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Guest Post: Why Would We Let Them Rig The Game?

Tyler Durden's picture




 

Submitted by Dylan Ratigan

Why is health insurance the only business that has an exemption from the Sherman Anti-Trust Act other than Major League Baseball? If the delivery of taxpayer trillions by our politicians to the banks to support their fraudulently paid bonuses hasn't shown you what our current government's values are, check this link out.

Through the governmental negligence that we as voters allowed, a health care system was created in which a single health care company controls at least 30 percent of the insurance market in 95% of the country, including states like the following:

Maine, where Wellpoint controls 71% of the market.

North Dakota, where Blue Cross controls 90% of the market.

Arkansas, where Blue Cross Blue Shield controls 75% of the market.

Alabama, where Blue Cross Blue Shield controls 83% of the market.

This monopoly, combined with the misaligned incentives that trap people in employer-based health care, is causing the skyrocketing health care costs that are hurtling our nation towards bankruptcy.

I don't know what's worse: that most Republicans seem to be against ending this unfair legal protection for an entrenched industry that is ruining our country with their non-competitive practices, or that most Democrats seem to be threatening this arrangement only as a bargaining chip to push for a meaningless public option that wouldn't be accessible to almost 85% of the population?

Instead of improving our country, through creating and enforcing free and fair markets, our politicians are currently engaging in backroom deals, most of which protect the very companies who profit the most from these disastrous outdated systems -- industries like health insurance and big Pharma.

While we clearly have the ability as a group of 305 million to update the system that is American Health Care and move our country into the 21st century in the process, it's becoming clear that we may not have the leaders to do it.

Instead of seeking answers to the problem of paying for and providing medicine, we are doing the exact opposite. Taxpayers' money is being played with by politicians who are desperately trying to protect the competition-stifling, false security of the monopolistic employer-based health care system and its outdated, over-charging, under-delivering ways. Given the least consideration are those affected the most -- the patients and the doctors who care for them.

This country's founders built an ingenious system of checks and balances for a reason: to ensure that no special interest or group could use government power to commandeer the creative and economic wealth of our nation to their own ends. How much longer must we live in a country where the citizens are subservient to the banks, health insurance companies and any other special interest able to control our government at the expense of our the most basic principles of fairness, our future as a nation and, as a result, our freedom?

Follow Dylan Ratigan on Twitter: www.twitter.com/DylanMSNBC

 

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Tue, 09/29/2009 - 16:18 | 82777 phaesed
phaesed's picture

Goddamn... well, we all knew the revolution wouldn't be televised.

 

Amazing to watch this country moves towards what may be the beginning of a civil war.

Tue, 09/29/2009 - 17:15 | 82859 Anonymous
Anonymous's picture

Respectfully, you're wrong: There will be no civil war.

The rest of the world realizes that Americans of today are a lesser people than their fathers and grandfathers: They are fat, lazy, and pathetic.

They won't protest—a few will bitch and moan for a while, but ultimately all Americans will acquiesce like the trained "non-judgmental" sheep that they are.

They deserve the small-motion collapse that is happening. Hell, they made it happen.

Tue, 09/29/2009 - 21:18 | 83196 Village Idiot
Village Idiot's picture

As one poster put it, "just in case you aren't kidding, go fuck yourself." 

If you haven't already pulled your head out of your fat ass, my fellow American, time to do so. We have work to do!

See, that is a much more empowering statement. 

 

Tue, 09/29/2009 - 18:30 | 82955 Anonymous
Anonymous's picture

"Amazing to watch this country moves towards what may be the beginning of a civil war."

-Not amazing to watch this at all as an immigrant, came here to make life better, little did I knew....
But I can tell one thing, people are very nice and educated, but are cowards from inside. The policies are definately worng and society is very scared to raise voice against any wrong doing and very scared to punish the wrongdoers, they are very instered in watching someone innocent executed in Texas for no mistake. I don't feel good here but I am trapped...can't go back and can't breath here amongst bunch of cowards.

Tue, 09/29/2009 - 19:41 | 83051 Anonymous
Anonymous's picture

A civil war is the only solution. I'm ready, are you?

Tue, 09/29/2009 - 23:23 | 83345 Anonymous
Anonymous's picture

Let's attempt to split the country peacefully first.
Then I am with you. Heart and soul. Blood if need be.

Tue, 09/29/2009 - 16:20 | 82782 sysin3
sysin3's picture

Just being snarky, but this is surprising why ?

It's the golden rule ..... he who has the gold makes the rules.

The rest of us are consigned to suck hind tit.

Tue, 09/29/2009 - 16:57 | 82833 Anonymous
Anonymous's picture

Sorry no tit for you. Too many pigs, not enough tits. Someone goes hungry.

Tue, 09/29/2009 - 18:51 | 82981 suteibu
suteibu's picture

The rest of us are consigned to suck hind tit...on the boar hog.

 

FIFY

Tue, 09/29/2009 - 16:21 | 82783 crzyhun
crzyhun's picture

NOOOOO, most conservatives want don't want the status quo, Mons. Rat.

We want open state competition among the insurance comp., portability, and more well run HSA's, to start with.

We want fraud and waste out of Medicare and Medicaid.

We want the gov't to be 'governor' of all the options as they are in regards to Medicare.

We want bloat gone, drones nailed, patronage cut 99%.

We want innovation with market solutions pointing to those uninsurables and pre-existing conditions.

The issue is people and they are hard to change. People run corp, small business and banks. Only in some ideal far away unrealistic place are there no 'special interests'. We all have them. Some are reasonable and some are not.

Tue, 09/29/2009 - 16:32 | 82798 ghostfaceinvestah
ghostfaceinvestah's picture

Depends on how you define "conservative". 

Ron Paul has mentioned the points you listed - let's get competition into the system.

I live in an urban area, where i have a choice of hospitals and doctors.  Why can't I get a quote for a simple doctor's visit?  Or a fixed price bid?  Or at least some kind of price list?

Before we add another player to the oligopoly, let's try competition first.

Sure, some people question: "you would go to the lowest bidder?"  NO, I don't take my car to the lowest bidder, I don't take my child for childcare to the lowest bidder, i don't get my haircut from the lowest bidder.

But I DO use the information available to make informed choices on the cost/quality tradeoff.

Give me price information and an online rating system for doctors (e.g. Yelp) and me and millions like me will "reform" healthcare.

Tue, 09/29/2009 - 16:39 | 82807 Anal_yst
Anal_yst's picture

Amen!

 

The fact that Doctors and health-care providers bill AFTER the fact with usually zero discussion of cost before hand is mind boggling, although not nearly as ridiculous as 99% of people just going along with it like mindless zombies.

Tue, 09/29/2009 - 17:34 | 82883 Hephasteus
Hephasteus's picture

My uncle is a certified public accountant, many people my family are. I felt really sorry for my cousin not passing his test the first time. He got a bit of pressure on him. LOL

Anyway I had the great experience of driving him around to various doctors for eye surgery paid with cash. After being dishonorably discharged for refusing to violate the constitution from the navy, leaving arthur anderson for refusing to bend accounting rules this was one cranky old man that doctors just didn't want to have to negoiate with.

"What you mean you don't know what it costs? You doctors have lost COMPLETE CONTROL OF YOUR PROFESSION!!"

Nurses standing around smiling. Me swapping stories about doing the lens physics for somene who was writing an application for a lense salesman who makes 2 million a year and has offices all over the country that are just phones in buildings. Discussing hospitals buying $900 bucks for the little metal poles to hang the IV bags on. It was a good day.

Tue, 09/29/2009 - 20:46 | 83136 long-shorty
long-shorty's picture

The doctors do this because it doesn't matter how much they bill, unless the patient has no insurance, they are getting paid whatever rate their local insurance monopoly/oligopoly decides to pay them (well, if they beg and file the claim three times, except for the 15% of the time when they still don't get paid), and because of the system that the government has established that assigns a value to documentation and procedures, but not to thinking or to making good decisions.

The profession of medicine, and primary care medicine in particular, is, like everyone who took a hit from the current economic crisis (which is everyone), a victim of bad government policy. The government has established a health care delivery system with large financial incentives for PC docs to see a lot of patients poorly and consult a lot of specialists. And then the specialists get paid the most when they do tests and procedures.

