …
The letter includes support from physician groups, venture capital firms and other organizations asking the Senate to repeal the 2.3% levy on medical device sales, which device makers will start paying in at the start of next year.”
More here from Politico
“Every day, America’s medical technology community gets up and goes to work, focused on improving the lives of patients throughout the world. Whether manufacturing pacemakers, CT scanners or catheters, our passion for innovation and ingenuity is why this proud American industry continues to lead the world in these challenging times.
Unfortunately, in fewer than 60 days, a new medical device tax will hit this innovative industry, and it threatens patient care and U.S. jobs.”
“This onerous policy — which is expected to cost more than $30 billion — is already having a real-world, everyday impact on our health care system and our economy. Even though it doesn’t take effect until Jan. 1, medical technology companies are already announcing job cuts and canceling plans to build plants to pay for the tax. Others are trimming budgets in important areas like research and development.
Put simply, this is a tax on innovation, and it is going to hurt American workers and patients most. Congress can and should repeal it immediately.”
Throw in a Primary Care Doctor shortage as well?
From Yahoo
“The United States will require at least 52,000 more family doctors in the year 2025 to keep up with the growing and increasingly older U.S. population, a new study found.
The predictions also reflect the passage of the Affordable Care Act — a change that will expand health insurance coverage to an additional 38 million Americans.
“The health care consumer that values the relationship with a personal physician, particularly in areas already struggling with access to primary care physicians should be aware of potential access challenges that they may face in the future if the production of primary care physicians does not increase,” said Dr. Andrew Bazemore, director of the Robert Graham Center for Policy Studies in Primary Care and co-author of the study published Monday in the Annals of Family Medicine.
Stephen Petterson, senior health policy researcher at the Robert Graham Center, said the government should take steps — and quickly — to address the problem before it gets out of hand.”
Even Obama supporters are forced to deal with this monstrosity, and yet they still supported him.
From Breitbart
“Stryker Corporation has announced that it will close its facility in Orchard Park, New York, eliminating 96 jobs next month. It will also counter the medical device tax in Obamacare by eliminating 5% of their global workforce, an estimated 1,170 positions.
Jon Stryker is heir to the Stryker Corporation, one of the largest medical device and equipment manufacturers in the world. Stryker’s grandfather was the surgeon who invented the mobile hospital bed. The company now sells $8.3 billion worth of hospital beds, artificial joints, medical cameras, and medical software every year.
Stryker, a member of the Forbes 400 list, was one of the top five donors to the Obama campaign. Having donated $2 million to the Priorities USA Action super PAC, Stryker also gave $66,000 in contributions to Obama and the Democrat Party.”
More layoffs at Stimulus-backed solar companies. Shocking huh?
From Heritage.org
“A pair of foreign-owned solar companies that benefited from a combined $84 million in Energy Department tax credits have announced they will lay off employees.
One of the companies, German-owned SolarWorld, was integral in the fight for tariffs against the importation of Chinese photovoltaic solar panels. The other, Chinese company SunTech, blamed those tariffs for its own layoffs.”
“SolarWorld received a credit worth $82 million, while SunTech’s was worth $2.1 million.”
A reason for Patraeus to resign that I hadn’t heard before.
From TheWeek
“When he admitted having an extramarital affair with Paula Broadwell, CIA Director David Petraeus, as a senior civilian in the presidential chain of command should something go catastrophically wrong in Washington, violated special behavior codes for officials who might one day be forced to execute nuclear strikes.
In classified presidential emergency action documents, the CIA director is among the dozens, if not hundreds, of officials who are listed as National Command Authority successors in the event that higher-ranking officials are no longer able to do their jobs.
Because under certain circumstances he’d have ready access to the nuclear satchel, Petraeus was indoctrinated into the Personnel Reliability Program, which evaluates and monitors the lifestyle and behavior of Americans with access to nuclear command and control mechanisms. Adultery is not a minor sin under the PRP rules.”
The Campaign continues. Now you know what the meeting with Obama was about.
