Category Archives: Health Care

Now Who?

Posted on August 6, 2009 | Leave a comment

While this news doesn’t take me by surprise, I am sorry to lose a guy like Lawson.  As far as I know, Lawson was a Libertarian running under the banner of the Republicans.  I thought that Lawson was a fine candidate in his own right and deserved to hold the seat no matter who was sitting there now.  But with Rep. Price sitting there, we really need someone to come along and offer Change We Can Believe In.

I have been trying to get Rep Price to clarify his position on the Health Care bill moving through the House.  I can’t do it.  His staff at all of his offices ware very vague when asked about his position.  As far as answering me:

I have not talked to Congressman Price in person.  I would not want to speak for him.

Now, with the recess in progress, I have been asking if he is going to hold any Town Halls.  As always, I am referred to his website.

It will be updated with any information.

When?

When new information is made available.

Do you think that he is going to conduct a Town Hall meeting?

I don’t know, I am not sure.  But I think that he is talking about having a Town Hall conducted over the phone.

It is the same attitudes and non-answers when I ask for more detailed information on the specifics of the bill.  For example, where does he stand on single payer?  Where does the Congressman stand on the thought of denying private plans if I want to change plans?  I get sent to the website.  From there I am able to e-mail the Congressman.  However, when you do go and send this “e-mail” you are simply sent the blurb that was the non helpful information on the website.

Silly.

We really need to see someone run and win against this man.

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Posted in Health Care, Politics: North Carolina

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Two Parallels in One Article

Posted on July 16, 2009 | Leave a comment

I’ve admitted before that I am no economist.  Fact is, I haven’t even ever taken a class in economics.  However, I did major in mathematics and work significantly with statistics at my current job.  As I tell my boss, “I’m nifty with numbers”.

So, as I wax poetic on all of these economic issues I do so with a bit of trepidation.  See, really, from an “expert’s” point of view, I don’t know what I’m talking about.

Which makes seeing two of my most often repeated mantras in text at one time very exciting.  This article from Mises.org just made my morning:

Mandating benefits for employees imposes costs on employment. The would-be worker bears the cost. It makes the worker more expensive to hire. The employer has to pay not only a salary but also a benefit. If you make it more expensive to hire people, fewer people will be hired.

It is no different from eggs at the supermarket. If they are $2 each, you will purchase fewer of them — you will economize. This is nothing but the law of demand: consumers will demand less of a good at a higher price than of a good at a lower price. A salary plus benefits amounts to a price that the employer must pay to purchase the work of a laborer. At a higher price, less work will be purchased by the employer.

You should read the whole article; it’s fantastically simple.  And for once, I see in print, what I seem to intuit.  And furthermore, it is verbalized with economic expertize that I simply can’t claim:

There is no real reason to prove these assertions empirically since they flow from the logic of economics.

The article is entitled  “The Jobs Program” and deals with health care:

Sadly, there is no way that free health care can be granted to all living things with the stroke of a pen. Broadening availability will require that the entire sector be turned over to the private sector, so that it can be controlled through the price system like everything else.

But while Mr. Rockwell is speaking about the current health care bill, his article could easily be speaking about the new minimum wage increase slated this month.

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Posted in Economics, Health Care

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The Economist Weighs In

Posted on July 1, 2009 | 1 comment

Look, I’m just a guy with a college degree.  I’m not an economist but I am handy with numbers.  And, mostly, I am capable of free thinking.  Which is why I find this article from The Economist laughable.

We start off well, in fact I had high hopes after just the first sentence.

DIAGNOSING what is wrong with America’s health-care system is the easy part.

I happen to agree with the author’s take.  I DO think that it’s easy to diagnose what’s wrong with America’s health-care system.  Which is why I was disappointed when The Economist got it wrong.  Not even 30 seconds later we are stunned to learn that nearly 50 million Americans don’t have coverage.  This is gross and simply unacceptable for a major news source to make a statement this absurd.  50 million.  Americans.  Uninsured.  Really?  Let’s take a look.

  • The real number being used is 47 million
  • Of those 47 million it’s been reported that 9 million are enrolled in Medicaid and failed to report it
  • 8 million are kids.  These kids are now covered by SCHIP

We’re down to 30 million now.  Fully 40% off the 50 million number quoted by the Economist.  But there’s more–way more.