And primary care salaries keep going down every year in real terms, which means you get people with MCAT scores of 17 from some osteopathic school rather than people with MCATs of 33 as the gatekeeper making the most diagnoses and controlling expense.

The system is FUCKED. Getting at good policy here is incredibly complex and against many entrenched special interests, so it isn't going to happen. We need a health care system that pays primary care providers generously when they provide good care and poorly when they don't. Not one that rewards ineptitude and greed.

- former top decile board certfied Internal Medicine doc who scored 40 on his MCATs, and left medicine to manage my own hedge fund (where even in my first year with microscopic AUM, I earned more than I could make as a primary care doc, with much less stress, and that was during the financial crisis).

Tue, 09/29/2009 - 20:48 | 83139 long-shorty
long-shorty's picture

if it wasn't clear from that, giving everyone a chance to have Medicare is not going to solve anything. it's a social program, not an answer to why we spend so much and don't get the best results for that expenditure.

Tue, 09/29/2009 - 21:28 | 83215 Rusty_Shackleford
Rusty_Shackleford's picture

Great posts. I too have known the vast, soul crushing Sisyphean ordeal and existential void that is primary care medicine. I hear you dude.

 

2 quotes I always try to remember regarding government "programs".

 

Government is force. Every government program, law, or regulation is a demand that someone do what he doesn't want to do, refrain from doing what he does want to do, or pay for something he doesn't want to pay for. And those demands are backed up by police with guns. - Harry Browne

 

Government is not reason, it is not eloquence, it is force; like fire, a troublesome servant and a fearful master. - George Washington

Wed, 09/30/2009 - 02:35 | 83457 handsfree
handsfree's picture

Congress has long ago given up all moral authority on this issue. But, go figure. When you lay down with whores, expect to wake up with STD's.

Goldman and Bank of Amerika run the markets along with Geithner, and beagle boy Ben. There is no free markets, only welfare capitalism and socialism for capitalism.

good articles; good articles 4 slow news day ..http://www.. hat tip: finance news & opinion updated daily

Tue, 09/29/2009 - 16:46 | 82817 D.O.D.
D.O.D.'s picture

+10

Tue, 09/29/2009 - 19:36 | 83039 Miles Kendig
Miles Kendig's picture

I gotta ask...  You know the Oaktown.  CR?

Tue, 09/29/2009 - 16:51 | 82826 Assetman
Assetman's picture

Depends on how you define "conservative". 

Democrats & Republicans = conservative

Revolutionists = liberal

Assetman = smart aleck

 

Tue, 09/29/2009 - 17:02 | 82835 TumblingDice
TumblingDice's picture

That sounds more like a "capitalist" POV to me.

Tue, 09/29/2009 - 17:20 | 82868 ghostfaceinvestah
ghostfaceinvestah's picture

Right, or "libertarian" maybe.  That is my point on the use of the term "conservative"; it has been co-opted by people who are anything but.

Notwithstanding political affiliation, there are plenty of economic studies that show markets are less efficient when there are informational asymmetries.  How can any market work without even a priori price disclosure?

Even though I have health insurance and thus have seemingly little incentive to price shop, I would do it on principal alone, besides the fact that it would improve the market in the long run and thus reduce my health costs.

Better yet, put me in a high deductible plan where the deductible can be paid with pre-tax dollars, and damn right I will shop like a motherf*cker.

Tue, 09/29/2009 - 17:44 | 82894 TumblingDice
TumblingDice's picture

But the government doesn't trust you to make the right decision, giving you less reason to trust the government. As this process continues there becomes only one reason to trust the government, and that is because you have to. Thats where many folks are right now. Not efficient at all.

The government doesn't have to spend a dime to fix this problem, but it won't because you can't buy trust and spending money is the only thing it knows how to do.

Tue, 09/29/2009 - 18:32 | 82958 Anonymous
Anonymous's picture

IMHO, the words "conservative" and "liberal" have become worthless, at least in the USA. I know people who work at firms which subsist primarily on government contracts, but call themselves "conservative", and even listen to Fox News, at work. They don't see the irony. As for "liberals", consider DailyKos. Is the primary goal of "liberals" merely to get "liberals" elected, and then, nobody knows? We probably need about a dozen new terms. For example, "Ronpauls" could include Ron Paul, Alan Grayson and, sometimes, Tyler Durden and the delectable but dangerous Marla Singer. Or, maybe, just abandon labels completely.

Tue, 09/29/2009 - 20:13 | 83084 defender
defender's picture

"the delectable but dangerous Marla Singer"

Nicely said.

Tue, 09/29/2009 - 17:14 | 82858 Anonymous
Anonymous's picture

Remove the job-health care connection by giving the tax break to the individual, not the corporation. That way when you switch jobs, you don't have to switch health care providers.

Sell "pre-existing condition" insurance that would guarantee you access to reasonably priced health care insurance if you develop a condition.

Remove/reduce the state regulations, so it's possible to move to a different state without having to switch health care companies.

Encourage high deductible policies - there's nothing like a little out of pocket expenses to get people to stop going to doctor every time they get the sniffles.

Tort reform! I've been losing the hearing in one of my ears for years. My doctor sent me to the specialist who orders a CAT Scan test for the one in a million chance that a tumor is causing the problem. That was strictly a CYA move that cost over a $1000.

Tue, 09/29/2009 - 19:35 | 82991 Miles Kendig
Miles Kendig's picture

We want fraud and waste out of Medicare and Medicaid.

Ya.  Right.  How many convictions for fraud were there and the total aggregate of said fraud from Jan 01- Jan 09?

That is why a conservative controlled government passed Part D?

So called liberal or conservative.  Just two sides of the same blood sucking, prostituting coin.

Tue, 09/29/2009 - 16:22 | 82784 Cognitive Dissonance
Cognitive Dissonance's picture

When the people decide to lead, the leaders will eventually follow.

Tue, 09/29/2009 - 16:22 | 82785 Veteran
Veteran's picture

Viva la revolucíon

Tue, 09/29/2009 - 16:24 | 82787 Edna R. Rider
Edna R. Rider's picture

Anecdote:  I run a smallish company.  We use Aetna for health insurance.  By coincidence our policy renews this month.  The new proposal is on my desk.  The premiums are INCREASING by 11.3% over last year.  I bought ($28) some AET as a hedge (sold $29, when learning the "public" option that other solvent countries have (Canada) had been voted down).  Barack n roll.

Tue, 09/29/2009 - 17:24 | 82872 Enkidu
Enkidu's picture

Edna - I live half in Canada/ half in UK and love the health systems in those countries because it does not matter what your status is. If you are divorced or unemployed or poor - everyone is treated the same. However, my question is why can't the Obama Administration just keep bringing Medicare forward so that it starts at 60 then 55... etc.? Isn't Medicare just like the systems already used in Canada/UK?

Tue, 09/29/2009 - 17:58 | 82915 shargash
shargash's picture

Medicare is more similar to Canada. The VA hospital system is more similar to the UK.

We can't have everyone treated the same in the US. That would be Marxist or something.

Tue, 09/29/2009 - 18:06 | 82923 Anonymous
Anonymous's picture

"However, my question is why can't the Obama Administration just keep bringing Medicare forward so that it starts at 60 then 55... etc.?"

How can the government pay for full and complete health care for 310 million people when there is $50 trillion of cumulative debt across the entire US economy?

Tue, 09/29/2009 - 19:11 | 82993 Miles Kendig
Miles Kendig's picture

Simply because a fair portion of that debt is earmarked not for actual services or expenditure, but for those that hold the crossroads of commerce.

Wed, 09/30/2009 - 02:07 | 83465 Enkidu
Enkidu's picture

Health costs rise as people get older for obvious reasons - so America has already covered the worst part of the curve. The younger part of the curve will be less expensive.

With regard to the payment, the US could halt or half their military adventures (US military spending is more than the next 10 countries put together), stop the rape of the Treasury by the financial services industry, end subsidies to the housing sector (as in Canada), etc.. It would seem that there is absolutely no limit to the amount of fiat that can be produced. I would sooner be confident in finding health services than I would in being handed cash for a car!