From CNN
“Several major labor unions are banding together to launch an ad campaign next week urging members of Congress to raise tax rates on the wealthiest Americans and to protect entitlement programs from major cuts as a solution to the looming fiscal cliff, a source with knowledge of the effort told CNN Friday.
The American Federation of State, County and Municipal Employees, the Service Employees International Union and the National Education Association are banding together for this campaign, which will be launched next week.”
“The effort will include a “six figure” buy of television ads, as well as ads online, the source told CNN.”
I love the smell of bailouts in the morning.
I told you about this one at the FHA already.
From TheLATimes
“The Federal Housing Administration, which has played a crucial role in stabilizing the housing market, said it ended September with $16.3 billion in projected losses — a possible prelude to a taxpayer bailout.
The precarious financial situation could force the FHA, which has been self-funded through mortgage insurance premiums since it was created during the Great Depression, to tap the U.S. Treasury to stay afloat.”
And now it looks like we may have another.
From the AP
“The federal agency that insures pensions for more than 40 million Americans last year ran the widest deficit in its 38-year history.
The Pension Benefit Guaranty Corp. said Friday that its deficit grew to $34 billion for the budget year that ended Sept. 30. That compares with a $26 billion shortfall in the previous year.
Pension obligations grew by $12 billion to $119 billion last year. Assets used to cover those obligations increased by only $4 billion to $85 billion.
The agency has now run deficits for 10 straight years. The gap has grown wider in recent years because the weak economy has triggered more corporate bankruptcies and failed pension plans.
If the trend continues, the agency could struggle to pay benefits without an infusion of taxpayer funds.”
🙄
Wandering Views 
All of that belongs on the Rant & Rave thread. We knew it was going to be this bad. But Obama is not going to relent. He is intent on bringing the health care system down. Then he will institute a “single payer”, i.e government, system.
Death panels and everything else that goes with it.
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Thanks for the news from Oklahoma. The best thing that could happen to the US would be the repeal of Obamacare, Medicare and Medicaid. Chas is probably right about the future, but right now all Texans are dreaming big.
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And Obama said he wouldn’t raise taxes on the middle class. Yeah, right. This is an indirect tax on us. When will anti-capitalist liberals see that raising taxes on businesses increases costs to consumers? Any and every company is in business to gain a profit, and any costs they incur are passed on to customers. Thus, this 2.3% tax on business is a 2.3% cost increase to us. An indirect tax, if I ever saw one.
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Two more because I know you can’t get enough. I think the second link from First Things may have some healthy insight for American Protestants. At least it explained something that has bothered me.
Executive violation: http://reason.com/blog/2012/11/15/president-obama-unilaterally-gives-cyber
Food for thought: http://www.firstthings.com/onthesquare/2012/11/forward
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Michelle, thanks for that First Things article by Wesley Smith. I’ve come to the same view that supports individual liberty in most economic and political matters along with orthodoxy in religious matters. I do think that one can find some orthodox Protestant churches such as that of the Missouri Synod Lutheran Church.
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Michelle, That was an interesting article. I was raised as a Southern Baptist, but have concluded that the congregational polity I was taught as a youth is unbiblical and destructive. I agree with Sails that there are Orthodox Protestant denominations in the US. However, the number of heresies and fringe movements that have arisen from the individualism of American Christianity is astounding.
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Single payer is a far more cost efficient method of delivering health care. Looking at the rest of the developed world, we can see better results (infant mortality, life expectancy, etc) for lower cost. The left would certainly have wanted Obama to go single payer but he went for the Bob Dole/Heritage Foundation/Romneycare idea. Its politically understandable as it negated any opposition from insurance companies who would fight single payer.
A shortage of primary doctors might be an indication of the success of the ACA. As more people have access to basic health care, demand will go up. If free market theorists are correct, this will only be temporary as the market will respond and the supply will increase. Unless of course you argue that health care is outside of market economics.
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Healthcare in the US left the free market in 1965.
