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Guest Post: Obamacare - The Neutron Bomb That Will Decimate The U.S. Economy

Tyler Durden's picture




 

Submitted by Charles Hugh-Smith of OfTwoMinds blog,

ObamaCare will act as a neutron bomb on the U.S. economy for systemic reasons.

Longtime readers know I have repeatedly explained why healthcare, i.e. sickcare, will bankrupt the nation. ObamaCare simply speeds up the coming collapse. Here are two of the dozens of entries I've written on sickcare: 

America's Hidden 8% VAT: Sickcare (May 10, 2012) 

Can Chronic Ill-Health Bring Down Great Nations? Yes It Can, Yes It Will (November 23, 2011)

I have also explained why ObamaCare's "fixes" are simulacra reforms that don't even address the systemic costs arising from the cartel-fiefdom structure of sickcare: 

Why "Healthcare Reform" Is Not Reform, Part I (December 28, 2009)

Why "Healthcare Reform" Is Not Reform, Part II (December 29, 2009)


Sickcare is unsustainable for a number of interlocking reasons: defensive medicine in response to a broken malpractice system; opaque pricing; quasi-monopolies/cartels; systemic disconnect of health from food, diet and fitness; fraud and paperwork consume at least 40% of all sickcare funds; fee-for-service in a cartel system; employers being responsible for healthcare, and a fundamental absence of competition and transparency.

Please glance at these charts to see how the U.S. healthcare costs are double those of competing nations on a per capita basis. Japan provides care for a mere 36% per person of what the U.S. spends--yet millions of Americans remain uninsured or underinsured.

If you set out to design a corrupt, inefficient, wasteful, unfair, deranged and unreformable system, you would arrive at U.S. healthcare/ObamaCare.


ObamaCare ignores the structural causes of our ill-health:

86% of Workers Are Obese or Have Other Health Issue Just 1 in 7 U.S. workers is of normal weight without a chronic health problem.

The Patient Protection and Affordable Care Act (PPACA), i.e. ObamaCare, is a neutron bomb for employment. A neutron bomb is an enhanced-radiation thermonuclear weapon that famously leaves buildings, autos, etc. intact but kills all the people, even those inside buildings. vehicles, etc.

ObamaCare will act as a neutron bomb on the U.S. economy for these systemic reasons:

1. It is immensely complex, and already-marginalized small business owners will shed employees or simply close rather than have to figure out what all those thousands of pages of regulations and statutes mean to the survival of their business.

2. ObamaCare's primary mechanisms of lowering costs, insurance exchanges and technocratic selection of "best care practices," do nothing to change the systemic flaws of sickcare.

Many other commentators have already outlined how ObamaCare is driving employers to replace fulltime workers with part-time workers to avoid having to pay outrageously expensive monthly healthcare insurance premiums.

I see this response as a Corporate-America strategy. Corporate America has the human resources infrastructure and financial heft to figure out compliance and exploit loopholes in the insanely complex law. Small business has neither the infrastructure nor the financial resources. Small business owners will rely on the same cartels that are currently providing insurance for guidance, and of course the ObamaCare offerings will suit the financial needs of sickcare cartels.

Once small business owners see the costs of their options, some may opt to pay the penalties and others may follow the corporate strategy of turning each fulltime job into two part-time jobs to avoid paying for coverage or penalties, but many will choose instead to call it quits: either downsize to a one-person/one-household business with no employees at all, or sell/close the enterprise and escape the burdens.

What the lobbyists and attorneys who wrote the Obamacare monstrosity do not understand (because they have no exposure to or experience in the real economy) is the fragility of most small businesses: costs keep rising but revenues are stagnant. The mental and financial stresses keep rising, and ObamaCare does nothing to mitigate either source of stress.

The inside-the-Beltway types who crafted this mess have no idea of the pressures facing legitimate (non-black-market) business in America, corporate and small business alike.

ObamaCare offers even more incentives for Corporate America to offshore operations, and it provides powerful incentives to millions of marginal small businesses to shut down or shed all employees.

I am not alone in simply not wanting to waste the time, money and energy required to understand the new law and its various impacts on my business. We will cling to our already insanely expensive private healthcare insurance, one of the few that has been grandfathered in: new self-employed entrepreneurs won't be able to buy the absurdly costly policy we have--they will be offered a range of even worse deals, with higher costs and less coverage.

3. Perhaps most cruelly, the bronze level of ObamaCare--the "affordable" care--is a mirage, a simulacra of insurance rather than actual insurance. Bronze level ObamaCare features deductables of around $6,000. In other words, you have to spend $6,000 before your insurance kicks in.

In an economy in which two-thirds of all households live paycheck to paycheck, this is the equivalent of no insurance. High-income sickcare lobbyists and millionaire politicos may look at $6,000 as no big deal, but for households with little savings or credit, that might as well be $60,000.

4. As many others have pointed out, the income levels that divide receiving a Federal subsidy from not receiving a subsidy are begging to be gamed. If $62,000 is the line in the sand that qualifies your household for a hefty subsidy on health insurance, the incentives to adjust earnings to fall just below $62,000 (or whatever the number is for the locale and household size) are immense.

People respond to the incentives and disincentives they are presented with, perverse or otherwise. The lobbyists, toadies and apparatchiks who wrote and passed ObamaCare could not have stuffed the bill with more perverse incentives if they had set out with that as their primary goal.

The neutron bomb has gone off, unseen by politicos and the Elites who wrote the bill. It is already undercutting fulltime employment, and it will soon add momentum to the free-fall erosion of small business growth and employment.
The strip malls and office parks will still be standing; there just won't be many employees in them.

Of related interest:

About Your $3.16 a Day Healthcare Insurance Plan... (February 21, 2013) MirageCare

What If ObamaCare, Too Big To Fail Banks and the State Are All the Wrong Sized Unit?(February 25, 2013)

 

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Thu, 11/21/2013 - 10:09 | 4176916 the not so migh...
the not so mighty maximiza's picture

limit corn syrup to just candy you would reverse the trend

Thu, 11/21/2013 - 10:14 | 4176931 Occident Mortal
Occident Mortal's picture

America should copy the UK system.

 

 

Thu, 11/21/2013 - 10:16 | 4176938 DaddyO
DaddyO's picture

/sarc?

Surely, you jest...

DaddyO

Thu, 11/21/2013 - 10:22 | 4176966 King_of_simpletons
King_of_simpletons's picture

I believe this system of care is called "Exceptional Care".

Thu, 11/21/2013 - 10:29 | 4176990 MissCellany
MissCellany's picture

Because there are so many exceptions to getting care?

Thu, 11/21/2013 - 10:39 | 4177036 Occident Mortal
Occident Mortal's picture

In the UK nobody gets turned away. Ever.

Controversially, even illegal immegrants get free heart bypass surgery if they need it.

 

And the whole system still costs less than HALF of US healthcare per capita.

Thu, 11/21/2013 - 10:44 | 4177057 Gene Parmesan
Gene Parmesan's picture

Who pays for everyone's healthcare? Who pays for the illegal immigrant's heart bypass surgery (hint: it ain't free)? How's the quality of care? Do you really believe that government is capable of running industry - any industry - better than the private market is?

Thu, 11/21/2013 - 10:57 | 4177124 icanhasbailout
icanhasbailout's picture

There's the "black swan" you have been looking for, folks.

Thu, 11/21/2013 - 11:05 | 4177160 johnQpublic
johnQpublic's picture

baxter the dog got his obamacare

whats not to like about a system that will insure a dog that has basically no income

Thu, 11/21/2013 - 11:11 | 4177182 Indian_Goldsmith
Indian_Goldsmith's picture

What decimated the American culture? I bet it was Feminism

Thu, 11/21/2013 - 11:29 | 4177260 CheapBastard
CheapBastard's picture

So...I should skip that BOGO Krispy Kreem Deal?

Thu, 11/21/2013 - 12:54 | 4177678 Herd Redirectio...
Herd Redirection Committee's picture

Feminism, was that where they turned families on each other, and married women against career women?

Thu, 11/21/2013 - 11:34 | 4177274 NoDebt
NoDebt's picture

Months ago, there was much gnashing of teeth about "where is all the new Treasury issuance going to come from for the Fed to continue buying under QE??"

To which I said:  "I present you with your solution:  Obamacare."

I still stand by that opinion.

Thu, 11/21/2013 - 13:34 | 4177927 August
August's picture

IMHO you can run a society based on Deism, but not on Atheism. As to Agnostiscism, I just don't know.

Feminism itself was the reaction to a public acceptance of the male "Rat Pack" ethos as laudable, and cool.

Thu, 11/21/2013 - 11:40 | 4177324 DoChenRollingBearing
DoChenRollingBearing's picture

We all now see what a disaster Obamacare is.  I wrote in June 2012 that it would be so.  What I did not foresee is that it would be so poorly done, even its website.  Now we see the terrible results, and we've only started!

"How's that Obamacare Working Out for You?"

http://tinyurl.com/m9trlj5

Thu, 11/21/2013 - 12:09 | 4177439 Kirk2NCC1701
Kirk2NCC1701's picture

They got WOG* Swans too.

 

* Westernized Oriental Gentleman.  Often, but not always, used in pejorative terms.  E.g. "Mr. X is a WOG" is not pejorative.  Although you can probably tell by the non-Anglo last name.  "X is a bloody WOG" is pejorative.

