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Guest Post: That Which is Unsustainable Will Go Away: Medicare

Tyler Durden's picture


Submitted by Charles Hugh Smith from Of Two Minds

That Which is Unsustainable Will Go Away: Medicare

Medicare is an example of an unsustainable system that will go away in the decade ahead.

Here are the sobering facts about the number of workers and those drawing Social Security, Medicare and Medicaid entitlements in the U.S. While the government claims to have a "trust fund" to pay for Social Security and Medicare, this is illusory propaganda. There are no funds set aside to pay these entitlements--they are "pay as you go" programs funded by current tax revenues. If the tax revenues don't cover the programs' expenses, the Treasury sells bonds, i.e. issues debt to pay the entitlements.

Social Security (SSA) has 61 million beneficiaries as of March 2012.

Medicare has 49 million beneficiaries as of November 2011.

Medicaid has over 50 million beneficiaries; another source puts the current number at 58 million.

Kaiser Family Foundation says roughly 7 million "dual-eligibles" who receive both Medicaid and Medicare, so let's use the data point of 50 million Medicaid-only recipients.

We can assume that most people drawing Medicare benefits also draw Social Security, while the 8+ million drawing disability from Social Security are also covered by Medicaid.

However you slice it, there are roughly 60 million people drawing Social Security and Medicare/Medicaid and another 50 million Medicaid recipients for a total of 110 million people drawing significant entitlements.

As I have noted here many times, there are only 115 million full-time jobs in the U.S.

That means the ratio of workers to recipients of significant "pay as you go" entitlements is roughly 1-to-1: 115 million full-time workers and 110 million people drawing Social Security and Medicare/Medicaid.

These programs consume the majority of the Federal budget. The Federal government spends around $3.7 trillion and collects around $2.6 trillion in taxes, so the basic deficit is $1.1 trillion. Off-balance sheet "supplemental appropriations" mean the real deficit is actually considerably higher.

Social Security costs $817 billion, Medicare and Medicaid costs total about $800 billion annually, and program outlays rise every year. The Pentagon/National Security budget is around $690 billion.

As I detailed in The Fraud at the Heart of Social Security (January 17, 2011), the program paid out $707 billion in 2010 and collected $631 billion in taxes, a $76 billion shortfall for 2010. The current program (2012) cost is $817 billion, a leap of $100 billion in a few short years as Baby Boomers flood into the program.

Of the roughly 150 million workers in the U.S., 38 million earn less than $10,000 per year, 50 million earn less that $15,000 a year and 61 million earn less than $20,000 annually. All these numbers are drawn directly from Social Security Administration payroll data.

100 million wage earners, or 2/3 the entire workforce, earn less than $40,000 per year.

Median pay in the U.S. is about $26,360 annually, while the average pay is about $40,000. Since the average American household takes in $63,091 per year, it seems the typical wage is roughly $30,000 a year.

The Medicare tax is 2.9% of wages, 1.45% each for employer and employee. If the typical worker makes $30,000 a year for 35 years, then lifetime earnings are about $1 million. If we take the $40,000/year average, then that rises to around $1.4 million in lifetime earnings. The 2.9% Medicare tax thus totals about $30,000 to $40,000 in lifetime contributions for the average worker.

The average benefits extracted from the system run from $393,000 to $525,000 (due to the benefits extended to non-working spouses, benefits for never-married people may be somewhat lower). Average annual costs per beneficiary run as high as $18,000, though expenses typically rise significantly in the last year of life.

As I have reported here earlier, a friend's father was in the hospital a few years ago for less than a week for "observation" and a non-invasive gall-stone procedure. Medicare was billed $120,000, or roughly the lifetime contributions of three workers for this modest procedure and a few days in a hospital. My Mom had an office procedure performed on one of her toes and Medicare was billed $12,000. An office procedure (not in surgery) that took a few minutes absorbed 1/3 of my entire lifetime contributions to Medicare.

What we have is a system where the full-time worker to beneficiary is already 1-to-1 and the system pays out 10 times more per person than it collects in taxes. The Medicare system would need about 10 workers for every beneficiary to be sustainable. Right now the ratio is just above 2-to-1. That simply is not sustainable.

Tweaking the payouts doesn't change the basic math: "pay as you go" entitlements are not sustainable when the number of recipients equals the number of full-time workers. Programs that pay out $400,000 per person (many of whom did not work a lifetime) and collect $40,000 per lifetime of full-time work are not sustainable.

Wishing the math were different does not make it different.


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Wed, 05/16/2012 - 12:10 | 2431736 francis_sawyer
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When will printed dollars go away is what I want to know...

Wed, 05/16/2012 - 12:12 | 2431742 Clueless Economist
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Thank you President Johnson...for bankrupting this once great country.

Hope it is nice and toasty warm in Hades.

Wed, 05/16/2012 - 12:14 | 2431749 Careless Whisper
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The Careless Whisper News Update & Threadjacking


Jamie Loves A Circle Jerk; The Winner on The Other Side Of JPMorgan's Losing $2 Billion Trade Was... JPMorgan

Google Has Its Own Air Force; Senator Wants To Know Why Google Is Leasing A Former U.S. Air Force Base & What The Hell Is Going On There

Caroline Kennedy Won't Support "The Liar"




Wed, 05/16/2012 - 12:20 | 2431765 el_brio
el_brio's picture

Anyone else getting sick of people posting OT stuff as replies to the first post?

Wed, 05/16/2012 - 12:23 | 2431783 toady
toady's picture


Wed, 05/16/2012 - 12:28 | 2431802 jeff montanye
jeff montanye's picture

here may or may not be another.  the question of too many older people versus younger is largely a result of the population crash that is occurring and is being intensified by the global depression.  check out this very good book on the subject.

Wed, 05/16/2012 - 12:36 | 2431828 TheSilverJournal
TheSilverJournal's picture

Hooked on ponzinomics worked for me...until it didn't.

Wed, 05/16/2012 - 16:41 | 2432993 Bicycle Repairman
Bicycle Repairman's picture

People like talking about SSI.  Well fortunately Medicare is the canary in the coal mine and it will come first.  Good luck dealing with the medical-industrial-complex.

Thu, 05/17/2012 - 00:41 | 2434169 StychoKiller
StychoKiller's picture


People want Doctors to take responsibility for making them well, AND they want someone else to assume the responsibility for paying for it. [/quote]

From:  "Dreams Come Due, Government and Economics as if Freedom Mattered", ISBN: 0-671-61159-3, by John Galt

The book is dated, but many of the things it talks about are still valid today

Wed, 05/16/2012 - 12:51 | 2431926 ElvisDog
ElvisDog's picture

I think fewer mouths to feed will be a very good thing in the not too distant future. The "population crash" you mention would be about the best thing we could do as a species for our long term sustainability.

Wed, 05/16/2012 - 13:00 | 2431974 New England Patriot
New England Patriot's picture

You know who else talks like this? Satan.

Wed, 05/16/2012 - 13:08 | 2432002 LawsofPhysics
LawsofPhysics's picture

LMFAO!!!!  The Laws of Nature really don't give a shit who "likes" what.  They are what they are and if you don't have access to clean potable water and food, you're dead just the same.  Do you have a point or would you like to tell us all how the Easter Bunny feels about all this because any statements on that would be just as pointless.

Wed, 05/16/2012 - 13:14 | 2432053 TheSilverJournal
TheSilverJournal's picture

Still no need to promote ideas of cleansing the planet. The thing to promote is a better allocation of resources so people have at least an opportunity to give themselves a better life when this worldwide fiat ponzi collapses. To say, "No big deal, just let government keep running the monetary system / charity / retirement because they're the best at destroying people's lives and that's good for humans in the long run," is pretty hateful of humanity.

Wed, 05/16/2012 - 13:30 | 2432132 LawsofPhysics
LawsofPhysics's picture

Let me guess, who's resources would you like to re-allocate first?

My point was that in order to have a productive discussion, you can't talk about fictional ideas.

Wed, 05/16/2012 - 13:41 | 2432188 TheSilverJournal
TheSilverJournal's picture

I don't want to re-allocate any resources. That is the point. The market allocates them better than any other entity. Right now the government and the Federal Reserve is allocating them very poorly, which is why this crash is coming in the first place.

Wed, 05/16/2012 - 13:53 | 2432246 LawsofPhysics
LawsofPhysics's picture

What is this "market" you speak of?

Correct capital and resource allocation in a functioning market only occurs when bad business models are allowed to fail and there are real consequences for bad behavior.  There are none, (FYI- having your "bonus" go from 25 million to 10 million, is not a real consequence) and hence there are no "markets".  The event horizan that you refer to has long since passed.  I have been jumping up and down about the socialization of private failures and capital losses for 20+, people think you are nuts, no way this won't get bloody now. Hedge accordingly.