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We’ve got a looming shortage of family practice physicians and it’s unlikely to improve soon. Medical school is hard to get into, expensive and long. I’m encouraging my own child to consider being a nurse practicioner or physical therapist–though those schools are just as challenging to get into.
People claim that after paying (or borrowing) for medical school, they only can afford to go into specialties. 😦
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My comment on the First Things article is too many American Christians confuse their American liberties with what it means to follow Christ. Christ bids us come and die–worshipping him involves submission to his rule and word and should be done communally in the sense that “they will know we are Christians by our love.”
I see a lot of individualism within the church bodies which can open them to heresies and a bullheadedness that I think is incompatabile with biblical Christianity.
But then, I attend a Missouri Synod Lutheran Church. Doctrine can have a good role in the Christian life.
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Medical schools and the costs thereof were designed for docs making those rediculously high salaries they earned while Medicare was still growing at an unsustainable rate. Michelle, It sounds like you are giving good advice.
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The video clip shows, to a large extent, the difference between free market and what we have now. Single payer is the farthest thing from free market.
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But a little transparancy and possibly using the same forms so people can figure out what is going on, would help. We have perfectly fine insurance but it is incredibly frustrating whenever I have to deal with them–and their picky little eyes searching for one minor error on the forms is maddening.
Reject!
Which is why so many people like the idea of someone else handling it all. 😦
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Michelle, before writing the comment above on the orthodoxy of the Missouri Synod Lutheran Church, I had not a clue that you are a member of that church. Just now, I am considering joining the Christ Lutheran [MS] Church in my Massachusetts town, which would involve leaving a Congregational church that my family has been involved with since the 1630’s.
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The Kaiser HMO in SoCal is laying off a bunch of people, it was announced yesterday. And I’m wondering if my own GP (private, non-Kaiser) will decide to retire just a little earlier than planned.
I think I also mentioned earlier that my veterinarian’s son, top-of-his-class in med school graduate, is rethinking the whole practicing physician route. It’s the control and restriction with regard to various treatments & even information that will be ushered in with government-provided health care that has his dad worried, I know.
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And, at least at this point, while it may be somewhat arbitrary, insurance will often capitulate to the squeaky wheel.
Grace needed a rather drastic medical treatment—six weeks of hospitalization for her feeding disorder. Initially, the ins said they don’t pay for speech therapy without an injury, they don’t pay for behavior therapy at this age, etc. Once I got an actual medical reviewer on the line and explained that A) this isn’t “See Jane run” speech therapy but rather training her muscles to chew properly and that if we didn’t do this that she’d be on a feeding tube, which would cost way more (and result in the same type of program to wean her off later anyway), it was approved.
But how many folks don’t do this, or don’t know how to? And I doubt that type of appeal will be available in the future. 😦
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Has anyone else seen this?: Democrat James Carville Says 80% of Democrats Are Politically Clueless.
A few lines:
“Ideologies aren’t all that important. What’s important is psychology.
The Democratic constituency is just like a herd of cows. All you have to do is lay out enough silage and they come running. That’s why I became an operative working with Democrats. ”
“What amazes me is that you could take a group of people who are hard workers and convince them that they should support social programs that were the exact opposite of their own personal convictions.”
“The voter is basically dumb and lazy. The reason I became a Democratic operative instead of a Republican was because there were more Democrats that didn’t have a clue than there were Republicans.”
So the truth is out. Carville is in it for the money, not for the right reasons.
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Thanks for posting, Peter. I confess. I put truth serum in Carville’s drink.
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Aside from Ricky’s truth serum, I suspect that being married to Mary Matalin helped matters.
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Sails, You are probably right.
I was feeling pretty proud on election night since only 15.6% of my county’s votes were for Obama. It turns out that was only good for 45th place among Texas counties. The winner (King County) cast only 3.4% of its votes for Obama.
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It seems King County won the National Championship of voting with its 2012 performance. That county only has only 286 residents and consists primarily of the 6666 Ranch. Apparently, the foreman does not hire any riffraff.
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As the video indicates, the foreman at the 6666 Ranch is as particular with his men as he is with his horses. No, I didn’t spot an Obama voter.
