The Market Ticker
Commentary on The Capital Markets- Category [Health Reform]

Gee, so you can't afford cash health care eh?

NEW YORK (MarketWatch) — Wal-Mart Stores Inc. pushed down prices for some generic prescription drugs to just $4 eight years ago, setting a new industry standard. Now it is trying to do the same for seeing a doctor.

$40.  Cash.  On the barrel.  Coupled with the $4 generics care to argue why you need so-called "health insurance" for anything routine any more?

We need to stop making excuses for the health-care scam at all levels -- individually, corporately, and in our government.  Those representatives and senators, whether state or federal, that refuse to take this scam on and dismantle it need to be shown the door -- with prejudice.

Now where are the honest reps and candidates that will take this on?

I've not yet seen one.

That's a problem.

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There are times that I spit my espresso on the monitor and keyboard; it wipes off the monitor but frequently winds up costing me a new keyboard.  This article, when I read it, got close.

We fling open the doors of America’s emergency departments to help those who can’t afford health care.  We have legislated this protection: No person can be turned away for financial reasons.  This is very compassionate, and represents the higher angels of our culture.  Alas, it also is emblematic of the stupider demons of government.  You see, the ER demonstrates the inverted priorities of American society.

Oh really?  Let's see your argument...

In the ER, expensive tattoos abound.  Piercing is ubiquitous.  Almost every adult and child has a smartphone, it seems.  All too many spend the duration of their ER visit glaring at the screen of said phone; barely looking up at the physician who is attempting to engage them in meaningful conversation about the reason they came for care.

And your ER is full of expensive toys and ridiculous cost models because?

See, the two are linked, aren't they?  You call this a "higher angel" but I argue that it's demonic.

It's demonic because that which you can "charge someone else for" provides a gross incentive for people to consume without consideration.  If booze was free how much would many people drink?  If steak was free how many ribeyes would you have?  I know my answer: I'd eat 'em every single day -- and probably two of them, for breakfast and dinner.

Of course I eat low-carb.

What prevents me from doing that?  I have to pay for the steaks.

Dental care? It is regularly ignored because, in the words of my patients, “I don’t have dental insurance.” Guess what. Neither do I, and I pay a lot for insurance. Dental care has typically been a cash business. That’s why dentists, crafty guys and gals that they are, spend their time mucking around the human mouth. Floss and toothpaste? Seems a bit excessive compared to a nice new tattoo.

Oh?  Or is the truth that people do floss and brush but (1) there is a huge genetic component, particularly related to gum disease and the rate of building of plaque and tartar (now being recognized as real, but formerly not) and (2) calling your customers liars is not conducive to repeat business.

As for more than the routine when it comes to dental care it's gotten damned expensive, except for cosmetics, which have come down quite a bit over the years.  Why?  For the same reason the rest of medical care has -- cost-shifting and monopoly protections granted by government to the industry.  Doubt me?  Go hop a plane and fly to Japan to have your major dental work done.  Bring cash, but about a quarter of it compared to what you'll be charged here.  Japan is not a third-world country either and even quite-serious dental work, such as root canals and crowns, are not "high tech" procedures -- they're things we've known how to do for decades.

A woman told me, recently, that her daughter (at birth) had a minor congenital abnormality that required daily application of a cream. “And I had to spend $200 of my own money!” She was aghast.

Why did it cost $200 a month (which incidentally is over $2,000 a year) instead of $20?  Again: Monopoly protections, which are supposed to be federal offenses and land you in the pokey for a decade along with getting you fined a million smackers -- for each instance.

We can’t keep this up.  We’ve created a monstrosity of entitlement.  I care for the poor; I love the poor and have always tried my best to help those in genuine need.  Those truly hurting.

But when cosmetics, vices and electronics are considered reasonable expenditures while the rest of us pay for necessities like prescriptions (or over the counter Tylenol and Motrin as I’m often asked to prescribe for Medicaid), then we are entering the death spiral.