Wed, 05/16/2012 - 14:35 | 2432487 TheSilverJournal
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You answered your own question.

Wed, 05/16/2012 - 14:01 | 2432301 Matt
Matt's picture

But what if the market of women decides they don't want to get married at 18 and pop out 8 children? What if the market AKA people, decide they don't want children, or that they want to have two children when they are 35 instead? The result of this choice by the market is less population. So the resources are already being allocated efficiently by a free market.

Wed, 05/16/2012 - 14:38 | 2432502 TheSilverJournal
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The federal government taking $2.2T in taxes out of the free market economy and the Federal Reserve creating currency out of thin air as it pleases (therefore stealing resources from the free market economy) and controlling interest rates is the misallocations I'm talking about. Not to mention regulation upon regulation so the "government can protect us."

Wed, 05/16/2012 - 13:55 | 2432268 tmosley
tmosley's picture

People are not allowed to use simple technologies to purify their own water, nor is anyone allowed to create innovative ways to produce more food with lower marginal cost because physics.

Wed, 05/16/2012 - 15:00 | 2432610 LawsofPhysics
LawsofPhysics's picture

Bullshit, they most certainly are, just like the do in India, China, Afghanistan, etc.  Do some quick math and tell us all how much arable land each of the 7 billion of us all get.  Winning!

Thu, 05/17/2012 - 03:38 | 2434331 MeelionDollerBogus
MeelionDollerBogus's picture

Total horseshit. Silver, chlorine & boiling have all been used regularly and continue to be affordable. For those who still go without clean water the fault is 100% on the parents for making babies BEFORE moving to where there is clean water and any supplies. MANY 100's of millions of parents are very bad parents who do this and it is THEIR fault.

Wed, 05/16/2012 - 19:46 | 2433474 piceridu
piceridu's picture

You mentioned The Easter Bunny but what about Santa and The Tooth Fairy...less Elves to hire and what would the Tooth Fairy do with all that extra free time.

Wed, 05/16/2012 - 13:59 | 2432278 Matt
Matt's picture

You think population reduction through people choosing not to marry 6 wives that are 11 years old is a bad thing?

You think not having 8 children is evil?

You think women going to college and choosing whether to get married or not, and whether to have children or not, is a satanic plot?

Or did I miss the sarchasm?

Wed, 05/16/2012 - 13:58 | 2432287 ElvisDog
ElvisDog's picture

Actually, Satan would laugh his ass off if we bred ourselves into oblivion until the starving masses tear each other apart for the last mud cake. Reducing family size in the face of resource/job scarcity is a rational thing to do.

Wed, 05/16/2012 - 13:20 | 2432074 onelight
onelight's picture

In fairness, I think you raise an issue that should be discussed, however ppl find themselves thinking about it. Within a decade or two, flexible automation (robotics) and digital printers will reduce even further the need for labor, leaving even more ppl w/o viable self-supporting work to do. At least the kind or work we can envision now. Granted, new needs and new jobs will be created, enormous opportunities are opening up for innovators, all of that is true. But even so, less work of the kind we have known for so long, seems to be the coming trend. Some groups like the Venus Project have a whole utopian vision of how that will be wonderful for humanity. Robots do the work, we all sing kumbaya, and think higher thoughts. But is that real? For how many is that real? What happens to the rest? I am neither for state determination of who lives and dies, nor am I for waiting to see what happens and then trying to figure out a solution. Thus, interested in others thoughts on this. It might be bigger than some of our current categories.

Wed, 05/16/2012 - 13:43 | 2432204 TheSilverJournal
TheSilverJournal's picture

Less work is good, not bad. That means more resources are freed up to do other things.

Wed, 05/16/2012 - 14:06 | 2432325 Matt
Matt's picture

But the distribution of those resources becomes more and more uneven, as a smaller and smaller portion of the population has more and more income, while the rest have fewer and fewer resources due to a lack of gainful employment or business opportunities. 

Wed, 05/16/2012 - 16:00 | 2432855 TheSilverJournal
TheSilverJournal's picture

There's ALWAYS things that people want that don't come automatically with the push of a button. When something comes automically and at will, the easier it is to pay someone and the higher the living standar there is for everyone. Everyone has a TV, everyone has a computer, most min. wage workes even have a car. Take away the automation to make those items, and suddenly living standards drop dramatically.

The point is much more can be exchanged for much less work.

Thu, 05/17/2012 - 03:27 | 2434322 MeelionDollerBogus
MeelionDollerBogus's picture

"The point is much more can be exchanged for much less work."


the point is when you make life too difficult for others to survive for your convenience, they surround you and kill you.

Thu, 05/17/2012 - 03:26 | 2434320 MeelionDollerBogus
MeelionDollerBogus's picture

"flexible automation (robotics) and digital printers will reduce even further the need for labor,"

Unaffordable to industry. For most work, except some heavy machinery automation (not much) it's self-repairing robots which make their own new versions that's wanted - slave humans.

Thu, 05/17/2012 - 03:24 | 2434319 MeelionDollerBogus
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Population BOOM. People are still making more babies and population is still increasing

Wed, 05/16/2012 - 12:56 | 2431837 Oh regional Indian
Oh regional Indian's picture

The medical system itself is unsustainable.

Totally set up to be that way, starting with obscenely expensive education for th edocs and ridiculous technology that each hospital MUST have, tests tests and more tests... sick, diseased industry, making sicker people and having really sick people work in them.

Of course the system that manages it will be dis-eased too. I remember someone I knew was in hospital (in the US)...went to see them, at dinner -time. After a f'n open heart surgery, the person had fries and buttered buns and pink jello for dinner.

It's enslavement we are seeing, not the curing of the sick.

Perhaps the ailing healthcare systme in the US is really indicative of the malaise in all spheres of life there. Here and everywhere actually.

My sis is a surgeon in the US medical system. Highly regarded to boot. Sad, overworked life.

Reject Allopathy, you DO NOT NEED IT!

Try Garlic/H202/Baking Soda instead. 



Wed, 05/16/2012 - 14:46 | 2432542 TheFourthStooge-ing
TheFourthStooge-ing's picture

ORI said:

Reject Allopathy, you DO NOT NEED IT!

Try Garlic/H202/Baking Soda instead.

I'd just like to add that garlic is one of the easiest things to grow in a garden. Turn the soil with a garden fork to loosen it up, plant the cloves in the autumn in a place that receives full sun, keep it weeded in the spring, and harvest in the summer. Insects don't bother it, so there's no need for pesticides.

Start with good garlic, like you might find at a farmers' market.

It really is that easy.


Wed, 05/16/2012 - 15:43 | 2432797 Cathartes Aura
Cathartes Aura's picture

agree heartily with you both.

I eat raw garlic daily with meals, luckily I have loved the flavour for years, so my body is accustomed to it.  when I'm feeling an incoming "cold" or low immunity, I use it "medicinally" which means: crush a large clove into a tablespoon, let it sit for 10-15 min to bring the allicin levels up, then swallow - I usually eat a piece of apple with this to keep it down - very powerful stuff, and if you're feeling delicate, your gag reflex will be strong!  do this before bed, good organ cleanse. . .

and definitely grow your own, even in a container!

I also advocate H2O2, inhaled - here's the method I've adapted, from Bill Munro:

for clarity, I'll add I buy "food grade 3% H2O2" and use a small plastic spray bottle from the "cosmetics" aisle in the pharmacy - literally pennies a day. . . I currently live in a heavily aerosoled area, and lung problems are common in the population - I picked up a very nasty version last Nov./Dec. which left me gasping for breath, rather like asthma - within 24 hours of using H202, I could catch my breath again - the remaining "headcold" effects took a bit to clear, and it was persistent in that it recurred a couple of times over about 6 weeks - but in the end, my lungs were more "clear" than they'd been in years - and folks that used antibiotics were having worse results.

garlic, H202, raw cilantro & chlorella (for cleansing the aluminium - cilantro releases it from the organs, chlorella gathers, binds and cleanses from the body - use together, so as not to have the aluminium persistent, but removed)

all easy, inexpensive and very potent.

Wed, 05/16/2012 - 23:14 | 2434007 Oh regional Indian
Oh regional Indian's picture

So funny CA, that in India it is impossible to get food grade H2O2 and the stuff we do get is sold in transparent white plastic bottles.

Strange, eh?

But yes, all those awesome ways.