Thu, 11/21/2013 - 11:40 | 4177323 Occident Mortal
Occident Mortal's picture

The Brits pay for it.

 

But even when they are patching up illegal immegrants they still pay less than half of what Americans pay per capita.

 

I don't think it's perfect, but the empirical evidence doesn't lie.

 

UK health care costs less than half of US healthcare and Brits are living 2 years longer on Average.

Better care, less expensive. Sounds shit right?

Thu, 11/21/2013 - 12:19 | 4177501 Lost My Shorts
Lost My Shorts's picture

Take your socialist facts and stuff them up your marxus.  We make our own reality around here, and in our reality, your facts aren't facts.

Thu, 11/21/2013 - 12:28 | 4177540 aerojet
aerojet's picture

Are doctors making bank in the UK?  In the US, we are making doctors rich.  And hospital administrators are getting even richer.  The US is a lobbyist society--this was covered here on ZH this week--you don't compete with other businesses, you hire lobbyists to work on directing funds and positive outcomes your way.  This is what ObamaCare is all about, the lobbyists bringing home the bacon.  Whether or not anyone receives treatment is not their concern at all.

Thu, 11/21/2013 - 13:32 | 4177911 MachoMan
MachoMan's picture

There are an incredible amount of doctors not getting rich at all...  The biggest piece of the pie is going to administrators...

Thu, 11/21/2013 - 12:26 | 4177527 aerojet
aerojet's picture

It doesn't matter who pays if that cost can be laundered through enough levels, you see?  If it isn't clear who pays, then "everyone pays" can be ignored as a fundamental problem.  It's like they come and break your legs, and then you have to figure out how to get by in that crippled state, but it's just "part of doing business" now, a cost that was added that further impairs your own ability to do anything else.  But hey, fuck the powerless little people, right?

The whole issue boils down to control and whether we want to live as free people making our own choices in life or if we want to be impaired little serfs with some tiny percentage, say 5% freedom that isn't any threat to the machine.

Thu, 11/21/2013 - 15:13 | 4178441 Rylie
Rylie's picture

Short answer is everyone pays the same know one is ever turned away.

Yes I think that the government can run health care better then the private industry. ObamaCare is a joke everyone knows that but other countries have better systems then the USA and its cheaper. France is Number 1  in health care rankings  the USA is 38.  The top 37 are government run, the USA also pays a lot more money for worse care.

http://en.wikipedia.org/wiki/World_Health_Organization_ranking_of_health...

I live in Canada we have about the same tax rate but we have health care provided by the government. I do not have to pay insurance and deal with premiums as people do in the USA. You argue that you should only pay for yourself, I guess you have never been really sick or have a family member get really sick. Why do the people of the US work their whole lives to save and retire, then get sick and live in poverty because medical bills had to be paid.

Why do you let corporations profit from your bad health?

 

Thu, 11/21/2013 - 11:24 | 4177239 rubiconsolutions
rubiconsolutions's picture

"In the UK nobody gets turned away. Ever."

Right. And this is the result - http://news.investors.com/ibd-editorials/082813-669050-british-health-service-on-brink-of-crisis.htm. I've been there. The lines and quality of care is dismal - http://www.csmonitor.com/2007/1019/p04s01-woeu.html. If you think the model of excellence in healthcare is Britain than you have a very low standard for excellence. Finally, read this - "The NHS has reached its crisis point" - http://www.dailymail.co.uk/debate/article-2496134/MAIL-ON-SUNDAY-COMMENT-The-NHS-reached-crisis-point.html.

Thu, 11/21/2013 - 11:37 | 4177302 Occident Mortal
Occident Mortal's picture

Yet on average Brits live 2 years longer than Americans. 

You value anecdotes more than the Macro data listed by the OP?

 

So Brits live longer and their healthcare costs less than half as much?

Let's just pretend this data doesn't exist shall we.

Thu, 11/21/2013 - 12:51 | 4177648 SgtShaftoe
SgtShaftoe's picture

The United States has historically been the vanguard for advanced and safer medical procedures.  The UK NHS is as if you put the DMV in charge of healthcare.  Many people die unnecessarily.  Mortality rate in the US is not bad healthcare.  The US has some of the lowest mortality rates for procedures, but more are done.  Americans are fat and don't give a damn about their own health. 

Breaking the healthcare system in a new way is not the answer.  Healthcare in the US has been taken over by government and private interest groups since the 70s.  If you've spent any time at all reading zerohedge, you'd have come to the realization that scale of systems is a major enemy.  You'd also have come to the realization that there is no government intervention possible at this point with outright fascist results.  Have your state run system paradise at the local or county level and you might not do as much damage, but any changes nationwide will result in utter catastrophe. 

Net, the NHS is a bunch of Butchers.  That's why the UK is building out private hospitals at record rates.  NHS kills people, predictably and efficiently.

Thu, 11/21/2013 - 14:30 | 4178207 buyingsterling
buyingsterling's picture

Britain is whiter, trimmer, works less hours, is less stressed, and is less cancerous than America, so the extra two years they live may have little to do with their pathetic health system. They control costs the same way all goverment programs do: rationing. In many European countries the elderly don't bother to call for an ambulance, they know it isn't coming.

Britain doesn't seem to care about its elderly residents who are dropping like flies for no good reason. Brits pay hundreds of billions/year for their .gov bureaucracy. Meanwhile, as many as 25000 UK residents/year die because they can't heat their homes in the winter. The goverment is now considering a 900,000 Pound plan (that's a million and a half bucks) to deal with this problem. They lose more to fuel poverty than America loses to murder, and we have 4x the population. If they targeted the 50,000 homes most at risk and gave each a $100/month subsidy for four months/year, the cost would be $20 million. If they saved 80% of those who would otherwise die, they would be saving each person for $1000/year. On second thought, that does seem kind of pricey. Never mind.

Thu, 11/21/2013 - 12:36 | 4177573 outamyeffinway
outamyeffinway's picture

@Occident

 

You don't know what you're talking about. As you age, care is based on an "as-needed" basis. 60 year old needs a kidney, 6 year old needs a kidney: bye gramps. Been nice knowing you. You had a good life.

Thu, 11/21/2013 - 13:04 | 4177736 Republicae
Republicae's picture

I would not even wish the UK's heath system on Obama!

This story from the Daily Mail, November 17, 2013..... reported last week that nearly 40% of National Health Service workers — doctors, nurses and paramedics — said they would not recommend their own workplace to friends or family who need care.

More than 101,000 NHS workers responded to a survey that asked them if they agreed with the following statement:

"If a friend or relative needed treatment, I would be happy with the standard of care provided by this organization."

While 63% said they agreed or strongly agreed, 12% said they disagreed or strongly disagreed while a quarter, reports the Daily Mail, "did not 'express a preference.'"

"That left 37% of staff who did not recommend treatment."

This finding is a significant indictment. Even worse, at two of the system's worst hospitals, only 35% said they would recommend care at their workplace, and 17% overall said they "did not think patient care was their manager's top priority."

What would be a manager's focus, then? Saving money in a state-run system that can't tax enough to pay for the care it has promised?

Playing the bureaucratic game in a regime in which health care decisions are made by politics rather than by the patient and doctor working together?

One hospital within the NHS no longer subject to politics is Hinchingbrooke. The facility, located in Cambridgeshire, north of London, was privatized last year after, the Mail reports, being "on the verge of going bust."

Read More At Investor's Business Daily: http://news.investors.com/ibd-editorials/030613-647023-british-health-care-workers-wont-recommend-their-workplaces.htm#ixzz2lIh2HS3A

Thu, 11/21/2013 - 14:03 | 4178029 Lost My Shorts
Lost My Shorts's picture

There is no more NHS in England.  (There is still in Scotland, Wales, and Northern Ireland.)  In England, the most of the facilities of the NHS have been privatized.  Funny how news is slow to get around.  It's still single payer, any failures are now failures of private contractors, so you will need to update your rhetoric of blame.

p.s. my source is behind a sign-up wall:

http://www.medscape.com/viewarticle/811443

Headline: 

The End of the National Health Service

Excerpt:  "Although the term National Health Service and the NHS brand continue to be used, a National Health Commissioning System or NHCS is in fact a more correct term. What was largely a public service is being replaced by a network of public, private and charitable services, still funded mainly through taxation but each operating independently."

Thu, 11/21/2013 - 15:19 | 4178471 RiseOfTheMachines
RiseOfTheMachines's picture

The daily mail is not a serious newspaper. My mother reads it because 80% of it's content is aimed towards older middle class women. Lots of stories about the Royals etc. It's more entertaining than informative. 

Laissez Faire policies result in the Law of the Jungle, that is not the way civilized cultures work. If you want to return to the Law of the Jungle then be prepared to be invaded and conquered by a more enlightened, organized and cohesive culture down the road.The existing system badly needs to be reformed. Tearing it down is not a solution as tempting as it seems. 

Maybe breaking up the US in to a handful of countries might work better to breakup the stranglehold of massive government. Have the country of the North East (Yankee Land), The South (Rebel country), The Central Plains, The SouthWest, The NorthWest and Texas. That would give you smaller government. Introduce competition between the regions regarding good vs bad government. 

On a different note the number of half mad people sleeping homeless around me in the US is very disturbing. These people need shelters and homes. It's not ok to have a society like this. Out of self interest it is upsetting. Maybe they are there as a warning to everyone else to stay in line ....... It doesn't make any sense to me but then again I've noticed how people here seem to be in fear of losing their job and health, with no safety net it keeps eveying quiet as mice.  

