The Truth About Health Care

Humans live in a finite world. The universe may be infinite, but the world of man is finite. There’s only so much stuff. Because there is only so much stuff, there’s always going to be a shortage of the stuff that people tend to like or need. It’s not always a desperate shortage, but there’s never enough so that everyone can take what they want. There’s always going to be one more hand reaching for the last item just after it is gone.

This is a basic axiom of life and one of the foundation truths of economics. It’s even a foundation truth of communism, which assumes scarcity can only be mitigated, but never fully eliminated, by the elimination of profit. Economists of all stripes work from the assumption that scarcity is an immutable fact of the human condition. The question they wrestle with is how to increase supply and distribute the results.

What this means is that all goods and services must be rationed. Since there’s never enough to meet the maximum demand, there has to be some way to say “no” to people demanding the goods or services. The most common way to do this is price. The poor guy who wants a Mercedes is told he cannot have a Mercedes by the big numbers on the price tag. This is how the supply of luxury cars is rationed.

The other way to ration goods and services is for men with guns to take control of the supply and create rules for who can and who cannot have access to the stuff.  Rocket propelled grenades are not very expensive. An RPG can be had for around $500 and the rounds are about $100. The government, at least in America, controls the supply of RPG’s and determines who can have them. In other words, the government rations the supply of RPG’s in America.

This is an iron law of economics. All goods and services are rationed. This is true for health care too. There are no exceptions to this law. Thus, the First Truth of Health Care: No health care plan or system can ever be taken seriously unless it addresses, up front, how it will say “No, you cannot have it” to people who want it. At some point, someone has to tell the patient they cannot have whatever it is they want or need.

In America, rationing is mostly done by price, but increasingly the state is taking over this role. In Britain, most people are denied services by the long lines for those services. The long wait times for basic services is a form of rationing. If you can deliver X per day and the demand is for 2X, you solve this by giving people numbers and having them wait a long time until their number is called. This is socialized medicine in nutshell.

The fact is, most people could pay out of pocket, for their health services. It is only when poor people get old or have accidents when they need someone to pay for their medical care. Most middle-class people should be able to put away a little every payday to reserve for their later years. That is, if they were not being taxed into poverty by the current system in America that has seen prices rise five times the inflation rate.

Thus, the Second Truth of Health Care: The current insurance model is just a wealth transfer from the middle-class to the health care industry, in order to cover the cost of poor people and the metastasizing layer of people who live off the system. Those is really just a tax. Most people use about 5% of their plan for themselves, the rest is used to pay for poor people and the army of people who work in the system.

That’s the thing politicians never want to discuss, which is the whole reason they are talking about health care in the first place. How does a modern society pay for the poor, who cannot afford needed medical services? How to we address the free riders on the system? More important, how much are we willing to pay for the health services to the poor? There’s a limit to all of this and that’s the question that always has to be answered.

Of course, one of the paradoxes of modern life is that you can get very rich off the poor, which is why liquor stores and furniture rental shops dot the ghetto. In the social welfare game, the point is to lay a massive guilt trip on the public, and grease the right political palms, in order to get the middle class to look the other way as their money is siphoned off for one program or another for the poor, always administered by a rich guy coincidentally.

Thus, the Third Truth of Health Care: Health services are a massive skimming operation. Today, the one area of the economy that “grows” is the health care industry. Every year, more and more people pile into that wagon, mostly in administrative roles. The number of nurses and doctors does not grow very much, but the number of bureaucrats grows like a weed.

Then you have the pill makers, machine makers, research people and lawyers. There are always lots and lots of lawyers. The health care industry is massive and government dependent. It’s why rub rooms are now called message therapy centers. They are angling to get it on the racket, by having their service declared an essential health care service. That way, you will be paying for some guy to get a happy ending.

That’s why reforming health care has become an impossibility. As soon as anyone makes any noises about fixing the system, the army of lobbyists, hired by every vested interest, shows up to bury the reformers. If they are not able to kill the idea of reform entirely, they set about corrupting it into another grift that their clients can use to get a free shot at your wallet. The only people not represented in these efforts are the voters. They get no say.

This is the main reason Trump’s efforts to address the problems of ObamaCare failed last week. What Ryan and the other crooks in the GOP were hoping to do is pass a bill that made it easier for their paymasters to skim money from the rate payers, while providing fewer services. Ryan’s bill was just an attempt to help the people feeding at the trough get a little fatter off the middle-class. Its failure suggests we have reached the end phase.

Talk to anyone responsible for paying health insurance premiums and they will tell you that the rates are reaching the point where they cannot be paid. When premiums are going up by multiples of inflation, there can be only one result. Once rates pass a certain level, people stop paying those premiums. You get black markets, non-compliance and a system that can only persist through brute coercion. Soon after you get collapse.