Tue, 09/29/2009 - 18:42 | 82972 Anonymous
Anonymous's picture

+1

Tue, 09/29/2009 - 20:26 | 83104 defender
defender's picture

This will never work.  Even with the high minimum age the three largest expenditures for the US govt are Social Security, Medicare/Medicade, and defence.  If it costs just as much to make thousands of tanks and airplanes for the sole purpose of being blown up in some distant land as it does to care for people over 65, how much is it going to cost to care for the rest? 

Two things need to happen:

1. Schools need to let more doctors in/graduate.  This is keeping an artificially high cost to all doctor visits.

2.  There needs to be more clinics.  This means decent places where you aren't just another number that they are squeezing for cash.  If the hospitals have to compete, then they will lower prices.

Tue, 09/29/2009 - 18:14 | 82933 Anonymous
Anonymous's picture

You should check out healthcare downunder. Public and private options. Going bankrupt through catastrophic illness is unheard of. Reading this piece I now understand why USA healthcare is 'rip your tits off' expensive. If only the average American Joe knew that your public system is more expensive per eligible person than the sum of all the healthcare per capita in every other Western country.....

Tue, 09/29/2009 - 23:04 | 83325 Rusty_Shackleford
Rusty_Shackleford's picture

Don't be so quick to accept the "epidemic of medical bankruptcies" meme.

 

The classifications used to determine a medical bankruptcy were odd. Only 28.3 percent of the sample cited self-reported illness or injury as a cause of bankruptcy.  However, H & W managed to almost double that figure (to 54.5 percent) by counting the following as "illnesses":

  • 1. A birth or addition of a new family member
  • 2. A death in a family
  • 3. A drug or alcohol addiction
  • 4. Uncontrolled gambling
  • 5. Loss of at least 2 weeks of work-related income due to illness or injury by anyone in the household
  • 6. Out-of-pocket medical bills of $1,000 in the two years before filing by anyone in the household
  • 7. Mortgaging a home to pay medical bills.

In a 2005 article in the Northwestern University Law Review, Prof. Todd J. Zywicki called the $1,000 threshold for contributing medical debt "indefensible." That's an understatement.  By H & W criteria, a bankruptcy with $50,000 in student loans and $1,001 in unpaid medical bills would be classified as a "medical bankruptcy." 

 

http://www.john-goodman-blog.com/medical-bankruptcy-myths/

http://blogs.abcnews.com/thenumbers/2009/03/medical-bankrup.html

http://www.fraserinstitute.org/Commerce.Web/product_files/HealthInsuranc...

Tue, 09/29/2009 - 16:31 | 82797 Anonymous
Anonymous's picture

For a while D.R. had me going, especially the phrase "governmental negligence"........but he immediately veered to the left as expected and his argument lost it's flavor.

Unwinding decades of bad government must be done extremely carefully, and my hopes are not high for it's successful outcome. When the foxes are guarding the henhouse bad things generally happen.

Tue, 09/29/2009 - 17:02 | 82843 I am a Man I am...
I am a Man I am Forty's picture

Not sure what you mean, didn't notice him veering in any direction.

Unwinding decades of bad government should happen at warp speed with a bill less than a page long.

 

 

Tue, 09/29/2009 - 19:21 | 83001 Miles Kendig
Miles Kendig's picture

Unwinding decades of bad government will never be accomplished carefully.  Such unwinding almost always happen rapidly as a great vacuum equalizing.

The time is rapidly approaching when most everyone will know who has the power, the monster or those that created and loosed the monster upon us.  Dylan Ratigan is a product of some simply enfeebled attempt to say something is being allowed to be said when next to nothing real is being said & done.  Just more expenditure of O2 rather than true pressure releasing by the monster creators.  Soon, the choice will be out of their hands as well.

Tue, 09/29/2009 - 16:37 | 82801 AN0NYM0US
AN0NYM0US's picture

This was originally published at HuffPo - amazing that the comment thread there is void of partisanship - Mr. Ratigan has tapped into a populist sentiment that resides in people of all political stripes. His message transcends party lines  and I suspect that void of any missteps or serious scandal he will hit prime time in the near future, not to mention a real shot at political office should he be interested. 

Tue, 09/29/2009 - 19:27 | 83008 Miles Kendig
Miles Kendig's picture

That is the whole concept.  Push the Unity '08 concept into '12 after the trillions were obtained, the concept of deferential justice cemented, south & southwest Asia bagged and the populace engrossed in how it will satisfy the gatekeepers of finance for the public & private notes.

Too bad the monster won't be satisfied with this and will demand ever more that it's creators or its host cannot satisfy.

Tue, 09/29/2009 - 16:40 | 82808 Daedal
Daedal's picture

Dylan, I miss you and Jeff Macke.

Tue, 09/29/2009 - 16:42 | 82809 kosherenchiladas
kosherenchiladas's picture

Is this that slut from "Fast Money?" What a tool... Although, he makes good points. For a dick.

Tue, 09/29/2009 - 17:48 | 82900 Anonymous
Anonymous's picture

I wouldn't call him a dick just yet. I'll just call him Major_Shill. We see his transformation from CNBC to MSNBC he's now a real good guy, not. Now the Obama admin has Major_Shill in their pocket.

-Disappointed.

Tue, 09/29/2009 - 16:42 | 82810 Anonymous
Anonymous's picture

Maybe if our leaders (i.e. legislative branch) was more concered with creating a better country for its citizens instead of how their votes will affect their reelection chances (especially as relates to donations from special interest groups), we might actually see something positive happen...

Tue, 09/29/2009 - 16:45 | 82811 D.O.D.
D.O.D.'s picture

Corporate Feudalism, that's what it is, whether the founding fathers, and whatever societies they may or may not have been a part of, had Corporate Feudalism in mind is debatable.

The question is, why are people still holding the hand that insists on holding them/us down? (Dylan, that's to you as much as anyone else.)

Tue, 09/29/2009 - 17:36 | 82888 Hephasteus
Hephasteus's picture

Corporate feudalism and illusory slavery versus real brutal slavery was the goal.

+10

Tue, 09/29/2009 - 16:44 | 82815 Anonymous
Anonymous's picture

Microsoft was allowed to be a monopoly for years

Tue, 09/29/2009 - 16:48 | 82818 Anonymous
Anonymous's picture

Dylan, Keep up the good work!

I'd say run for office, but I am sur ethe many trysts that you have would make you un-electable. In any regard, keep putting needles in these motherfuckers eyes.

CNBC has lost all credibility. They tell one side of the story and on teh rare occasion they have a dissident, one of the lemming anchors will not let him or her finish their sentence.

Tue, 09/29/2009 - 16:56 | 82820 TumblingDice
TumblingDice's picture

How much longer must we live in a country where the citizens are subservient to the banks, health insurance companies and any other special interest able to control our government at the expense of our the most basic principles of fairness, our future as a nation and, as a result, our freedom?

Until such a time when we have nothing to lose. It is our choice in the end.

Tue, 09/29/2009 - 17:47 | 82897 Anonymous
Anonymous's picture

freedom's just another word...

http://www.youtube.com/watch?v=5FMhnl0__Vo

Tue, 09/29/2009 - 16:49 | 82821 Commander Cody
Commander Cody's picture

Dylan's point is: Get rid of the anti-trust exemption.  Are we for or against this?  Personally, I think the exemption should be lifted.  Does anyone think it is in the public's interest to let it stand?

Tue, 09/29/2009 - 16:50 | 82824 arnoldsimage
arnoldsimage's picture

i doubt we''ll be discussing health care in the next two months. it absolutely blows me away that the sheep are still grazing in this country. we will be more concerned where we are going to get our food and water from. i know, because i have prepared for what's coming. people refuse to believe what is about to happen to our country, even though all the signs are evident before them. it will most likely be a combination of events. here they are in no particular order. 1) the heat will start to pick up regarding the taking of the swine flu vaccine. 2) false flag event of some sort in the country... major terrorist threat or dirty bomb detonation. 3) martial law imposed... whatever remaining rights we had are gone. 4) market utterly collapses. 5) foreign troops and private security forces police our states. they are here now by the way. i hope i'm wrong.