Wed, 05/16/2012 - 23:37 | 2434058 Cathartes Aura
Cathartes Aura's picture

from all I've read, most folks are using the stuff with "additives" - and yet I've not read of any reactions noted - Bill Munro uses the 35% solution that he dilutes himself - and cautions others in their dilution/usage - but I found the "food grade" at a local health store, so was lucky. . . not sure how long these products will be available, given the state of the economy, but the store is gracious in ordering what they don't have in stock, so I'm somewhat mollified. . . even using it multiple times daily doesn't make all that much of a dent in volume - the spray is a few drops at a time at best, such small amounts, for such amazing results, eh!

best to you V.

Wed, 05/16/2012 - 12:39 | 2431867 Jack Sheet
Jack Sheet's picture

better than commercials like "my neighbor's brother's sister's cousin makes $2/hr on the laptop ".

Wed, 05/16/2012 - 12:45 | 2431895 NotApplicable
NotApplicable's picture

First post is the traditional thread-jack post. I'd suggest either getting used to it, or finding another internet.

Wed, 05/16/2012 - 12:50 | 2431917 pods
pods's picture

I much appreciate the effort by CW, as opposed to the threadbombing daily of MDB.  

Wed, 05/16/2012 - 12:23 | 2431766 MillionDollarBonus_
MillionDollarBonus_'s picture

Here’s an extract from my new book entitled “Lies of the Right”. I thought I’d run it passed you guys so you can offer some constructive criticisms. This is an excerpt from the chapter dedicated exclusively to libertarians:

Chapter 7

Common Libertarian myths:

1. Government regulation impedes businesses from growing

This is one of the most widespread and tragically misleading myths spread by the internet libertarian machine. the truth is that most government regulations actually help businesses to grow. For example, if a business has to comply with health and safety regulations, they will improve their image and moral and will attract more customers.

2. The government can't pick winners and losers:

This is so easily falsifiable that it's a wonder the myth ever gained traction. A clear example of the government successfully picking winners was in 2008, when Treasury Secretary Hank Paulson successfully bailed out insurance giant AIG. This turned out to be remarkably successful, with AIG steadily recovering after many thought they would collapse.

3. The Federal Reserve distorts the business cycle:

The Federal Reserve Bank has been the subject of hysterical hatred and attack by libertarians. Libertarians sometimes go as far as to promote elaborate conspiracy theories, in which the Federal Reserve is stealing the wealth of the lower and middle classes. The truth is that the Federal Reserve has promoted prosperity for all Americans by delivering both low interest rates and economic growth.

Wed, 05/16/2012 - 12:24 | 2431789 UP Forester
UP Forester's picture

OK, to get back to the original topic:


Anybody else think a 1:1 ratio of McDonald's workers paying SS, Care and Caid recipients isn't exactly a good tradeoff?

Especially when the benefits received are about 150% those "paid in?"

Wed, 05/16/2012 - 12:34 | 2431823 Poetic injustice
Poetic injustice's picture

It's good for receivers of benefits.

Of course, paying dunno, 5000 dollars in year in taxes means that to pay for one 400,000 operation this person has to work just eighty years. So in short, of course system will crash and more likely sooner than later. For good examples you can see Asia - especially China and Phillipines, and Eastern Europe, for instance Latvia.

Wed, 05/16/2012 - 12:28 | 2431798 El Oregonian
El Oregonian's picture

What a schmuck. Go screw yourself dummy. There, is that constructive enough?

Wed, 05/16/2012 - 12:37 | 2431848 Jack Sheet
Jack Sheet's picture

Shit a brick. The FED program again. Sorry mate, no users here.

Wed, 05/16/2012 - 12:40 | 2431850 Zero Govt
Zero Govt's picture


in response to your points:

1. small biz in the UK spends 5 hours a week just form-filling and on other Govt garbage's not only killing European and US biz, it's killed Empires before (see demise of Ming Dynasty strangled in paperwork). You are obviously a cretin (academic?) with no real world experience

2. The Govt cannot pick winners and losers is absolutely 100% correct. Just see the garbage of public-private schemes/scams in US housing, healthcare, education, subsidising farmers, green energy

Total news to you but AIG will go bankrupt will GM, so did Solyndra, so is AmTrak, so is Tesla, so will NASA

Everything Govt touches turns to crap. Indisputeable Fact with 2,000 years of history backing it up all the way... what part or reality don't you get dickhead?

3. The Federal Reserve distorts the business cycle because it is a monopoly on money... and what do we know about every monopoly in history? It produces garbage because it is not a competitive system which has to provide value to end-users

The Fed and its fraud money will collapse as they will trash it for the greed of those on top and to the detriment of end-users. That's what monopolies do

Your book will be garbage, as predictable as the garbage that Govt (always) produces

Wed, 05/16/2012 - 12:48 | 2431911 tarsubil
tarsubil's picture

The problem seems to be that the more obvious you make your schtick, the more people get angry at you. Maybe it is time for another track?

Thu, 05/17/2012 - 03:16 | 2434314 MeelionDollerBogus
MeelionDollerBogus's picture

"was in 2008, when Treasury Secretary Hank Paulson successfully bailed out insurance giant AIG. This turned out to be remarkably successful"

Except that was a criminal act of money laundering, moving money to Goldman Sachs where Hank Paulson came from with AIG just being a pass-through and NOT doing well since then.

Wed, 05/16/2012 - 12:22 | 2431780 Joe Sixpack
Joe Sixpack's picture

"Thank you President Johnson...for bankrupting this once great country.

Hope it is nice and toasty warm in Hades."


According to Dante, failed rulers end up at the base of the mountain representing Purgatory, where they await their judgement.


Jeesh, even after life, politicians are cut some slack!

Thu, 05/31/2012 - 16:42 | 2481110 Older Than Dirt
Older Than Dirt's picture

By George I think you've got it!

LBJ wasn't the only villain in this play; although pushing through Medicare in 1965 (aka The Social Security Act of 1965) is one of the 2 major "accomplishments" for which he will be "warmly" remembered.

The other gem he -- and the Congress -- gave us was the Gulf of Tonkin Resolution. It was based on a lie, and led to the Vietnam "War." Lot's of older guys who were drafted and lived through that period remember it well.

To the point of this post:

1. Medicare is intractable. With a payroll tax deduction of 1.45% for employees and a matching percent for employers there is no way in Hell that it can ever be solvent!

2. Social Security is often either misunderstood or misrepresented. By law, Social Security (FICA) taxes are "invested" in interest bearing "special issue" securities.

In any current fiscal year, disbursements (aka "benefits") are paid from taxes received in that year (nominally used to purchase special issue "certificates"). Thus the weasel words that Social Security is a "pay as you go" program. As of July 1 of the current year, any excess of taxes received over "benefits" paid are used to "purchase" (again, nominally) special issue "bonds" with various maturity dates (nomally, the excess funds are allocated in 15 approximately equal "tranches" with maturities ranging from 1 to 15 years). The total of both types of securities comprises the balance of what is laughingly called the OASI Trust Fund. At the end of 2010, the "balance" in the fund was approximately $2.4 Trillion.The special issue securities are backed by the "full faith & credit of the U.S. Government."



Wed, 05/16/2012 - 12:24 | 2431777 pkea
pkea's picture

from a former health professional perspective I must add, the problem is not in the just funding healthcare in any form but how it is structured. There is an enormous waste and overpay for services close to 75% in this system. A basic healthcare doesn't worth as much as wasted.


Wed, 05/16/2012 - 12:28 | 2431803 UP Forester
UP Forester's picture

Enormous waste?

You mean like Medicaid recipients coming into the ER for a sore throat, instead of going to a walk-in clinic that has a small co-pay?

Or the mother that brings in to the ER all 5 of her kids, each with different last names, for sore throats?

Wed, 05/16/2012 - 12:56 | 2431853 pkea
pkea's picture

exactly... there are millions of biils like that of probably close to 10k-25k every month on  average are footed by the taxpayers. or people not taking taxi to the medical office but instead going there on the medicare paid ambulance which cost taxpayer's another 1800 at the very least one way, there are millions of people every year who don't need to be in the ambulance go in it to every appointment, just because medicare covers it.

pure idiocy.

probably only 25% who come in the ER really need to be there. others leave with the prescription for motrin, aspirin or tylenol. please, people go to clinics. there are plenty of those, google them.

I had an honor visiting one of the local socal ERs last month where a nurse yelled at the patient moaning in pain to shut up and take some mild pain killer in the waiting room and just breathe. though in some sense she was right about course of action but the manner it was presented is common. i would assume the cows before they slaughtered are be treated more gently....

and come on people paying 1.45% for the medicare is ridiculous, it is outrageously low tax. perhaps the only tax that everyone shouldn't mind paying.... the only problem is how it is spent as everywhere

Wed, 05/16/2012 - 12:27 | 2431804 toady
toady's picture


There are thousands of middlemen between every doctor and the computer that prints the checks.