  • 1.7 million are parents making more than 300% of FPL [federal poverty level]
  • 5.9 million are non-parent adults making more than 300% of FPL
  • 3.1 million are adult parents eligible for assistance today
  • 2 million are non-parent adults who are eligible for assistance today

Now we’re at 17.3 million.  17.3 million people who are not covered.  Now for the best part.  Wait for it—wait…waaiit……9 million aren’t even US citizens.  How AWESOME is that?!?

So, after getting the number down to 17.3 million, we’re able to shave off another cool 9 mill  bringing us to the grand total of 6.3 million.  And we get 50 million from The Economist.  Gross.

Next the author compares the benefits of American health services with OECD and their averages.  As far as I can tell, the comparison used three metrics:

  1. Infant mortality rate
  2. Life Expectancy
  3. Survival Rates for Heart Attacks

Again, the depth, or lack thereof, in reporting is surprising.  It has been documented that the infant mortality rate in the US is much higher than other countries because of the methods used in reporting.  According to WHO the definition of birth is:

Live birth refers to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life – e.g. beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles – whether or not the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered live born.

However, in many cases, countries fail to report all births due to their own definitions; for example:

  • In Switzerland and other parts of Europe, a baby born who is less than 30 centimeters long is not counted as a live birth. Therefore, unlike in the U.S., such high-risk infants cannot affect Swiss infant mortality rates.
  • In Belgium and France — in fact, in most European Union countries — any baby born before 26 weeks gestation is not considered alive and therefore does not “count” against reported infant mortality rates.
  • Some of the countries reporting infant mortality rates lower than the U.S. classify babies as “stillborn” if they survive less than 24 hours whether or not such babies breathe, move, or have a beating heart at birth.
  • In Canada, Germany, and Austria, a premature baby weighing <500g is not considered a living child.

When these and other reporting anomalies are factored in, Norway, which has the lowest infant mortality rate in the world, ranks no better than the United States.  Further, since 2000, 42 of the world’s 52 surviving babies weighing less than 400g (0.9 lbs.) were born in the United States.  Hardly an indicator that the United States if failing in the area of infant health.

The CIA has the United States ranked 50th in life expectancy.  And, as noted above, the article uses this metric in it’s assessment of the United State’s system.  However, it has been reported that Life Expectancy is not a valid measure of a country’s health care system:

…robust statistical analysis confirms that health care spending is not related to life expectancy.  Studies of multiple countries using regression analysis found no significant relationship between life expectancy and the number of physicians and hospital beds per 100,000 population or health care expenditures as a percentage of GDP.  Rather, life expectancy was associated with factors such as sanitation, clean water, income, and literacy rate.8 A recent study examined cross-national data from 1980 to 1998.  Although the regression model used initially found an association between health care expenditure and life expectancy, that association was no longer significant when gross domestic product (GDP) per capita was added to the model. Indeed, GDP per capita is one of the more consistent predictors of life expectancy.

Yet the United States has the highest GDP per capita in the world, so why does it have a life expectancy lower than most of the industrialized world?  The primary reason is that the U.S. is ethnically a far more diverse nation than most other industrialized nations.  Factors associated with different ethnic backgrounds – culture, diet, etc. – can have a substantial impact on life expectancy.  Comparisons of distinct ethnic populations in the U.S. with their country of origin find similar rates of life expectancy.  For example, Japanese-Americans have an average life expectancy similar to that of Japanese.

And this is just the first paragraph.  Keeping up with the Liberal press is simply exhausting.


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Posted in Economy, Health Care

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Universal Health Care: French Edition

Posted on June 22, 2009 | 2 comments

So, the President travelled to the Mid-East and then Europe earlier this month.  While in France, the President delivered his Weekly Radio Address.  In this address, he spoke directly about our health care situation and how we need to change it.  I think that we should take the opportunity to explore the French version of this vision.

With just a little bit of Googling I found numerous articles from sources such as:

Reuters

The Organisation for Economic Cooperation and Development

Business Week

After just an easy overview of these articles, it is apparent that the French are kicking our asses in the whole health care thing.  In the Business Week article, France has itself coming in 1st with the US rounding out at 37th.  In Reuters, Uncle Sam is running 19th in a 19 man race while France, again, places 1st.  All in all, no matter how you look at it, America is lagging.  Perhaps Mr. Oabama had it right to initiate his Health care kickoff in the country that has it going on.