Thu, 11/21/2013 - 10:29 | 4176991 Occident Mortal
Occident Mortal's picture

Lol,

 

Healthcare insurance only works when everyone pays the same flat rate.

 

 

Otherwise a whole bunch of people are incentivised to not contribute until their circumstances change. Which makes the whole show more expensive for everyone.

 

Look at the figures above, I'm not making it up.

Thu, 11/21/2013 - 10:52 | 4177052 Urban Redneck
Urban Redneck's picture

If everyone pays the same flat rate, no one is financially incentivized to live a healthier lifestyle.

Thu, 11/21/2013 - 11:12 | 4177186 Cugel
Cugel's picture

And yet Americans have both the greatest financial incentive and the least healthy lifestyles.

Thu, 11/21/2013 - 11:48 | 4177366 666
666's picture

How did Americans survive before the Great Depression? There was no Social Security, Medicare or any other support systems. Look at pictures from then. People were not overweight, ate healthier non-packaged foods, worked manual labor jobs, did not know what diabetes is, etc. Our current diet and sedentary lifestyles are killing us, but our healthcare system does not recognize this. Instead, it has turned into a massive Ponzi scheme that feeds on itself, where big bucks are to be made by pushing pills instead of exercise and diet. Healthcare in this country has evolved into a new form of taxation where, you guessed it, the rich get richer.

Thu, 11/21/2013 - 12:07 | 4177446 JailBank
JailBank's picture

In the near future I think you'll get the answer of how. When the money runs out or the money doesn't buy services anymore a lot of people will find out how to live without these things.

Thu, 11/21/2013 - 12:40 | 4177594 Withdrawn Sanction
Withdrawn Sanction's picture

"Our current diet and sedentary lifestyles are killing us, but our healthcare system does not recognize this"

Oh, I think it does recognize this (at least the big pharma guys recognize it). After all, if you can keep a patient on _______ (statins, insulin, SSRIs, etc.) you have built a long-term recurring income stream.  Teach them how to be/eat healthy, where's the blockbuster drug in that?

"Do you take drugs, Danny?"

Thu, 11/21/2013 - 12:58 | 4177703 Herd Redirectio...
Herd Redirection Committee's picture

Treatment is profitable, because they just keep coming back.

A cure....  Hell, how do you even price a cure?  The patient gets better and never comes back?  Where's the profit in that?

If you'll excuse my attempts at thinking like a sociopath.

Thu, 11/21/2013 - 15:33 | 4178537 Kobe Beef
Kobe Beef's picture

A true sociopath would be engineering diseases and then selling treatments. If Monsanto or Merck isn't doing it yet, check back in a few years.

Thu, 11/21/2013 - 14:10 | 4178116 Tall Tom
Tall Tom's picture

666 wrote, "How did Americans survive before the Great Depression? There was no Social Security, Medicare or any other support systems."

 

The answer is poorly. They survived and survival was paramount. They were NOT HEALTHY. The Life Expectancy for both sexes was 59.7 years in 1930. Today it is 78.7 years which is an increase of 31.8% and substantial.

 

Sorry to confuse you with the facts.

 

Source: http://www.infoplease.com/ipa/A0005148.html

 

No I do not support the ACA. I DO SUPPORT THE TRUTH and am tired of Satanic LIES.

 

Get thee behind me Satan. Make like a Tree and LEAVE, FUCKING LIAR.

Thu, 11/21/2013 - 17:05 | 4178801 Urban Redneck
Urban Redneck's picture

Facts are no fun, especially when an educated and knowledgeable person can fuck with statistics and when the unread masses believe the misguided notion that a person dying of old age dies younger when life expectancy is shorter...

We're one world war or flu pandemic away from achieving the same 59.7 year life expectancy that we had in 1930.

Moreover, since a significant number of the people who are dying today have not been made to suffer a cradle to gave GMO and corn diet and the normalization of obesity and diabetes-- we could well get back to a lower life expectancy even without war, plague, famine, or whatever other gifts the Pale Rider brings forth.

A couple centuries ago my great great great grandfathers were each knocking up their respective series of wives 20+ times and doing it well into what's now considered "retirement", so the wives had a lower life expectancy, and perhaps a fifth of the children died in childhood, and a bunch other kids died in various wars, but the buggers that made it to middle age also basically all made it into their 80's & 90's. So yes, the mathematical average age of death was lower, but that's math not truth.

Thu, 11/21/2013 - 17:29 | 4178948 Tall Tom
Tall Tom's picture

You can deny Mathematics if you choose. You can approach life from the anecdotal Outliers on the Bell Curve if you shall choose.

 

But life was pretty crappy during the Great Depression. Those pictured people were not thin because of Physical Fitness. Most people were thin because of FAMINE...they went hungry.

 

You may not know about Hunger. I do not mean "skipping a meal". I mean "True Hunger".

 

People whom are MALNOURISHED suffer from compromised Immune Systems. There were no Antibiotics to ward off infectious disease. The Science of Disease Prevention was non existent. Polio ran rampant throughout the populations during the late Summer Months.

 

Americans have a rude awakening awaiting them. Oh I expect that Life Expectancy dramatically decreases as America STARVES TO DEATH.

 

You can deny Mathematics all that you want. I could not care less. You will not be able to deny the consequences of the Economic Collapse...which will happen.

 

Have you ever gone to Mexico? Did you ever notice how much larger Americans are when compared to them? Do you think that might have something to do with NOURISHMENT?

 

What is their Life Expectancy? They are just 20 Miles away from me. Why is it such a Drastic Contrast?

 

BTW...That Chart which I sourced differentiates between Race. Why were Black People's Life Expectancies significantly lower than that of Whites during the Great Depression? Can it be that they were not getting enough to eat?

 

Did you ever talk to your Grandfolks about what it was like? Mine told me of the misery and despair as the Great Plains turned to dust. Yes that was anecdotal. But the photos bear out and reflect the numerical data.

 

Few did well. Far fewer prospered. Most suffered tremendously. Many died young. That is the truth.

Thu, 11/21/2013 - 11:41 | 4177329 Occident Mortal
Occident Mortal's picture

 

Avoiding death is usually enough incentive.

 

 

Thu, 11/21/2013 - 12:44 | 4177608 Withdrawn Sanction
Withdrawn Sanction's picture

You doubtless meant "postponing death."  One cannot "avoid" an inevitability; that's what makes it inevitable. 

Welcome to your first 2 weeks in fight club, Chatty Cathy.

Thu, 11/21/2013 - 15:40 | 4178565 Occident Mortal
Occident Mortal's picture

Yes, you are correct the US has a fantastic healthcare system because of semantic errors.

Thu, 11/21/2013 - 12:01 | 4177427 11b40
11b40's picture

I am incentivized because I happen to like being healthy.  That's not reason enough?

Thu, 11/21/2013 - 11:12 | 4177184 max2205
max2205's picture

Retail sales this dec through dec 2014 should be a puke feast...followed by govt stimulus schemes which will be too little too late

Reps will get back the senate. But they are morons as well

Thu, 11/21/2013 - 11:30 | 4177265 CheapBastard
CheapBastard's picture

stores are empty

Thu, 11/21/2013 - 11:35 | 4177291 rubiconsolutions
rubiconsolutions's picture

"Healthcare insurance only works when everyone pays the same flat rate."

Bullshit! So what you are saying is that someone who smokes, drinks to excess, is morbidly obese and has diabetes or heart problems because of poor eating habits should pay the same insurance rate as someone who eats healthy and exercises regularly and doesn't smoke. That doesn't make sense on any level.

"Otherwise a whole bunch of people are incentivized to not contribute until their circumstances change."

Again, bullshit. People are (or should be) incentivized to take care of their bodies to avoid the need for healthcare by having rates commensurate with their lifestyle. Insurance is a risk pool and was designed for catastrophic events. Instead, health insurance has been turned into a pool that everyone can swim in for everything from wellness programs to contraception to mani-pedi's.

Saying that everyone should pay the same flat rate is like saying that everyone should be paid the same regardless of the type or quality of work they do. That kind of thinking is precisely why this country is doomed.

Thu, 11/21/2013 - 15:37 | 4178551 Kobe Beef
Kobe Beef's picture

b-b-but EQUALITY! Human Rights! Social Justice! We're entitled to your earnings!

Yes, the USSA does not have a future. Good riddance to an awful lot of roaches.

Thu, 11/21/2013 - 19:03 | 4179212 StychoKiller
StychoKiller's picture

So, you're saying I shouldn't expect to receive "Cadillac" insurance for my "Yugo" premiums?

Thu, 11/21/2013 - 12:14 | 4177478 Clark Bent
Clark Bent's picture

I recall that the Brit system cherry picks the numbers that go into lifespan whereas the US doesn't. An example I read about somewhere is that the Brits do not count infant mortality in their figures whereas the US does. The US also has a much larger "third-world" population class than Britain. This class is accustomed to murder and other unhealthful conduct (indeed encouraged by the Left) and has heinous mortality rates for a so called developed nation. That would bend the curve in misleading ways. 

Thu, 11/21/2013 - 12:31 | 4177550 aerojet
aerojet's picture

The US also takes on more risky births that other countries allow to die and that changes the numbers considerably.  We save more infants.

