Gee, Ya Think?
The Market Ticker - Commentary on The Capital Markets
2017-02-05 06:00 by Karl Denninger
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Gee, Ya Think?
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What more needs to be said?

In Bangalore, India, heart surgeons perform daily state-of-the-art heart surgery on adults and children at an average cost of $1,800. For the record, that’s about 2% of the $90,000 that the average heart surgery costs in the United States. And when it comes to the quality of the heart surgery, the patient outcomes are among the best in the world.

Why?

Simple: There is no financialization.  

You can't make someone else pay for your medical treatment in India.

Most families in India have no health insurance, and often need to borrow the money to pay for surgery.

And there are no guarantees on the debt either: You can't exactly repossess a heart operation!

Quality?  Better than in the United States.

How about drugs?  Let's talk insulin:

The medication had identical action to what's sold in the U.S. And its preloaded syringes, with a sophisticated calibrating mechanism, were more accurate in dose than any I've seen. What was most remarkable was the price — less than 10% of what it costs Americans with diabetes today. The combination of massive scale and appropriate pricing accounted for the 10-fold difference.

What's missing from this article?

Any mention of the fact that the only reason drug prices haven't dropped like a stone is that it's illegal to import that Insulin here to the United States.  Were it not Novartis and the other insulin makers here wouldn't sell a single dose at 10x the price, especially when their dosing systems are inferior.

I've often said that the total cost of medical care would drop by 85% if we simply enforced the law, specifically 15 USC Chapter 1, against all medically-related firms -- including pharma, hospitals, device makers and doctors.

This article is evidence that I'm being conservative and the actual drop might even exceed 90%.

Of course to do that you need to take all the monopolists -- which means damn near all of the doctors, hospital administrators, drug company executives, "pharmacy benefit managers" and more out back and........

 

 

 

Indict them.

If we don't, and if we keep doing what we've been doing then eventually those who are condemned might just decide to take some of them out back and do something a less-lawful than indicting them.

Will Trump do anything about this?

Based on the best evidence available to date, NO.

Don't bet your first nickel on him doing a damn thing about any of this, despite it being very clear that mere restoration of a competitive market would make "health insurance" entirely unnecessary for essentially everyone in the United States.

Pfizer has already said they have no intention of altering their pricing model after the recent pharma meeting. Why should they until and unless their entire executive office gets indicted on many-thousands of counts of federal felonies under 15 USC?

In the meantime if you need treatment for something serious -- get on a plane.

If you currently have, or are on the path toward a chronic condition that requires continuing medical assessment and treatment if it's possible to stop or reverse that you had better or you're going to be bankrupted, dead or both.

And if you're already past the point of being able to do anything about it?  Make peace with God.

Until and unless Trump does start indicting this entire segment of the economy (or he makes clear that if they don't cut the crap right now he will, and if challenged, he does) he is not your friend, he will not stop the detonation of this nation's finances nor your financial and personal destruction and yet it is entirely within his power to do both right now, without Congressional involvement since the laws necessary to do so already exist.

Trump may be my President just as he is yours if you live in the United States, but any President who has the power of the Executive to put a stop to this crap under existing law and fails to do so, when it constitutes nearly one dollar in five spent in America today and 37% of last year's federal spending is a five-alarm dickhead, irrespective of what other policies he may or may not implement.  That refusal literally kills hundreds of thousands of Americans a year and financially ruins millions more -- far more than any terrorist or even war has managed to claim.

And that's a fact.

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Attilahooper
Posts: 2685
Incept: 2007-08-28

New York, by way of Montreal Canada.
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The last paragraph is the money shot, irrespective of all the headline issues. How can we get this through to Trump?
Oldpool, you reading this? Hmmmm? You know who I'm talking about.

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Ilerdl
Posts: 4
Incept: 2013-06-10

Utah
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Karl,

I've not posted a lot on your site before, nor have I been a participant in many of your blog discussions.

But is it possible that health care cost escalation is being done on purpose as part of the Cloward-Piven strategy on a national level?

Whether or not anyone believes a Cloward-Piven strategy is being actively pursued is academic. So many things about our present system are unsustainable, even without Cloward or Piven.

Cordially,

Dave
Tickerguy
Posts: 147962
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A True American Patriot!
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Quote:
I've not posted a lot on your site before, nor have I been a participant in many of your blog discussions.