One of the top five rules of any business is "cut out the middleman"!

Wed, 05/16/2012 - 13:05 | 2432004 James-Morrison
James-Morrison's picture

Our healthcare system makes me sick!

Wed, 05/16/2012 - 12:13 | 2431744 New England Patriot
New England Patriot's picture


Wed, 05/16/2012 - 12:15 | 2431745 El Oregonian
El Oregonian's picture

Time to find a shaman/medicine man...

Wed, 05/16/2012 - 12:33 | 2431818 toady
toady's picture

I'm helping to send my nephew to medical school with the understanding that I will receive free medical.

Wed, 05/16/2012 - 12:55 | 2431948 tarsubil
tarsubil's picture

That's an interesting concept.

Wed, 05/16/2012 - 12:44 | 2431890 Oh regional Indian
Oh regional Indian's picture

El O, anytime you need healing advice, don't hesitate to ask.

But if it's a cure you're looking for, I guess there is always the Run! ;-)


Wed, 05/16/2012 - 12:17 | 2431748 hedgeless_horseman
hedgeless_horseman's picture



..."pay as you go" entitlements are not sustainable when the number of recipients equals the number of full-time workers. Programs that pay out $400,000 per person (many of whom did not work a lifetime) and collect $40,000 per lifetime of full-time work are not sustainable.

They built it to be fueled by inflation that would be exported to the third world and marketed as, "growth."

Wed, 05/16/2012 - 12:14 | 2431750 spooz
spooz's picture

Until we seriously look at how to reduce costs, health care will never be affordable.  There are plenty of ways to make a single payer health care system sustainable, but that would cut out Big Pharma, corporate health care and insurance, so ain't gonna happen with the current duopoly, who are more interested in special interests than sustainability.

Wed, 05/16/2012 - 12:18 | 2431758 Jack Burton
Jack Burton's picture

Clearly you are correct. But too many feed at the health care dollar feed bag. They have political power to kill single payer.

Wed, 05/16/2012 - 12:18 | 2431760 New England Patriot
New England Patriot's picture

People are going to get sick and die. You could spend an infinite amount of money on healthcare, or none, and it would still happen.

Wed, 05/16/2012 - 13:07 | 2432007 Cruel Aid
Cruel Aid's picture

My source tells me that a large majority of patients have self inflicted conditions which trigger a varity of complications.

In other words, not everyone runs up the same amount of debt before death.

Wed, 05/16/2012 - 13:45 | 2432207 blunderdog
blunderdog's picture

Generally, folks who die the youngest cost the least. That includes the fat fucks, the alcoholics, the smokers with lung cancer/emphysema by 60, hang-gliders/rock-climbers/motorcycle riders, and all the various congenital conditions that kill people young.

Of course, you wouldn't have any reason to care who does what if you didn't have insurance in the first place.

Wed, 05/16/2012 - 12:30 | 2431812 TheAntiBen
TheAntiBen's picture

"There are plenty of ways to make a single payer health care system sustainable..."  No, there is NO way of making single payer health care work. There is not even a SINGLE example of it working correctly, without deficits, in the entire world. 


You know what works, 100% free market without government intervention.  Have you noticed that our Government does not provide auto, homeowners, renters or life insurance?  Notice that we don't have a massive problem there?  Notice that we do not get these from our employers at all?  What a concept, a PRODUCT that is being SOLD with people's POST-TAX money, which is OPTIONAL.  Wow... go figure, who would have a thought a system like that would work where you have to buy something on your own and you have some skin in the game if you use it...

Wed, 05/16/2012 - 12:45 | 2431888 spooz
spooz's picture

Know what?  People don't NEED those other forms of insurance.  Health care is something everybody NEEDS, so apples and oranges there.  

And isn't free markets, as far as health care providers, what we have now?  Only the big and powerful corporate interests (Big Pharma, corporate health care and Insurance) have managed to get a seat at the table so they can maximize profits at the expense of affordable health care.  Insurance should be totally optional, for above and beyond basic standard cost universal health care, provided by salaried employees, and we should increase the number of these employees as needed, not as dictated by the AMA. I could go on, but the point is, there are ways to make this necessary service affordable, and it doesn't include free markets where corporate profits stand in the way of effective and affordable care.

Wed, 05/16/2012 - 13:01 | 2431971 tarsubil
tarsubil's picture

Take a field trip to CMS headquarters in DC. Go around and talk to the people there. You'll figure out that this pipe dream of yours requires some fictional mythical smart and efficient government bureaucrat in large numbers and that they don't exist. Pipe dream. Your incredible naivete makes you perfect for government/politics work though. If that is too demeaning for you, you could suck wangs for 10 bucks a pop.

Wed, 05/16/2012 - 13:14 | 2432044 spooz
spooz's picture

Just because we are caught up in a crony capitalistic nightmare is no reason to not point at it every chance we can.  Certainly we need to point out the propaganda that tries to pass the blame off on different groups of sheeple instead of focusing on where the money REALLY goes.

Wed, 05/16/2012 - 13:18 | 2432062 tarsubil
tarsubil's picture

The first thing a crony capitalist system needs is an unchecked government monopoly of force. The government is never going to protect you from big pharma, they are going to be the sole enabler of helping big pharma fuck you over. Trashing big pharma while calling for universal health care is just about the most naive and stupid thing ever.

Wed, 05/16/2012 - 13:26 | 2432107 spooz
spooz's picture

I disagree, but I won't call your comment cynical and deceitful.  IMO, the FIRST thing a crony capitalistic system needs is corporate interests that become powerful enough to own our legislature.  Which is where we are now.  Other countries with universal health care certainly are able to keep Big Pharma from taking more than their share.  Other than stating the obvious, that we are now stuck with a corrupt political system that needs to be replaced, your comment makes no sense.

Wed, 05/16/2012 - 13:30 | 2432148 TMT
TMT's picture

People NEED food too.  Should we have a single-payer food system?

Today we don't have anything close to a free market healthcare system.  The government insures about half of the population (medicaire, medicaid, VA, etc.).  How are those programs working?  The other half of the system is quasi government controlled due to the infinite regulations.

You should soon give up your dream of having the government take care of you because we are broke and soon the sheep who have been conditioned to depend on the government will be ripped off the nipple and have to provide for themselves.  Nothing is "free" just because the bloated inefficient corrupt government runs it.

Wed, 05/16/2012 - 13:52 | 2432250 spooz
spooz's picture

No, we have food stamps, duh.

Again.  The problem isn't "the government" alone.  Its the crony capitalistic relationship the government has with corporate interests, in this case BIG PHARMA, CORPORATE MEDICINE and INSURANCE, who suck profits out at the expense of providing sustainable health care.

Wed, 05/16/2012 - 13:47 | 2432226 TheAntiBen
TheAntiBen's picture

"Health care is something everybody NEEDS."  Wrong again.  Dang, that's two strikes today for you.  You don't NEED health insurance.  Go lookup what "insurance" stands for in the dictionairy, and then lookup the definition of "oxygen," and tell me which one you "need."  This may come as a shock to people, but there are individuals in the US that don't have health insurance at all and live a long happy life.  If YOU feel you aren't going to live a long issue free life, then you sound like a candidate for PURCHASING health insurance.  If you think your life is going to be REALLY short, maybe you'd like to load up on some life insurance as well (hmm, funny how those "other forms" of insurance all the sudden sound similar to health insurance.)

Wed, 05/16/2012 - 14:16 | 2432349 spooz
spooz's picture


Sure you don't NEED insurance.  That is, unless you have assets that you don't want to be wiped out if you are unlucky enough to need health care.  I suspect most of those freedom-loving folks without health care insurance have no assets to protect.  Lets just drag the whole middle class down with the health care system, right?  Give up your health care!  Ride 'em cowboy!

You, obviously, are too young, too naive or too broke to know about the dangers of not having health insurance.

Everybody needs health care.  Not everybody needs the other insurable interests.  

Thu, 05/17/2012 - 00:57 | 2434189 StychoKiller
StychoKiller's picture

Here are seven things that a good attempt at Health Insurance reform should do:

1. Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.  Now employer health insurance benefits are fully tax-deductible (for the Employer, that is!), but individual health insurance is not (So sorry, middle-class, wage-slave!).

2. Repeal all state laws which prevent insurance companies from competing across state lines.  We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able to use that insurance wherever we live.  With no real competition in CA, is it any wonder that Blue Cross can raise their rates around 39%?