Tue, 09/29/2009 - 17:31 | 82881 Anonymous
Anonymous's picture

Within 60 days?

Then chickens have lips.

Tue, 09/29/2009 - 18:13 | 82931 Anonymous
Anonymous's picture

"i doubt we''ll be discussing health care in the next two months."

I'm fully convinced at this point that health care, cap-and-trade, etc., are serving as manufactured distractions so the Obama administration doesn't have to be compelled to focus on fixing the fundamental problems with the economy. Much easier to sign a "stimulus," claim you're "creating or saving" a made-up number of jobs, and call it a day rather than make some hard decisions that might make people not treat you like a rock star.

Tue, 09/29/2009 - 16:51 | 82825 Philologus TaXitus
Philologus TaXitus's picture

This is a great example of Corporatism and while trying to find a witty quote to insert in defense, I ran across this article from 2002 and, in my humble opinion, this Robert Locke guy is a freakin' oracle.

Excerpt:

http://97.74.65.51/readArticle.aspx?ARTID=22594

 

We are probably heading into some economic heavy weather which will spur needed debate on what's right and wrong with our economy. This will require our being clear about what kind of economy we really have. I have mentioned before that we increasingly live not in a capitalist society but in a corporatist one, and I would like to flesh out this notion.

What is corporatism? In a (somewhat inaccurate) phrase, socialism for the bourgeois. It has the outward form of capitalism in that it preserves private ownership and private management, but with a crucial difference: as under socialism, government guarantees the flow of material goods, which under true capitalism it does not. In classical capitalism, what has been called the "night-watchman" state, government's role in the economy is simply to prevent force or fraud from disrupting the autonomous operation of the free market. The market is trusted to provide. Under corporatism, it is not, instead being systematically manipulated to deliver goods to political constituencies. This now includes basically everyone from the economic elite to ordinary consumers.

Tue, 09/29/2009 - 17:02 | 82842 AN0NYM0US
AN0NYM0US's picture

+1 for the link

Tue, 09/29/2009 - 18:27 | 82953 Anonymous
Anonymous's picture

we remember reading this back in 2002.
it blew our mind then, still does now.
especially when we would personally disagree with the writer with virtually every other subject he writes about.

thanks for sharing again. his points stuck with us long after we forgot where we read them.

"Anyone who is serious about getting rid of corporatism must explain how they are going to restore these two kinds of trust or persuade people to live without them."

yup...this is a question we must try and answer. we think the answer lies somewhere in each and every social encounter.

Tue, 09/29/2009 - 16:54 | 82828 Careless Whisper
Careless Whisper's picture

Dylan ??? Dylan ??? Dylan ???

nice article. welcome aboard.

Tue, 09/29/2009 - 16:55 | 82829 Anonymous
Anonymous's picture

"Why would we let them rig the game?"

Because it's already rigged. Has been for a long time. Now they're going to get the outcome in D.C. that makes them the most money. Believe me, savings for the average health care consumer won't even be within the top 5 priorities of the final bill.

One thing I don't understand is why Presidents of all stripes always have to go for "The Big Bill" which tries to conquer a gigantic issue all at once. Why not just send up a bunch of individual bills? Like one to increase competition and cut down on state monopolies. Then one looking at cost issues. Then one addressing the uninsured. Then one looking at tort reform.

Instead we get this giant omnibus, too big for any congressmen to actually read and stuffed with pork, compromised solutions, and bad unintended consequences.

Tue, 09/29/2009 - 17:35 | 82887 Anonymous
Anonymous's picture

Sure you understand.

In chaos there is profit.

Tue, 09/29/2009 - 18:33 | 82959 Translational Lift
Translational Lift's picture

Why Presidents of all stripes always have to go for "The Big Bill". 

Nothing more than people with small dicks and large heads!!!

Tue, 09/29/2009 - 16:56 | 82830 Anonymous
Anonymous's picture

More corporate bashing rant from DR. When he states government is set up so "no special interest or group could use government power to commandeer the creative and economic wealth of our nation to their own ends" he somehow misses the point that we need to protect ourselves from the government's use of government power "to commandeer the creative and economic wealth of our nation to their own ends." Government is the only ones with absolute power. DR is guarding the wrong man.

No one in government is truly interested in "creating and enforcing free and fair markets" - although not sure what "fair" means (equal outcomes?). Some of us don't think the government should be in the business of "seeking answers to the problem of paying for and providing medicine" - it just leads to more power to the government - which is more dangerous than corporations' limited power. The liberal view is that most people are nearly completely unable to find their way through the world without lots of government help -- the entitlement, government dependency agenda.

Tue, 09/29/2009 - 17:08 | 82851 TumblingDice
TumblingDice's picture

The point here is the fusing of government and corporate interests, making corporations more powerful than they would be in a free market system.There are different types of powerful government, and Dylan is siply highlighiting the worst kind: the kind that has surrendered (been captured, however you want to put it) much of its power to non-democratic entities.

Tue, 09/29/2009 - 17:15 | 82861 Anonymous
Anonymous's picture

Willing to bet DR is not particularly interested in a truly "free market system" for corporations where the role of government is as limited as possible. None of his solutions suggest such. Seems he is looking to penalize corporations, not free them.

Tue, 09/29/2009 - 18:26 | 82950 TumblingDice
TumblingDice's picture

IDK. The impression I get is that he simply wants to end the special privilages extended to them by the gov't.

Tue, 09/29/2009 - 18:34 | 82960 Anonymous
Anonymous's picture

What special privileges have been extended to health insurance companies?? Whatever they are, I am sure they would trade them for unfettered freedom to sell insurance where ever they please, with no mandates for acupuncture coverage etc

Tue, 09/29/2009 - 19:37 | 83042 TumblingDice
TumblingDice's picture

for starters, how about the privilege discussed here about the exemption of anti-trust laws. there are countless others, but the most fundamental ones appear in our financial system. One is the difference between HY and IG bonds (very complex issue but the crux of it is that the more established and entrenched corporations are assumed to have the backing of the government and thus have to pay lower rates) and how that handicaps competition, second is no big contracts from the gov't, and third is the whole damn premise behind the creation of FRN's and the way the system is maintained. In times of trouble the govt doesnt hesitate to take a hit for the banks with the taxpayers money.

Trust me, the handicaps that are there are mostly for show. The real goal is perfect partnership between corporations and government. Sort of like in Godfather 2 when Roth is in Cuba. Only this time its masked behind democracy.

Wed, 09/30/2009 - 15:09 | 84117 Anonymous
Anonymous's picture

Those primary privileges are not endemic to the insurance industry.

If the problem is the fusing of government and corporations which is most at fault? Seems government is because their power (tax, confiscate, regulate, print money, etc) trumps the limited power of a corporation. Government may have succumbed to the wishes of corporations, but corporations can not force government to do anything (there just out there looking to make money and will use government as best they can to do so). That is a government problem at the end of the day. Take a scalple to government -- not sure that we will have a different outcome as to what corporations survive / thrive, but don't care if we do or don't.

So much of the rants are "corporations are screwing the people." If so three solutions for the consumer: 1) stop using their product; 2) use a competitors; or 3) if they are generating obscene profits for poor service, start your own company to compete with them if it is so easy to do it the "right" way. But regardless, stop complaining. having government whip them into shape is absurd -- government is clueless how to best do things.

Tue, 09/29/2009 - 20:23 | 83100 Miles Kendig
Miles Kendig's picture

hahaha

A beneficiary of anti trust exemption will never willing trade their free cookies away for the prospect of fighting for someone else's cookies.

Tue, 09/29/2009 - 21:04 | 83166 Miles Kendig
Miles Kendig's picture

 

Check out the source Andy.. I decided to pick a movie role as well to expand my perception of the role I can fill.

After all, hope is the best of things, no?

Tue, 09/29/2009 - 21:12 | 83182 Miles Kendig
Miles Kendig's picture

 

 

Better yet.  To get him to chase you then have the FBI destroy his second home you decided to hold up in. hehe

Tue, 09/29/2009 - 21:10 | 83177 Miles Kendig
Miles Kendig's picture

 

 

Indeed

Tue, 09/29/2009 - 21:09 | 83176 Miles Kendig
Miles Kendig's picture

 

I still have hopes my book will find its way out of the vault one day.