But is it possible that health care cost escalation is being done on purpose as part of the Cloward-Piven strategy on a national level?

Whether or not anyone believes a Cloward-Piven strategy is being actively pursued is academic. So many things about our present system are unsustainable, even without Cloward or Piven.

Cordially, you say?

This is just another excuse for some "grand conspiracy" line of horse**** that allows YOU, and everyone else, to walk around saying "la la la la la" instead of rising up and demanding that this crap stop.


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Winding it down.

Oldman47
Posts: 50
Incept: 2008-10-19

Wisconsin
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Posted both the article and your blog to
facebook.

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Throw the bums out. All 535 of them.
Supertruckertom
Posts: 1187
Incept: 2010-11-07

USA
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I bombed Fbook with this: "Now for something more important than football, your health care costs" headline.
Then linked the story.


Not staying up waiting for replies.

India Airways might be a good stock pick for medical tourism?
How will the medical monopolies put a stop to that?





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Tickerguy
Posts: 147962
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People are too stupid to do it.

**** it, I'm done.

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Winding it down.
Pitz
Posts: 900
Incept: 2010-04-08

voluntary resigned
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Went to Canada to get an elective medical procedure done a few weeks ago. Price was half of what most places in the USA charged. And the procedure was done by the man who invented it, with published studies of pain levels and recovery times literally half of the equivalent offerings in the US.

When discussing the whole thing with the surgeon, he mentioned that a key piece of equipment he uses, made in Germany and used successfully around the world for more than 3 million procedures, has been hung up in the FDA approval process. Why, he opined? Because the FDA cronies want to protect a big Chicago-area company that is currently making a fortune selling inferior technology they haven't invested a dime into in more than 15 years except for marketing.
Supertruckertom
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USA
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Could probably get a good deal on cremation if something goes wrong.
That is another group of vampires here in the USA.

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Tickerguy
Posts: 147962
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**** them. Take a walk on the ice if it comes to it.

I'm ok with that.

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Winding it down.

Flappingeagle
Posts: 2540
Incept: 2011-04-14

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I once checked into opening a natural cemetery and crematorium. There just didn't seem to be much money in it. :(

Flap

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Here are my predictions for everyone to see:
S&P 500 at 320, DOW at 2200, Gold $300/oz, and Corn $2/bu.
No sign that housing, equities, or farmland are in a bubble- Yellen 11/14/13
Trying to leave the Rat Race to the rats...
Vernonb
Posts: 1728
Incept: 2009-06-03

East of Sheol
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Quote:
Could probably get a good deal on cremation if something goes wrong.
That is another group of vampires here in the USA.

Lol... right down by the Ganges right Tom? :-)

Hey, I want a Viking funeral in a boat just to******off the environmental wackos with my CO2 emissions. Make sure by middle finger is raised after I've gone. -lol

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"Mass intelligence does not mean intelligent masses."
Supertruckertom
Posts: 1187
Incept: 2010-11-07

USA
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That low demand for cremations is probably because you aren't near Chicago.

Cardiologist bill so far today is a $240 co-pay. Have not reached my out of pocket limit. Of course the clerk didn't know what the cash price was.
I am 48 and easily over 60 pounds beyond optimum. Echo cardiogram just looked good. An hour wait for the treadmill stress test next.

Getting things checked now.
My employment and insurance situation could change at any time.
I would fall back on Kaiser where my wife works.
Cash and airplane tickets if we both are out.
One good thing about my daughter working at Emory was she met a lot of people from India that are physicians.


Found a good pair of Reeboks half price.
Need to wear them out by Summer.
To the end of my road heading South and back is 2.1 miles and pretty flat.
Cooked fresh Brussel Sprouts and broccoli last night in the steamer then finished with real butter and cheddar cheese in the microwave.
Everyone liked it.
Creamed cauliflower , squash and onions in butter and fresh pork chops tonight.

Love my new work schedule.
I have time to cook for myself and with just a 9 hour work day I can get in exercise before or after my rest.


I am just going to try to live the healthiest life I can from here on out.
Wife finally quite smoking and is on a CPAP now. One week in and she has more energy than I can remember her ever having.
She needs more improvement though.
Losing weight and possibly getting off of insulin I pray is next for her.
One step at a time.


