Why The Libertarians MUST Lead On Health Care
The Market Ticker ® - Commentary on The Capital Markets
Posted 2012-08-03 18:24
by Karl Denninger
in Health Reform
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Why The Libertarians MUST Lead On Health Care
 

It's time to call out those who think this is not:

  • A winning campaign issue.

  • Where they should put their political capital.

I am speaking directly of serious reform of the medical system, specifically, hospitalization and so-called "insurance."

I have argued often that it is very common for people to be billed at ten times the rate that something should cost, mostly because (1) we allow illegal aliens and others to steal medical care which they cannot pay for (by forcing us to eat the billing) and (2) we destroyed the charity-care system -- on purpose -- so that firms, including doctors, hospitals and pharmaceutical companies could fleece us. 

In other words these firms bought Congress to get special laws passed that allow them to screw everyone -- theft by government, literally.

I've been challenged on this assertion.

Well, those who have said I was wrong have just been proven to be incorrect.

I place before as "Exhibit A" The Surgery Center of Oklahoma.  This is a surgical facility that performs all sorts of common procedures.  But it's very different than all the other medical centers in your neighborhood.

See, it only accepts payment in one way: Cash.

That's right -- money.  Now.  Up front.  Actual cash or a cashier's check.  That's it.  No credit cards, no checks, no "I'll pay you laters", nothing of the sort.  Fork up the money, get the service.

They also expose their infection rate.  It is a tiny fraction of the national average.  In other words, they "do it right" and thus your risk of contracting an infection in their facility is lower.  Much lower.

So what does this do to the cost of medical care?  I'm glad you asked.

First, there is a $200 consultation fee.  If you are not recommend for surgery, or decide not to have it, that's the bill.  If you decide to go ahead, that is applied to your procedure.

Let's take an example.

"Open reduction internal fixation" -- that is, an open fracture that has to be repaired with screws, a plate, or similar.  Their price: $4,455.00 for the entire thing, except for the hardware which is provided at actual, invoiced cost -- no mark-up.

Now there's a person on my forum who happened to need this surgery performed rececntly.  He was on a HSA so he saw the entire bill.  It was $25,000.

His girlfriend had a cervical disc fusion, two levels -- $150,000.  Their price is $21,500.

Another user on the forum had a Lumbar Laminectomy performed and the bill was over $50,000.  Their price? $9,900.

A few other examples:

Achilles tendon repair, $5,730.

Simple (closed) fracture reduction and cast: $1,925.

Hernia repairs, including the mesh, from $3,060 to $4,500.

A mastectomy: $5,005.

Getting the idea yet?

Sure, it's expensive to have an operation.

But these are the sorts of costs that you could go take a loan out for against your house or even car, or in many cases just take a cash advance on your credit card!

This is typically 1/5th of what you "pay" now.  Or, if you prefer, 80% off.  And this is the entire deal -- including the surgeon and anesthesiologist.

Do you know why?

Because they don't have to treat people who can't pay or don't pay.  They don't have to take Medicare or Medicaid and have the government tell them they'll pay $500 for a procedure that costs them $5,000 to perform.  And they don't have to treat Juanita the illegal Mexican, unless she has money.

Leverage spent a lot of time on this subject and recommended exactly this path -- forced level billing and published prices.  I've been writing on it for years.  I've had people tell me that this model is impossible, despite the fact that it's the very model we had in the 1960s and 70s and it definitely worked then.

We have proof it works folks.

Any politician that doesn't support this is in fact supporting stealing from one person to give to another.  This is not about "compassion" -- if it were then we'd be talking about how to raise the charitable contributions to fund procedures at this sort of price.

It's about theft, and it is time for all Americans to rise and say in a loud, concerted voice:

No more stealing.

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User Info Why The Libertarians MUST Lead On Health Care in forum [Market-Ticker]
Noodleman
Posts: 2386
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Very interesting business model for a surgi-clinic. I wonder how long they've used this model and how many procedures they do per month? Let's hope it's successful so more follow their lead.

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"Ammunition beats persuasion when you are looking for freedom." Will Rogers, 4 Nov 1879 - 15 Aug 1935

Musicandnature
Posts: 1947
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NJ
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wow I'm surpised .gov allows this place to operate in the states. These doctors and surgeons are scofflaws and must be shut down like them evel mari-juana bars. <sarcasm>

I know Mexico has cash /cc cancer treatment centers and folks fly to other countries for surgery. Wonder if it is a state-specific thing.
NJ is quite statist with its heath care 'laws' but drug cos are reaping sheaves from Medicare and medicaid.

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Since it costs a lot to win, and even more to lose, You and me bound to spend some time wonder'n what to choose. Goes to show, you don't ever know, watch each card you play and play it slow...Wait until that deal come round, don't you let that deal go down, no no. Garcia/Hunter.
Throxxofvron
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Hyper-Speculative Psycho-Facsistic Parabolic Blow-Off
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What happens to such a Business when Obamacare kicks in and People are 'TAXED' for NOT buying into the .GOV Mandated Force Placed Medical Insurance to pay for Other People's Services?