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Teapartydoc
Member
3 years ago

With most things the market and the ability to pay are what do the rationing. Two things prevent this, the monopoly power conferred by licensing, accreditation and regulation, and the widespread notion that everyone deserves equal access to health care resources. Unless market economics are allowed to affect what takes place in health care (note that I did not use the words “free market”, I begin to get nauseated when I see these words used together) there will not be a market regulated form of rationing. An example. Rural health care is a big deal. Small towns are losing or… Read more »

Teapartydoc
Member
3 years ago

One more thing: if you can’t get a market-like means of rationing to work, the only thing left is to impose one. That, my friends is government health care.

Waco Bob
Waco Bob
Reply to  thezman
3 years ago

The British have not kept their medical services functioning. Most public doctors are foreigners. Most people cannot afford access to the private system. Therefore the system serves to delay death rather than prevent it. It also serves to impose standards on the public. Break your arm but smoke, service denied. Overwight and break your leg, service denied.

Think of healthcare as the VA. Would you wish to have to attend only the VA for healthcare?

Karl Horst (Germany)
Karl Horst (Germany)
3 years ago

The time for “Social” healthcare for American is long overdue. Stories are well known even to Europeans how so many Americans have lost their life savings, retirement plans or even their homes to pay for medical bills. The fact that many Americans don’t even have basic access to health care puts the US well behind Europe, Australia and Canada and even some developing countries.These facts are indicative of a health care system that is severely broken. The German health insurance system has, in one form or another, been around for over 100-years and remains one of the best systems in… Read more »

Teapartydoc
Member
Reply to  Karl Horst (Germany)
3 years ago

Try having 60 million free riders in your system. What works in one place won’t work in another.

Drake
Drake
Reply to  Teapartydoc
3 years ago

And try getting the crooks in Congress to pass tort reform.

Guest
Guest
Reply to  Teapartydoc
3 years ago

60 million? I wish! Medicaid/CHIP enrollment in 2017 is estimated at 74 million. Medicare enrollment is estimated at 57 million. That’s 131 million, which is approximately 40% of the US population, receiving free or extremely subsidized health insurance coverage. But wait, there’s more! Approximately 85% of the 14 million people who purchase insurance on the Obamacare exchanges will receive a subsidy averaging around $400/month. Just to make the math easy, let’s call it a total of 140 million, which is 43% of the U.S. population, receiving free or extremely subsidized coverage. When nearly half of the population is receiving free… Read more »

Bill Jones
Bill Jones
Reply to  Guest
3 years ago

It’s not a social healthcare system if you have the insurance companies, who, let’s remember perform no health care services add massives costs, skim massive profits and act as gatekeepers.

james wilson
james wilson
Reply to  Guest
3 years ago

In an unregulated, and extra points for non-credentialized (free) system, the prices being paid in general would be far less than what is paid to subsidize the medi programs are right now. In an actual free system medicine would evolve and not metastasize. Everybody wins, except government. Welfare would remain welfare and not be confused with insurance. Insurance would be insurance and not be confused with full medical payer plans. “Insurance” is as destructive to markets as government is,which is why they have become allies. See your vet for pricing. He’s not cheap but he is real.

Tim Broberg
Tim Broberg
Reply to  james wilson
3 years ago

Maybe I should see the vet for health care…

Lorenzo
Lorenzo
Reply to  Teapartydoc
3 years ago

The German system’s mandate for coverage eliminates the free riders, except for Merkel’s immigrants.

Anonymous White Male
Anonymous White Male
Reply to  Karl Horst (Germany)
3 years ago

You can say that the German Healthcare system works only if you ignore the fact that the immigration system does not work. Germany is the totality of all the different divisions in German society. Healthcare cannot be separated from every other policy that the German government has imposed on the existing populace. The question Germans should be asking is will the system continue to work now that we have introduced lunatic policies that will guarantee that the people that created that country will slowly be strangled to death by the introduction of a parasitic group of people that have no… Read more »

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  thezman
3 years ago

The German health care system works because – 1. All citizens are required by law to have health insurance and pay for it. 2. No one can be denied health care insurance and can not be charged extra for existing health issues. 3. Profit margins of health care providers and insurance companies are strictly regulated by Federal, State Government and private consumer groups. 4. We limit law suits. Here are some quick facts and questions – 1. No German has ever lost their house or life savings because of a serious medical condition. Is that true in the US? 2.… Read more »

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  thezman
3 years ago

@ thezman – The same way it works for all unemployed German citizens. Just as in the US, they are supported by social benefits or welfare. Considering unemployment in Germany is currently less than 5%, it’s not an issue. And with the recent cut backs in immigrant benefits, many are leaving when they find out how far € 220/month doesn’t go. Keep in mind all citizens in Germany must register in the town hall where they reside by law. This is true when you leave one town and move to another. It is virtually impossible for unregistered residents to use… Read more »

MikeCLT
MikeCLT
Reply to  Karl Horst (Germany)
3 years ago

“3. Profit margins of health care providers and insurance companies are strictly regulated by Federal, State Government and private consumer groups.” This is where the bulk of the money goes in the US healthcare system-to compensation for not just doctors and nurses but to all the administrators and lawyers who are part of the system. Additionally, the rest of the world free rides on the US healthcare system for innovation and R&D. This figure dwarfs the free ride the EU and Asia get from the US military budget. Europe hasn’t developed a new effective antibiotic in 20 years. Without the… Read more »

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  MikeCLT
3 years ago

@ Mike – “Europe hasn’t developed a new effective antibiotic in 20 years.” What total nonsense! Europe may not produce or develop as much as the US, but it’s a simple issue of scale, not lack of ability. Next you will be telling me the US produces more wheat than Europe – really!? Who would have guessed it?