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Preparing to go Hunting.
Supertruckertom
Posts: 1187
Incept: 2010-11-07

USA
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The Viking pyre can wait.
Passed both Echo and treadmill.
Took a while to get up to 160 BBM heart rate.
I was pleasantly surprised.
Cleared to start working out.
Not saying much but they said I was better off than most people that walk in there despite weighing 294.8 pounds today.
I could do a mile and not drop dead but I obviously would not be leading the pack.
230 would be reasonable with my current muscle mass.
Diet diet diet with cardio and endurance style weight training.
I still wrestle with the heavy converter dollies that weigh about 3000 pounds hooking up the double trailers most nights.

PSA and roto rooter inspection of the plumbing next.

That ought to get me to the yearly deductible.

Some of my classmates from High School class of 1986 are already starting to pass on.
Leukemia was the most recent killer.

Thanks for the warning and example Karl.

I am preaching 15 USC to every receptionist and local politician and thinking adult I meet.

Might go ahead and get my Passport too. Me and the Mrs. need to travel now that the youngest are about to turn 20.
I want to see Athens and Rome before they are sacked by the Religious Zealots of the Invading Armies of Islam.

Belgrade, Prague, and Helsinki would be on the itineraries as well.

Got people we want to meet there.
One is a Dr.

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Preparing to go Hunting.
Keenan
Posts: 225
Incept: 2013-01-11

Western PA
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I just concluded a 15 minute conversation with an aide to US Rep Tim Murphy ( PA 18th ), giving him an earful on the oft articulated points raised by our host on medical monopolies, 15 US Code and the USA Today article referenced in this Ticker.

The aide cited this piece by congressman ( http://www.washingtonexaminer.com/a-bett.... ) which I told him is all well and good, but the congressman isn't addressing the big problem: That law on the books is not enforced uniformly. And in Rand Paul, a fellow republican, has legislation to give sanction to medical monopolists.

The aide promised a reply from Murphy and I will advise this community of the congressman's response when I receive it.

Call me cynical but I expect little more than a form letter with a copy of his Examiner op ed. But one must continue trying.
Aquapura
Posts: 600
Incept: 2012-04-19

South of Canada
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My spouse really wants to visit Thailand. I keep telling her that we will someday visit when I need a "procedure" done. The vacation can be the recovery while sitting on the beach.

Quote:
I want to see Athens and Rome before they are sacked by the Religious Zealots of the Invading Armies of Islam.


I took the wife to Paris last year in hopes of seeing it one last time before it's too late. April 2016 was already too late for that once great city. I had been there about 16 years prior and it's far from the city it was even then. St. Petersburg Russia is on my bucket list and part of me thinks they might actually hold onto a country worth seeing someday, rest of the continent not so much.
Analog
Posts: 1378
Incept: 2010-12-29

arkansas ozarks
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Good for you @Supertruckertom

Quote:
I am 48 and easily over 60 pounds beyond optimum. Echo cardiogram just looked good. An hour wait for the treadmill stress test next.

Getting things checked now.


my heart attacks that resulted in bypasses were at age 49 and 59. I could post my flatlines..... At 69(last year) i got some more stints.

I am convinced the vegetable oils and high carb diet of years gone by ,
... combined with closet type A personality,
are the culprits in my life.

Been working KD's LCHF for about a year now . Walk a steep hill every morning, sometimes two or three times over the day.
Raised my eject fraction from 26% to 35% . Dropped about twenty pounds.

Cardiologist says "Whatever it is you're doing keep on doing it. "


fwiw , you have a twenty year head start on me.

Best of luck to you,
and thanks for your always common sense posts.

a.

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Supertruckertom
Posts: 1187
Incept: 2010-11-07

USA
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St Pete would have to be after Helsinki.
My Finnish friend has it out for Russians.
He recently revealed a Russian collaborator in his Reserve Unit.
He comes to Florida to skin dive every year.
We want to go see him and it will probably be in the Winter.

Eastern Europe seems to be the only area even trying to defend itself.
Warsaw would be special because of the struggle there.
Probably would visit the camps for some quiet contemplation and prayer.

Flying home out of Switzerland would be a good finish.

I am taking the advice to live life while it is still good.
We lost 3 drivers last year in my terminal due to deaths behind the wheel.
A crash and burn was the worst.
The family was relieved that the autopsy showed no smoke in his lungs.
He was dead before he hit the trees.

I have made my peace and our kids are old enough to take care of themselves.