Tue, 09/29/2009 - 17:30 | 82880 Anonymous
Anonymous's picture

So if corporations have X too much power, do you think the government has 2X too much power? 5X? 10X?

So government is getting pushed around by the corporations...interesting.

Corporations should not be granted citizen status, but they also should not be paying taxes. Only "entities" which can vote should be taxed (citizens) so voters can understand the true cost of government (not via indirect corporate taxes on consumers) and decide if they like the amount of taxes they are paying and do something about it if they don't.

Tue, 09/29/2009 - 18:55 | 82961 TumblingDice
TumblingDice's picture

No one is getting pushed around except the taxpayer. and you are right that our tax system and democratic process, two very relevant issues, need sorting out.

I would do the opposite of what you recommend though. The way income is traditionally defined by our judicial system is as a profit, and by that definition the only legal tax out there is a corporate income tax. The problem with relying solely on corporate taxes is that corporations can too easily evade those taxes by manipulating their production to yield the final product in a country with a low corporate tax. Sony might send their "almost finished" DVD players to the Phillipines to have them wrapped, sold, and taxed at a lower level. Same thing with any American based corporation. Very hard to get around this problem without giving up some sovereignty, something that I am highly against.

I do agree that we should strip corporations of their "person" status but then we have to consider how to shape the legal definitions in a more appropriate way. A seperation of person and corporations would need different laws for each.

Tue, 09/29/2009 - 18:46 | 82974 Translational Lift
Translational Lift's picture

You mean like Imelt running GE into the ground then teaming up with (ie giving 10's of millions $) the leftist gov to support "cap & tax" and "health care reforms" hoping that will bail out GE.  Sounds like a bargin with the devil to me....all the while selling out the American public.

Tue, 09/29/2009 - 20:43 | 83128 Gilgamesh
Gilgamesh's picture

That bargain was struck a long time ago.  Jeff is just one who is more eager to hold up his end.  That is the only thing explaining his being picked, and why he is still in place.

Tue, 09/29/2009 - 18:35 | 82964 Anonymous
Anonymous's picture

you really need to read that Robert Locke referenced above.

it's not corporate bashing, it's corporatISM.
dylan may be on to something bigger than he even realizes.
and that's saying a lot, given the size of his EGO.

Wed, 09/30/2009 - 15:01 | 84101 Anonymous
Anonymous's picture

If the problem is the fusing of government and corporations which is most at fault. Seems government is because their power (tax, confiscate, regulate, print money) trumps limited power of a corporation. Government may have succumbed to the wishes of corporations, but corporations can not force government to do anything (there just out there looking to make money and will use government as best they can to do so). That is a government problem at the end of the day.

Wed, 09/30/2009 - 06:10 | 83496 Anonymous
Anonymous's picture

government, corporations, is there a difference? where do you draw the line between the 2, if there is one?

Tue, 09/29/2009 - 16:59 | 82839 Anonymous
Anonymous's picture

Can someone make a defensible argument as to why health insurance should be a for-profit endeavor?

Does competition and profit motive in this case produce a better insurance table, or does it just allow companies to craft slick ways to bilk its customer base out of money and services.

Pharma is a different matter, probably more complicated. Given the benefits of a healthy population, it would benefit our national interest to lower health care expenses and promote preventive care rather than expensive pharmacological treatments.

Tue, 09/29/2009 - 17:01 | 82840 Anonymous
Anonymous's picture

The state health insurance company market shares quoted only mean we should let insurance companies compete openly across state lines -- an idea opposed by every Democrat....unclear why...

Tue, 09/29/2009 - 17:07 | 82847 Anonymous
Anonymous's picture

from dylan's link:

"So far the powerful insurance industry has held back waging a full-out battle against Democratic health reform proposals because companies stand to gain tens of millions of new customers."

"He said the insurance industry would accept legislation prohibiting it from discriminating against customers because of pre-existing medical conditions in exchange for a government mandate that requires tens of millions of Americans to sign up for coverage."

at least everyone's being honest about what this is all about now.

question: who here that doesn't have insurance is going to buy insurance under the current 'plan' if they are mandated to?

not us.

however, if they are willing to truly reform the system, then we would be happy to participate, mandate or no.

we are happy to tell the judge the same thing before he carts us off to jail. at least there, we'll have 'free' healthcare.

Tue, 09/29/2009 - 17:10 | 82854 Anonymous
Anonymous's picture

Dylan when you interview someone keep the question under 3 minutes so the answer can be more than 3 seconds. I hope your not the GE carrot being dangled before my sore eyes.

Tue, 09/29/2009 - 17:23 | 82857 Stevm30
Stevm30's picture

I guess the question is: what does an ideal system look like?  That's what everyone is trying to figure out.

A couple thoughts:

Proposal 1: Remove the business tax exemption.  Result: Insurance companies will cherry pick healthy people, and you will have those most in need without insurance

Proposal 2: Allow state insurance regulation to cross state lines: Result: Insurance companies will cherry pick regulators.  States will become competitive and this in effect is removing regulation

Proposal 3: Require insurance companies not to discriminate on the basis of gender, weight, age, pre-existing condition, but don't mandate universal coverage.  Result: People will wait until they get sick to sign up for insurance, and only sick people will want insurance.  Insurance rates will go sky high (basically the same as paying out of pocket anyway).

Proposal 4: Have a government entitlement for health care: Result: less innovation and less motivation for people to enter the field.  Government inefficiency and rationing of care.  Politicization of medicine.

Proposal 5: Remove all health insurance regulation (more direct way of doing Prop 2).  Result: Insurance companies will discriminate against anyone with a pre-existing condition.  There will be a constant flow of high profile "rip-off reports" as people feel they got screwed and have no one to bitch at.  This inevitably leads to public demands for REGULATION of the industry.

Proposal 6: Set up a very high deductible catastrophic government run insurance plan. Individuals pay first $15000/yr of costs.  Result: Low cost and effective way to deal with the truly catastrophic.  People begin to think twice about visiting the doctor for minor ailments.  People run price checks on routine medical operations/procedures... leading to competitive pricing.  People will pay out of pocket for the great majority of their medical expenses.  BIG BAD insurance companies will be dramatically decreased in size and influence, as people don't see the justification in paying.  Some people continue to buy supplemental coverage.

Obviously the insurance companies are going to work hard as hell not to let 4 or 6 happen... any of the others give them the ability to continue to rake in huge profits, and manipuate the Congress/state regulators for preferential treatment.

 

Tue, 09/29/2009 - 17:35 | 82886 Anonymous
Anonymous's picture

This presumes we have determined everyone has a right to health insurance.

And once the state has a vested interest in the health of everyone, they should get to make a lot of other requirements to protect their vested interest -- how much health care one should get, tax on anything they deem "unhealthy," etc.....

Can not believe so many want to hand the government that kind of power (which will never be retrieved once extended).

Tue, 09/29/2009 - 18:46 | 82976 Anonymous
Anonymous's picture

"tax on anything they deem "unhealthy," etc....."

ah, they're already doing that. not only that but criminalizing certain 'unhealthy' plants (cannabis) while subsidizing other 'healthy' ones (like corn).

Tue, 09/29/2009 - 18:43 | 82973 Anonymous
Anonymous's picture

ah, we'll take door #6 please Alex.

Tue, 09/29/2009 - 17:23 | 82871 Anal_yst
Anal_yst's picture

Nice to see some MSM types posting here.

Tue, 09/29/2009 - 17:33 | 82882 Crook County
Crook County's picture

"This country's founders built an ingenious system of checks and balances for a reason: to ensure that no special interest or group could use government power to commandeer the creative and economic wealth of our nation to their own ends. How much longer must we live in a country where the citizens are subservient to the banks, health insurance companies and any other special interest able to control our government at the expense of our the most basic principles of fairness, our future as a nation and, as a result, our freedom?"

We will stop letting them rig the game when we repeal the 17th amendment and get the INSANE AMOUNTS of campaign money out of Senatorial Politics.