Anonymous White Male
Anonymous White Male
Reply to  Karl Horst (Germany)
3 years ago

“The German health care system works because –”

Because the German government forces the Whites of Germany to make it work. What happens when more Germans decide they don’t want to pay for Abdul to have his sex change operation? Or to keep 95 year old vegetables in nursing homes alive? Your economy is teetering. The only reason the chickens haven’t come home to roost is because of the work ethic of White Germans. When they no longer support the government that was imposed on it by the WW2 victors, your “healthcare” won’t work.

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  Anonymous White Male
3 years ago

@ AWM – If you did a little homework, you’d find out all European countries have a similar system to Germany. It’s why we all have health care and most Americans don’t. It has nothing to do with imposition by “US victors”, Germans have had health insurance since 125-years ago!

Al from da Nort
Al from da Nort
Reply to  Karl Horst (Germany)
3 years ago

Karl; It is true that there are horror stories in your press about the US medical system. Note that they are largely about the financing of medical care. As mentioned above, the US has historically used prices to allocate medical care, however imperfectly. This is what’s under media attack. You use political means of allocation. Simply due the the nature of this fallen world, it is hard to imagine that there are NO medical allocation horrors in a country as large and complex as Germany. Those medical care finance horror stories you saw and cite were largely developed and hyped… Read more »

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  Al from da Nort
3 years ago

@ Al Nort – As noted previously, all European countries have a similar system as Germany. It works because everyone must have health insurance. Yes, it is not cheap and can be up to 15% of monthly income, depending on what one earns. Consider if German unemployment is 5%, that means 95% of the population has health insurance and is paying their monthly premiums. When you control what insurance companies and hospitals can generate in profits, it’s clear a system like this can and does work for everyone without failing those who need health care.

Drake
Drake
Reply to  Karl Horst (Germany)
3 years ago

You might want to look up the definition of “insurance”. It certainly is not what you are describing.

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  Drake
3 years ago

@ Drake – Health insurance is exactly like car insurance. Tell me, is car insurance an option for car owners in the US or is it required by law? Everyone in Germany who drives has to have it and pay for it. And just as car insurance is required by law, so is health insurance…and you can pick any provider you want. The law simply forces everyone to comply (contribute) so everyone benefits. Your Social Security is no different. I doubt Americans can “opt out” of that. Now if you want to talk about a failed system in Europe, look… Read more »

Dorf
Dorf
Reply to  Drake
3 years ago

I think Karl believes that insurance equals healthcare when it most certainly does not. Most people in this country (US OF A) have some level of Health care regardless of whether they have Health Insurance to pay for said care.

I can give a few examples if need be.

teapartydoc
Member
Reply to  Karl Horst (Germany)
3 years ago

I’ve been a doctor for over thirty years and have yet to see anyone lose a house over a health care bill. Most of the bankruptcies I’ve seen are ones where the couple involved (it never seems to be a single person) run up a bunch of bills, medical and otherwise before declaring. They tend to be bankruptcies of convenience that they then blame on their elective health care bills. I’ve only seen one after a cancer.

Bill Jones
Bill Jones
Reply to  thezman
3 years ago

I continue to be amazed at this “defense” bullshit.
The US occupies Europe to loot it, not to “defend” it.

Defend it from what?

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  Bill Jones
3 years ago

@ Bill Jones – As much as most Germans are very happy with our relationship with the American occupation forces (and the Brits and French by the way) we often ask ourselves why are Americans still here?

No one thinks the Russians are going to roll through the Fulda gap anytime soon. Most believe, and I would agree, it’s been a US ploy to spend billions on their industrial military complex. You should have listened to President Eisenhower.

wordly wiseman
wordly wiseman
Reply to  Karl Horst (Germany)
3 years ago

@karl

You might want to reconsider what you wrote about the Russians. BBC says they are invading south-east England this summer

Ron
Ron
Reply to  Karl Horst (Germany)
3 years ago

Germany would be hard pressed to provide health care if the US pulled all its military bases out. The loss of US revenue from servicemen spending their paycheck locally and contracted work, with the added burden to spend more on their military to make up the ensuing gap would significantly impact their ability to sustain it. Europe has been riding on US tax payers foreign aid and military bases subsidy since the end of WW2. Same with Japan and South Korea. Cut them all off the US purse strings, and then see how well they can continue to be models… Read more »

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  Ron
3 years ago

@ Ron – US military bases have closed all over Germany with little if any impact on local residents. For example, the USAF hospital in Wiesbaden is now a police headquarters. Lindsey Air Station was turned back to the German government and converted into private housing. Rhein Main Air Base in Frankfurt was turned over and used to expand the Frankfurt International airport. Considering that most service members shop on the base where they pay no US or German taxes, they actually contribute very little to local economies in Germany, UK, Italy or anywhere else. Given the US spends upwards… Read more »

Blindman
Blindman
Reply to  Karl Horst (Germany)
3 years ago

Your system works in Germany because it’s full of Germans. A lot of other systems would work there too.