Thu, 11/21/2013 - 12:57 | 4177697 SgtShaftoe
SgtShaftoe's picture

Um, no. Bullshit. 

Insurance only really provides value for catastrophic events, like your house burning down, or a totaled car accident.  It fails for the patient when they have their insurance company pay for checkups.  That design is just a fancy way of the insurance companies extracting rents.  It's called RENT SEEKING.  Look it up. The insurance system has been created at the behest of the insurance companies - Fascism again.  In the 1960s, everybody paid for healthcare in cash.  Now, nobody can afford it. 

If you're going to be blabbing on an enlightend economics website, you should at least understand basic economic principles.  Your magical line of thinking goes nowhere. 

Thu, 11/21/2013 - 10:30 | 4176995 Cugel
Cugel's picture

Why not? Look at the "Public" segment of those charts -- the US government is already spending more per citizen than countries with fully socialized medicine. Why not throw out the jumble of programs currently in place and take 100% coverage plus $250bn/year in deficit reduction? How is that worse than what we have?

Or are you one of those "Government hands off my Medicare" guys?

Thu, 11/21/2013 - 10:37 | 4177023 Occident Mortal
Occident Mortal's picture

Exactly,

 

The US is already spending more on public healthcare per capita than the UK.

And the UK has free universal healthcare for every citizen. Brits can even take their free healthcare with them, when they go travelling overseas. People in Scotland even get free medicine. 

 

What does the US have? $6000 deductables? HAHA, and people defend this? Pods.

 

Thu, 11/21/2013 - 10:50 | 4177088 therearetoomany...
therearetoomanyidiots's picture

Nothing, I repeat, NOTHING is free.  

Thu, 11/21/2013 - 11:43 | 4177342 Occident Mortal
Occident Mortal's picture

Yes, it's free at the point of use.

 

The data above shows it costs Brits about $3,000 per capita. Which compare favourably to US costs.

Thu, 11/21/2013 - 21:32 | 4179648 fxrxexexdxoxmx
fxrxexexdxoxmx's picture

Free at the point of use. If you put gas in your car and then wait two weeks before you use it then the gas free at the point of use.

You keep repeating the same lies over and over. TH NHS in England fucking sucks, period, end of discussion.

Now go get sick/ cabcer/ something really expensive to treat and see how the NHS is right on the spot treating you, fuck off.

Thu, 11/21/2013 - 11:26 | 4177249 Watauga
Watauga's picture

(1) Only Obama and his disciples defend Obamacare; most Americans despise it.

(2) UK's system stinks.  When I lived in the UK (two years) I saw with my own eyes the level of care provided.  Months-long waits for treatment, 3rd world facilities for most people, death panels. . .    Only an insane person would trade U.S. healthcare for UK healthcare.

(3) Flat rates in the UK?  Are you insane?  Anyone who can pays for quality care OUTSIDE the system.  Tens of millions of dollars are paid directly from user to provider every year.  No one works within the system if he can afford to work outside of it.

(4) U.S. healthcare is a mess because of the costs of litigation, malpractice insurance, and so forth.  Require judge alone trials or mediation, with caps at actual, out-of-pocket costs upon proof of malpractice, injury, and nexus, and U.S. healthcare costs plummet. 

(5) Healthcare is simply another tool by which power-hungry Statists seek to control people.  It is the opposite of liberty.  It is the opposite of private property.  It is pure, Statist evil.  Take from the working man to give to the Statist voter. 

It started when Lincoln chose to go to war against a sovereign nation, killing over 600,000 people, to impose the will of the Northern monied interests.  It proceeded through administration after administration, nearly all in the pocket of those same interests.  WW and FDR, in particular expanded the Progressivist/Statist agenda and consolidated the power of central government to carry it out.  Along came LBJ, who opened the floodgates to foreign invasion with immigration "reform" and created not the Great Society, but the Dependency Society.  Obama is simply carrying on, using central government power more aggressively.  He will, by January 2017, have accomplished his mission.  None of this is incompetence.  It is deliberate destruction.

Thu, 11/21/2013 - 11:49 | 4177367 Occident Mortal
Occident Mortal's picture

Yet somehow...

 

life expectancy

UK 79.7

US 77.9

 

Cost

UK $3129

US $7538

Thu, 11/21/2013 - 12:12 | 4177462 artless
artless's picture

Umm your stats just tend to prove the articles point regarding the health of a nation and the factors that contibute to the lack thereof.

Great Britains live 1.8 yrs longer. Have you looked at the rates of health issues? Say obesity? Cancer? Heart disease? Suicide? Homocide?(kinda think we kick there asses in those two alone) Diabetes?

No, you didn't. Beacuse then your one pointless macro data argument would go up in smoke. Which brings me to another point. Macro data is only so useful when analyizing things that involve human activity. Way too many factors to consider. That's probably why Keynesian clowns always miss the obvious 'cause they tend to look at the macro data and pointless formulas.

The US "cost" is higher because we tend to have far more options at a wide range of prices that are in many cases artificially inflated due to many of the reasons mentioned in the article such as opaque pricing; quasi-monopolies/cartels; systemic disconnect of buyer/seller, fraud , fee-for-service in a cartel system; employers being responsible for healthcare, and a fundamental absence of competition and transparency. Throw in things like elective surgery, something Brits do not really comprehend BECAUSE THEY USUALLY CANT GET IT, and your numbers, I'm guessing would take a very different shape.

But don't worry. Just keep closing your eyes and sticking your head into the sand while beLIEving that collectivist, coersive, government programs will save you from everything bad in life. Because as we all know Medicare has been an amazing success!

And great thinkers like Marx and Engels never wrote anything about national healthcare.

Except the part where the stated its utmost importance along with a progresive income tax as pillars to socialism.

Oh, and the German, French, Swedish, and Canadian systems are all on the brink as well. Just in case you want to drop that canard into the argument.

There done. That is how you eviscerate a statist's moronic argument. Let all who posted pointless bullshit in response to Occidental please, please take note.


Thu, 11/21/2013 - 12:34 | 4177562 Cugel
Cugel's picture

Yet their collectivist coercive government is charging them $800 a year less for public healthcare than yours is.

Your argument is that American welfare should be this much more expansive than the UK's? How do you defend the extra spending?

Thu, 11/21/2013 - 12:42 | 4177602 Occident Mortal
Occident Mortal's picture

Brits can purchase whatever surgery they like, that's the private element of the cost as shown in the chart.

 

The fact remains that it's possible to keep a similar population of people alive for 79.7 years at an annual cost of $3,200. There is real world evidence which proves this.

 

If the US had comparable healthcare costs to the UK, then US consumers would have an additional 9% in their ass pocket.

Thu, 11/21/2013 - 12:18 | 4177488 Kirk2NCC1701
Kirk2NCC1701's picture

The REAL reason foreigners* laugh at the US health system, is the both the CURRENT system and OBAMACARE are a disaster and a scam.

Most Americans and ZHers seem to miss this point, and would rather argue which pair of diapers is less shitty.  Un-fucking-believable!

* Foreign countries with quality health care, where the STATS back it up (with life expectancy, infant mortality rates, etc).

Thu, 11/21/2013 - 14:38 | 4178242 Tall Tom
Tall Tom's picture

Source your Life Expectancy data. My data states 78.7 years for US overall as of 2010..the latest year available.

 

Source:  http://www.infoplease.com/ipa/A0005148.html

Thu, 11/21/2013 - 13:37 | 4177941 MachoMan
MachoMan's picture

U.S. healthcare is a mess because of the costs of litigation, malpractice insurance, and so forth.  Require judge alone trials or mediation, with caps at actual, out-of-pocket costs upon proof of malpractice, injury, and nexus, and U.S. healthcare costs plummet.

Practically speaking, this is already the system we have...  please develop another thesis.

Thu, 11/21/2013 - 15:51 | 4178599 Kobe Beef
Kobe Beef's picture

How about transparent, competitive pricing?

Thu, 11/21/2013 - 19:19 | 4179247 MachoMan
MachoMan's picture

Well, the easiest thing to do is be proactive and ask your health care professional how much a procedure costs before you do it...  The "pay a de minimis co-pay at the door and never ask how much anything costs" era is dead.  This is no different than going to any other professional, e.g. accountants, lawyers, roofers, plumbers, yard mowers...

I'm also not sure what transparency is exactly?  Maybe posting prices online?  Certainly reasonable, but I'm not sure it needs to be mandated...  If they want to stop the countless phone calls asking for prices on things, then they can post them somewhere conspicuous.  If you're talking about a final bill for services, then it ought to be itemized...  if it is not clear, then you need to call the billing department and inquire.  Again, be proactive... 

Competitive pricing is tricky...  About the only way that you get it is for all of the large medical service providers to go bankrupt.  Essentially, we're locked into prices due to capital/fixed costs.  We're also at the mercy of cost push inflation, which tends to impact the things we need moreso than others...  in this case, medical supplies and devices.  Further, you've got the issue of wages and the last people you want staffed in a hospital are minimum wage employees...  that's how you end up with dead people unnecessarily. 

It's no different than college tuition...  get the hand of the government out of it and the whole thing falls down.  However, there aren't any more price decreases possible through "tort reform" (giving the benefit of the doubt that tort immunity even lowers medical costs to the end consumer...  it doesn't, but I digress).  Once the market is free to compete for prices, then you'll see them decrease.  Until that day, we're at a standoff where no one has insurance that any practitioner will accept and no practitioner can keep the lights on without seeing patients. 