Quit ripping people off and I'll listen to you.  You can talk to me about this when it costs $100 for 15 minutes of your time to stitch up my finger or foot instead of $5,000; $400 an hour is pretty good money, and commensurate with your training and experience, and is about what your time is worth on the free market (for an example again, go try for the same care in Japan or other first-world nation ex-United States.)  $20,000 is outrageous and trying to bill me for that after-the-fact without fair and full disclosure (say much less an opportunity to negotiate beforehand) is theft and extortion, both of which are supposed to be felonies.

Until then go **** a duck Edwin, and you better pray you don't need computer or networking help, because I have a special hourly rate just for you -- it's $20,000, you see, payable in advance -- and in cash.

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Heh heh heh....

More than a dozen states plan to cancel health care policies not in compliance with ObamaCare in the coming weeks, affecting thousands of people just before the midterm elections.

"It looks like several hundred thousand people across the country will receive notices in the coming days and weeks," said Jim Capretta of the Ethics and Public Policy Center.

The policies are being canceled because states that initially granted a reprieve at the request of President Obama are no longer willing to do so.

There's good news and bad news.

The good news is that if you were one of the idiots who bought into the "reporting" that claimed Americans "like" Obamacare, and are pleasantly surprised at the "improvement" or "lack of harm" it has done to them, you're about to get lots of stimulation of your prostate, and that may be a pleasant surprise.

For most, however,including the 50% of the population that doesn't have a prostate, I suspect you'll instead call it rape.

That, of course, is the bad news.


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Here it comes....

NEW YORK –  Wal-Mart Stores Inc. plans to eliminate health insurance coverage for most of its part-time U.S. employees in a move aimed at controlling rising health care costs of the nation's largest private employer.

Starting Jan. 1, Wal-Mart told The Associated Press that it will no longer offer health insurance to employees who work less than an average of 30 hours a week. The move, which would affect 30,000 employees, follows similar decisions by Target, Home Depot and others to eliminate health insurance benefits for part-time employees.

Big surprise -- not!

In fact, this was exactly what I expected -- and here's the problem with that position -- Obamacare means someone is going to pay that bill, and either way it's the employee. 

That is, the choice not to pay it (and not have it) is now gone; ergo, the economic impact is at best a cost shift and (unfortunately, and at the margin) a cost increase for consumers, which means less disposable income to spend everywhere - including at WalMart.

On the margin this is a small change.  But it's all those small changes over time that wind up being a big change in the health of an economy, and for the most part Obamacare's impact has been delayed (but not removed) by all the unlawful "executive decision" delays, whether they be the employer mandate or otherwise.

Delayed impact, however, does not mean evaded.  It simply means delayed, and in this case the important factor is that it's delayed until after the election.

Obama could have pushed hard for an end to the monopoly and price-fixing ways within our medical system in 2009 and actually accomplished something.  The legal framework to end that crap already exists.  Instead he got on his knees and paid tribute with political fellatio aimed at the entire medical and insurance industry, and you, dear citizen, are being lined up to pay for it.

So lube up America and assume the position, because here it comes again.

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Ah, those subsidies....

A federal judge in Oklahoma ruled that those receiving Obamacare through the federal insurance exchange aren’t eligible for subsidies for their health-care coverage. 

The Affordable Care Act explicitly states that those who purchase insurance on “an exchange established by the State” are eligible for subsidies for their coverage, but challengers say that language does not include those covered by Obamacare’s federal exchange. 

That's because it doesn't.

The intent of the legislation was to "coerce" states into offering exchanges.  Some said "nuts", and the Feds then turned around and "interpreted" the statute to neuter what was intended to be a means of coercion but which had failed.

That's illegal -- period.

But nobody cares today about the law.  Nobody has cared about the law when it suits them for decades.  The lawless nature of our own government has reached the point of absurdity, and so the IRS simply "interpreted" the law to mean what they wanted it to mean.

Well, this judge said no.

We shall see how this all plays out as the various challenges work their way through the system; ultimately this likely will go back to the Supreme Court, where I suspect the black-robed bastards will again rule that The Constitution is a dead letter, effectively challenging both the States and The People to decide whether to sit for yet more lawlessness or finally stand up to both the black-robed brigands and the Feds generally and say this far you have come but not one inch more forward shall you move.

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