3. Repeal government mandates regarding what insurance companies must cover.  These mandates have increased the cost of health insurance by billions of dollars.  What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying. Why should a single man have to pay extra for OB-Gyn coverage, for example?

4. Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. Perhaps then Doctors can go back to ordering medical tests when they're necessary and not just to cover their @ss, when dealing with some lawsuit-happy patient!

5. Make costs transparent so that consumers understand what health care treatments cost.  Ever see a price list in a Doctor's office?  Neither have I, yet we're expected to pay $?? whenever we get an appointment!

6. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and RESONSIBILITY.  Too many people (especially their children!) order Doctors to "Spare No Expense" when it comes to saving granny's life, even though she's been bed-ridden and on a ventilator for the last year.  With no Quality of life, just what are these people trying to save?

7. Revise tax forms to make it easier for individuals to make a voluntary, tax deductible donation to help millions of people who have no insurance.  In Minnesota, we can volunteer to spend some extra tax for a Wildlife fund, why not a "People's Health Fund?"

Wed, 05/16/2012 - 12:49 | 2431912 Goldust
Goldust's picture

Imagine if people expected from auto insurance what they expect from health insurance...  Auto coverage would be growing at 10+ %/year in cost and outlay as well.  You don't have your auto insurer pay for your wear & tear and routine maintenance do you? oil changes, replacing worn belts & hoses, replacing worn tires, old spark plugs, air filter, etc. etc.  You also do not demand that your insurer replace a blown Yugo engine with the newest and most advanced Mercedes engine available...  So many people have the expectation that they should pay nothing for their own healthcare, and that they should receive the best care someone else's money can buy - HOW DO YOU POSSIBLY JUSTIFY THIS????  A-Holes... all of them.

Healthcare will never be "fixed" because people's expectations are unrealistic.  Incredibly unrealistic.  F those people, especially public unions...

Wed, 05/16/2012 - 13:02 | 2431990 tarsubil
tarsubil's picture

Look at a truly free market medical service like lasiks. It has gone down in price and gone up in quality. People have every right to expect quality healthcare. Expecting that when it is government run is the true pipe dream. Fuck the government in the ass until it dies and then we will get quality health care.

Wed, 05/16/2012 - 13:11 | 2432037 spooz
spooz's picture

The cost of health care can be reduced if profits of Big Pharma, corporate health care and Insurance are reduced/eliminated from the equation.  Salaried health care providers, not limited in number by the AMA, can make providing health care more affordable.  There are ways to reduce costs besides just cutting the "lazy" people off.  You listen to too many knee-jerks.

Wed, 05/16/2012 - 13:48 | 2432221 blunderdog
blunderdog's picture

"Health care" doesn't require insurers.  It requires health-care providers.  The more we permit other industries and institutions to collect money that we pretend is spent on health-care, costs will rise.

Wed, 05/16/2012 - 14:49 | 2432551 Ropingdown
Ropingdown's picture

That insureres or pharma are the main culprits in high US healthcare costs is the AMA's propaganda.  The WSJ did a study of it several years ago, as have others:  The problem, compared to other developed nations, is the costs, fee levels, of physicians.  As in dentistry, the cost of entry is made prohibitively high and both the standards to enter and years of study to enter are kept much higher than in Europe.  The taxpayer pays more than half of every medical education cost and more than half of all medical bills, but essentially has no say in the nature of the physician-producing system.  The system as it stands is absurd.  Free enterprise doesn't and shouldn't apply when the taxpayer is forced to foot the bill, unless that system clearly reduces costs compared to systems regulated in the taxpayer's interest.  Medicine fails that test in the US.  Americans are apparently afraid to tell physicians "no, we will set the requirements for pre-med education, number of residencies, number of medical schools, and levels of payment."  No guts or insufficient brains? 

Wed, 05/16/2012 - 15:11 | 2432661 spooz
spooz's picture

Agreed, we need to educate more heath care providers.  Its so obvious I can't believe its not talked about more.  

But that doesn't let Big Pharma, insurance and corporate health care off the hook, despite what that WSJ says. I would hardly expect that rag to say anything that would offend corporate interests.

Wed, 05/16/2012 - 18:53 | 2433350 blunderdog
blunderdog's picture

      That insureres or pharma are the main culprits in high US healthcare costs is the AMA's propaganda.  The WSJ did a study of it several years ago, as have others:  The problem, compared to other developed nations, is the costs, fee levels, of physicians.

I'm not sure precisely what you're trying to say, so I'll reply with a few comments that came to mind while I puzzled over your paragraph.

Physicians traditionally priced according to what patients could afford to pay.  The rich folks paid the most because they could.  The poor paid very little, or even nothing, because they had no money, and because even physicians are human beings with functioning moral centers.  Physicians occasionally provided treatment at their own expense because sometimes they actually have some desire to help another person who has a medical problem.

In a "bill for service" model of medicine, physicians bill high because they know full-well they can't ensure payment.  Once the patient has received treatment (or even diagnosis), there's nothing to prevent him from throwing away the bills.

I'm not compelled by your reference to some studies by some guys you may have read in the past.  Cite them, or you're just another propagandist who has no basis to dismiss a competing viewpoint as "propaganda."

For damn sure: in the USA, we have been allocating huge amounts of money to the medical industries for the past 50 years, and we have derived huge benefits from that spending.  It may be malinvestment, or it may be subsidization of medical infrastructure and R&D.  There's no point in quibbling over it.

Wed, 05/16/2012 - 15:33 | 2432752 fajensen
fajensen's picture

So what, health care is not a business to turn a profit, it is the state looking after its citizens, the reason people agreed to form a state in the first place.

Your mythical "100% free market" only exists in the tribal areas between Pakistan and Afghanistan, the Riff mountains and similar places of renowned living standards and exciting drive-by's by Obamas drones.

Besides, one could run medicare for 300 years for what it cost to bail the bankers!

Wed, 05/16/2012 - 13:03 | 2431987 pkea
pkea's picture

amen spooz


 it is all about big pharma pushing on people mostly unneeded drugs and HMOs


 still 1.45 % medicare tax  should be higher . pretty sure it wont hurt anyone to pay 2 4% more for their helathcare(which we most pay much more anyway via insurance premiums)and drop the federal rates lower

Wed, 05/16/2012 - 13:05 | 2431993 tarsubil
tarsubil's picture

Wake up! Give CMS more money? Those fucking retards couldn't manage their way out of a paper bag. For fuck's sake people.

Wed, 05/16/2012 - 13:07 | 2432011 pkea
pkea's picture

not without big changes in spending structure of course mentioned above.

the thing is that the needed changes are very slight but the wall of corruption to climb is almost impossible to overcome due to population ignorance how easily this problem including financial system fraud can be fixed

Wed, 05/16/2012 - 12:31 | 2431751 Mercury
Mercury's picture

It's almost like we should consider bringing back fee-for-service medical care and draw back the curtain on supply and demand.

Believe it or not there was a time when you could go to a doctor, get your check-up or whatever and he would say "That will be $50" and you'd reach into your pocket and give him $50.  I once witnessed a 10 lb. lobster exchanged for minor eye surgery.

Obviously many medical services are more complicated and expensive than that but today the patient usually doesn't know or care what a service costs, the doctor tries to game the payment system that the state has set up for him and the patient's "insurance" is structured to cover all kinds of things that real insurance shouldn't be covering.

Obamacare's "solution" is basically to have the government ration medical services and make the system even more complex and opaque than it already is.

Wed, 05/16/2012 - 12:32 | 2431816 spooz
spooz's picture

Not sure your definition of fee-for-service is the commonly used one.  I believe that is the current system, where doctors are like assembly line workers, paid by procedure/office visit instead of effectiveness of treatment. Talk to people who work in health care and you will hear about all the unneccesary procedures getting done to maximize profits.  I'd rather see salaried medicine, think its the only sustainable system. 

Wed, 05/16/2012 - 12:40 | 2431872 Mercury
Mercury's picture

Yeah I know - I mean fee-for-service as in the the patient and doctor engage in commerce in a much more direct manner than the way the system is set up now.

Wed, 05/16/2012 - 13:09 | 2432017 Poetic injustice
Poetic injustice's picture

How can you even think about that?
Just think about hungry eyes of executives, accountants, regulators, etc etc who would receive no money in this model.
Feel ashamed, you bad bad communist!


Wed, 05/16/2012 - 13:19 | 2432067 Mercury
Mercury's picture

...or allow them to redirect their skills and labor to more productive ends.