America is increasingly full of Guatemalans and Senegalese and basically NOTHING works in Guatemala and Senegal. This is not a coincidence.

Unless you stop Merkel and her coreligionists soon, your children are going to understand this problem very well.

[That was a figure of speech, of course you don’t really have any children either. Europe is failing at the most basic level of biological imperatives defining living things and so should be a little cautious about criticizing.]

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  Blindman
3 years ago

@ Blindman – It works in Germany because everyone has to have insurance. Just like car insurance. And it works in Switzerland, France, Austria and most European countries too.

The big difference between the US health care and social services and German is we don’t provide free health care, education and benefits to illegal residence. And we regulate what hospitals and insurance companies can profit.

teapartydoc
Member
Reply to  Karl Horst (Germany)
3 years ago

Car insurance is required in most states, and people still get into wrecks constantly with people who have no insurance. Just because you have a law doesn’t mean people are going to follow it.
Try getting the twenty or thirty million here illegally to obey our laws. God you are a fucking idiot.

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  teapartydoc
3 years ago

@ teaparydoc – What does people getting into wrecks have to do with the ability of people to get car insurance? Huh? And because you don’t personally know anyone who’s lost a house, doesn’t mean it hasn’t happened. What logic is that? The fact that you practice medicine in a country that cannot provide affordable access to health care speaks little for your industry. I’d rather be an idiot with excellent health care than an American doctor who can’t accept the fact his country’s health care system has utterly failed it’s people on just about every possible level. And for… Read more »

Teapartydoc
Member
Reply to  Karl Horst (Germany)
3 years ago

Many people have already told you that you cannot apply what appears to work in Germany to other circumstances. You have ignored all of them. You say that your system works because you have laws requiring people to purchase insurance. We have experience with having laws requiring people to get insurance and see those laws ignored by huge swaths of our society in other instances. Your inability to be able to see how this applies to the argument that your system wouldn’t work here, at least not as well, is an act of stupidity. As usual your only argument is… Read more »

Teapartydoc
Member
Reply to  Teapartydoc
3 years ago

As for Germany’s superior health system, I had a colleague from Germany once. Every year or two he would go to a specialty conference back home, and after a while we noticed that he stopped going and asked him why. His answer was that they kept talking about the same thing they’d been talking about for the past twenty years and he couldn’t keep up if he kept going to the meetings there. He quit going because his continuing education was being held back by it.

Al from da Nort
Al from da Nort
Reply to  teapartydoc
3 years ago

Doc;
Give Karl a break. In Germany, having a law meant compliance. Why_?: Germany, until the last couple of years was inhabited by law-abiding Germans.

What Karl doesn’t seem to understand is the the US is not anymore exclusively inhabited by law-abiding Americans. So while we may have laws like the Germans, we can’t anymore rely on voluntary compliance. Involuntary compliance is costly, and our elite must, perforce, ration enforcement. Hence, compliance is strategic and not universal. This is something Karl and his compatriots are too slowly finding out right now in the Moslem no-go zones.

TWS
TWS
Reply to  teapartydoc
3 years ago

Karl you have learned nothing about America. Which is ok because you’ve obviously forgotten nothing as well.

Until you understand how social services, insurance, medical care, and illegal aliens in America you will continue to be pig-ignorant and absolutely certain you are right.

Bill Jones
Bill Jones
Reply to  teapartydoc
3 years ago

There is a natural gatekeeper when you consume healthcare: the provider.
There is no such gatekeeper for the use of roads.
Try not to be unnecessarily stupid.

Anonymous White Male
Anonymous White Male
3 years ago

These are fundamental truths that should be self-evident. Unfortunately, what it all boils down to is do humans have the “right” to live. Well, do they? Not in reality. In a legal sense, a right is a power, privilege, demand, or claim possessed by a particular person by virtue of law. Law is refereed by some social organization that has the power to do so. Once a parasitic class has the “right” to vote themselves a transfer of wealth, two things will happen. One is that the parasitic class will grow because their perpetuation is guaranteed. The second is that… Read more »

LetsPlay
LetsPlay
Member
Reply to  Anonymous White Male
3 years ago

But we are such a rich country? Why should anyone have to suffer? Are you just a cruel and inhumane person? You must, must be one of those conservative, republican types! We must do it for the chillun’s. The Left/Liberals are more caring about their fellow man. /sarc

Until they run out of other people’s money which is what will happen with ObamaCare. They the reality of Death Panels will make their appearance and the balancing of the budget will become a priority of the ruling class because the burden cannot be sustained.

Member
3 years ago

Will the end of the USA be Venezuela or Atlas Shrugged? Or is there another possibility?

