Archive for the ‘US health care’ Category

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First thing we do, let’s kill all the mosquitoes

May 13, 2016

The lawyers will have to wait.

Let’s Kill All the Mosquitoes
Now is the time to wipe the disease-carrying critters off the face of the Earth.

“The level of alarm is extremely high,” said the head of the World Health Organization on Thursday, describing the spread of Zika virus around the world. As well it should be: The disease, which seems likely to be causing birth defects, could affect millions of people in several dozen countries. And the virus may be on its way into the U.S. As of Friday morning, no fewer than five New York residents have been diagnosed as Zika positive. […]

Consider the statistics: Mosquito-borne diseases kill hundreds of thousands of people every year. Malaria alone claims the lives of 6 million people per decade, mostly small children. The economic costs are similarly staggering, likely in the tens of billions of dollars every year. […]

You might’ve thought that news about the Zika outbreak would have convinced humanity to crush the mosquito. But all we keep hearing are proposals to take the battle to the virus, not its host. We’re told that scientists must work hard to find a new vaccine, as if that would be the best solution to the problem. The hunt for a Zika cure could take a decade—and in the meantime we’re left to wait and watch swarms of evil on the wing, mating in midair, and landing on our shores. An enemy has made its way to the nation’s borders. Now is not the time for soft responses.

It’s time to kill all the mosquitoes. It’s time for mass mosquito-cide. […]

As the article mentions later, there are plans for a trial in Florida of genetically modified mosquitoes that will interrupt wild mosquitoes’ breeding cycle. Evidently, the approach has been tried successfully in other locations.

Tell the FDA What You Fear More: Zika, or GMO Mosquitoes?

What are you more afraid of, the Zika virus, or genetically engineered bugs being released in the wild?

If you feel strongly about this issue, you have until midnight Friday to make your opinion known as the U.S. Food and Drug Administration considers whether to approve an effort to kill the disease-carrying mosquitoes by releasing genetically engineered bugs in Florida.

The biotech firm Oxitec plans to release non-biting male mosquitoes that have been modified to produce offspring that don’t survive after mating with wild females. Researchers believe that within a few generations, this should sharply reduce the mosquito population.

Scientists have weighed in on both sides in the nearly 1,300 comments viewable online so far. Fear is also a common theme, but there’s a split over what people find more frightening: genetic engineering, or birth defects linked to Zika. […]

I don’t know what the downsides to wiping out skeeters might be, but offhand it sounds like a great idea. And (as the first article mentioned), it worked for the screwworm fly.

In fact, there was a spooky sci-fi story in the late 70s titled The Screwfly Solution. It was made into an episode of Masters of Horror (a show I’ve never watched).

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When things get politicized

September 6, 2015

What a great object lesson on why the government should have as little power as possible.

Because most things it touches get handled the way Tom Harkin handled health care.

The Alternative Medicine Racket: How the Feds Fund Quacks

James Randi, call your office.

H.T. Jeff G

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Supreme Court duct tape

June 26, 2015

Peter Suderman writes at Reason’s blog (my emphasis below).

In Upholding Obamacare’s Subsidies, Justice Roberts Rewrites the Law—Again
Time to start calling the Affordable Care Act SCOTUScare.

Supreme Court Chief Justice John Roberts has rewritten the law to save Obamacare—again. […]

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he writes. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

And so Roberts decided that a law which explicitly and repeatedly states that subsidies are limited to exchanges “established by a State,” and which defines “State” as one of the 50 states or the District of Columbia, actually allows subsidies in exchanges established by a State or the federal government. Roberts’ decision does not interpret Obamacare; it adds to it and reworks it, and in the process transforms it into something that it is not. […]

As Justice Antonin Scalia writes in a scathing dissent, Roberts presumes, with no definitive evidence, that his interpretation is the one that Congress intended. “What makes the Court so sure that Congress ‘meant’ tax credits to be available everywhere?” Scalia asks. “Our only evidence of what Congress meant comes from the terms of the law, and those terms show beyond all question that tax credits are available only on state Exchanges.” […]

As even Roberts admits in his opinion, the law “contains more than a few examples of inartful drafting” and generally “does not reflect the type of care and deliberation that one might expect of such significant legislation.” It is a shoddy, messy piece of legislation, held together, barely, by Supreme Court duct tape.