Libertarian Candidate Johnson might CLAIM to have had a change of heart about ending the collusive cost-shifting bull**** in the Medical Care Industry or prosecuting fraud or whatever; -but, I would NOT believe Him as these have NOT been his positions in the past.
-Politicians Who's campaigns are going nowhere ( and Johnson's is pretty much going nowhere ) tend to say whatever They think will get Sheeple to pull the lever for them...


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DIONYSUS: " Thou hast no knowledge of the life thou art leading; thy very existence is now a mystery to thee. " -from 'The Bacchantes' By Euripides “During times of universal deceit, telling the truth becomes a revolutionary act.” -George Orwell

Twainfan
Posts: 147
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There is a clinic out east somewhere doing the same thing. They take no insurance and work only for cash. Can't recall where it was at the moment. They are having great success too. Between this and fraud, a candidate could basically run unopposed. Any opponent wouldn't get over 5% of the vote.
Jack_crabb
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Peoples' Republik of Maryland
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But that would require an honest politician, Twainfan. I don't see THAT happening anytime soon.

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Molon Labe

Where is Henry Bowman when you need him?
Jstanley01
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You can't cheat an honest man. ~P.T. Barnum
Analog
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arkansas ozarks
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found one in idaho a few years back.
some doctors bought an old motel and made a nice little surgical center.
wife had her cancer surgery there.
wonderful folks.
Ser100
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Incept: 2010-06-27

Lincoln California
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Thank you for this ticker! Now I know where to go to have a hernia repaired. Kaiser has refused to fix it saying that it is just not yet big enough for them to repair.
Themortgagedude
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saint louis
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No reason this couldn't work with insurance as well. You pay cash upfront and are reimbursed 70 percent of fees. In exchange you pay about half the current premium. I don't see why that wouldn't make sense

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I'm already visualizing you with duct tape over your mouth.
John2k
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NJ
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Here's a somewhat similar example of what happened to a friend of mine. 3 years ago he was treated for a kidney stone. The hospital sent the bill directly to him, the cost was $9,500.

$9,500 is what the hospital was charging my friend for treatment.

He has insurance, though, so he forwarded the bill to his insurance company. They paid the bill and sent him a copy of the paperwork.

The cost for payment in full to his insurance company: $650.

This example was a little different than what Karl described, but is similar enough and just as ridiculous. It's crazy that a hospital would send a $9500 bill to an individual but to the insurance company the bill is only $650.
Cluelessinfl
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Sorry, don't look for anymore of these hospitals to crop up. They're banned in Obamacare.

http://news.heartland.org/newspaper-arti....

...Section 6001 of the health care law effectively bans new physician-owned hospitals (POHs) from starting up, and it keeps existing ones from expanding. It has already halted the development of 24 new physician-owned hospitals and forced an additional 47 to struggle to meet the deadline to complete construction, according to the Physician Hospitals of America (PHA)...



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Land of the Free my ass.
Howardnyc
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clueless beat me to it.

being one of the few people who has actually read the new health care law, i remember that part. i wasn't sure if it applied only to facilities accepting medicare patients or all physician-owned hospitals; or it it would apply to non-hospital surgical facilities. i made a note in case i get suckered into a business like that again (so much friggin' red tape, makes my head hurt).

but this oklahoma facility is awesome. i would love to work in a place like that. (i'm an anesthesiologist.) straight cash, homie. prices posted up front. it's so crazy, it just might work, if the government stays out of the way.

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kd told me (and i believe him) that
"We (Americans) deserve a Depression."
Morla
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The insurance sector has one job and one job only; To figure out what people on average are willing to pay for peace of mind, and charge exactly that much for it (what the market will bear). Irrespective of the PPACA, with the collusion that is already allowed in healthcare I consider the health insurance industry in general to be anti-competitive/capitalistic (They may bid, you may not). Now, bring in the PPACA and its enshrinement of the corporate insurance sector.. Oh, bother.

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Fear of govt IS the government.. Statism is a pack of unbacked threats; If govt gets out of control, ignore it and go about life as you see fit. Where's your crown, King Nothing?
Xtbjeff
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A few weeks ago my wife had some vertigo, and went to the local walk-in clinic. They diagnosed it as a possible stroke, and transported her to the local ER, where it cost over $5000 for 4 hours of tests. She was pretty much over it by the time she left. $1300 an hour! (We have high deductible, so most of it comes out of our pocket.)

Reason: typo
Debtpie
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This is not a winning issue at all and shows why Libertarians can't get 1% of the vote...

Pick a 100 people at random and bring up this topic; 99 will stare at you like you're insane and (if you're lucky) 1 person will be a Libertarian...LOL!