Drake
Drake
3 years ago

You got it right. Free-market healthcare works. Single-payer healthcare sucks, but it works. The hybrid model that is Obamacare and the crap Ryan tried to pass last week, doesn’t work at all.

Not signing up next year to have $250 removed from every paycheck, while still paying for every doctor we see, is becoming very tempting.

Drake
Drake
Reply to  thezman
3 years ago

Some of the single-payers like the UK dodge the direct answer. Instead the use the wait times to kill off people they didn’t want to treat.

Have a cancer diagnosis? Politely queue-up over here and wait. And if the cancer metastasizes while you are waiting, too bad.

Bill Jones
Bill Jones
Reply to  Drake
3 years ago

Yet the outcome is that the UK has a two year life expectancy advantage over the US with a healthcare system that’s half the cost.

The biggest single thing is that they don’t spend a quarter mill on the last six months.

jay
jay
Reply to  Drake
3 years ago

Yes it appears the veterans administration is doing the same thing

Matt
Matt
Reply to  Drake
3 years ago

Fortunately there are places like ZoomCare (https://www.zoomcare.com) and the like who provide very affordable coverage for every day care.

The problem with self-insuring is when you need hospital care you end up paying the PRICE ON THE DOOR. The insurers have negotiated the rates they pay. Only the very rich can afford to pay the posted rates.

Drake
Drake
Reply to  Matt
3 years ago

Everyone knows the price on the door of a public hospital is fake. If you cry poverty, threaten to appeal to the state, and offer to pay half the bill they will gladly agree.

james wilson
james wilson
Reply to  Matt
3 years ago

Correction. The rich do not pay the posted rate. I’ve witnessed the rich negotiate hospital rates and bills. They didn’t become rich by being dupes. The silly rates are a result of the insurance game. Medicos charge twenty to get ten. If they only get six they try charging thirty to see if they can get eight. And on and on.

Reply to  Drake
3 years ago

My old boss (2003) from Canada had a father who was a Mountie, retired. His father broke his leg and made an appointment to see a doctor. The opening was 6months. His dad insisted on using the Medical system that he is in (his son, my old boss, was wealthy enough to to bring him to the US and take care of it right away – but he would not budge, he wanted to use the system he “earned”). 6months later he went to his appointment, no waiting, right on time. They x-rayed him, and confirmed that he broke his… Read more »

Michael F. Martin
Michael F. Martin
3 years ago

Healthcare is a mess in this country and it is a pity that most people do not understand why. Perhaps it is because they are no longer educated in our schools, but indoctrinated into accepting the socialist and fascist systems that currently control our government. I am looking at Trump making a play at the Ryan plan as both a mistake and a boon. It is Trump’s first attempt to be a politician, rather than act as a CEO or dictator through executive action. He came off being called incompetent rather than being accused of being a Nazi. Oddly enough,… Read more »

James LePore
Member
3 years ago

Trump and Schumer will get together and edge us toward a single-payer system. The easiest way would be to lower the Medicare sign-up age and at the same time raise the income max at which people are eligible for Medicaid. Both done in increments. Eventually they will meld into one big government run program. This will result in ever increasing de facto rationing and will eventually bankrupt the country, but that will take a while. We’ll all be dead, our grandchildren will have to deal with it.

FaCubeItches
FaCubeItches
Reply to  James LePore
3 years ago

“We’ll all be dead, our grandchildren will have to deal with it.”

Looks like we win.
– Curly Bill Brocius

Member
3 years ago

I’d suggest a fourth truth about healthcare (in fact reality): you cannot insure against certainty. People have the bizarre notion that one should be able to buy healthcare “insurance” that covers preexisting conditions. It’s absurd. It’s like offering car “insurance” that covers accidents that you had last week. If this was for some reason mandated, what you’d see is (a) nobody can afford car “insurance”, because it is absurdly expensive, except (b) everyone who has an accident buys it.

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  thezman
3 years ago

Insurance is simply legal gambling; you put money on the table betting you will get sick. The insurance company takes the bet knowing from their studies that the odds are in their favor that you won’t based on age, lifestyle habits, etc. This is why they’re in business. The house always wins. Is the car insurance industry going broke? No. Is the home insurance industry going broke? No. What’s killing the health insurance industry isn’t people using the services, it’s the uncontrolled profits from ridiculous doctors salaries, inflated pharma costs and unregulated profits. Go look up what doctors get paid,… Read more »

FaCubeItches
FaCubeItches
Reply to  Leonard
3 years ago

The problem is that *all* health issues are certain; the only question is one of distribution. I might get diabetes, while you might get cancer, but eventually, both of us will get something, and — if we live long enough — more than one something. Comparing health insurance to any other form of insurance doesn’t work very well. Car insurance, for example, covers stuff that *might* happen: collisions, theft, etc. Same thing with home insurance or flood insurance: you might get flooded; you might have a fire, but it isn’t certain that you will. It is a dead certainty that… Read more »

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  FaCubeItches
3 years ago

@ FaCubeItches – True. But statistically the need for health care increased with age. That means if younger people are paying for it, but not using it, it’s like a savings plan for when they do need it as they age. But you have to start and everyone has to be involved. Otherwise the system doesn’t work – like in America. Do the research yourself, German health insurance works because we’ve had a 125-year head start going back to when big industry came into being. However this was not the case in the US or the UK where industry refused… Read more »

catullus
catullus
3 years ago

I’ve read that, in the old days, you could speak to a medical doctor on the phone and he would even come to your home if you were too sick to go to his office. Not in my lifetime of course. I don’t know; it sounds utopian.