It looks like we’ll be saddled with the PPACA indefinitely, despite passing it and finding out what’s in it.

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He’s all about political advantage

November 10, 2014

On the one hand, I have to admire Mr. Gruber’s candor. And I agree with his analysis of the games that were played to pass PPACA.

If Mr. Gruber chooses to attribute the PPACA’s passage to the ‘the stupidity of the American voter’ rather than attributing it to intentional obfuscation by Congress — as he should — well, that’s his choice I suppose.

A lot of sharp folks were calling BS on the proposed law but its sponsors refused to speak straight to its faults: they were all working the politically expedient angles. Thanks, Pelosi.


On the other hand, this is exactly the kind of "enlightened despotism" that we need to guard against. When a government gets to the point that some parts of it start to bend its own rules to fool other parts — gaming the CBO score in this particular case — then it’s too messed up to trust.

What particularly galls me about this clip is Gruber’s saying that PPACA was designed so that it could not be regarded as a tax. But when the Supreme Court ruled on it, the Chief Justice based his argument supporting PPACA on calling it a tax and on Congress’ authority to levy taxes.

So we’re damned if they do call it a tax – and we’re damned if they don’t. What a deal.

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The Health Care Special (4)

February 22, 2014

The reason I title these posts about Obamacare as I do is because when it kicked in I wanted to do a parody of Midnight Special about it. But that didn’t pan out.

Luckily, we have this parody of Dolly Parton’s 9 to 5 to fill the gap (from Reason.tv).

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How to manage health care

December 22, 2013

I’ve mentioned price transparency for health care before. This article in The Freeman describes a surgeon who’s making it happen. And he confirms my long-held idea that what makes medical care so expensive is all the paperwork and overhead.

Can This Man Save Healthcare?

While the country focuses its attention on the sputtering implementation of the Affordable Care Act (ACA), one man is quietly revolutionizing American medicine. Dr. Keith Smith, founder of the Surgery Center of Oklahoma (SCO) in Oklahoma City, is bringing market forces to healthcare by posting his prices online.

Healthcare costs in the United States have increased at an average rate of 7.7 percent per year since 1980, compared to 4.6 percent for the consumer price index. Smith believes price wars and other market mechanisms, not increased government control, are the best way to stem and reverse this inflation. With the ACA’s implementation, the prospects for formal healthcare policy changes are limited. Smith hopes, however, that he and a handful of other transparent fee-for-service providers will be the vanguard of a free-market movement that runs parallel to the ACA. “The price transparency and price deflation,” Smith says, “aims at the soft underbelly of the beast.” […]

Healthcare Doesn’t Cost That Much

According to Smith, “Healthcare doesn’t cost that much, but what healthcare professionals charge is another matter.” By cutting out hospital administrators and the bureaucracy involved with third-party payers, the SCO is able to offer healthcare services at deep discounts. For example, for a patient with a bad back, the SCO was able to perform a two-level disc decompression for $8,500. That paid for the surgeon, anesthesia, and supply costs as well as an overnight stay. The patient’s next-closest bid was $60,000, saving his company’s health plan $51,500. While few would argue that high four- to low five-figure treatment costs are cheap in absolute terms, in relative terms they are. For major spine surgery, the SCO charges $16,500, which Smith admits “is a lot of money, but people are flying here from Alaska and Massachusetts to get this price because in their home states it’s not uncommon for this surgery to cost $175,000.” […]

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The cost of affordable care

November 25, 2013

As I’ve mentioned, I think the problems with the Affordable Care Act are (a) it does nothing to increase price transparency and (b) it entrenches and subsidizes the current health insurance-based structure for paying for medical care (insurance companies and all).

So I thought Coyote nailed it with his post about the opportunity costs of PPACA, as shown by a study at The Manhattan Institute. RTWT.

Health Care Lost Opportunities

One of the real frustrations I have with Obamacare is that I believe we were on the cusp of a revolution in health care costs and payment systems, which the PPACA will likely kill. As more and more of us adopted high-deductible health insurance plans, there was an increasing transparency in pricing, and new delivery models were emerging to serve this consumer-based, non-third-party payer health niche.