But, before we acknowledge that we have indeed failed, let’s take a look at what it is that has France ranked so high in all of our studies.  For example, in the Reuters study, it was a ranking of 19 nations in preventable deaths due to treatable conditions.  And in the Business Week article, it quotes the ranking done by WHO, The World Health Organization, that has France coming 1st and the United States a dismal 37th.  In that ranking, the WHO lists infant mortality rates, life span, available beds and doctors per citizen as well as deaths from respiratory disease.  And all of this, of course, as the United States pays more for it’s health care than any other nation.

On the face of things, it would seem that indeed, the United States is in dire need of reform and, in fact, may finally have to implement some form of national health care.  After all, America remains the only industrialized nation not to have such a system.

In the following days, I will look deeper into the claims made by various agencies.  Look deeper into the numbers and identify if yes, the United States is in as bad as shape as it would appear.

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Posted in Economy, Health Care

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Health Care and the Capital “O” Ought

Posted on May 27, 2009 | Leave a comment

So, it seems as if this country is going to get ready for some big time politics surrounding the health care industry in the next several months.  And it is going to be Democrat vs. Republican.  Liberal vs. Conservative.  It’s going to be “What we wish it could be like” vs. “This is how it is”.

Wait.  Did I say that?

The problem that I have with liberals is that they see inequity and just simply say “That’s not fair!” and then stomp their feet.  Then, they look around and say, well, sheesh, if the rich have this, than I want that too!  And then they legislate that.  All the while never understanding that what they are doing is putting those poor folks deeper and deeper in the hole than when they started.  I’ll never forget reading that when the minimum wage was enacted, hundreds of thousands of African Americana’s became unemployed.

Anyway, so here it is, the challenge:  Regarding health care; what is it that you want?  What is broken now that you wanna see fixed?  What metrics will you use?

Is it basic care that you want given to all people?  is it emergent care that you want?  Life threatening illness care?  What, exactly, do you want?

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My Japanese Carolina Experience

Posted on May 24, 2009 | 2 comments

So here I am, up well past my bedtime strolling through the internet when a friend of mine points me to this example of “Single Payer Health Care”.

It is the story of a man in Japan who is describing his experience with the Japanese style of health care; Single Payer to be specific.  In it, our hero is suffering from strep throat and is taking the time to describe to us how treatment went in Japan.  His story begins with a  fever and a sore throat and … well, I’ll let him take it from there:

I walked into the hospital and was seen by a bi-lingual physician almost immediately (maybe a 5 minute wait after showing my National Health Care Card)

Now, the sticking point with this whole Universal Health Care, Single Payer Health Care or Socialized Medicine is the concept of rationing.  Ya see, we have far far fewer medical practitioners than we have demand for free medical care.  Serious, imagine if any medical procedure or treatment were free, do you think the system would be overwhelmed or underwhelmed?  Right, me too.  So, we do what we do in all markets [well almomst all markets.  In most markets, we are much freer than in the medical care market, but that is for another post] and that is ration by cost.  That is, we let people determine, based on how much they are willing to pay, when they will seek medical care.  We ration the available care by allowing the consumer the choice.

So anyway, brother was seen almost immeadiately.  Well, maybe a 5 minute wait after showing his Nation Health Care Card.  While perhaps only a minor point, I would like to know how long it took him to show his card AFTER walking the door fot he facility.  Anyway, the drama unfolds….

examined my throat, asked when it had began and took my temperature. He decided that a throat culture was necessary and it was sent to the lab. In the meantime he prescribed a painkiller and antibiotic …..

Now, everything seems cool so far.  Doc, bi-lingual Doc at that, correctly concludes that a throat culture is required.  Good man.  AND we get drugs prescribed too.  So far, so good.

…and asked me to come back in 2 days.

Yowza!  And here is the rub.  THIS is the rationing.  THIS is what HAS to take place.  Because the demand for care out strips the supply of care, we HAVE to ration it.  And when we let people think that we are providing FREE care, we have to ration it by …… wait for it [pardon the pun] TIME.

When I went back to the hospital they informed me that I had a severe case of Strep throat and I needed a much stronger antibiotic, which was prescribed immediately.

So, the SECOND trip to the hospital found the cause of the trouble and they prescribed the correct drug to treat.  Excellent.  Though I should point out the catch phrase “prescribed immediately.   As if.  Actually, it was prescribed immeadiately AFTER a 48 hour [and five minute] wait.  So, how much did this most excellent of all services cost our protagonist?  Why, it’s FREE you say.  He doesn’t have to pay a thing!  Right?  Wrong!