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I take it no one sees the present insurance based model as a free market system.
The OK video is interesting but the message or lesson I got from the video is transparency — I don’t think their model provides a method for universal health care rather its a good model for cost containment and a better alternative for corporations instead of large insurance companies. I would like more transparency — I would like my provincial government to send a yearly itemized statement of their medical costs just so people knew what they were getting for free and to see if medical practitioners and companies were over billing.
However, if the goal is universal access to health care, we need to look elsewhere. And as one can’t defend the current HMO/insurance model as free market, why not look at single payer. After all, we are only looking from the most pragmatic way to have the population access health care, which I would argue on the basis of comparative evidence is some form of single payer.
If we’re not looking for the best means to have the population access health care, then there’s no point discussing health care as a political issue and just leave it as a private issue similar to purchasing groceries or a car.
I must say I find the notion of HMOs and preferred suppliers to be strange. When access medical care, I go where I want not where the province wants me to. And even when accessing medical services covered not by the province but by workplace insurance I still go where I want and then insurance company pays the bill. Corporately managed insured health care is foreign to me and strikes me as a violation of my personal rights.
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HRW, When over half of the costs of health care are paid by Medicare, Medicaid and local governments, that is not the free enterprise system.
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HRW,
One of the big issues with healthcare, and one the AFA did little to address, is the cost. The video shows you the comparison of what a drug costs the hospital, and what the hospital charges the patient and/or their insurance. It’s absolutely ridiculess. What they are offering is healthcare at what it actually costs, plus a small profit for Doctors, instead of the outrageous excuse for a bill the hospital and insurance agree to. Also note the part about where some companies are now sending employees to them, and paying the bill outright, rather than at the inflated price insurance offers. I think it’s going to catch on, and it should.
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If: a. The federal government paid for 98% of the cost of cars for all old people;
b. the federal government paid 100% of the cost of cars for all poor people; and
c. counties were require to provide a car for anyone who needed one, what do you think would happen to the cost of cars?
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ricky — cars and groceries aren’t the same as health care which is why they are treated differently, if you think so then by all means espouse free market health care. Of course that means not everybody will get health care and not everyone will get the best health care just like not everyone gets a car and a Cadillac.
However, I would like to think society has reached the point where we would like all people to have access to health care and thus we can’t treat it like any other commodity.
real AJ — Transparency is important in any business or service. Insurance companies are hopelessly incompetent and corrupt. From my experience with auto insurance, I can just imagine how badly they run health care. Insurance companies make the government look good.
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“Insurance companies make the government look good.”
That’s a scary thought!
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HRW, I do espouse free market health care. I want to return to 1964 – before Medicare and Medicaid. I lived at that time and had many relatives who lived at that time. Most were poor. By today’s standards, I was poor. We all received the health care we needed, no thanks to the government.
Since you want the government to provide universal health care, why stop there? How about free housing for everyone? All need a place to live. How about free food? We need that. Why not free golf? We need to exercise.
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karen — scary but true. I never encountered so much paperwork in my life for a simple accident and I work for the gov’t. I thought special education was over-bureaucratic but it had nothing on private insurance. I can only imagine the waste in US health insurance, although the video was demonstrative.
ricky — do you think that complete free market health care will give the same results in terms of life expectancy, infant mortality, cancer survival, etc? If I could be convinced that the free market would give people better health care results, I would think it an appropriate mechanism. As it is, I think free market health care might work for cost containment but would be at the risk of lower health care results.
Universal housing has been tried and I wasn’t impressed (I toured eastern Europe in 91). The market is good at providing suburban tract housing (albeit with gov’t subsidies to roads, etc) and rental units. However, there does seem to be a role in gov’t and non-profits in providing low-cost family housing.
Its interesting you mention food. Until the late 19th century, gov’ts were heavily involved in the agricultural sector as food security was considered more important than defense. The UK changed that by going free market (repeal of the Corn Laws, 1848) and allowing itself to become dependent on imports. This almost proved costly in WWII. Even today gov’ts heavily subsidize food production (with the notable exception of Canada and New Zealand). Although in the US, most food subsidies are corporate not family farm. Personally, I would repeal almost all of them.