Thu, 11/21/2013 - 15:32 | 4178531 RiseOfTheMachines
RiseOfTheMachines's picture

It started with Adam and Eve in the Garen of Paradise, taking a bite of that tempting apple, it's all Adam's fault.

Thu, 11/21/2013 - 11:52 | 4177380 czardas
czardas's picture

Just returned from Scotland and visited someone we met on a cruise. The hospital looked like an old dilapidated house - the ventilation so bad the smell gagged. His wife saw our expression and told us Scotland's hospitals were a scandal, so bad that the NHS was forced to make surprise visits (starting 10 years ago) revealing widespread filth, sanitation and medieval conditions.   Naturally, no one in their right mind wants a State hospital but only the wealthy can afford the modern private centers with high standards and quality care. 

The NHS is so "good" that the wealthy spend lots of money in order to avoid it.  A doctor's quality is judged by his employer - state (poor or foreign), private (top of the class)  Because it occurs slowly one doesn't notice the loss of specialists who refuse to toil for a middling salary, the horrible physical conditions, the triage mentality.   the lack of R&D that is somewhat finessed by the rise of the US and Japan for the vast majority of patents.

Of course, it's only possible because health care professionals are badly compensated, lack of research (partly finessed by using that done by the US and Japan).  Relying on state funding means buildiings degrade, surgery gets postponed and quality declines as the best & brightest flee or reject medicine. This is the future of health care under Obamacare. 

Thu, 11/21/2013 - 15:45 | 4178575 RiseOfTheMachines
RiseOfTheMachines's picture

Odd for such an awful system it was celebrated at last years opening Olympic Ceremony regarding the NHS and Great Ormands Childrens Hospital. At the end of the sequence they show a huge NHS in the center.

http://www.youtube.com/watch?v=KjEgookioiY

I though it was odd that the Chinese 4 years earlier celebrated their military and rise to power while the Brits celeberated universal healthcare and the industrial revolution. 

http://en.wikipedia.org/wiki/Great_Ormond_Street_Hospital

Britain and Europe has a much longer history of on/off Laissez Faire politics than the US. It may not be what you are wishing for.  

Thu, 11/21/2013 - 15:54 | 4178613 Kobe Beef
Kobe Beef's picture

The Image Makers also celebrated a fictitious, happy, harmonious "diversity", which likewise has no basis in reality.

Thu, 11/21/2013 - 16:28 | 4178728 czardas
czardas's picture

Not sure what an Olympics pageant had to do with crappy hospitals, bad sanitation, poor care, loss of doctors or long waits for surgery but I'm sure there is a link somewhere.   The UK is like the rest of the EU (I lived in Finland for awhile).  As the number of workers declines, retirees grow.  The ONLY way to maintain a NHS is through increased worker contributions or State efficiency (an oxymoron). Otherwise you must (1) Stress good health (failed), (2) raise taxes (check), (3) slas  provider pay (check), (4) cut research (check), cut national defense (check), charge for more and more selected services (check), go into debt (check) and FINALLY introducing private care.  

US totals are skewed due to the low scores of blacks.  Oddly, Latinos live longer than whites or blacks, the reason given being their  "natural" diet and the fact that "fast food" in Mexico is fresh fare.

Thu, 11/21/2013 - 10:16 | 4176939 Truthseeker2
Truthseeker2's picture

"In fact Obamacare has so many systemic fatal flaws, inherent economic inefficiencies and pervasive procedural defects that the dangers have become quite evident, especially its implementation right in the midst of an intractable and deep recession.  It ever there was a time NOT to enact such an extremely unpopular law, this is it.  Therefore, many ask the question: Was this a planned social, economic and political cataclysm?"

 

http://stateofthenation2012.com/?p=2442

^^^


Thu, 11/21/2013 - 10:28 | 4176957 duo
duo's picture

I see a need here.  Obamacare copay insurance.

Let's say your family is visiting relatives out-of-state.  You could buy a weekly policy that would cover the $13K OOP in case of an accident or medical emergency that would for sure be "out of network".

Or, included with the price of a ski lift ticket, is a one-day policy that covers the $13K that you would have to fork over if you fell and tore your ACL (helicopter rescue would be extra).  It would be like buying the collision damage waiver when you rent a car.

Obamacare, the "insurance" that you need other insurance to protect you from.

Thu, 11/21/2013 - 11:54 | 4177390 czardas
czardas's picture

Better than that (and this will defintely be considered) is subsidizing the deductible much as the Fed monetizes everything. So then we'll have yet another huge expense although few are counting at this point.

Thu, 11/21/2013 - 10:23 | 4176967 TeamDepends
TeamDepends's picture

We've said it before and we'll say it again:  Barry was installed to be the Final President, to once and for all eviscerate the deeply ingrained American concepts of freedom and self-determination.

Thu, 11/21/2013 - 10:33 | 4177013 g speed
g speed's picture

But--as usual the gov't has it wrong again --this will hasten the end of gov't as we know it--trust me on this one

Thu, 11/21/2013 - 10:31 | 4177003 gaoptimize
gaoptimize's picture

Understand the reasons why:  http://2016themovie.com/

Thu, 11/21/2013 - 10:38 | 4177032 Skin666
Skin666's picture

What full blown nationalization?!

The NHS is a fucking disaster. You go into hospital, not knowing if you'll ever come out again!

I can't afford private insurance, yet am forced to pay, through National Insurance, for this socialist monstrosity!

NHS will be dead within 10 years

Thu, 11/21/2013 - 12:23 | 4177515 tony wilson
tony wilson's picture

uk killing system you fucking numbhead baffoon.

look uop liverpool care pathway these lunatics in the uk have killed 100s of thousands.

we are cattle that is all.

Thu, 11/21/2013 - 13:34 | 4177900 Kirk2NCC1701
Kirk2NCC1701's picture

Occidental Mortal: "America should copy the UK system."  <--- Sarc, right?

The US should start from scratch.  Re-invent the entire Health Care System.  For example...

Benchmark Best Standards and Practices from around the globe (see what works and what doesn't) and "raise the bar" when creating a new, rational and economically-sustainable system.  Be prepared to chuck out most of the "cherished" old notions, which offer little real value.  Think outside the Box.  And "fuck" the Middle Men aka "Insurance providers" that offer little value-add, but cream off a fortune in wealth.  Don't fall for false-flag (red herring) arguments by any of the current interest groups, that merely want to preserve their lifestyle and wealth.

Strongly suspect that NO such solution will come out of DC or its "(S)Think Tanks", but that an Open Forum needs to be created by a group of smart and informed people (Doctors, Dentists, Nurses and Patients, as well as Debate Moderators).  Bank(st)ers, Insurance providers, Lobbyists, Politicians, Wall St Brokers and all related players/parasites (little or no-value-add people) are NOT invited -- since their true objective is to (a) skim off a very nice living for themselves, and/or (b) to inflate the Currency/Debt supply, and thus keep the USD Ponzi going.

You start out with Brainstorming for ideas and add them to the mix of Best Practices in foreign countries, thus casting a really wide net of ideas (some old, some new, some borrowed, some blue).

You then start the down-selection process in a number of iterations.  You first define Terms (say what you mean and mean what you say), and agree on End-Goals and Interim Objectives.  You then need to create Selection Filters (criteria) beforehand, thus being able to weed out unsuitable ideas in an objective manner.  You now have something that resembles a rational and objective process that has good odds of reaching at least one viable solution, but hopefully several viable solutions.  Perhaps various regions of a country can adopt one of these for themselves, thus allowing for "regional preference" (driven by culture) that doesn't over-compromise a National solution.

Seems to me that this kind of grass-roots endeavor is FAR more noble and useful, than just organized or disorganized "bitching & moaning".

Kirk out.

Thu, 11/21/2013 - 13:41 | 4177958 MachoMan
MachoMan's picture

How about just letting the market decide and keep your nose out of it?  Once medical providers are allowed to fail due to their patients not being able to afford service, then the market will be forced to adapt...  it's magic.

Thu, 11/21/2013 - 15:10 | 4178305 Kirk2NCC1701
Kirk2NCC1701's picture

In theory... YES.  But I submit that the "market" is a figment of imagination.  An academic construct.

There is NO such thing as an "ideal" or "un-manipulated market".  The organized manipulation of politics, interest rates, mortgages (MBS), gold prices, etc should tell you that.  We don't have a "market".  We have "crony capitalism", because the crooks have taken over everything -- including the so-called Health Care / Sick Care.

I'd like to see a system that does not ignore or glorify human nature -- the way Communism, Fascism, Feudalism or Socialism do -- but one that accepts and deals with it (its follies and weaknesses): a "Free Market with Rules & Enforcement".  Perhaps this is what you mean.  If so, then we agree.  But even getting there, or getting "back" to it (if we were ever there) is not easy.

For example...

Since everyone looks after their own interests, the wealthy & powerful are in far better position to look after their own interests.  Especially when the get organized -- and they do!  They do this by leveraging their wealth and power to change the rules and playing field (what we used to call the "Checks & Balances") in their favor.  You will never get away from the 1% vs 99% games of manipulation and dominance (the "bully/gunslinger vs. scared towns people"), if you have a pure "laissez-faire" approach ("No laws, no rules, no sheriff"), and if you do not build in a way to maintain said "Checks & Balances" of the game.