Turns out our hero has to actually cough up [punny again, I know] the small small fee of ….. $385 a MONTH!  Let’s see, 385 bucks a month is $4, 620 a year.  A YEAR.  Now, the story doesn’t tell us if this is before or after taxes, so let’s just pretend that it ‘s before.  As in, just like a normal tax.  This means, that unless our hero makes more than $46k a year, he is paying more than 10% for medical care.  Oh yeah, he also has to pay a 30% co-pay.  Yeah……not so free, huh?  Oh, and his wife is paying too!  So, let’s not pretend that this is free or without costs.  This is, quite simply, mandatory health insurance.

Further, as I kept reading the post I found a picture of what looks to be our author.  He is the one on the right.  Looking at the pic, I am guessing the man is younger than, oh, say, 30.  He is younger than 30.  Now, when I was younger than 30, AND when I am queried by folks that I come across who ask me about this sort of thing, I tell them at age 30 all you need is catastrophe insurance.  Why?  Because at ages younger than 30, you DON’T GO TO THE DOCTOR!090523_141001

In any event, lemme tell you about MY strep throat story in the good ol’ US of A.

One day I woke up with a very soar throat and mild fever, it persisted and got worse the following day.  I decided to call my primary care physician who said that she could meet me that afternoon.  I decided to accept her offer and made an appoint at DUKE MEDICAL CARE!  However, after having some coffee and getting ready to go to the office, I decided that I wanted to stop at the grocery store to buy some fruit for the day.  As I left the grocery I noticed the pharmacy across the street.  I remembered that they have a clinic.  I stopped.  I also had about a 5 minute wait.  The Doc took my temp and swabbed my throat.  She said that I would need to have the sample tested; I said I would wait.  I asked how long, she said 10 minutes.  I browsed the store, bought some birthday cards, bought some supplies for my home office and even a present for each of my kids.  By the time I was done shopping, the results were in; strep.  The correct medicine was presented to me with zero wait and I was on my way.

I called DUKE MEDICINE to cancel and my doc said “That was good thinking.”

Total cost?  Zero dollars.  Of course I do have to pay about the same as Mr. Progressive Tokyo here, but, you know, that covers me, my wife and two young children.

Funny.  Capitalsim and the free market.

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Posted in Health Care

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State Run Health Care

Posted on February 9, 2009 | 2 comments

Was reading an article last night regarding North Carolina’s State Health Care system.  This is a program that offers employees health insurance.  What caught my eye was the headline:

State health plan wants the young, healthy

That’s awesome.  Another way of reading that headline would be this way:

State health plan wants the people who don’t have health problems to pay for health care.

I get where the State is coming from, I really do.  They have found that they are $138 million short in their fiscal planning.  And that’s a lot of money.  But the problem I have with this really became apparent to me as I was reading the article and mentally comparing it to my life in corporate America.  You see, I have a wife and some kiddos, so I can relate to the manipulation of pricing when trying to cover the family.

The problem, you see, is that the State was $138 million short in their goals.  That is, they are losing about $138 million.  In other words, the plan that they operate is not profiting.  What?  How can that be?  Is it possible that a business, run by the government, competing directly with private corporations is losing money?  Are you KIDDING me?  And then it REALLY came home and began to sink in.  Why in the world is the government in the business of selling health insurance?

The rest of the article talks about ways that the government is going to have to manipulate their model to become profitable.  The problem with this, however, is that the hard decisions required to do that will not be allowed to be made.  You see, it would require that some people won’t be able to afford the care that the government thinks that they need.  And the reason government thinks that certain people need certain coverage is because, well, because they were voted in by those people.  In short, it is NOT the goal of this government to run a profitable health insurance company, or even to provide the care they think they should.  The goal of these government folks is to stay in government.  There is no way the government can turn a profit here.

Now, I work for a Big Ugly Company [BUC] and I have health insurance through that BUC.  But guess what?  The insurance that I have through the BUC is not BUC’s Health Insurance.  Rather, BUC has negotiated with several different  other health insurance providers and found, what I hope, to be the best deal for me, or at least for the BUC.

Why can’t the State of North Carolina do the same thing?  Why is it that the State feels that they have to offer their own insurance?  If they would contract with a private firm, they would be able to set up SLA’s, minimums and yes, perhaps maximums as well.  There would be contractual expectations that would need to be met, and if they weren’t, the State could take their business elsewhere.  And in this economy, even the mean insurance companies don’t want that!