As for golf, well some corporations in the US subsidize fitness club memberships in hopes of lowering their insurance costs. Germany is famous for its use of “spa” treatments as preventive health care. It might be cheaper for gov’ts to offer free fitness club memberships to prevent health care costs.
I know you are being slightly sarcastic but Im trying to make the case for pragmatic gov’t to increase success. And as my reference to agricultural subsidies and roads, gov’t intervention is already alive and well in areas we think are free market.
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Among many myths is that health-care is, as HRW remarks, outside the bounds of the free market. Paul Ryan contradicted this with the example of lasek surgery that allowed one to see well without glasses. He originally paid 4,000$ for each lasek surgery. Just now that surgery is 800$ per eye.
The truth is that HRWs contention is mistaken.that health-care is some sort of exception to to market economics.
Leftists prefer government over-regulated health care that is inevitably much too expensive and at best mediocre in result. The health-care industry despite romantic pretensions is merely another economic enterprise. Doctors as nurses, like all of us have clay feet.
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Lower prices for lasik surgery demonstrate that technology, not health care, continues to lower itself in price. Technology continues to get cheaper.
In Ontario, dentistry and eye glasses are similarly free market , and in the 4o some odd years I’ve been a customer of either service the prices has continued to rise. Unlike lasik, neither are new services originating in new technology and thus do not benefit from the continuing lowering costs in technology.
If leftist solutions are so mediocre and expensive why do countries with single payer have lower cost and better results than the US which has a corporatist system. Now you could easily claim that a hypothetical free market health care system could do better but one doesn’t really exist and perhaps there’s a reason for that.
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HRW, statistics on American medical results reflect the American reality that minority populations tend not to care well for themselves. Switzerland would be a fairly good example that a healthy population does better with essentially free-market medical insurance and health-care. Why is it that so many Canadians cross the border to the U.S. for medical care rather than wait a long time for vital care?
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The Swiss program has an individual insurance mandate and insurance pools exactly what the ACA hopes to implement. Perhaps Romney copied the Swiss model for Mass. When the ACA is fully implemented, maybe it will have similar results as the Swiss.
Using racial explanations for lower results is scraping the bottom of the barrel. I might add that many European countries, Canada, Australia etc have large minority populations — why then are only American minorities so irresponsible? Is there something about the US which produce irresponsible minorities or is your theory just plain wrong.
The Swiss model is fairly successful but the Scandinavians still get better results and for slightly less money.
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Don’t kid yourself, HRW, Canada has far fewer Blacks and Latinos than America. This obviously affects medical numbers. Many Canadian minorities are Asians who medically take good care of themselves.
You didn’t answer the question as to why so many Canadians cross the border to obtain vital medical care, as opposed to waiting in long lines.
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HRW, Sails is right. As Phil Gramm noted, the US is the only country in the history of the world with fat poor people and skinny rich people. That was not always the case. Prior to LBJ, poor people looked like other Americans, and I dare say they were much healthier before Medicaid, food stamps and the rest of the Great Society.
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Contact lenses are a lot cheaper than the used to be. My glasses are exceedingly expensive, but they’re progressive lenses–lightweigh, scratch resistent and do the work of three others. So, the technology has improved, I guess, in that I get three pairs in one without leaving marks on my nose and without breaking even when I drop them.
$600, however, is still a lot to swallow on a pair of glasses. Ouch!
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What is the cheap food sold in the US? Does anyone take home economics in school–which is where I learned about calories and food choices, not to mention how to balance a diet and cook from scratch?
A lot of the thin wealthy people I know may not be fat, but they are not necessarily healthy.
It’s been interesting watching all the moaning about Hostess going under. My husband and I could not remember when we last ate one of their products–45 years ago in elementary school? My teacher mother correctly pointed out all those years ago that Twinkies, Ho-hos, Wonderbread and the like were mostly sugar and empty calories; she wouldn’t waste her limited grocery money on products that had no nutritional value.