Juat think what a simple, one page income tax code would do...

Wed, 05/16/2012 - 15:39 | 2432784 fajensen
fajensen's picture

There is already a global over-supply of bad porn, the production cost for a porn movie would go to 30 dollars, maybe 100 for bestiality, once all these skilled people flooded the market.

Wed, 05/16/2012 - 15:04 | 2432632 Ropingdown
Ropingdown's picture

Salaried medicine is absolutely the only system which works.  We also need vastly more lower-paid first providers, and a change to two years of pre-med science, not four.  We allow medical practices owned by "the first to arrive" to rake off huge amounts of taxpaper money.  In a system with an adequate supply of physicians this profit would serve a purpose, measure something. However, in a system with poor cost controls and a perpetual undersupply of physicians, plus endless taxpayer funds, such profit lands in every practice-owning physician. 

Wed, 05/16/2012 - 12:36 | 2431829 TheAntiBen
TheAntiBen's picture

One of the "good" news shows did a report a few years back on a doctor that went rogue and fired all his "health insurance" staff and went strictly to a fee based service.  He said when he did this, he saved money by not requiring full time staff to handle all the health insurance junk, which let him price his regular visits at $30, cash.  He said that in the end, he was making just as much money by NOT participating in the health insurance scam, AND, he was happier because he had more time since he didn't have to deal with all the insurance companies, government regulations and paper work.


What a crazy concept... The idea that health care is actually a "product" instead of an entitlement.

Wed, 05/16/2012 - 12:59 | 2431962 Mercury
Mercury's picture

That = better margins for him (the doctor) and it allows him to opperate a smaller, private practice that otherwise might not be viable these days because only the bigger outfits have the scale to afford all those paper pushers.

But it probably doesn't = lower priced medical care for his patients (I don't think) because Medicare is pretty strict about what it allows doctors who take Medicare patients to charge non-Medicare patients.

So, if you want to charge whatever the hell you want as a doctor you basically have to do it outside the Medicare system which excludes most people who need medical (old people).  You're basically limited to kids and rich foreigners.  Trying to make a better buck off the former has unsavory PR issues but many big hospitals make ends meet by being a go-to destination for Saudi princes who fly in and order up anything they want a-la-carte and on demand.

Direct, fee-for-service medical care is becoming big business in places like India and Central America who cater to Americans that don't want a lot of BS between their demand and medical care supply. 

Wed, 05/16/2012 - 15:23 | 2432716 Miffed Microbio...
Miffed Microbiologist's picture

A few years ago I worked part time for a private lab doing HPV testing off of Pap smear samples. Someone accidentally left their fee charges on the copier and I had a good laugh. For cash they charged $100.00 for the test but for insurance they billed 650.00! Of course people never feel medical costs because they are insulated. Five years ago I had an emergency appendectomy. It was a clear cut case but my surgeon insisted I get a MRI to confirm it (why?) it was removed before bursting and I left AMA the next day (couldn't miss my Vegas Conference!) even with that they billed my insurance for 40,000. This is just insane! Some how we've got to get off this merry-go-round before it eventually face plants. Unfortunately I've worked trauma and in large scale disasters you just triage like in a war zone. Scary thoughts.


Wed, 05/16/2012 - 12:17 | 2431753 Jack Burton
Jack Burton's picture

Medicare is clearly the main problem. Our entire health care [sick care] system [non-system] is out of control.

And now we face the epidemics brought on by an overweight young population. A doctor recently wrote that he soon expects patients to present with hearth disease while they are still in High School!

I have several friends who work as rehad nurses in a major rehab center. I keep telling them they need to write a book and expose the true costs of this system. Medicare is being milked without mercy!  It is Patients demanding more, it is children demanding more for their parents and doctors knowing medicare will pay so they treat to the maximum. The horror stories I hear would turn a 21 year old's hair white.

Surely if nothing in the delivery system changes, Medicare and many other payment systems will collapse.

We pay more than double what other 1st world nations pay and our results are near the bottom. How is that justifiable?

Wed, 05/16/2012 - 12:20 | 2431756 hedgeless_horseman
hedgeless_horseman's picture



...and our results are near the bottom.

Spreading untruths will not help the cause.  Our medicine is great relative to other nations.  It is our diet and lifestyle that is unhealthy.

Wed, 05/16/2012 - 12:20 | 2431778 Jack Burton
Jack Burton's picture

Just look at how many die in the hospital from Hospital infections and wrong drug doses!  How does this continue to happen at a rate other nations don't have? Even Britian's NHS has been winning the battle against the deadly hospital infections.

Wed, 05/16/2012 - 12:32 | 2431793 hedgeless_horseman
hedgeless_horseman's picture



how many die in the hospital from Hospital infections and wrong drug doses

Not very many, relatively speaking.  Several orders of magnitude more die of lifestyle diseases such as heart disease and lung cancer.

Jack, I would guess you would like to have the government take over all of healthcare in America.  Correct?  Uncle Sam would set things straight, just like in those wonderful VA hospitals?  No MRSA or wrong meds administered in those fine examples of government efficiency.

Wed, 05/16/2012 - 12:43 | 2431879 john39
john39's picture

deaths by prescription drug (prescribed) are higher than traffic deaths for starters:

the best thing you can do for yourself is stay out of hospitals...



Wed, 05/16/2012 - 12:53 | 2431921 hedgeless_horseman
hedgeless_horseman's picture



I agree with staying out of hospitals.  However, your NPR reference is tripe.


The Los Angeles Times has found that prescription drugs [not prescription errors] are responsible for thousands of deaths annually. 


About 100 people a day die from drug overdose, and most of those are preventable deaths, in which doctors, pharmacists and patients all bear some responsibility.

Preventable deaths...doctors...bear some responsibility.

I love how the LA Times assigns responsibility of drug over dose to a living party with known financial resources.  This message brought to you by the L.A. County BAR Association.

Wed, 05/16/2012 - 12:57 | 2431965 john39
john39's picture

prescription drugs even when used as prescribed are a major cause of death, look it up.  The truth is that the U.S. medical system is nothing but monoply for big pharma and hospitals to rob the wealth of the country.  the smartest thing I ever did was abandon the medical system and learn about holistic health and treatments.  My quality of life improved tremendously, and I saved huge amounts of money opting out of the bullshit useless insurance and treatments that fascist governement and corporations would foist on all of us.

Wed, 05/16/2012 - 15:30 | 2432023 hedgeless_horseman
hedgeless_horseman's picture



You sound pretty proud of yourself.

...the smartest thing I ever did was abandon the medical system and learn about holistic health and treatments.

I wish you good luck fixing an open ankle fracture with just prayer and herbs.  You can even have a chiropracter wave a "therapeutic laser" over the wound and rub your back 5 times per week for 6 months... and don't forget the acupuncture...none of which are free.


As for me, I will take the pain meds, modern antibiotics, titanium plate and screws, board certified anesthesiologist, and an orthopaedic surgeon trained in America.

In just 6-8 weeks time we'll see which one of us did, "the smartest thing."


...and I saved huge amounts of money opting out of the bullshit useless insurance and treatments...

So, not if but when your broken ankle eventually requires you seek treatment at a hospital, as just another uninsured patient, and one with a bone infection requiring I.V. antibiotics, multiple debridement surgeries (you will want prescription pain meds), and a prolonged inpatient stay, are you going to pay cash, or just leave it up to the rest of us that did not, "save[d] huge amounts of money opting out of the bullshit...," to cover your debt?

There is no free lunch, but in America, there is plenty of "free" healthcare.  Hospitals are required to treat this injury, even if you cannot afford to pay.  The rest of us suckers will be picking up the tab through higher medical costs, higher taxes, and the inflation tax.

Still proud of yourself?

Wed, 05/16/2012 - 15:39 | 2432789 Miffed Microbio...
Miffed Microbiologist's picture

Normally agree with you but you're dead wrong on this one. I have worked trauma in the USA and without a doubt is the best in the world. I have seen people so mangled in car accidents with out heart beats be brought back and walk out of the hospital. No where else in this world can you get such amazing care. The fractured ankle you show is not the over all drain on healthcare. It's the chronic illness that is crippling us. This includes the over use of pharmaceuticals. Do you realize when a study is done on a drug it is only done in individuals who aren't taking a multitude of other drugs so to gauge it's efficacy? So if the average drug use is 5 drugs per person there is no way when you add another drug to the mix what the long term results will be. People are being treated like guinea pigs. Then when they get symptoms from the new drug they take more drugs! When does the insanity stop? Probably never because big Pharma is making too much money with the status quo.