Member
3 years ago

A small change. “The IRS indicated that it will accept tax returns lacking this information in light of President Donald Trump’s executive order directing agencies to minimize the ACA’s regulatory burden. While the requirement to have ACA-compliant coverage or pay a tax penalty has been in place since 2014, starting this year the IRS was to have begun automatically flagging and rejecting tax returns missing that information.” The IRS reserves the right to come back and assess penalties later, but they are acknowledging that ACA might go away. I also think it might. But what will replace it, I can… Read more »

MikeCLT
MikeCLT
3 years ago

The Z Man is right that Obamacare and health insurance in general are a huge tax increase in the form of raised deductibles and premiums. BCBS raised my company’s premiums 31% this year. That has followed double digit increases the past few years as well. And deductibles are up to $5,000 from $2,500. This is a huge tax on US employers.

Ned2
Ned2
Member
Reply to  thezman
3 years ago

Free vagina inspections are GREAT!
I usually have to spend a small fortune taking her out to dinner.

Cloudswrest
Cloudswrest
Reply to  Ned2
3 years ago

Indeed. If he got to pick the vaginas that would be an excellent deal.

John the River
Reply to  thezman
3 years ago

Yes, my old policy cost about the same.

The new (mandated) one cost $625 and included pediatric childcare, birth control and yes the ever popular and useful gynecological coverage .

As a 60-year-old man who was recently widowed and out of work I thought that was just great.
And the local restaurants I wasn’t going to as often, the car dealership that waited a few more years for me to come in and so forth; they think it’s great also.

LPT
LPT
3 years ago

On the German/UK systems. You can approximate a market based system with a state run system by: – Actually having profit seeking companies provide the health care service. This could be at the insurance company or hospital level. In the UK you get an abysmal service – this is highly variable regionally, and in my experience tends to be better at the clinical than general practitioner (i.e. “family doctor”) level. Absent this, being ruthless with the unions and staff is necessary. As it is, the healthcare system is to a great extent an inefficient way of keeping government workers salaried.… Read more »

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  LPT
3 years ago

The reason it’s mandatory is because people should pay for what they receive. It’s just that simple. Of course some people will have higher needs as they age, just a young people have lower demands on the health care system. But that’s the whole point. Like a retirement plan, the idea is you put something in now so you have something later. But in order for everyone to benefit, everyone has to contribute. The few that don’t need much care will offset those who need more, but you can’t do that without unregulated costs. To that point, deregulation has crippled… Read more »

TJ
TJ
Reply to  Karl Horst (Germany)
3 years ago

Karl I respectfully have a serious question. What happens in Germany if a guy simply refuses to pay his part, then while hanging out and drinking, he gets shot up. Goes to hospital and is fixed up at tremendous cost. Then when he can walk out he flips the bird at the staff and says he’s not paying a cent. What happens now? What happens when he gets hit by a baseball bat the next week, then has another cost but simply won’t pay? Im not being provocative, I’m genuinely curious.

LPT
LPT
Reply to  Karl Horst (Germany)
3 years ago

Sorry this doesn’t add anything. My previous points stand.

Al from da Nort
Al from da Nort
3 years ago

Along with making explicit when NO comes into play, I think that the other question to answer is what, explicitly, is charity-care going to look like. Maybe that’s what you mean. The Prog scam has been to weaponize charity-care to gobble up normal medicine using secularized Western Christian social mores with coercive means. To flesh this out, we need to back up and look at historical examples from other complex societies. Several points: – Even in primitive societies that we have records of, where medical care, such as it was, was usually provided by friends and family, there were ‘medical… Read more »

Merrell Denison
Merrell Denison
Reply to  Al from da Nort
3 years ago

Al from de nort “– We can literally thank God that this is not our situation now, but the above is the basic human nature behind the debate and why so much compulsion must be involved.” Another way of considering the parable would be to walk on past, because “The downtrodden will be with us always”. The good Samaritan parable isn’t about caring for the poor and downtrodden, it’s about loving your enemy, the Samaritan in this case. Even Chuck Schumer became a Christian a day or two ago supporting immigration. Support Democracy when your side has the votes, quote… Read more »

