Tag Archives: Single Payer

Now Who?

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 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.


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

Two Parallels in One Article

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.

The Economist Weighs In

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.

The Chairman’s Weekly Radio Address: June 6, 2009

Barack Obama’s Weekly Radio Address

June 6, 2009

Over the past few days, I’ve been traveling through the Middle East and Europe working to renew our alliances, enhance our common security, and propose a new partnership between the United States and the Muslim world.

You can call it that, in fact, many do.  I mostly call it an apology, but hey–that’s just ME.  Oh yeah, psst, when, umm, are the, you know, Muslims going to step forward and propose a new relationship with the United States?

But even as I’m abroad, I’m firmly focused on the other pressing challenges we face – including the urgent need to reform our health care system.  Even as we speak, Congress is preparing to introduce and debate health reform legislation that is the product of many months of effort and deliberation.  And if you’re like any of the Americans I’ve met across this country who know all too well that the soaring costs of health care make our current course unsustainable, I imagine you’ll be watching their progress closely.

Closely.  Yeah, that’s a word.

I’m talking about the families I’ve met whose spiraling premiums and out-of-pocket expenses are pushing them into bankruptcy or forcing them to go without the check-ups or prescriptions they need.  Business owners who fear they’ll be forced to choose between keeping their doors open or covering their workers.  Americans who rightly worry that the ballooning costs of Medicare and Medicaid could lead to fiscal catastrophe down the road.

Okay, so really, turn down the lights and put away the mics.  Serious.  Medicare and Medicaid.  In a speech designed to convince me that we need to turn our health care system over to you, you bring up Medicare and Medicaid?  Maybe, just maybe, before you decide that you wanna add another program to our debt load, you would think that you would fix these two?  No?  how come?  Really, yeah….details….

Simply put, the status quo is broken.

Perhaps.  But I am SURE you have no clue as to why.

We cannot continue this way.  If we do nothing, everyone’s health care will be put in jeopardy.

Not true.  Not true at all.  See, people who continue to value health care will make sure that they have it.  Those that don’t, well, won’t.  But jeez, that would require that you have experience in the real world, and well, you don’t have that.  Do you?  My, how embarrassing.

Within a decade, we’ll spend one dollar out of every five we earn on health care – and we’ll keep getting less for our money.

Wanna talk about that whole “Less for our money thing”?  Did you know that the world’s wealthiest most powerful people come to America for medical care?  You know, King Hussein, you know, King of Jordan, traveled to a small farm town in the middle of Minnesota;s farm land to see a doctor.  Meanwhile, a small town teacher in the heart of the same farm community also drove to the Mayo for treatment.  Gotta hand it to those conniving merciless profiteers out there in Rochester.  Bastards!

That’s why fixing what’s wrong with our health care system is no longer a luxury we hope to achieve – it’s a necessity we cannot postpone any longer.

Postpone.  I suspect that’s a word you will get used to saying.  Perhaps not hearing.  Cause, well, you know, YOU won’t be expected to be covered by this crappy insurance.

The growing consensus around that reality has led an unprecedented coalition to come together for change.

Huh?  Flashback Presbo?  What in THEE hell are you talking about?

Unlike past attempts at reforming our health care system, everyone is at the table – patient’s advocates and health insurers; business and labor; Democrats and Republicans alike.

No one is at the table you crazy loon.  Just you.

A few weeks ago, some of these improbable allies committed to cut national health care spending by two trillion dollars over the next decade.  What makes this so remarkable is that it probably wouldn’t have happened just a few short years ago.

Right.  Along with the President of the United States firing a CEO, limiting executive pay and compensation and then just kinda shredding bankruptcy law.  But hell, who’s keepin’ score?

But today, at this historic juncture, even old adversaries are united around the same goal: quality, affordable health care for all Americans.

See, you politician speak on this one.  We all agree that “medical care” is high.  But you don’t wanna fix that.  Nope, no way.  What you wanna do is keep it high and then just make everybody pay for it.

Now, I know that when you bring together disparate groups with differing views, there will be lively debate.  And that’s a debate I welcome.

Welcome.  You keep using that word.  I do not think that word means what you think it means. /sexyspanishaccent

But what we can’t welcome is reform that just invests more money in the status quo – reform that throws good money after bad habits.

We must attack the root causes of skyrocketing health care costs.  Some of these costs are the result of unwarranted profiteering

See buster.  I KNEW you could do it.  Damn profiteers.  I mean really, who would think that modern economic theory was so so wrong!?

that has no place in our health care system, and in too many communities, folks are paying higher costs without receiving better care in return.  And yet we know, for example, that there are places like the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions that offer some of the highest quality of care in the nation at some of the lowest costs in the nation.  We should learn from their successes and promote the best practices, not the most expensive ones.  That’s how we’ll achieve reform that fixes what doesn’t work, and builds on what does.

Whoe nellie!  That’s not what you’re saying.  What you are saying is “Lets take this same crappy system and just nationalize it.  Let’s just make everybody buy insurance and then tax the hell out of ’em”.  You never once have mentioned innovation in terms of “medical care” delivery.  Never!

This week, I conveyed to Congress my belief that any health care reform must be built around fundamental reforms that lower costs, improve quality and coverage, and also protect consumer choice.  That means if you like the plan you have, you can keep it.  If you like the doctor you have, you can keep your doctor, too.  The only change you’ll see are falling costs as our reforms take hold.


I also made it very clear to Congress that we must develop a plan that doesn’t add to our budget deficit.

Stop.  Serious.  Who is buying this?

My budget included an historic down payment on reform, and we’ll work with Congress to fully cover the costs through rigorous spending reductions and appropriate additional revenues.  We’ll eliminate waste, fraud, and abuse in our health care system, but we’ll also take on key causes of rising costs – saving billions while providing better care to the American people.

All across America, our families are making hard choices when it comes to health care.  Now, it’s time for Washington to make the right ones.  It’s time to deliver.  And I am absolutely convinced that if we keep working together and living up to our mutual responsibilities; if we place the American people’s interests above the special interests; we will seize this historic opportunity to finally fix what ails our broken health care system, and strengthen our economy and our country now and for decades to come.

Good night.  I am done.

Health Care and the Capital “O” Ought

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?

My Japanese Carolina Experience

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.

Universal Health Care vs. Government Offered Health Insurance

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.