I think this even more as I read about the CMS revising its future health care cost inflation numbers to take into account a flattening of medical price inflation that has been occurring over the last few years. The Left has hilariously claimed credit for this cost reduction via some kind of time-travelling effect of not-yet-implemented PPACA measures. But Charles Blahous reads the CMS report more carefully and finds that the PPACA has nothing to do with these inflation reductions, and in fact is if anything slowing the cost reduction progress.

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The Health care special (3)

November 10, 2013

Like many other people, we got a cancellation letter from our health insurance carrier. It contains the same news people all over the country are getting.

Anthem Blue Cross and Blue Shield is discontinuing your individual health benefit plan because it doesn’t meet all the requirements of the new health care reform laws (also called the Affordable Care Act).

anthem-cancellation-letter
(Click for a larger, readable view.)

Are we upset? You bet!

1. Did the President and his administration lie about "if you like your plan, you can keep it"? That’s what NBC News reports.

And the Obama administration is still claiming that at this writing. I like the part on that page about how they’ll "debunk the myth that reform will force you out of your current insurance plan or force you to change doctors" since those are exactly the problems my family faces now.

Thanks, Obama!

2. The "Affordable Care Act" name is blackly humorous because this new plan we’re offered would cost more than twice what we currently pay for a plan with the same deductible. That $1,417.59 number in the letter would be our monthly cost.

A health care plan for three of us, for only $17,000 per year? What a deal!

3. I expected that a Federal bureaucracy would put itself in the business of deciding for the entire country what constitutes an "acceptable" health care plan and would then force everyone to buy one like that. And so it happened. At our ages, my wife and I don’t need maternity and newborn care but those "must be included on all non-grandfathered plans at no out-of-pocket limit."

I get the principle of pooling risk behind insurance. And it’s obvious that forcing everyone to pay for maternity and newborn care is a way to lower the cost for those who actually need it. Plus, the Democrats get the political advantage of saying that they’ve addressed "Womens Health" issues (by plundering everyone else).

The point is that the decision used to be taken freely; now it’s a compulsory action decided by a bureaucracy.

I’m sure that many would say, "But now young people will be sharing the risk of your age-related care too." That’s likely true as well. But I don’t think the young folks should be compelled to do that. If I had my way, I wouldn’t be forcing my sons (and their peers) to pay my bills.


The fix that the US health care system needed was more price transparency so patients could make better-informed decisions. Just try asking your doctor or dentist what the costs will be beforehand. If your experience is like mine, you’ll get blank looks and people who ask "Why do you care? You’re not paying for it."

It’s a fact that my dentist charges me only half of what he charges an insurance company for a check-up and cleaning. Those days are gone now.

I don’t expect that transparent prices will be a panacea. Transparency won’t solve cases of life-and-death urgency nor will it make everyone medically literate when shopping for a doctor. But I don’t think there’s any perfect solution for all cases. Remember: hard cases make bad law.

Price transparency is what’s needed to allow the market to work despite those counter factors. Why do prices for procedures not typically covered by insurance plans ("elective procedures") keep falling? Markets at work.

But PPACA goes in the opposite direction. Not only does it fail to fix the pricing problem, it entrenches and effectively subsidizes the current system of hiding price information. Welcome to the one-size-fits-all-means-it-fits-nobody world.


4. But what has me most angry is not President Obama nor the Democratic Party congressmen who saddled us with this disaster. They only did what they’ve been saying for years that they’d do. Instead, I’m upset with all of those people who voted to put Obama and his party in power.

So instead of sarcastically saying, "Thanks, Obama!" what I’ll say sarcastically is, "Thanks a lot, Fellow Voters!" Thank you so very much for forcing us all to join a health care buyers’ club whether we wanted it or not.

Do not blame Caesar, blame the people of Rome who have so enthusiastically acclaimed and adored him and rejoiced in their loss of freedom and danced in his path and gave him triumphal processions and laughed delightedly at his licentiousness and thought it very superior of him to acquire vast amounts of gold illicitly. Blame the people who hail him when he speaks in the Forum of the ‘new, wonderful good society’ which shall now be Rome’s, interpreted to mean ‘more money, more ease, more security, more living fatly at the expense of the industrious.