Even my autistic son is really taking to 3D CGI and Python programming.
He recently got a job offer from a local shop. He is self taught using available online and print resources.
He has a small portfolio of models and animations he is slowly building up.
Pinewood Studios is doing a lot of work here on the Southside of Atlanta and there are not enough people that are skilled in modern video production and post production CGI special effects.

Live the best life you can.

Tom.






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Ellimist
Posts: 2
Incept: 2014-09-25

Oklahoma
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@Pitz

Similar story with a parenteral nutrition compound known as Omegaven - the FDA continues to drag their feet on approving what has already proven itself in Europe to be a highly valuable treatment option for those in need of IV lipids. It has omega-3 fatty acids in an appropriate amount, while the FDA-approved IV lipid formulas are exclusively omega-6. Karl and many others here certainly know what this means for those receiving it in the hospital who are already in a proinflammatory state.

I used to be a clinical dietitian and left that gig over the shoddy science we're forced to treat according to. That we can't get better materials (so to speak) to work with due to the racket we call American Medicine. Now I sell cars, and it's by far the more honest profession.
Flyanddive
Posts: 2001
Incept: 2008-10-10

Detroit
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The immigration EO was completely legal, yet the courts blocked it. Even if Trump decided to prosecute the medical fraud, the courts will just block it as well. We all know he won't do it. The Trump presidency is a complete failure at this point. Moreover, this country is in complete failure, as no branch of the government will follow the rule of law.

It's over folks.

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"I've seen people go into real poverty trying to pretend to be rich."
Cloudeleven
Posts: 798
Incept: 2007-09-06

USA
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Looks like some Breitbart Trump-worshipers are finally starting to see some light. Saw this posted in the comment section of the "President Trump: Obamacare Repeal May Take Until 2018" article just now:

"A too big to fail tidal wave of "health care" collapse is coming........and it is going to make the 2008 Lehman Bros/AIG Bailouts..........look like pre-school."
Supertruckertom
Posts: 1187
Incept: 2010-11-07

USA
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The IP and knowledge base will survive.
The Buildings are not going to meet a wrecking ball.

It will be a tough lesson in how government cannot serve the people when it is controlled by politicians that serve the donor or Rentiers class.

Senate 222 has dropped all mention of price transparency and replaced it with bones being thrown to the diet supplements industry, the health club racket, and fitness equipment manufacturers.
Wow, we can write off our yoga mat now.

Section 601 is still there with the 15 USC Exemption.

Patient Enslavement Act of 2017

https://www.congress.gov/bill/115th-cong....


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Tickerguy
Posts: 147962
Incept: 2007-06-26
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Quote:
(a) Application of the Federal Antitrust Laws to Health Care
Professionals Negotiating With Health Plans.--
(1) In general.--Any health care professionals who are
engaged in negotiations with a health plan regarding the terms
of any contract under which the professionals provide health
care items or services for which benefits are provided under
such plan shall, in connection with such negotiations, be
exempt from the Federal antitrust laws.

**** you Rand. With a rusty chainsaw.

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Analog
Posts: 1378
Incept: 2010-12-29

arkansas ozarks
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hmmm

Insurance industry was given power to levy taxes.
now underwritten by IRS ?


Quote:
SEC. 224. HEALTH INSURANCE PREMIUMS.

``(a) In General.--There shall be allowed as a deduction the amount
of premiums paid by the taxpayer for health insurance coverage (as
defined in section 9832) of the taxpayer, the taxpayer's spouse, or any
dependent (as defined in section 152, determined without regard to
subsections (b)(1), (b)(2), and (d)(1)(B) thereof) of the taxpayer.
``(b) Coordination Provisions.--


could there be more blatant proof of regulatory capture ?

health insurance industry owns legislative branch.

choosing Rand Paul to sponsor this is their "in your face victory dance", rubbing our face in the dirt.

arrogant little ****s. I'll build the guillotine and haul it to DC.


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Eli
Posts: 8471
Incept: 2007-09-10

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Well, IDK.

Looks like Trump and the Republicans are working hard at getting exactly nothing done when it comes to health care.

Nice to see Rand formalizing and making******the law of the land.

I think Karl is correct once again when he said.

"**** it, I'm done"

If people do ever decide to go to India to get treatment, our government would just outlaw it and throw people in jail for it.

This freight train is closing fast.

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If you want a vision of the future, imagine a boot stamping on a human face - forever.
George Orwell

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