She’d probably say the same thing about Starbucks . . .
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Sails — really, there’s nothing wrong with US health care except we have unhealthy minorities ….. unlike the rest of the western world whose minorities don’t stand out health wise. You need to ask why a black Cuban lives longer than a black man in Mississippi.
Rickyweaver — instead of looking at the advent of medicare as the starter to obese poor people a better correlation would be the advent of glucose as a sweetener as opposed to real sugar. And other unhealthy practices of the prepared/preserved food industry.
Sails — I missed the cross border shopping comment. I think the Cdn use of US health care is exaggerated. Its estimated that 60 to 85K people from around the world travel to the US for medical treatment. Interestingly, about 750,000 Americans leave the US and travel elsewhere for medical treatment.
http://en.wikipedia.org/wiki/Medical_tourism#United_States
You can follow the footnotes to an institute of public affairs study. A survey/study, called phantom in the snow, done in the late 90s which track Canadian use of hospital services in Washington State, the Detroit area and Buffalo found Canadian use of medical services negligible. And access to diagnostics tools which constituted the majority of the trips in the 90s has improved significantly since then.
http://content.healthaffairs.org/content/21/3/19.full
anecdotally, I remember having a conversation with a nurse who worked in Niagara Falls, Ont who mentioned frequent use of Canadian hospitals (esp for child birth) along the border by uninsured Americans since it was cheaper.
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$600 … wow I paid 300 for a pair of prescription RayBans (and they threw in two cheap pairs for free) Two years later I bought progressive pair with scratch-proof etc for less than 300. My workplace insurance covers a new pair every two years upto 300. I didn’t pay anything so I know its under 300. There’s something seriously amiss if you’re paying twice the amount I do.
I also agree with your food comment. I have no idea what Americans pay for fresh fruit and vegetables but its as cheap if not cheaper than processed food here (high Cdn dollar gives me dirt cheap California produce). Home economics should be re-added to the middle school programme with an emphasis on eating unprocessed food.
For the record I never had a Twinkie, etc (but if Americans really want them, Cdn bakeries will continue to make them … time to cross border shop)
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Best prices for glasses and contacts I know of are found at Costco & Walmart.
But progressive lens eyeglasses are very expensive, especially if you add the coating for computer work & a thinner lens (which I need as my prescription is quite strong).
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hwesseli,
You are apparently unaware of the current structure of family farms. Most US ‘corporate’ farms are still family farms. When they change their structure to a corporation or LLC or a partnership they still are a family farm. Out of necessity these family farms have had to grow to survive but still are family run and operated.
Our main farming operation is currently a general partnership with two siblings being partners through their trusts and two siblings being partners through their corporations which are owned by their trusts. We currently have 14 full time employees and 7 part/temporary employees. 2 of the full time and 2 of the part/temporary workers are also family members.
For specific reasons we also have an S-corp and a LLC actively farming and limited partnership that owns land rented to the general partnership. Some of these entities have an additional two off farm siblings as owners. My dad used to have his main farm operation a C-corp.
Much of the complexity of current US farm structure is tax related – especially efforts to keep from having to sell some or most of the farm when it is transferred to the next generation. It takes a huge amount of capital in farmland and equipment to farm these days. It also takes a huge amount of operating capital to grow the crops. But these economies of scale and lower profit margins are what has allowed most of Americans to leave the farm and move to the cities in the last generation.
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PLEASE don’t pay a lot for progressive lenses. They cost manufacturers about 11 cents more than normal lenses to make. That’s probably an exaggeration, but I know the markup is bogus. In the past two years, I’ve purchased online two pairs of progressives, with anti-reflective coating and sunshades, for $55.80 and $42.75, respectively, shipping included. And I actually prefer the $42 pair. If you want to see the invoices, I can provide them. My vision provider reimbursed me.
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HRW
Under your “Single Payer” system, all health care workers will only work for one employer.
What if my doctor doesn’t want to work for that entity?
Do you see any problems with this?
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