The towns people have the right to organize (sheriff, town council, etc) -- and they should -- if they want to get the best chances for peaceful co-existence and protection from the Bad Guys: the Fly-by-night operators/scammers, strong bullies, rich bullies, and criminals. 

I use this Frontier analogy for illustration only, but I mean it in a regional and national sense, where the "good players" (towns people) are the health care providers and consumers, and the "bad players" (scammers, bullies and crooks) are the players with little or no value-add:  the middle-men** that I mentioned above.  These "bad players" need to be either run out of town, or jailed and duly prosecuted (in stockades or hang 'em high).  Else, these roving parasites, scammers, bullies and criminals will band together, and take over and terrorize the productive and peaceful towns people.  So to speak.

** Bank(st)ers, Insurance providers, Lobbyists, Politicians, Wall St Brokers, Oligarch families.

Bottom line:  I am not advocating the absence of a "genuine free market" in Health Care in my above post, but its creation and maintenance.  On that, I think, we can agree.

Thu, 11/21/2013 - 15:42 | 4178571 MachoMan
MachoMan's picture

I agree that self interest is present in every conscious human action...  no doubt about it.  However, the issues you've presented are largely only issues because failed institutions aren't allowed to fail...  and they behave accordingly.

And, yes, even if you have a free market today, it may not be so tomorrow.  I get it...  However, until you're able to actually devise every intricate detail of a better system, it's the piece of shit we're forced to use if we want to use the best option out there.  From here, we get to a free market by allowing failed institutions to fail...  if that means they desperately try to take everyone else with them, then so be it.  I trust self interest to pick up the pieces and, for at least a little while, be forced to be honest and desire to actually compete.  The mechanism to force them "out of town" is to keep the government from playing weekend at bernies with them.

As far as maintenance goes, I think the process for changing the law ought to be a more difficult standard...  We may actually be at a greater risk from overregulation than underregulation...  the legislative process ought to reflect this reality.

Thu, 11/21/2013 - 15:24 | 4178495 Kirk2NCC1701
Kirk2NCC1701's picture

Further to my above post (in creating a New Paradigm a New System), here are some suggested End-Goals

   (and please excuse my formatting that has too much spacing between lines):


  -  Regional Solutions of one or several States (Min. goal)

  -  National Solution (Stretch-goal)

  -  Possibility/Option of grouping risk groups by Common Affinity (job categories), thus allowing for separate Pools of Low, Medium and High Risk groups

  -  Possibility of further customizing both Risk Groups by Lifestyle Risk Factors – which is exactly what life insurance policies already do.  So, no need to “agonize” if this is “right”.

  -  Allow for multi-level Care, depending on individual’s ability to pay.  E.g. Basic, Standard, Silver, Gold, Platinum levels. 

         §  These can be ‘defined’ regionally.  E.g. ‘Basic’ level is what a convict or illegal alien gets, courtesy of the US Taxpayers (i.e. by those who actually pay taxes!)

         §  In broad strokes… Standard = No Collar, Silver = Blue Collar, Gold = White Collar, Platinum = Fancy Collar, i.e. Hi-level managers and “Financially Independent”.

Some suggested Interim Objectives:

  -   Create Project Team:

       §  Identify and select grass-roots Think Tank (the best & brightest, w/o a hidden or biased Agenda)

       §  Select Debate Moderator and Assistants/Scribes

  -  Identify and Select Global Best Practices

  -  Create Pool of Ideas (old or new)

  -  Create Down-Selection Filters (criteria), to be applied against End-Goals

  -   Create Debate Forum (with Rules of Engagement)

  -   Create Voting (selection and down-selection) process

  -  ID Risk Classes (by age groups, career choices, lifestyle choices)

  -  ID and Define Care Levels (e.g. Basic, Std., Silver, Gold, Platinum)

  -  Allow Free Market to “self-organize” into Risk Classes and Pools

Some suggested Down-selection Criteria/Filters (for each proposed Idea/Solution):

  -  Apply Filter 1 (e.g. Risk Pools):

      §  How many are there?  Not too many, not too few (5-10?)

      §  What are there?

  -  Apply Filter 2 (e.g. Care Levels:  Number of Levels and Workable Definition)

      §  E.g. 4-6 levels

      §  See what solutions are left

  -  Apply Filter 3 (e.g. Ability of people to form, and join or switch Pools)

      §  See what solutions are left

  -  Etc, etc, until 3 or 4 solutions are left, one of which can be adopted regionally.

The above is an example of a Structured Approach, as conducted by a skilled Professional Management Professional (a PMP from PMI.Org)

Thu, 11/21/2013 - 11:32 | 4177270 prains
prains's picture

America !

 

you are letting the INSURANCE companies make the rules so the formula looks like this;

YOU + Insurance Company + Doctor = HEALTH

 

what would happen if the formula looked like this;

 

YOU + Doctor = HEALTH

 

Ho Lee FUK meets Ben Mi Ova

 

Thu, 11/21/2013 - 10:11 | 4176924 ghengis86
ghengis86's picture

Operation Cloward-Piven proceeding as planned. Do not deviate from script.

Thu, 11/21/2013 - 10:15 | 4176934 DaddyO
DaddyO's picture

Unfortunately, the awakening that is underway will prove too little, too late.

Obummer is not going to back off from enforcing this, even in view of the revolt currently taking shape in the blue party.

The red party is behind this as well, contrary to their bluffery of late.

Prepare accordingly.

Cloward-Piven unfolding before your very eyes.

DaddyO

Thu, 11/21/2013 - 10:17 | 4176940 GetZeeGold
GetZeeGold's picture

 

 

Saul Alinsky is drinking ice water in hell!

Thu, 11/21/2013 - 10:30 | 4176997 johnQpublic
johnQpublic's picture

its been ongoing, for what, like 40 years now?

once the rest of mexico arrives, its game over

then we get to play a new game

zombie apocalypse maybe

maybe risk

or monopoly

Thu, 11/21/2013 - 10:54 | 4177107 HardlyZero
HardlyZero's picture

Both major sides are expecting and planning for collapse, and ACA definitely speeds up the collapse.

Two major parties which are planning for collapse, but with different plans and outcomes:

1. statist are thinking Cloward-Piven (and broken windows).

2. minimal government conservatives think Reset then small governement and free markets.

But, the Dark Ages took 500 years to emerge.

Cloward-Piven assumes society and government will survive and provide resources to do their statist things.

Soviet Communism showed how there are no resources to govern or maintain society in a Big Government system.

Either way, it looks like society have jumped the cliff (with fiat printing) and gravity will assist the collapse.

There are many small and medium size doctor practices that will be impacted as well.

What will happen to private ownership rights ? 

Thu, 11/21/2013 - 10:12 | 4176926 Long-John-Silver
Long-John-Silver's picture

It's not a bomb, it's a melt down.

Thu, 11/21/2013 - 12:14 | 4177474 PrintemDano
PrintemDano's picture

It's a Cook Book !

Thu, 11/21/2013 - 10:17 | 4176927 TeamDepends
TeamDepends's picture

It appears more and more this was the plan all along, to usher in a single-payer system = commie care.

Thu, 11/21/2013 - 10:18 | 4176945 kralizec
kralizec's picture

Yup.  The misery has only begun...

Thu, 11/21/2013 - 10:18 | 4176947 DaddyO
DaddyO's picture

Agreed, watch and see, the regime will let this get really bad and then they will "acquiese" to repeal and replace with a new and improved single payer version.

DaddyO

Thu, 11/21/2013 - 11:28 | 4177256 Vincent Vega
Vincent Vega's picture

And to that single payer system be sure to add in 'means testing'.

Thu, 11/21/2013 - 12:19 | 4177493 Clark Bent
Clark Bent's picture

I heard Obama say it the other day, America is a "rich" country. He apparently is blessedly unaware that we are broker than shit. The Left always starts from the false premise that there is a huge treasure hoard somewhere that counts for national wealth, rather than th reality which is that 98% of the population (and welath creators) live on the thin margin seeling their labor week by week. Obamacare is a massively regressive middle class destroying nuetron bomb that will crsh the very life out of the option of earning one's living. The damned thing won't survie becuase we are far too poor to afford it. But how many have to suffer while the most childish among us refuse to accept that their fantasy is bullshit. 

Thu, 11/21/2013 - 10:42 | 4177049 Zadig
Zadig's picture

That our rulers expect to prosper regardless of the success or failure of their policies is a given, but I don't think this mess was planned.  The puppets clearly don't like being laughed at and the insurance companies didn't expect their slice of the pie to decrease.

Thu, 11/21/2013 - 10:48 | 4177075 TeamDepends
TeamDepends's picture

Yeah, but the puppet-masters are laughing right along with us, which is kind of creepy.

Thu, 11/21/2013 - 12:08 | 4177451 czardas
czardas's picture

Bill Frist (former Senator and heart surgeon) wrote that Obamacare would fail in its primary task - reducing health care.  It never focused on the REASON for poor general health - a bad lifestyle.   The vast majority of problems come from obesity, smoking, substance abuse, lack of exercise and bad food. Maintaining these unhealthy lifestyles is  expensive.  Diabetes costs $8,000/yr and it correlates with obesity.  