Wed, 05/16/2012 - 16:40 | 2432809 hedgeless_horseman
hedgeless_horseman's picture



The fractured ankle you show is not the over all drain on healthcare.

Please read the post instead of just looking at the picture.  It is those that want something for nothing that is the drain on healthcare.  Healthcare is just like any other necessity we have to pay for, such as food, energy, shelter, water, education, transportation, etc. 

You do agree that nobody is forcing you, me, or anyone to consume prescription pharmaceuticals, not to mention an average of 5 of them regularly?  It's a choice, just like deciding to eat at McDonalds.  However, the government is forcing you, me, and everyone else to pay for it when citizens like ZH poster John39, above, decides he wants needs his free lunch healthcare.

I understand you are upset, but your post doesn't make much sense to me.  Please, try again.  When you say, "you're dead wrong on this one, " and tell me what, exactly, you disagree with in my post, above?

Wed, 05/16/2012 - 16:45 | 2433010 Miffed Microbio...
Miffed Microbiologist's picture

Yes healthcare is a privilege not a right by definition. If it were a right then someone would have to be forced to provide it for you. Therefore it must be paid for as a privilege in this country. Medical insurance was never designed to pay for the every day aches and pains and sniffley noses. It was designed for catastrophic care when the individual couldn't afford a massive expense all at once. In the 1990s with 2 young children, I opted for a catastrophic policy. It was 1200/yr for a family of 4, 250 person deduction, 750 family, 80/20 to $5000 and 100 percent above. For 10 years we paid our basic medical out of pocket because we never reached our deductibles. Then Prudential got smart and got tired of us not paying enuf into the pool and raised the cost to 5000/ year plus upped the deductibles dramatically. I had to switch to the HMO because I couldn't afford the old policy. So what I am trying to say is that people often opt out of insurance simply because it is ghastly expensive now even for catastrophic coverage which should be reasonably priced. I felt you were ridiculing some one with an image of a compound fracture that, obviously, was not going to be treated with herbs and salves. I'm weighing the costs of both scenarios and claiming fixing the castrotrophic injury in this country is cheaper than the chronic illness. Right this moment everyone is getting it all for "free".

Wed, 05/16/2012 - 17:00 | 2433044 hedgeless_horseman
hedgeless_horseman's picture



So, it sounds like you don't really disagree with anything that I said, but it did upset you?  Maybe I hit a little too close to home?  If so, I apologize. 

Trying to tell people that there is no free lunch does not make one popular.  Thus, we have the government that you see in office.


Wed, 05/16/2012 - 17:25 | 2433116 Miffed Microbio...
Miffed Microbiologist's picture

You know, it's I who really need to apologize. I'm frankly not upset at all but after rereading my post I can see where that would be construed. Perhaps staying home all day with a chest cold and reading these threads has got me too feisty. Please accept my apology, Ive always enjoyed your posts and really didn't mean to come off so strong. I think, ultimately, we are pretty much on the same page.

In friendship and honor


Wed, 05/16/2012 - 16:17 | 2432901 Cathartes Aura
Cathartes Aura's picture

people are wedded to their white-coat high priests of medi-sin, but there IS research out there should anyone take the time to seek it - I've learned that one must do the research themselves for it to be effective, one needs to desire to know in order to reverse embedded cultural myths - suffice to say, I agree with your posts here, and will just add a quick search to your arguments:

According to the study led by Null, which involved a painstaking review of thousands of medical records, the United States spends $282 billion annually on deaths due to medical mistakes, or iatrogenic deaths. And that's a conservative estimate; only a fraction of medical errors are reported, according to the study. Actual medical mistakes are likely to be 20 times higher than the reported number because doctors fear retaliation for those mistakes.

[...] Prescription drugs are only a part of the U.S. healthcare system's miserable failings. In fact, outpatient deaths, bedsore deaths and malnutrition deaths each account for higher death rates than adverse drug reactions. The problems run deep and cannot be remedied without drastic, widespread change in the system's money and ethics.

and sure, for accidents / trauma, emergency rooms & surgeons, etc. can do wonders - very few will dispute this - but for overall ill-health care, for cures and not just "maintenance" of ill-ness, one needs to be weaned off the handfuls of pharma drugs. . .

Wed, 05/16/2012 - 17:09 | 2433083 Miffed Microbio...
Miffed Microbiologist's picture

THANK YOU cathartes aura!! Beautiful post. Medical errors are an extreme problem that very few are aware. I ve seen many errors made in hospitals and NONE were reported. I've seen patient's flock to incompetent doctors (he's such a nice man!) and prayed they would survive. I personally tried to remove an incompetent dr, 5 drs told me in private they agreed with me but none would testify with me so I lost. I was personally in the room with a dr who accidentally cut across the aorta during open heart surgery on 2 patients! I got yelled at for not getting the 5 units of blood there fast enough. I could go on and on. You may not see it in headlines but it is out there and not too many health professionals will talk about it for fear of reprisal. What a depressing state of affairs the medical field is in.


Thu, 05/17/2012 - 04:20 | 2434367 Cathartes Aura
Cathartes Aura's picture

I've heard the horror stories from first hand observers such as yourself, and have had the same difficulties in trying to share this information with people who are wedded to pharma & doctors.  it's really sad to watch more and more people surrender to just being told what pills to take, or procedures to allow, all to keep within the "good graces" of insurance providers or the doctors they're assigned to - a kind of enforced, learned helplessness.

the doctors themselves have "allegiances" - both to each other, and to their titles, which they've invested huge sums in, so obviously their minds are narrowed towards those ends.  it's the same with most "professions" really, tight loyalties to each other, excluding the person paying for the(ir) service, who is seen as "lesser" in the transaction.

not all doctors are like this of course, but the pressure to conform is there, and so many are just in the field for the monies, hence the "specialists" being so popular.

hope you feel better, take care.

Thu, 05/17/2012 - 21:04 | 2438023 Miffed Microbio...
Miffed Microbiologist's picture

Your comments are very true. How nice to find a kindred spirit! I have found the allegiances to which you speak are, unfortunately, very hard to penetrate even for us in the "inside". In my ignorance I have assumed it was only pervasive in the medical field due to the government, insurance, professional societies interaction but you're probably correct, it's universal and you're correct again, patients are left as mere consumers rather than participants in their own care. But, to be honest, I have worked with many wonderful, dedicated and truly gifted Drs in my 27 years, that, if I had any serious medical condition, would be there for me or give me good guidance to whom I should see for consultation. The sadness I have is that this is not available for the average person.

Perhaps my greatest problem with all of this is HH's argument that we have free will take pharmaceuticals or not. Of course we do but when these drugs are advised by Drs in white coats with numerous degrees, professional memberships and certifications plastered on office walls, I think the average person is blinded by the God-like persona (drs are trained to encourage this) and forget they are dealing with a human being. I myself have fallen into this trap, thank god I'm older and wiser. Thankfully now with the internet, there are many other sources of information pertaining to health rather than blindly following the dogma of the AMA. It amazes me that even here, a financial blog, so many people are aware and practicing alternative therapies!

A few weeks ago I was asked to give a talk at our local health food store on the rise of drug resistant bacteria and possible solutions for patients. A owner of a raw certified dairy was giving a talk too and we both laughed that we practically gave the same talk. Most of the people there were questioning modern day medicine and were searching for alternatives to Big Pharma. I was shocked there was so much interest. Perhaps there is
Thanks for your kind words and, yes, I am feeling late response to you because I had to return to the lab today, once again a cog in the medical machine!


Wed, 05/16/2012 - 12:35 | 2431792 LawsofPhysics
LawsofPhysics's picture

Don't confuse the ignorant sheep HH.  Moreover, the question I tend to ask is what good will a cure for every illness be if there isn't enough healthy food to go around?  Sometimes letting those bad genes die off is a good thing eh?

The capital and resource mis-allocation and mal-investment continues, for now.

Wed, 05/16/2012 - 12:37 | 2431836 hedgeless_horseman
hedgeless_horseman's picture



Jack is not ignorant.  Evil, maybe, but not ignorant.

Wed, 05/16/2012 - 14:00 | 2432288 tmosley
tmosley's picture

If you have cured every illness, then you have cured plant illnesses as well, and have more that doubled worldwide food production even before use of more intensive practices that can't currently be used because they encourage disease.

Malthusian death worship is aliveand well.  How ironic.

Wed, 05/16/2012 - 14:31 | 2432464 akak
akak's picture

Simply acknowledging that there are SOME fundamental limits to human population growth on a finite planet is hardly "death worship".  Or is a farmer who refuses to try to cram 10,000 head of cattle onto a one-acre pasture "worshipping death" as well?