Al from da Nort
Al from da Nort
Reply to  Merrell Denison
3 years ago

Merrell; Schumer repented_?!! After all those soul-blackening years as a NY politician_? Halleluja_!!! A miracle has just happened right before our very eyes_! But seriously, the context of the parable was a smart-assed Pharisee (ancient Jewish lawyer) asking Jesus, “And [just] who is my neighbor_?”, right after Jesus admonition to “…love thy neighbor as thyself…”. So it wasn’t just or mostly about caring for the poor and downtrodden, although there are many other such admonitions elsewhere in the Bible. My possibly poorly stated point was that this was seen as an extravagant, even shocking, level of voluntary, charity medical care… Read more »

el_baboso
Member
3 years ago

Ignoring for the moment whether or not healthcare is a right, I think we all can agree that any healthcare system must not be corrupt. Our American system — based on spending growth and employment patterns alone — most certainly is and seems to be another one of these physics-defying plates spinning long after common sense and gut-feel tells us it should be on the ground in pieces. I will leave it to Z man’s European and Asian readers to determine if their own health systems are corrupt. But with defense spending being squeezed out and national debts growing at… Read more »

Bill Jones
Bill Jones
Reply to  el_baboso
3 years ago

“But with defense spending being squeezed out ”

What is it with you clowns?

There is no more corrupt segment of government expenditure than “defense spending”

el_baboso
Member
Reply to  Bill Jones
3 years ago

Interestingly, my post does not infer whether defense spending is corrupt or not. It merely states a fact that it is being squeezed out by health care spending.

Amazing how you dunces can’t comprehend English.

Bill Jones
Bill Jones
Reply to  el_baboso
3 years ago

On thr contrary squeezed out clearly infers reluctance.
Value nuetral terms would be cut or reduced.
Not a native English speaker, are you?

el_baboso
Member
Reply to  Bill Jones
3 years ago

Please don’t tell anyone! They’ll fire me from Fancy Bear.

LetsPlay
LetsPlay
Member
Reply to  Bill Jones
3 years ago

Tell that to all the loons around the world who have been pulling up their pants, putting on their hats and strapping up during the Obozo years, and are running loose creating havoc. All we tend to hear about is the corruption in DC these days but things are pretty dicey out in the hinterlands to which you seemingly prefer to ignore and not spend on defense.

Now don’t get me wrong. I do not like the MIC anymore than you, but there is a valid reason to heed the saying “Si vis pacem, parabellum.”

Karl Horst (Germany)
Karl Horst (Germany)
Reply to  el_baboso
3 years ago

@ El_Baboso – I am not saying German health care is perfect, but I can say it works and it works very well. It works because everyone participates and we enforce the law that everyone is required to participate. It’s a social contract. In order for any social contract to work, whether for a local fire department, police department or public school, everyone must contribute. Sure, not everyone’s house will catch fire, and not everyone’s house will be burglarized. But still, everyone pays regardless of how much of that system they use. This is a age old concept that goes… Read more »

el_baboso
Member
Reply to  Karl Horst (Germany)
3 years ago

Karl, setting aside for a moment that like many conservatives from the Anglosphere, I don’t believe in positive rights, I am willing to accept that health care – especially the preventative sort – is a public good. Therefore, some public subsidy is justified to pay for it. I don’t know if you are familiar with the work of Gert von Hofstede. But if you are, you know that American culture is an extraordinarily individualistic culture. We also have a very low power distance. Our societal models don’t export well and our Progressives’ attempts to graft European practices that work in… Read more »

LetsPlay
LetsPlay
Member
Reply to  Karl Horst (Germany)
3 years ago

Good grief Karl… time to give it a rest. Bitte schoen?

Dutch
Dutch
3 years ago

US healthcare policy hasn’t decided whether it is insurance or a tax/welfare scheme. It has elements of both, which is likely worse than either one or the other.

Healthcare needs to bill the user for each interaction, even if it a token amount. “Free” creates overuse. Mostly cover the big stuff, so people don’t lose their homes because of an operation, but cover less of the small stuff, so people self-regulate their use of the system.

YIH
YIH
3 years ago

Charles Hugh Smith (excellent economics blogger BTW) has written extensively about health care: http://charleshughsmith.blogspot.com/search?q=health+care And in fact, did so today: http://charleshughsmith.blogspot.com/2017/03/forget-obamacare-ryancare-and-any.html What a lot of the ‘nattering nabobs’ especially on talk radio don’t realize or understand is about 2/3rds of the US is actually on ”public healthcare”; Medicare, Medicaid, the gold-plated plan Congress is on and, of course, the VA. Also, due to a Reagan-era law: https://infogalactic.com/info/Emergency_Medical_Treatment_and_Active_Labor_Act Anyone that shows up at an ER must be treated (or mother in labor…) regardless of ability to pay/insurance. A hospital can refuse to participate in EMTALA, but means they become ineligible for… Read more »

LetsPlay
LetsPlay
Member
Reply to  YIH
3 years ago

Fraud, playing the system has to be one of the biggest drains on funds there is. And yet no one talks about tackling the sanctity of Welfare benefits by going after fraud. I have two sisters who worked at county hospitals and they tell me story after story about the degree of fraud perpetuated by all classes of people, including those who “could” opt out and pay their own way, but are too cheap to do so. Of course, as YIH says above, their personal ability to do anything about it was severely hampered but they would do their best… Read more »

tdurden
tdurden
3 years ago

I’m inclined to agree with Karl Denninger on this one. Start enforcing the antitrust laws which apply to health care just like they do to every other industry, save the dullards in sportsball of course. Send in the US Marshals to frog-march a couple of major hospital chain, drug and insurance company CEOs and about 1/3 of the problem evaporates in less than a month. And it needs to be more brutal than just sticking the shareholders with some fines with no admissions of guilt. Exexcutives and boards of directors need to get real time in real federal prisons, assets… Read more »

Bill Jones
Bill Jones
3 years ago

“This is the main reason Trump’s efforts to address the problems of ObamaCare failed last week.”