He suggests that a healthy lifestyle and technological advances (early warning, disease eradication, cheaper all in one tests, better diagnosis, etc) will lower costs far more than this monstrosity. It would actually be cheaper to give food, cooking lessons and group dinners than the 4,000 levels of administration required by Obamacare.

Thu, 11/21/2013 - 12:21 | 4177503 Clark Bent
Clark Bent's picture

Then tell me where the atrial fibrillation epidemic is coming from? 

Thu, 11/21/2013 - 10:13 | 4176930 IridiumRebel
IridiumRebel's picture

This is what you do to counteract rising healthcare:
Listen closely.....

1) get fake ID

2) pay "penalty" which is much less than Ofuckcare

3) get sick, go to ER and use fake ID/name

4) rinse repeat until collapse

Thu, 11/21/2013 - 10:23 | 4176969 Big Corked Boots
Big Corked Boots's picture

Step 1 has been very, very difficult to achieve in the last few years.

Thu, 11/21/2013 - 10:32 | 4177007 johnQpublic
johnQpublic's picture

you dont need ID to vote

make draft card on your printer...if thats a felony, maybe make a library card

Thu, 11/21/2013 - 10:46 | 4177066 therearetoomany...
therearetoomanyidiots's picture

Unless you're mexican....apparently.

Thu, 11/21/2013 - 12:40 | 4177590 Big Corked Boots
Big Corked Boots's picture

I have been picking my own vegetables for years and I still don't look Mexican.

Maybe if I picked someone else's?

Thu, 11/21/2013 - 10:33 | 4177012 Rainman
Rainman's picture

Good luck to the docs and hospitals trying to collect the $ 6k deductible from the paycheck to paycheck crowd. Collection losses will dwarf that of full recourse student loans ....11% +

Thu, 11/21/2013 - 10:50 | 4177090 TeamDepends
TeamDepends's picture

We've come to reposess your liver, you are now 90 days past due....

Thu, 11/21/2013 - 11:43 | 4177341 krispkritter
krispkritter's picture

Great!  They can have the old one, it's been rather abused since I found ZH,  I'll get on a list for a new one. Voila! More drinking!

Thu, 11/21/2013 - 11:14 | 4177197 MachoMan
MachoMan's picture

They may, but what will happen is that the medical service providers move to a system where they don't have to worry about collecting the remainder -> you pay at the door or you don't get seen...  and, if you have any balance due when you show up next time, then you don't get seen until it's paid.  There are an incredible amount of medical providers already doing this...  it will only get worse.  The present system is set up for the medical professional to bill your insurance on your behalf (as a courtesy), however what will happen in the future is that you pay the medical professional the entirety of the bill and then you'll have to seek reimbursement from your insurance company after the fact.

The only thing forcing providers to see patients is credentialing (contract with an insurance provider).  Once the insurance carriers drop those medical professionals from the ranks (no more in network) or, alternatively, the medical professionals drop the insurance providers, then we'll pretty much have a purely self pay system (even though the same people paying out of pocket for services will be expected to have insurance/pay penalties).  Those practitioners who can transition to a self pay system are already testing the waters...  and they'll be miles ahead of their peers when this hits (especially in having a client base full of people who can actually pay for the services, whereas many practitioners couldn't care less about the financial status of patients given insurance picks up the tab).

Thu, 11/21/2013 - 12:12 | 4177463 Almost Solvent
Almost Solvent's picture

My family has one of those employer high deductible plans. We're able to contribute the maximum HSA pre-tax to cover our max $6,300 out of pocket annual total. Any we don’t spend rolls over year to year.

Almost all of our providers, at least over the last 2 years, now require that we “pre-pay” the estimated out of pocket for the services to be rendered. In fact, most require that we leave our HSA card imprint (uses VISA) so they can charge our account the day of services – otherwise they want cash on the barrel the day of services.

Last month, I noticed a new prominent sign at the office making everyone either provide a HSA/FSA debit or credit card upfront to charge or pay the estimated out of pocket amount based on your insurance. If they collect too much, they will credit your account for your next visit, or you can request a refund in writing.

 

Pre-pay is already here in my area other than the hospital which by law has to take everyone that shows up at the door.    

Thu, 11/21/2013 - 12:33 | 4177561 aerojet
aerojet's picture

That's because they are operating on such thin margins that they could run out of day to day capital if the spice doesn't flow.  It's all teetering on the brink of collapse, in other words.  Lots of people just stiff their providers and never pay anything at all.  The US is full of deadbeats and full of hospital administrators who are millionaires.

Thu, 11/21/2013 - 12:15 | 4177480 czardas
czardas's picture

This is yet another reason insurance should be for catastrophic cases only (except accidents requiring immediate attention.)  This would reduce prices immediately but politically it will not be allowed.   "Concierge medicine for the rich"   There is a chart on the internet (forgot URL) showing percent of doctors accepting Medicaid patients.  In TN (my state) it's 60% and dropping fast.   In CA it's 53% and in MJ it's 40%.  So what does Obamacare do to help those with coverage ad no doctor? [uncomforatable question that will never be asked at a news conference]

Thu, 11/21/2013 - 13:24 | 4177779 MachoMan
MachoMan's picture

Before obamacare, medicare and medicaid were long on their way to being universally dropped.  The reimbursement rates aren't too bad for most things (relatively speaking).  However, the issue is the paperwork and administrative hoops and ancillary staff that are required to bill every hour/service...  Then, dealing with audits and clawbacks on top of all the other hoops, ends up making the reimbursement rate, all things considered, cost prohibitive [you can perform a service for a patient and then have the money clawed back because you didn't put an X on some line of an unnecessary form].  The only people left who will bill it are the mega entities that can pay for all the software costs, training, and compliance issues...  of course, those are the primary people who need the government's reimbursement (because their fixed/capital costs are so high, they'll go bankrupt if the money stops flowing for a second).

Self pay = absolute bare minimum medical records and ancillary costs.

Thu, 11/21/2013 - 12:22 | 4177510 Clark Bent
Clark Bent's picture

And currently medical costs can be discharged in bankruptcy. Probably not after the government becomes our health care provider. Just like they are our "education" provider.

Thu, 11/21/2013 - 12:21 | 4177504 artless
artless's picture

Fucking Brilliant!

But I do not think you'll get a chance to rinse or repeat. System will collapse too quickly.

BTW, who are all these people in such dire need of "healthcare"?

I'm 44 and I think I've been to doctor perhaps a dozen times in my whole life. Six of which were emergencies like stitches ($180)

tooth ($350) and the like. Shit, I paid $5000 cash for a 4+ hour sugery to rebuild my jaw and face here in NYC. And that was after I told the surgeon I was paying cash. SO he took the bill from $11,000 to $5000.

Everyone needs to remember "cost" and "price" are very, very different things.

Thu, 11/21/2013 - 10:16 | 4176937 Ima anal sphincter
Ima anal sphincter's picture

Just another brick in the wall. The DIC (dickheads-in-charge) WANT to bring this down. Fiat currency is the foundation, but all the others, outsourcing, EPA, traitor-care, IRS....... ALL of it. "They" are going to crush us.

How many times must you be kicked in the head until you say.....enough?

Thu, 11/21/2013 - 12:35 | 4177572 aerojet
aerojet's picture

I've come to agree.  It looks like some kind of Marxist takeover.  The Fast & Furious thing was a very cold, calculated ploy to attempt to install sweeping gun control.  These people have read about how stuff like that was done in Russia and elsewhere and they are attempting it in the US.

Thu, 11/21/2013 - 13:13 | 4177776 Herd Redirectio...
Herd Redirection Committee's picture

I am pretty sure their forefathers both wrote that book, and financed what happened in Russia.

"read about how stuff like that was done in Russia"

Thu, 11/21/2013 - 10:17 | 4176943 SheepDog-One
SheepDog-One's picture

Gee...almost as if it was designed to crush the U.S. economy.

Thu, 11/21/2013 - 10:19 | 4176944 Quinvarius
Quinvarius's picture

Just drop out and stop paying Warren Buffet insurance premiums.  Watch Wall Street flop around without any insurance money being invested.  So many orafices for Obamacare to invade and destroy the system.

Thu, 11/21/2013 - 10:41 | 4177042 g speed
g speed's picture

Hubris will end this gov't ---plain and simple---to those on here who are ready and willing to acquiesce please don't polute the fountain of liberty. 

Thu, 11/21/2013 - 10:18 | 4176946 billwilson
billwilson's picture

Single payer! The only way to go! Screw the sickness industrial complex.

There can be no efficient and workable free market in health care. With the US spending double what anyone else does, covering fewer people and getting worse results we have proff that the free market DOES NOT work for health care ... but it does work for big pharma, big insurance, big ...

 

Thu, 11/21/2013 - 10:21 | 4176959 Quinvarius
Quinvarius's picture

The problem is medicare and other government subsidies running up prices.  Single payer is a bad idea.  The government needs to completely stop getting involved.  More Socialism not the answer.

Thu, 11/21/2013 - 11:38 | 4177307 mark mchugh
mark mchugh's picture

The government is, in effect, already the single payer.  When you add up the cost of government run healthcare (medicare, medicaid, military etc.), healthcare for government employees and healthcare paid indirectly by the government (people who pretend to be in the private sector, but are actually 100% dependent on the government) you're talking about 70% of all healthcare spending.  At most, 30% of all healthcare costs are actually paid by anything that could be called "private" money with a straight face.