Wed, 05/16/2012 - 14:52 | 2432567 Hohum
Hohum's picture

T Mosley: Where trend is destiny and no further analysis is needed.

Wed, 05/16/2012 - 15:01 | 2432626 LawsofPhysics
LawsofPhysics's picture

Precisely, T mosley, ZH's own walking contradiction and fear monger.  no critical thought required to understand his post.

Wed, 05/16/2012 - 12:27 | 2431794 Hannibal
Hannibal's picture

"Medicare is clearly the main problem",

So is the trillion dollar DHS, the War machine and.....

Wed, 05/16/2012 - 13:25 | 2432060 pkea
pkea's picture

dear god people,


the problem IS in the PRIVATE system. You have PRIVATE  healthcare. The problem is that the PRIVATE COMPANIES are ROBBING PUBLIC medicare.

Medicare isn't at fault except the system is corrupted to be robbed.... as the treasury . 





Wed, 05/16/2012 - 14:52 | 2432571 Hohum
Hohum's picture


I think you're right.  But criticisms will be thrown at you because, well, Medicare stinks.  Of course, Medicare administrative costs are lower than private, but...that's a fact and not part of this discussion.

Wed, 05/16/2012 - 14:49 | 2432554 Hohum
Hohum's picture

Jack Burton,

No disagreement here about Medicare cost overruns.  I am inferring, though, that you and some others here think that life would be much better if Medicare disappeared.  For many people and most seniors, it wouldn't.  Of course, perhaps these people are lazy and don't figure into your calculations are worth anything.  But the suffering would be there just the same.

Wed, 05/16/2012 - 12:18 | 2431754 Cranios
Cranios's picture

BUT the interim stage will be Medicare being means-tested away for anyone who has been reasonably responsible over the course of life, and therefore has assets. That interim period will probably last a long time. We'll pay and pay and only trailer dwellers, tattooed persons and saggy-pants hip hoppers will get the benefits.

Wed, 05/16/2012 - 13:05 | 2431995 Joe The Plumber
Joe The Plumber's picture


Start in your fifties your financial plan to appear impoverished like I am doing

But you need a trustworthy set of children

It is not fair only the irresponsible will get full benies. The conniving should get them too lol

Wed, 05/16/2012 - 14:00 | 2432284 blunderdog
blunderdog's picture

You sound like one of the TEA Party guys I met up with a few years ago in Texas.

He said he opposed the government involvement in everything, mostly because he thought there was too much fraud and theft by the "fuckin' illegals." 

Then he proudly described several methods he used to steal from Medicare.

I asked him if he saw any hypocrisy in that, and he said, "Hell no, if they're going to steal from me, I have every right to steal something back."

I think that pretty well demonstrates the problem. 

Wed, 05/16/2012 - 12:18 | 2431755 Burr's 2nd Shot
Burr's 2nd Shot's picture

I disagree, if you use political calculus, the numbers work out just fine.

Euclid sucks!

Thu, 05/17/2012 - 04:59 | 2434400 MeelionDollerBogus
MeelionDollerBogus's picture

Political calculus: basis vectors with imaginary numbers and final solutions scratched out with a lobbyist signature & agreed dollar-figure!

Wed, 05/16/2012 - 12:19 | 2431762 Hannibal
Hannibal's picture

Fiat currency magically created by a mere computer entry at the Fed,....Voila!

It  magically "pays" for: 

TBTF, TPTB, Govt Perks and Pensions, MediCare, SocSecurty, Wars, Drones, Nukes, DHS etc etc.

Wed, 05/16/2012 - 12:27 | 2431799 Joe Sixpack
Joe Sixpack's picture

...until it doesn't.

Wed, 05/16/2012 - 12:19 | 2431763 tmosley
tmosley's picture

Relevent to this topic:  Celebrating 100 Years of Medical Fascism

Wed, 05/16/2012 - 12:26 | 2431796 Zero Govt
Zero Govt's picture

Yep, and it's the same right across Europe as it is in America

..from rigged drug markets to rigged pharmacies to rigged pricing of Doctors practices to the monopolistic garbage of State healthcare

State hospitals are more 10 times dangerous to your health on a few days visit than a lifetime smoking ...which one do the Health fascists plaster the warning signs all over?

Fuck the fuking State

Wed, 05/16/2012 - 12:19 | 2431770 NotApplicable
NotApplicable's picture

ZIRP says your unsustainability is MOOT! Fedgov will lend itself infinite amounts of "money" as  needed to fund all of this crap.

As long as fiat is accepted as payment, TINA's ZIRP rules.

Wed, 05/16/2012 - 13:08 | 2431771 distopiandreamboy
distopiandreamboy's picture

Ponzi math doesn't work that way. For instance ponzi math says there will be 200 million jobs in the next 5 years and the typical wage will be $100k a year. Meaning plenty of fiat to go around. And you can't argue with math.


Wed, 05/16/2012 - 12:20 | 2431772 Zero Govt
Zero Govt's picture

another bankrupt expensive joke

another public-private shambles

Govt: 10/10 for consistency.. consistently total garbage

Wed, 05/16/2012 - 12:22 | 2431773 guinea
guinea's picture

Where's all the money going? I'm a surgeon and I get $800 from Medicare for a complete mastectomy with lymph node removal and that's including 90 days of any complications.  This is a big ass operation we're talking about.  My fender bender and paint job costs about that much.  That huge bill you get? I end seeing maybe 15% of it if I'm lucky.   Physician reimbursement from Medicare has declined by about 10-20% in the past decade, while overhead and malpractice costs have skyrocketed.  So where's all the Medicare money going?  Midlevels?  Hospitals?

Wed, 05/16/2012 - 12:24 | 2431788 New England Patriot
New England Patriot's picture


Wed, 05/16/2012 - 12:25 | 2431795 LawsofPhysics
LawsofPhysics's picture

Correct, lawyers and insurance companies.  the paper-pushers win again.  The people who actual add the real value, lose again.  Atlas is indeed shrugging.

Wed, 05/16/2012 - 12:42 | 2431857 hedgeless_horseman
hedgeless_horseman's picture



Where's all the money going?

Health insurance companies that want to believe they are growth stocks, not income stocks, so the management teams can be compensated like AAPL executives rather than Otis Elevator.

Covered lives are flat or declining. 

Physician reimbursements are declining. 

M and A is done.

Premiums are the only way they can get quarterly earnings growth.

Health Insurance is NOT a growth industry!

Wed, 05/16/2012 - 12:42 | 2431883 LawsofPhysics
LawsofPhysics's picture

More "atlas shrugging" as people who make healthy lifestyle choices question why they should carry the burden of costs for those who don't.  This is really the only underlying structural problem that no one wants to talk about.

Wed, 05/16/2012 - 13:22 | 2432087 Cruel Aid
Cruel Aid's picture


Pay more to eat right, buy health equipment and gear AND use it, What do you get?  Ramping insurance rates that you know are going into the toilet and the back of a huge line when you eventually need some work done.




Wed, 05/16/2012 - 13:57 | 2432279 TMT
TMT's picture

Bingo!  Those fat asses who eat McD's and don't exercise should be paying about 10x what I pay per month.  And we all know they don't.  Fucking scam.

Wed, 05/16/2012 - 14:00 | 2432297 blunderdog
blunderdog's picture

This is faulty reasoning.

Wed, 05/16/2012 - 15:04 | 2432631 LawsofPhysics
LawsofPhysics's picture

So bad behavior should be rewarded?  I think that may be what has gotten us into this mess to begin with.

Wed, 05/16/2012 - 16:51 | 2433034 fajensen
fajensen's picture

There is bad behavior and BAD behavior: The fatties primarily hurt themselves, the Dick Parsons first hurt everyone else and become millionaires, then they are bailed out and use public money  to scale up a magnitude and become billionaires - by causing trillions in losses to society!

Wed, 05/16/2012 - 19:00 | 2433365 blunderdog
blunderdog's picture

What's the "reward" for eating McDonald's food and getting fat?

The rhetoric-meter is pegged.  Back up a step and tell me what you're trying to say. 

If I had to guess, I'm thinking you're saying that providing medical treatment for people who don't live according to your standards of health/diet/whatever is some kind of "reward."  Now *perhaps* we really do all owe it to you to live as you prefer we should, but you'll have to make a really good argument for that, I'd say.

Thu, 05/17/2012 - 04:57 | 2434398 MeelionDollerBogus
MeelionDollerBogus's picture

The reward is sugary-candy food that makes children stay children even at age 50 and dumb as posts, and no suffering for it because we all pay for it.

That's a big fat fucking reward and I think we should have a say.

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