Jail. Now. Not Bailouts
The Market Ticker - Commentary on The Capital Markets
2017-07-14 08:00 by Karl Denninger
in Corruption , 313 references Ignore this thread
Jail. Now. Not Bailouts
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The latest Senate attempt to pass Obamacare Lite is now out.

It contains a number of provisions that are interesting but exactly zero of them address cost.

Notably, it does not include my one-sentence bill that would instantly destroy health insurance extortion rackets which are destroying the middle class and, if ended, would immediately force down costs for everyone in the system.

Nor does it include any of the other provisions that I have in my larger model legislative proposal that would force price transparency and end collusion -- the very essence of which violates 100+ year old law.

It's not like these provisions aren't known to the Senate.  They are.  They're also known to the House.  And they're known to Trump too, who has run a company for decades and is well-aware of the rank lawless nature of a "business" that refuses to quote you a price and charges people 5, 10 or 100x as much money based on whether or not you bought a "preferred" service from someone else.

Yet there is not one word about any of that -- which would bring down cost, and solve the problem.

Nope -- instead we have..... billions to "fight" opiod addiction.

A problem that, it appears, is at least in part the responsibility of a company that just got fined.

(Reuters) - Mallinckrodt Plc, one of the largest manufacturers of the generic opioid painkiller oxycodone, will pay $35 million to resolve allegations that it failed to report suspicious drug orders, the U.S. Justice Department said on Tuesday.

The deal, in which Mallinckrodt did not admit wrongdoing, marked a record settlement of claims that a drugmaker failed to properly notify the U.S. Drug Enforcement Administration of suspicious orders for drugs such as oxycodone, the Justice Department said.

Of course they didn't admit wrongdoing -- they never do.

But it appears they weren't reporting "suspicious" orders for their pills -- that is, orders which they knew or had good reason to know were going to pill mills and others who were dispensing them inappropriately -- meaning for profit and to boost addiction rather than for therapeutic use.

Instead of shutting down this company and jailing their executives for drug running (which I remind you we're all to happy to do if it's some ordinary person who similarly is selling drugs for an illicit purpose) they instead "paid a fine" and "didn't admit wrongdoing."

Oh, yeah, and they're still able to sell their drugs too.

The Senate is complicit in both the opiod epidemic and a direct enabler of the lawless nature of our entire "health care" system in the United States.  We must put a stop to this -- all of it -- or it will destroy our nation.  We do not have the money and cannot raise it to keep expanding health care expenses at multiples of the size of the economy and every bit of it is happening not because people are getting older but because providers collude both among themselves and with other parties to fix prices and restrain trade -- practices that were declared illegal more than 100 years ago and which in many cases carry felony criminal penalties.

Yet utterly nobody -- at either the State or Federal level -- will enforce existing law, instead putting forth the sort of twaddle that the Senate has now released.

Minnesota will sue CenturyLink (a DSL and telephone provider) for failing to honestly disclose prices so why won't they sue every single damned hospital and doctor's office that fails to do the same?

Solve this problem now, America, or our way of life dies as do both State and Federal budgets.  This is not going to happen at some well-off time in the the future; it has already crippled GDP and productivity growth and at present rates of expansion will have inflicted critical and perhaps unrecoverable damage before the next Presidential election.

WE ARE OUT OF TIME TO DIDDLE OURSELVES AND PRETEND WE ARE "HELPING."

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Azengrcat
Posts: 408
Incept: 2010-05-31

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What I don't understand is there not a lawyer out there that wants to become rich and famous suing these bastards? Fighting big tabacco made lawyers millions, "big medical" has billions if not trillions of fraud built in that can be shaken out by lawyers.
Zappafan
Posts: 2934
Incept: 2007-11-30

Atlanta
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Our entire economy is based on fraud. The one that got my blood roiling was the CBO's budget and deficit forecast, released yesterday.

Now I know that the CBO's hands are tied and it's "Garbage in, garbage out" in terms of underlying assumptions fed to them by the executive branch. However, these bastards released a forecast based on 5% GDP growth by 2027. We haven't had a year of 5% GDP growth since Reagan's first term.

If that isn't a fraud, I am not sure what is.

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Ich bin der Tankendau!
Aquapura
Posts: 627
Incept: 2012-04-19

South of Canada
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You had the same thought I did on the Centurylink lawsuit. Let's sue the "hated" phone company ISP because someone didn't get their promised promo rate but meanwhile every resident of the state is continually getting ass raped by the medical cabal and nobody lifts a finger. The MN attorney general is worthless and only interested in a token publicity stunt not actually helping anyone.
Cerich
Posts: 939
Incept: 2008-12-17

ga
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35 million, what a joke. That fine will be received so well that more than the fine will find it's way to campaign funds from the drug company.

In other news there was a announcement of 400+ arrests for a billion dollar plus in over billing and over prescription of opiods..connect those dots
Dantes
Posts: 1
Incept: 2017-07-14

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You don't get it. This is a Ponzi scheme. The government depends upon this to prop up Medicare/Medicaid spending. There is no relation between cost of care and reimbursement, which is decided simply by numbers and what someone thinks it should cost. All providers know this. So they have to make up the difference by charging private patients more money.

Don't blame us doctors.