The reason we pay so much for healthcare is because it's essentially a socialist system that allows profiteering (and not by actual health care providers, but by people who shuffle paper).  Healthcare is now 17% of GDP and Obamacare will drive it over 20%, making our economy even worse.

There's only two ways to make it better: Get the government completely (and I mean COMPLETELY) out of the game.  No healthcare provided for government workers, no Medicaid, nothing.  Face it that's not going to happen.  The other choice is take it over, and DRIVE DOWN THE COST.  Healthcare should be no more than 10% of GDP, and probably more like 7%.

Those really are the only two choices - anything else will make health care a bigger part of the economy, making the real private economy even weaker.  What I think needs to be done is recognize a socialist system for what it is and treat it as such.

Thu, 11/21/2013 - 12:29 | 4177541 Clark Bent
Clark Bent's picture

I would add that it was the government programs that recreated health care in the uS by establishing the manner in which costs are approved and paid. Since they are the biggest proivider they opened the model to insurance companies to come in and separate the patient from the doctor and to create what the article's author calls opaque payments. HSA's are a step in the right direction to mitigating this monopoly, but Im pretty sure Obamacare eliminates those. 

Thu, 11/21/2013 - 10:29 | 4176989 d edwards
d edwards's picture

So your answer is to give it to lying, corrupt, manipulative, thieving Big Gov't?

Thu, 11/21/2013 - 10:35 | 4177015 youngman
youngman's picture

eliminate the trial lawyers and prices will drop 30% overnight

Thu, 11/21/2013 - 11:17 | 4177207 MachoMan
MachoMan's picture

I'll make a bigger post to address this point elsewhere in the thread, but your theory is patently false...  go check out what has happened in states with "tort reform"...  lower premiums?  [also remember, tort reform is something that is centuries old, not something you thought up yesterday]

Thu, 11/21/2013 - 12:31 | 4177546 Clark Bent
Clark Bent's picture

Tort reform is the venue of insurance companies. In Ohio it takes $50k upfront just to get a claim to the point where it has a possibility of settlement. If you can't come up with the money your claim does not exist. 

Thu, 11/21/2013 - 13:21 | 4177840 MachoMan
MachoMan's picture

Yes, but that's only on the cases where the plaintiff's attorney thinks there is a preponderance of evidence that malpractice has occurred...  the rest are just discarded from inception.   

Thu, 11/21/2013 - 11:32 | 4177271 uncle.bigs
uncle.bigs's picture

Right....then we'll have no consequences for botched surgeries.  If I were a surgeon I would require a complete and total waiver of all claims prior to the surgery.  I'll do my best but you shouldn't have eaten butter balls every day for the last 30 years.

Thu, 11/21/2013 - 10:49 | 4177084 g speed
g speed's picture

No Bill Wilson --fuck gov't and fuck you-- gov't shill.  Gov't mandated monopolies and corruption in the courts and laws by and for lawyers are the problem.

FDA a problem--check

IRS a problem--check

Federal gov't a problem --check

MIC a problem --check 

and on and on --so lets have a single payer--aka gov't ----

I'm thinking maybe you and your type are the problem--- 

Thu, 11/21/2013 - 10:54 | 4177110 Weisshaupt
Weisshaupt's picture

The US spends more largely because it is DEMOGRAPHICALLY  and CULTURALLY different.  Don't make the assumption that people in other countries have the same distribution of ages ( Boomers don't exist in many places)  and as the article points out,  a culture that promotes bad health. Without controling for these factors, Life Expectancy is a mpoor metric for measuring health care outcomes.  When you bother to compare apples to apples ( I know, you are a lefty and too stupid to understand why that would be a good idea)  you will find that across the borad more people survive a specific illness in the US than they do in other countries.  This is also easy to explain: Socialist nations centrally plan thier health care spending. They decide we will spend $X per capita.  If your population needs more? Well, they don't get it.  If you really need 6 CAT scanners, and the govt has decided 5,  1/6 of the peple who need CAT scans DON'T GET THEM.  They may live longer ( in general )  because thier populations are younger, and their cultural ways are healthier..  but if you need a treatment denied or unavailable because of central planning - you die. 

So yes, thanks, I will thank you to mind your own business, and buy an insurance policy to cover your OWN expenses without holding a govt gun to my head and demanding I pay for you - you leaching non-contributing Zero.  Because I don't need a little monkey like you ensuring I don't have access to a live-saving treatment because central planning didn't budget for it this year  - or because I don't hold the right brand of politics ( or did your forget that Obama was using the IRS for such things? THink he wouldn't use Health care for it as well? Leftists are evil like that)  No, if I can't pay for something because I don't provide enough value to others to arrange  pay for it, I will take the consequences. Life isn't fair, but having some evi hateful l toadying totalitarilan fascist liberal decide it will be unfair for me isn't goign to get my buy in.  Its time the left grew up and accepted thier adult personal repsoniblity to care for themselves and put down the guns they are using to demand everyone else care for them. 

Thu, 11/21/2013 - 11:29 | 4177262 billwilson
billwilson's picture

The Canadian system beats the US system HANDS DOWN! 

Lower costs better results! 98% of Candians would never give up their health care for a US style clusterfuck.

Thu, 11/21/2013 - 11:40 | 4177319 LawyerScum
LawyerScum's picture

that's great, I guess we can ship our 20 million illegal aliens up to the halcyon fields of Canada and they will be easily absorbed and well taken care of.

Thu, 11/21/2013 - 11:48 | 4177362 Max Cynical
Max Cynical's picture

Yea right...that's why Canadians with money come to the U.S. to get their healthcare...because it's so great at home.

Thu, 11/21/2013 - 12:43 | 4177606 Big Corked Boots
Big Corked Boots's picture

The last time I was at the Mayo Clinic, about 10% of the cars in the garage ("ramp") had license plates from Canuckistan. Maybe it isn't the maple paradise after all.

Thu, 11/21/2013 - 13:56 | 4178051 Jena
Jena's picture

The parking lots of Southern California resort area hospitals always are filled with Canadian cars, too.  Must be visiting American relatives, right?

Thu, 11/21/2013 - 11:45 | 4177345 Max Cynical
Max Cynical's picture

billwilson...any solution to curbing the rising costs of healthcare must include the option for a healthcare system free from one iota of government control.

You can't argue that the "US [is] spending double what anyone else does" after the fact. The gov has interfered in this market for decades. Is it any wonder health care costs have risen exponentially when consumers can't buy insurance from any provider in any state or is restricted from importing meds from foreign countries?

Thu, 11/21/2013 - 13:54 | 4178040 Jena
Jena's picture

billwilson: "Single payer!  The only way to go!"

Yes, and then everyone can enjoy the VA experience, one of the worst and least satisfying healthcare systems out there.  Very long wait times, for procedures and/or specialists, lots of incompetence and little to no redress for mistakes or outright negligence.

Brilliant!

Thu, 11/21/2013 - 10:28 | 4176955 Mercury
Mercury's picture

3. Perhaps most cruelly, the bronze level of ObamaCare--the "affordable" care--is a mirage, a simulacra of insurance rather than actual insurance. Bronze level ObamaCare features deductables of around $6,000. In other words, you have to spend $6,000 before your insurance kicks in.

 

Wrong.

Assuming this kind of insurance pays every penny of your bills over $6k (separate issue) if you get cancer, break you neck etc. - this is exactly what insurance is supposed to be: protection against rare, unexpected and expensive (in this case, medical) events.

 

Coverage for regular, predictible expenses is not insurance, it's a pre-payment plan or welfare. That's why no one will sell you grocery insurance and if they do it won't be worth the money.

Thu, 11/21/2013 - 10:38 | 4177030 johnQpublic
johnQpublic's picture

yes, but a catastrophic plan isnt supposed to cost more than a comprehensive plan

should cost no more than a couple hundred bucks a month with a deductible that high

my wife and i have only crested our deductible once in 22 years

 when i had kidney stones

the rest of the time we end up paying 3500 out of pocket for 7 stitches and shit like that

Thu, 11/21/2013 - 10:47 | 4177071 Mercury
Mercury's picture

Well the real world economics are that the catastrophic plan is supposed to cost you more year-to-year if you don’t have a catastrophe.

 Pre-ObamaCare you could pay out-of-pocket, deductible expenses ($0-$6k in this case) from a health savings account with pre-tax money. That’s gone.

Thu, 11/21/2013 - 10:54 | 4177111 g speed
g speed's picture

It would be funny if it weren't so stupid---Obama care is nothing like a catastrophic plan---in the Bronze I can't chose my doctor or hospital or where I want to die-- 

You fucking people that are trying to sell this shit are so obvious its a joke---

 

Thu, 11/21/2013 - 11:02 | 4177146 Mercury
Mercury's picture

I’m not trying to sell OCare…far from it.

But people on all side of the issue have lost touch with what insurance actually is, what it isn’t and what the implications are of passing the later off as the former.

Thu, 11/21/2013 - 11:14 | 4177191 HardlyZero
HardlyZero's picture

Uhh...its not so simple.

Problem is ACA dictates what you MUST do, now what options you have.

Some areas will have options and others won't.

So do you move to where there are more options ? 

If you are single and not tied down and don't have a good job then moving around is not an issue.

Long term there will be bad expensive healthcare and few will have insurance.

Collapse may be the best option to eliminate this taxation without representation.

Many sick who had policies are not represented at all by ACA...just the opposite.

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