People don't care about this; the majority get (nearly) "free" care from their employer...another huge chunk get 100% free care from the government (medicaid)...and gigantic number get cheap/excellent coverage again from the government through Medicare.

Then add in all the young and healthy immortals and what you have left is 0.25% of the population to which this issue might resonate.

LOSING ISSUE BIG TIME!

Libertarians need to learn how to play political ball; you gotta sell a piece of your soul to get power...then you can really do something about fixing things the way you think they should be fixed...instead of shouting out from the political basement where no one can hear you or really cares to.


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A Leader, or an Opportunist? "A leader has the capacity of vision, the ability to see where things are headed before people in general see those things." Mitt Romney --- DebtPie's definition: a leader decides where "things" should head and "leads" us there.

Debtpie
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Xtbjeff,

Similar situation in my family years back...long story short..final diagnosis was severe indigestion...final bill was ~$16,000...they didn't pay a dime of that...stuck it all on Medicare and supplemental.

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A Leader, or an Opportunist? "A leader has the capacity of vision, the ability to see where things are headed before people in general see those things." Mitt Romney --- DebtPie's definition: a leader decides where "things" should head and "leads" us there.

Morla
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Debtpie wrote..
People don't care about this; the majority get (nearly) "free" care from their employer...another huge chunk get 100% free care from the government (medicaid)
There is no gradual exit from statism. You'll run face-first into a chicken-egg dilemma where nobody learns responsibility in an environment where responsibility is punished and the irresponsible are not allowed to fail. Sadly, the rug must occasionally be pulled and a cold-turkey process must occur. The Great Depression bought us many decades of wisdom, and now it's time to pay that price again, or abandon wisdom for madness and God have mercy on our souls.

They know not what they do, I'd sooner forgive someone who haplessly killed millions than someone who killed a single man but knew better. It's critical to understand that most statists are not evil, they live in a world where the laws of nature are ridiculed, they can't get from there to here unless circumstances force them to. That is what must happen.

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Fear of govt IS the government.. Statism is a pack of unbacked threats; If govt gets out of control, ignore it and go about life as you see fit. Where's your crown, King Nothing?
Jonesapple10
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I would support this 100%.

Quote:
People don't care about this; the majority get (nearly) "free" care from their employer


Really?

We spend about $8000/yr on premiums for a "premium plan" The plan SUCKS (my wife is a teacher and we are on her plan). We end up paying co-pays, there is always an extra charge, medications are over the top. (the only good thing is antibiotics are free at Publix) Looking at my end of year statement last year, my insurance provided around $300 of coverage and I paid around $100. What a deal.

Of course we only have insurance because if we have a major problem, it could bankrupt us without insurance. With this type of facility, we could pay our dues in escrow for 3 years and have $24,000 in emergency care and I would feel confident that we'd be fine. We've been on this plan for 9 years, and I would guess we've had about $12,000 in benefits TOTAL, and paid over $70,000. How many illegals does that pay for?
Sd79
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Quote:
"Open reduction internal fixation" -- that is, an open fracture that has to be repaired with screws, a plate, or similar


So when someone with no money NEEDS that above, then what? Do it, bill them and let them bk out of it?

Or not do it cuz they have no money?

If we do it when they can't pay, then those who need other treatments will want to be treated and just bk after they are treated.

How does that change the mess we are in?

Oh and I wish I knew if they were still in business but a private hospital opened in Mexico, gulf side, a few years ago. Can't find them online now but this was in 2007 or 08. They had hip replacements at about 10K then.

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“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
~ Albert Einstein
Downrange
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Well, to statists that's a "loophole" that needs closing.

Once you see quite clearly that the vast majority of voters are/approve of statists, you will see the only answer is Tom Baugh's - let it collapse. Hasten it, even...

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"If this is how the state treats its law-abiding citizens, it doesn't deserve to have any" A. Solzhenitzen
Twainfan
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SD79, those tat can't afford it go to charitable hospitals and clinics like they did before EMTALA. They would get the care they need and charities would cover the costs.
Sd79
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The old fashioned True "non-profit"?

If it worked, it's a great idea. When I look at the world though, I gather that system is still in effect 3rd world but not in developed countries.

So what works in 3rd world countries is better, in the long run?

I know I'd love to work, for less money, but no fear of lawsuits, if it were possible. (nurse here)

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“Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
~ Albert Einstein
Sutluc
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When I look in their "prices" page the very first line is:

NOTE: If you are scheduled for surgery at our facility and we are filing insurance for you, the following prices do not apply to you.

It appears from this that they do deal with insurance as well as cash over the counter.

Looking at their blog, a couple of entries back they discuss a Canadian patient and the Canadian health care model's failings.
I think the Canadian experience must be very individual and vary from province to province, because I've never known anyone that had to wait a very long time for anything, but I hear second hand like this about people that are waiting ages for things to happen.
Tm22721
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Who is John Galt ?

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The country is terminally ill and IT JUST WANTS A PILL.

The only way up is down.
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