Tue, 09/29/2009 - 17:39 | 82892 Gilgamesh
Gilgamesh's picture

Some would say that the Cloward-Piven strategy is being used to take down the framework built by our founders.

Tue, 09/29/2009 - 17:40 | 82893 Anonymous
Anonymous's picture

Is that "causing the skyrocketing health care costs" or in part is GE causing skyrocketing costs by selling MRI machines for $12 million dollars that cost just $3700 to manufacture??

Then the doctors and hospitals jump on the wagon and say: "if GE can get away with this so can we"!

How about setting an example for us and do the right thing instead of trying to peddle this socialist agenda of yours.

I'm not interested in what you have to say anymore Shill. Talk to the hand my brotha.

Tue, 09/29/2009 - 17:55 | 82911 FredFubar
FredFubar's picture

I'm sure a statistically significant percentage of the population here believes the crap about ACORN. Nevertheless, for those who aren't at the intersection of MediaMatters and ZH

MSNBC airs discredited allegation linking White House to ACORN from Media Matters for America

RedState contributor Brian Faughnan suggested on MSNBC that White House political affairs director Patrick Gaspard was formerly a "senior" official at ACORN -- a charge that was discredited minutes later by the Politico's Ben Smith. During the segment, MSNBC host Dylan Ratigan did not challenge Faughnan's statement and did not point out to the audience that MSNBC had not verified that the charge was true.

Tue, 09/29/2009 - 17:56 | 82912 BennyBoy
BennyBoy's picture

Now that medicaid, medicare and veterans hospitals are running flawlessly, it's time to expand to the private sector! And monopoly is a good thing, just look at how my FED runs, putting $trillions on the public debt and aint nobody can do nuthin' about it!

 

Tue, 09/29/2009 - 18:11 | 82930 Anonymous
Anonymous's picture

Amen Brother Benny. Powerless to the people.

Wed, 09/30/2009 - 02:35 | 83450 handsfree
handsfree's picture

Congress has long ago given up all moral authority on this issue. But, go figure. When you lay down with whores, expect to wake up with STD's.

Goldman and Bank of Amerika run the markets along with Geithner, and beagle boy Ben. There is no free markets, only welfare capitalism and socialism for capitalism.

good articles; good articles 4 slow news day ..http://www.. hat tip: finance news & opinion updated daily

Tue, 09/29/2009 - 17:57 | 82914 Anonymous
Anonymous's picture

The game is rigged because the extraordinarily centralized power structure in this country makes it easy for a few large interests to rig the game.

We allow it because the vast majority of people in this country are too far from the center of power and therefore less able to effect real change.

We allow it because we have confiscatory tax rates that require two-income households. Parents are less able to oversee the education of their children, and their children become victims of an educational system that indoctrinates them into accepting the status quo and churns out dumbed-down zombies.

We allow it because our leaders have finally achieved what they sought; a majority of dependent voters who are too afraid of losing their goodies to vote away the power structure, and a minority of entrepreneurs, business owners, and hard workers who are leeched off of in order to pay for it all.

The leeches get to keep an ever-shrinking part of the government pie, the workers become fewer, and the power brokers in Washington get to keep their Congressman/Lobbyist-For-Life positions as long as the structure will hold.

It will only end when there are too few ants to pay for too many grasshoppers (a situation that we are currently spiraling towards). Washington will have to be dragged kicking and screaming away from centralized power (either to the unemployment line or to the gallows, depending on how long they want to drag this out).

You want to see the game end? Dismantle Washington as the source of power in this country. Our leaders longer follow constitutional law, nor do they even pretend to represent the people. They need to have their power taken away from them, by force if necessary. Corruption will still be there but much more localized, and therefore closer to the torch-and-pitchfork crowd who keeps tabs when rule of law fails through corruption of government.

Right now Washington is corrupted on nearly every level. The financiers have lied, cheated, and stolen while the regulators either look the other way or have encouraged the corruption. Our government is completely overrun with rats and there is usually only one way out of a situation like that...burn the place to the ground (figuratively, of course).

Tue, 09/29/2009 - 18:35 | 82963 Anonymous
Anonymous's picture

There's no changing this whole mess. Impossible. Why?

"a majority of dependent voters who are too afraid of losing their goodies".

Obama marching orders; Hamster wheels 4 errbody except for those who want to feed out of my new and improved gold plated trough(health care included yo).

Tue, 09/29/2009 - 17:59 | 82918 Anonymous
Anonymous's picture

The game is rigged because the extraordinarily centralized power structure in this country makes it easy for a few large interests to rig the game.

We allow it because the vast majority of people in this country are too far from the center of power and therefore less able to effect real change.

We allow it because we have confiscatory tax rates that require two-income households. Parents are less able to oversee the education of their children, and their children become victims of an educational system that indoctrinates them into accepting the status quo and churns out dumbed-down zombies.

We allow it because our leaders have finally achieved what they sought; a majority of dependent voters who are too afraid of losing their goodies to vote away the power structure, and a minority of entrepreneurs, business owners, and hard workers who are leeched off of in order to pay for it all.

The leeches get to keep an ever-shrinking part of the government pie, the workers become fewer, and the power brokers in Washington get to keep their Congressman/Lobbyist-For-Life positions as long as the structure will hold.

It will only end when there are too few ants to pay for too many grasshoppers (a situation that we are currently spiraling towards). Washington will have to be dragged kicking and screaming away from centralized power (either to the unemployment line or to the gallows, depending on how long they want to drag this out).

You want to see the game end? Dismantle Washington as the source of power in this country. Our leaders longer follow constitutional law, nor do they even pretend to represent the people. They need to have their power taken away from them, by force if necessary. Corruption will still be there but much more localized, and therefore closer to the torch-and-pitchfork crowd who keeps tabs when rule of law fails through corruption of government.

Right now Washington is corrupted on nearly every level. The financiers have lied, cheated, and stolen while the regulators either look the other way or have encouraged the corruption. Our government is completely overrun with rats and there is usually only one way out of a situation like that...burn the place to the ground (figuratively, of course).

Tue, 09/29/2009 - 18:40 | 82969 Robert Paulson
Robert Paulson's picture

Why do we let monolithic corporate interests control the affairs of state?

Because amongst the indulgent, slovenly, obese masses, we wander in the land of endless distractions.  Most alpha males decide to play the game to get their piece of the pie.  The remaining strong-willed men, who do not play along, sit idly on the sidelines.  We are placated by mere discussion, conjecture and conspiracy.  Our own fear controls us.  Our will is weak.  We are effectively dominated.  Our castration is almost complete.

Tue, 09/29/2009 - 18:52 | 82983 Anonymous
Anonymous's picture

...and then we will realize that somewhere in our impotency lies true power...

Tue, 09/29/2009 - 19:34 | 83034 Miles Kendig
Miles Kendig's picture

WOW!  That was an inspired piece of self reflection.

Tue, 09/29/2009 - 20:52 | 83146 TumblingDice
TumblingDice's picture

So alpha males get shit done with their discussion, conjecture and conspiracy while we are placated by it?

No sir, thought, discussion, and craft is how we change our world, and each person does it their own way. In no way are we placated by this process. The game goes on.

Tue, 09/29/2009 - 18:55 | 82985 lizzy36
lizzy36's picture

This is from a Bloomberg special report.

It notes all the area's where excessive costs plague the US system.

Canadian Health Care, Even With Queues, Bests U.S. Sept. 18 (Bloomberg) -- Opponents of overhauling U.S. health care argue that Canada shows what happens when government gets involved in medicine, saying the country is plagued by inferior treatment, rationing and months-long queues.

The allegations are wrong by almost every measure, according to research by the Organization for Economic Cooperation and Development and other independent studies published during the past five years. While delays do occur for non-emergency procedures, data indicate that Canada’s system of universal health coverage provides care as good as in the U.S., at a cost 47 percent less for each person.

“There is an image of Canadians flooding across the border to get care,” said Donald Berwick, a Harvard University health- policy specialist and pediatrician who heads the Boston-based nonprofit Institute for Healthcare Improvement. “That’s just not the case. The public in Canada is far more satisfied with the system than they are in the U.S. and health care is at least as good, with much more contained costs.”