I don’t know who said this but it describes the state of affairs all too well. It’s often attributed to Cicero (but there’s some dispute about that).

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The health care special (2)

November 10, 2013

Frankly, I’d find this a lot funnier if I weren’t the fish who will soon own a bicycle.

fish-on-bike

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The health care special (1)

November 10, 2013

A former workmate sent the letter below about someone he knows with an attitude. (I’m keeping him anonymous for obvious reasons.)

I think he’s a little over the top predicting an economic death spiral, especially from one observation. Anecdotes aren’t data, after all. On the other hand, who knows how prevalent this attitude is? It certainly applies to other things than health care benefits. So he may be right that it’s a harbinger of disaster.

In any event, the attitude he describes is bad cultural juju. Taking ‘free’ government benefits that you could buy for yourself strikes me as a violation-by-proxy of the Golden Rule. Give your fellow citizens a break, people (even if some of them are wealthier than you).

I have to add that I’d feel a lot better if his acquaintance with the attitude were a 20-something rather than a 50-something. That’s the scariest part IMO.

I have a close acquaintance who shall remain nameless. Single and in his/her mid 50s. While s/he seems to be in good health, s/he is a functional alcoholic; drinks all day long, every day.

S/he had several jobs in IT in Silicon Valley area back in the ‘80s and 90’s but decided it wasn’t his/her cup of tea. Now s/he supposedly run a seasonal small business in the northern Midwest. S/he hires day laborers only and pays them in cash each day. S/he only buys business insurance when required to show a active policy to bid on bigger commercial jobs.

In the winter s/he closes down the operation up north and heads to the south to spend winter. The winter business apparently is not as productive (due to lack of demand) so s/he does all sorts of odd jobs to supplement income. I have no idea what his/her annual income is and suspect that s/he operates on cash basis as much as possible to avoid paying FICA, Medicare, state and federal income tax. And of course s/he has no medical insurance.

A few days ago I was watching the news and of course the segment was on the Obamacare debacle.

S/he walked in and stated that s/he was looking forward to Obamacare so s/he could afford medical insurance. S/he then described how the high deductible medical insurance s/he retained for a few years was “a complete waste of money.” So apparently s/he did not get sick or injured often/seriously enough to meet the deductible. S/he said “This was a total waste of $10,000.” I asked if the medical plan was $10000/year (which seemed extraordinarily high). “No. That’s what I paid over 8 or so years.” So when s/he had insurance s/he paid about $105/month for coverage. S/he went on about how greedy insurance companies are and how much better the Obamacare exchange plans will be. Note I said “will be” as s/he had not yet bothered to try and sign up.

And part of the reason s/he had not explored his/her options under Obamacare was the extensive reports of the web interface failure. The other stated reason was s/he wanted to know where s/he would get the “best deal.” In the northern mid-western state or in the southern state (that also has no income tax).

So I asked why s/he had not at least checked to see what the cost/options were as there are plenty of other resources, short of signing up, where s/he could get preliminary estimates? Answer: Website problems (missing my point) and the fact that the deadline is weeks/months away. I dropped the discussion at that point.

A week or so later the subject came up again and s/he stated “Well its most likely I’ll just pay the $95 fine.” When I asked if s/he got monthly cost estimates, s/he just reiterated s/he would “go with the fine and then pick up insurance if/when s/he needs it or just file bankruptcy like everyone else does.”

So my acquaintance enjoys a life where s/he can afford to spend the winter in the south, in an apartment loaded with electronic toys (LCD TV, PCs, iPad, iPhone), drink all day long, and work when it is convenient or perhaps necessary when cash flow tightens.

And s/he wants everyone else to pay their medical care going forward because doing paying their own way would effectively deny him/her the lifestyle they have selected.

I am betting my friend’s approach is going to be replicated by millions of other folks.

The ‘sick’ may get better deals and they’ll likely take advantage of them.

Many of the able will remain uninsured until the last minute, because they can.

An economic death spiral is inevitable.

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