Was this Trump’s effort or was this Trump killing Ryan’s corporate written effort?

Let’s see what happens next.

It strikes me that Trump is perfectly prepared to “lose” in the short term if he ultimately wins.

LetsPlay
LetsPlay
Member
Reply to  Bill Jones
3 years ago

Agreed. Part of me thinks one goal was to mortally wound Ryan and get him out of the picture as soon as possible. As is being said of Trump, he seems to be good at giving people enough rope and opportunity to hang themselves.

FaCubeItches
FaCubeItches
3 years ago

The healthcare skim may end up destroying the government just like the Vegas skim did the Mob in the Midwest. When the Mob was content with a small skim, everything ran like a Swiss clock. But as they demanded greater and greater amounts of cash, it got to the point where everyone and everything — including the organization itself — would be sacrificed to keep the money coming in. They were able to kill enough people to keep it coming for a while longer, and to hide it for a little longer still, but soon enough, everything fell apart, and… Read more »

notsothoreau
notsothoreau
3 years ago

Within my lifetime, we have gone from being able to pay medical bills out of pocket to needing insurance to cut down costs. Consider what is happening with veterinary medicine. We are seeing costs rise, coincidentally with the rise of people having insurance to cover their pets. And I don’t think that animal hospitals are any more transparent about their costs. I think we can cover a lot of these costs for the poor with block grants and leaving to the state. It’s how my late husband’s medical bills were handled. I would have loved to have had him on… Read more »

Dutch
Dutch
Reply to  notsothoreau
3 years ago

“Look at the largest buildings in your town”. Nailed it. Hospitals here, too.

Guest
Guest
3 years ago

This is an appropriate place to put in a plug for the Surgery Center of Oklahoma. Prices Posted. Payment terms: cash. No insurance accepted.

https://surgerycenterok.com/

Pricing is frequently 10% to 30% of prevailing costs. Not 10% to 30% lower.

This is what happens when you let the market work.

notsothoreau
notsothoreau
3 years ago

I read an article yesterday about a doctor that found a cure for sepsis. It’s a big problem in hospitals. He tried using an IV to deliver high doses of vitamin C and hydrocortisone. It worked. He kept using it and wound up adding thiamine to the mix. He’s in the process of trying to convince other hospitals to do the same. But like he says “It only costs $60 to do this.” And that is why I don’t want a German style health care. My insurance will cover a pulmonologist. I’ve been working on the problem with a naturopath.… Read more »

Cabron
Cabron
3 years ago

Wait a minute: are you saying the gubmint will pay for my happy endings? C’mon Elizabeth Warren!

TomA
TomA
3 years ago

And I would add that the sooner we crash and burn, the better off we will be. A near-term high bottom is much preferable to a miserable slow slide to the deepest of bottoms, from which any resurrection may be all but impossible.

The health care bubble is but one of many such societal cancers that are all precariously nearing a bursting point.

PasserBy
PasserBy
3 years ago

RE: auto vs. health ‘insurance’ It seems all would agree auto insurance does ‘work’ and is relatively stable as are prices for auto service. It also seems clear the analogy is a stretch at best; however I can’t help but observe: – I always see an estimate and a subsequent itemized bill for auto service of my vehicle, regardless of who is paying. (I paid out of pocket for an MRI recently and was charged less than half the initial ‘price’ – I was also able to negotiate the price of the dr. visit over the phone with the billing… Read more »

Tim from Nashua
Tim from Nashua
3 years ago

Skin for skin, yea, all that a man hath will he give for his life. – – – Satan
Only now we find that mankind will take from others also in order to ‘save’ his/her life.

Fred Z
Member
3 years ago

I’ve been stewing about this excellent post since it came out, and finally decided to leave a lengthy comment about how government run healthcare works up here in Canada, just so you’ll know what’s coming at you if you don’t deal with it. In 2012 my father required an oxygen generator at home. The government got him one, rented from a private supplier for $331.00 per month, and my father’s share was $82.75 per month. Dad loved to drive and be driven about, so I started looking for a portable generator to replace his tanks, which were only good for… Read more »

LPT
LPT
3 years ago

Korea is the place I’ve been most impressed with. It is a government supported system but mostly privately run. Quite a lot of small hospitals. Relatively high deductibles prevents misuse. I had a mole removed when I was there last time and it was $5. Yes, $5. With a laser and everything. You’d think for that price they would have to get a dog to bite it off.