Canadians live two to three years longer than Americans and are as likely to survive heart attacks, childhood leukemia, and breast and cervical cancer, according to the OECD, the Paris- based coalition of 30 industrialized nations.

Deaths considered preventable through health care are less frequent in Canada than in the U.S., according to a January 2008 report in the journal Health Affairs. In the study by British researchers, Canada placed sixth among 19 countries surveyed, with 77 deaths for every 100,000 people. That compared with the last-place finish of the U.S., with 110 deaths.

Infant Mortality

The Canadian mortality rate from asthma is one quarter of the U.S.’s, and the infant mortality rate is 34 percent lower, OECD data show. People in Canada are also 21 percent more apt to survive five years after a liver transplant.

Yet the Canadian “bogeyman,” as U.S. President Barack Obama called it at an Aug. 11 gathering in Portsmouth, New Hampshire, may have “all but defeated” the idea of a public option in the U.S., said Uwe Reinhardt, a health-care economist at Princeton University in Princeton, New Jersey.

Senate Finance Committee Chairman Max Baucus, Democrat from Montana, introduced on Sept. 16 compromise health-care legislation that, unlike other House and Senate bills, omits a government-backed choice for the uninsured living in the U.S. who can’t afford private coverage.

Insurance Mandate

Private insurers, the pharmaceutical industry and the medical profession fear the “market power” of a public plan, Reinhardt said. They “deployed certain think tanks to find horror stories around the world that can be used to persuade Americans a public health plan in the U.S. would bring rationing.”

Given that Congress is likely to pass a mandate to cover the uninsured, Americans forced to buy policies will be left with no alternative to coping with “double-digit rate increases” on commercial premiums, Reinhardt said.

“Both systems ration medical care,” he said. “In Canada, they make people wait. In the U.S., we make people pay.”

Fifty-four percent of chronically ill Americans reported skipping a test or treatment, neglecting to go to a doctor when sick, or failing to fill a prescription because of the cost, according to a 2008 survey by the Commonwealth Fund, a foundation that focuses on health care, and pollster Harris Interactive. That was more than twice the number in Canada, data from those New York-based groups showed.

Payment Worries

As the price of health care in the U.S. has risen three to four times faster than the rate of inflation, surveys show that Americans have become concerned they won’t be able to pay medical bills. Forty-three percent of consumers in a June poll by the University of Michigan in Ann Arbor said they worried they might not be able to afford care, even with insurance.

“Canadians value fairness, and they cannot conceive of a system in which someone can’t get health care,” said Wendy Levinson, a Canadian who runs the department of medicine at the University of Toronto and worked in the U.S. from 1979 to 2001.

The U.S. spent $7,290 on health care for each person in 2007, 87 percent more than Canada’s $3,895, according to the latest OECD data. The U.S. also devoted the highest percentage of gross domestic product to health care, 16 percent, OECD numbers show. Canada’s expenditure was 10.1 percent.

Canada’s system consists of 10 provincial and three territorial nonprofit insurance plans that cover all citizens, including those with pre-existing conditions. It operates like Medicare, the U.S. program for the elderly and disabled. In Canada, the government uses taxpayer funds to pay claims by doctors, who mostly work in private practice or for a hospital and are paid fees for their services.

Effect of Technology

Care is free where it’s provided, as in a doctor’s office, except for dentistry, nursing home stays, prescription drugs outside hospitals, and rehabilitation services. The elderly and low-income residents get help with pharmaceutical purchases.

Technology partly explains the cost discrepancy between the two nations. There are 67 percent more coronary-bypass procedures in the U.S. than in Canada and 18 percent more Caesarean sections, OECD data show. In 2006, the U.S. had more than four times the number of magnetic resonance imaging units - - 26.5 for every million residents compared with 6.2 for every million in Canada -- making Americans three times more likely than Canadians to get a scan, according to the OECD.

In the U.S., technology is “overused” because doctors have to justify equipment purchases with revenue, according to Gerard Anderson, a professor of public health and medicine at Johns Hopkins University in Baltimore. Canada in the 1960s was about as expensive as the U.S., he said.

No. 1 in Cost

“The real difference has been their ability to control technology costs,” said Anderson, who directed reviews of health systems for the World Bank and developed U.S. Medicare payment guidelines for the Health and Human Services Department. “The only thing the U.S. is consistently No. 1 in when it comes to international comparisons with Canada and other OECD countries is cost.”

Less technology and, according to a 2007 report from the World Health Organization, 20 percent fewer doctors in Canada than in the U.S. have led to longer lines north of the border.

In 2008, 20 percent of chronically ill Canadians surveyed by the Commonwealth Fund reported waiting three months or more to see a specialist. Five percent of Americans polled said they had to wait that long.

Television Commercial

Washington-based lobbying groups including Americans for Prosperity and FreedomWorks have seized upon the delays, arguing that Obama’s proposal for a public option would eventually put private insurers out of business and force everyone to live with government-paid coverage and substandard care. FreedomWorks is led by Dick Armey, a former Republican congressman from Texas.

An educational foundation affiliated with Americans for Prosperity paid $3.3 million to run a 60-second television commercial on U.S. stations in which Shona Holmes, a 45-year-old native of Waterdown, Ontario, accused the Canadian health-care system of almost causing her to die by delaying critical treatment, according to Amy Menefee, a spokeswoman for the foundation. The ad ran for three weeks and was repeated on Sept. 9 after the president’s speech.

The TV spot first aired in May. Holmes, a mother of two and a self-employed family mediator, said in the ad that she went to the U.S. for care. She traveled 2,237 miles (3,599 kilometers) to the Mayo Clinic in Scottsdale, Arizona, and spent $97,000 for treatment of a benign brain tumor rather than wait for insurance-paid care in Canada, she said in a telephone interview.

Bridge to Canada

“I felt strongly I could speak out because I’ve seen both systems,” Holmes said. “I have seen how government involvement plays very negatively.”

Obama administration officials are trying to use the public option as “a bridge” to a system like Canada’s since “they realize it isn’t politically acceptable to go directly to that,” said Phil Kerpen, the director of policy for Americans for Prosperity.

In Ontario, where Holmes lives, the average waiting time for surgery to remove a tumor was 99 days in the second quarter, according to the Ontario Health Insurance Plan’s Web site. If a patient was willing to go closer to Ottawa, the wait was 36 days at Pembroke Regional Hospital Inc. in Pembroke, 460 miles from Waterdown and 93 miles northwest of the Canadian capital. Closer to Waterdown, a patient could go to St. Joseph’s Healthcare Hamilton, less than 10 miles away, with a 56-day wait.

Ontario Appeal

Holmes began speaking out publicly, she said, after she couldn’t get Ontario in July 2005 to speed removal of her craniopharyngioma, a type of slow-growing cystic tumor that can put pressure on the brain or optic nerve. She is now pushing for the province’s insurance plan to reimburse her for the money she spent on surgery, tests and follow-up, she said in the interview.

Andrew Morrison, a spokesman for the Ontario plan, said Canadians need approval before getting care outside the country if they want to be reimbursed. He declined to comment on the Holmes case. Lori Coleman, registrar for the Toronto-based Health Services Appeal and Review Board, which handles complaints about the Ontario plan’s eligibility and payment decisions, also declined to comment.

Even with the waits, a majority of Canadians balk at the idea of turning government insurance over to private hands. In a July Harris/Decima poll, 55 percent of respondents said improvement should be made through the public plan, while 12 percent favored a private solution.

Doctor Visits

In both the U.S. and Canada, 26 percent of people interviewed told the Commonwealth Fund survey of chronically ill adults they got a same-day appointment with a doctor when they were sick -- the lowest number in any of the eight countries polled by the foundation. Thirty-four percent of the Canadians said they had to wait six days or more, compared with 23 percent of the Americans.

Canadians visited their doctors more frequently: 5.9 visits per person compared with four for those in the U.S., according to 2005 OECD data.

The U.S. leads industrial countries in the portion of the health-care dollar devoted to processing claims and paying providers, the Commonwealth Fund said.