Now, the State could even offer to pay 100% of the cost if they wanted to.  This isn’t to say that they should, but they could.  If they want to feel that they are competitive in the field, attract and retain the best employees, it may very well be in the State’s interest to do this.  If, on the other hand, the State finds that they can obtain very skilled labor, say 85% of the best while only paying half the premium, they should do that.  It’s called open market.  And it works.

The State of North Carolina should be getting back to the business of the State.  After all, the State doesn’t manufacture their own paper clips, right?


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Posted in Economics, Health Care, Politics: North Carolina

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Socialized Medicine vs Health Care Reform

Posted on January 18, 2009 | Leave a comment

Arguments, you know, are sometimes more about miscommunication than they are disagreement about an agreed upon topic.

I wanna make sure I clear this up right away.

I am against Federally supported health care, medical care or health insurance.

I am FOR making the health care industry more stremlined, less burdened by administration costs and delays and for making it as safe as possible.

I am ALWAYs for making things better.

Just sayin.

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Posted in Health Care, Politics: National

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Universal Health Care vs. Government Offered Health Insurance

Posted on January 17, 2009 | Leave a comment

I have been sitting on this one for awhile now.  It’s a tough one.  Something that no one wants to see and few have the answers to.  From the right, we all know the responses, but do we really know the reasons?  And, to be honest, do we really believe what it is we are saying?  I am talking about health care.  And, specifically, the availability, or lack thereof, of that care.

I think that when you ask the right about this topic, they picture people who refuse to work, refuse to better themselves or refuse to create for themselves a situation where they can obtain basic medical care.  Or, at the very least, purchase catastrophic health insurance.

Similarly, if you ask the left about health care or medical care they are envisioning individuals suffering due to tragic life threatening illnesses.  Situations where the individual has little or no control and the result is complete and utter financial ruin.

In short, I think that we are talking about two different things.  On one hand, we are discussing health or medical care as an industry; something that is in the macro sense.  On the other, we are discussing that same care on a deeply individual and tragic level.  And so, lost in conversation, the left and the right have no hope of compromise, no hope of a shared or common understanding.  How could they?  They’re not even talking about the same things.

And so it is when I discuss health care.  Coming from the right, I shudder at the thought of Nationalized Health Care.  Or Socialized Medicine.  Or Single Payer Insurance.  Or anything that is called whatever that means everyone is able to seek any medical care and not receive a bill.  And yet, these same opponents of mine will lash out at me as in separate conversations as being part of the Religious Right.  I don’t get it.  At the same time I am someone who is deeply religious and yet I am able to turn a blind [and greedy] eye to the grandmother suffering in pain, struggling to stay alive and knowing that she is going to bankrupt her family?  I just shake my head.

I don’t understand how anyone could possibly hear such a story and walk away untouched, unmoved; certainly not me.  But again, we are reading from two different scripts here.

And so it is that I continue to support what I know to be true.  Medical Care is a service.  And as such, it creates a certain demand or need or want.  And there is more of that want that there is supply of the service.  And so, as we all know, that service, that medical care, has to be rationed in some way.  However you want to close your eyes and sing lalalalalalala and not believe it, there is simply NOT enough supply to satiate all of thedemand.

There are many ways to solve this problem.  I’m not going to list them here.  But my favorite method to resolving this delta in supply and demand is …… price.  It is by price that we SELF ration the demand and come to a equilibrium where the supply is in harmony with the demand. [Cue Disney Hummingbirds].

However, I also am a big BIG believer in Role of Government.  That is to say that at each level of government, there are certain and appropriate roles and expectations.  For example, I do NOT thin that it is the role of the Federal Government to mandate or assume management of Health Insurance.  However, as we get more and more local, in fact, if we even just jump from Federal to State, we find that the role or expectation of the Government changes.  I think that this is true for the case involving abortion and I think that it is tru here; for Health Care.

And so it is that I find this development, not an attack on Conservatism, but as example [could it be better?  Sure.] of what can happen when members of a community State gather together, discuss what is important to them as people, and vote that they want to offer this type of service where they live.  That they want to offer care to those that are less fortunate.  This, THIS I believe is the role of the State.  Not, however, of the Nation.

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Posted in Health Care, Politics: North Carolina

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