Private-insurance administrative costs in the U.S. are 12.7 cents of a dollar, and as high as 18 cents for some companies, said Karen Davis, president of the Commonwealth Fund. Government plans, including Medicare and Medicaid, spend 5.8 cents excluding costs of private drug plans, she said. In Canada 4.2 cents is spent on administration.

“If we lowered our administrative costs to that of the lowest three countries with mixed public-private health-care systems, we could save $50 billion a year,” Davis said. “This would go a long way toward financing coverage for the uninsured.”

Tue, 09/29/2009 - 20:15 | 83020 Miles Kendig
Miles Kendig's picture

Makes me wonder what the wait times would be like if everyone that needed specialist care was actually attempting to access the system rather than fighting to be able to do so. Insured or not.

Lizzy, have you ever gone this long before?  I thought I was the only one that used this much space.  Thanks for doing so.

From the perspective of so called "wealth" of insurance, I am a 100% disabled veteran with total care at the VA, a retired federal civil servant with federal employees health benefit plan coverage & MEDICARE, all before I reached my 40th my cynicism from what I have borne witness to leads me to ask everyone one question.

Who do you want making your health care/medical treatment options decisions, a Twinkie eating for profit bureaucrat or a not for profit Twinkie eating bureaucrat?  As long as our society places "squids" of various sorts at the crossroads of commerce these are the choices we are left with.  We being those citizens who cannot consider paying all of the potential medical expenses out of pocket.

Tue, 09/29/2009 - 19:19 | 82999 tjfxh
tjfxh's picture

 

"How much longer must we live in a country where the citizens are subservient to the banks, health insurance companies and any other special interest able to control our government at the expense of our the most basic principles of fairness, our future as a nation and, as a result, our freedom?"

UNTIL WE GET THE MONEY OUT OF POLITICS!!!!

Until we get public financing of political campaigns, as in other liberal democracies, and an end to the legalized bribery called PAC's and lobbying, America will remain a plutocratic oligarchy in which the wealthy and powerful rent the government to do their bidding.

 

Tue, 09/29/2009 - 21:00 | 83161 Anonymous
Anonymous's picture

Here here. This is the crux of the whole problem.

I hate when people say "the government is trying to screw us!" as if there's some big conspiracy.

Really, "the government" is just politicians whose main concern is keeping their jobs, i.e. getting re-elected.

In order to keep their job, i.e. get re-elected, they need a lot of money for advertising.

So they take money from special interests, which in less civilized areas is known as a "bribe" or "corruption".

Said politicians are then on the hook to help out the special interest they took money from, to stay in their good graces for the next election.

It's not a conspiracy folks, or powerful people trying to screw the little guy. Just regular people looking out for their own self-interest, just like you and me. The result unfortunately is the disaster we see today.

Tue, 09/29/2009 - 19:39 | 83048 Anonymous
Anonymous's picture

dylan ratigan is becoming the MSNBC version of glenn beck.....

Tue, 09/29/2009 - 20:45 | 83133 TumblingDice
TumblingDice's picture

not even close

Tue, 09/29/2009 - 21:17 | 83194 Miles Kendig
Miles Kendig's picture

Duces!

Tue, 09/29/2009 - 19:57 | 83071 mkkby
mkkby's picture

"How much longer must we live in a country where the citizens are subservient to... any special interest"

Dylan and Everyone Else:

The root of the problem is this notion that corporations have constitutional rights. This means they can give politicians campaign contributions (read that "bribes"), and it cannot be limited because of free speech. This in turn allows them to write the rules that govern them, and pressure regulators to ignore their misdeeds.

Forget this silly fight between political parties. If you truly want to end corruption, the real battle is taking money out of politics. That battle MUST start with limiting constitutional rights to real, living human beings who have a vote.

Tue, 09/29/2009 - 21:00 | 83158 Anonymous
Anonymous's picture

Agree, but you got to get rid of corporate taxes too. It is that whole "taxation without representation" thing.

Wed, 09/30/2009 - 05:19 | 83492 Intuition
Intuition's picture

Absolutely agree. I've never been able to grasp where the notion came from that allowed the legal system to endorse corporate rights. Our rights are natural rights. How can artificial entities enjoy so many of the same natural rights? Freedom of speech would seem to be an inalienable right, meaning that it cannot be delegated. It makes absolutely zero sense to afford corporations the right to free speech.

Tue, 09/29/2009 - 20:29 | 83107 wackyquacker
wackyquacker's picture

Daaawwg, you gotta be kidding me. Center for American Progress??? Harry and Trent????? What are you smoking? Honestly, TD, stick to the finances and econs. This kind of stuff I would expect from a high school sophomore.

Competition from the government?? Competition from the government???Competitive how?? Think about that for a second or two; let it roll around a little. THIS is the reason a competitive market doesn't exist in medical care: dupes who actually assert crap like this as basis for argument.

Tue, 09/29/2009 - 21:02 | 83163 Anonymous
Anonymous's picture

Amen. So the group that makes all of the rules and has the ability to confiscate (tax) and print money will provide some fair competition. We have alot of morons in this country who believe this.

Wed, 09/30/2009 - 02:35 | 83441 handsfree
handsfree's picture

Intelligent service provision to customers to ensure and improve quality of service around algorithm-selection, execution quality, market structure, technical advice etc.

Goldman and Bank of Amerika run the markets along with Geithner, and beagle boy Ben. There is no free markets, only welfare capitalism and socialism for capitalism.

good articles; good articles 4 slow news day ..http://www.. hat tip: finance news & opinion updated daily

Tue, 09/29/2009 - 21:36 | 83227 ShankyS
ShankyS's picture

DR - I appreciate your work, esp since you left CNBS. I liken you these days to a more sane Glenn Beck that has actual content worth listening to. If you want to do a post that gets the ZH crowd going, spill some beans on the CNBS crowd. Thanks for sharing.

Wed, 09/30/2009 - 02:00 | 83463 i.knoknot
i.knoknot's picture

Glenn Beck is pro-constitution and asking some valid questions. Encourage that.

RE:DR's article, if we were to allow unregulated cross-state access, who else believes we'd be looking at another face sucking squid in that industry? While the current system is broken in many ways, careful the 'simple fix' we enact...

Tue, 09/29/2009 - 21:45 | 83240 digalert
digalert's picture

This whole healthcare reform has nothing what so ever to do with an individuals health!!! It's all about money, power and control. Yet people will argue up and  down all day long how 14 billion people everyday lose or don't have health insurance blah blah blah.

next

Cap & Tax

next

Telephone co. reform

next

Cable, TV, Radio reform

next...

Tue, 09/29/2009 - 21:48 | 83242 Anonymous
Anonymous's picture

Finally, a voice of wisdom.

Wed, 09/30/2009 - 01:18 | 83413 Anonymous
Anonymous's picture

I rather thought that the American political system was designed to make takeover by the merchant class easy.

Wed, 09/30/2009 - 02:32 | 83422 handsfree
handsfree's picture

Good point here

Goldman and Bank of Amerika run the markets along with Geithner, and beagle boy Ben. There is no free markets, only welfare capitalism and socialism for capitalism.

good articles; good articles 4 slow news day ..http://www.. hat tip: finance news & opinion updated daily

Wed, 09/30/2009 - 10:51 | 83713 trader1
trader1's picture

please stop spamming the comment threads.

Wed, 09/30/2009 - 01:54 | 83461 Anonymous
Anonymous's picture

People have the power, no question about it. The closest analogy would be shareholders in a company.

But if the right to vote and speech are not excercised by enough people it has no meaning. We need VOLUME!!!
The entire country must rise against the politicians who are wrecking this country by selling it for a few 1000 dollars a pop.

Now if all the top blogs got together in a massive common effort this might just be possible. This might just be the first Internet Revolution.

Wanna start the ball rolling ZH?...

Wed, 09/30/2009 - 06:51 | 83503 rubyspringer
rubyspringer's picture

Make the bastards compete. Get rid of the exemptions. No one really wants Free Markets especially the Health Care con men.  Free markets would mean competition. That is what they lobby to prevent, hoping to gain or maintain any priveledge that the state has given them.   

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