Item: Senator Daines, Republican MT, announces 1.4 million dollar grant to Butte Community Federal Health center. This in addition to 1 million dollars a few months ago by Senator Tester. The Community health center sees all patients, not just Medicare/Medicaid/Indigent. As a result, in Butte MT, there are 75% fewer physicians in private practice than 10 years ago. The rest have left or are employed by hospital or Community Health Center.

Doctors pay taxes, have to work within a budget, etc. Not the Community Health Center, in which Federal Money is airdropped to subsidize the clinic even more.

Your solution is a non starter.
Renov8
Posts: 38
Incept: 2016-01-05

Eastern PA
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The one thing I have come to realize about anything getting done in this corrupt political environment...file suit

Filing suit is the only recourse that gets results nowadays. The Liberals are doing it on a daily basis on everything from stopping Trump on immigration, to friggin transgender bathrooms, to BS suits because a baker does not want to bake a cake for a same sex couple. Personally, I hate lawyers and everything they represent...fall in the same category as politicians. (common character flaw in both). However, filing suit forces the parties to achnowledge each other, it forces them to come together, and it forces the issue if you can find a judge that supports the suit.

Karl, I think you need to get their attention in the manner that gets attention...sue the federal government. It will get you the right exposure and possibly a sympathetic ear to your message.


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"As a society, we rediscover that the value of a right is not in what it hides, but in what it protects."
Tickerguy
Posts: 149209
Incept: 2007-06-26
A True American Patriot!
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Quote:
You don't get it. This is a Ponzi scheme. The government depends upon this to prop up Medicare/Medicaid spending. There is no relation between cost of care and reimbursement, which is decided simply by numbers and what someone thinks it should cost. All providers know this. So they have to make up the difference by charging private patients more money.

Oh I get it alright Ponzi schemes are illegal and you just admitted to participating in one in a public forum gee I wonder what that means should happen to you....

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Winding it down.
Redbrian
Posts: 22
Incept: 2010-06-25

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No man's life, liberty or property are safe while the Legislature is in session - Gideon J. Tucker
Jack_crabb
Posts: 5226
Incept: 2010-06-25

Peoples' Republik of Maryland
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One would think a doctor would have decent reading comprehension and reasoning ability. Dante proves otherwise.

Yeah, Dante, doctors are part of the problem. You willingly participate in the scam. If you refuse to believe or accept that, then **** you.

Judging by your first post, I don't expect you to be here at TF very long.

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Molon Labe
Where is Henry Bowman when you need him?
How many are willing to pledge this? We mutually pledge to each other our Lives, our Fortunes, and our Sacred Honor
Comrader
Posts: 247
Incept: 2010-06-10

pa
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dantes, so the government doesnt give you enough money so you have to steal it from the poor son of a bitch that cant afford to buy insurance. well at least you admit what you are. you are just grabbing what you think you deserve, despicable.
Tickerguy
Posts: 149209
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A True American Patriot!
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The next time some doctor says that we don't understand or that it's not clear what's going on well now you have your poster child to know full well that they're willing and intentional participants do with that information what you will

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Winding it down.
Renov8
Posts: 38
Incept: 2016-01-05

Eastern PA
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Personally, I would like to hear back from Dantes, regarding what else the good Dr's do to ensure full payment for their services.

On a side note, we are screwed any way you look at it. When the head of the largest bank in the world has to tell our lazy as **** Congresspeople to stop the crap and start doing what they where put there in the first place to do, you know its hitting the bottom of the barrel.

I sure hope all of you have the wherewithall to have some beans and bandaids put away...cause I feel that day is coming sooner than later.

MSN has stopped all comments on their site. I am surprised by that move to shut people up and limit comment...maybe because it wasn't going in the direction they wanted.

As the song says...Sign, sign, everywhere a sign
Blockin' out the scenery, breakin' my mind
Do this, don't do that, can't you read the signs?

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"As a society, we rediscover that the value of a right is not in what it hides, but in what it protects."
Tickerguy
Posts: 149209
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The good doctor hasn't had to make a saving throw.... Yet

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Winding it down.
Oldno7
Posts: 2582
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RECALL STATE USA
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Wife gets stiches pulled out which took a nurse about 10 minutes. Dermatologist charged $418.47 and Medicare approved amount was $28.30 which they had to accept because they accepted the Medicare assignment. So can someone tell me how they are scamming the people by charging $418 and know they only get $28. What do they do write this off as a loss? There has to be a scam in here somewhere.

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IT'S THE SPENDING STUPID The US must become less a government of men, and more a government of LAW.When people lose everything and have nothing left to lose they lose it -Gerald Celente
Psdrone
Posts: 3
Incept: 2016-04-04

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The comment about Medicare/Medicaid reimbursement rates has some merit. I believe that all health care "prices" should evolve based solely on normal market forces - supply/demand, level of quality, reputation etc. Most health care professionals and knowledgeable observers believe that the government-set rates for the two welfare programs in many cases do not cover the applicable costs of service delivery (particularly Medicaid). Thus, we first have to get the government to admit to creating the "whack-a-mole" environment pursuant to which it allows the craven pricing of services to the non-indigent, non-elderly citizenry. For example, EMTALA needs to be immediately revoked. Indigent care provided by hospitals should then be billed to the appropriate governmental agency at a fairly derived "cost". No more non-publicized BS State or Federal "rebates" to make up for all of the "free" care provided. Next, stop BS'ng the public on the true cost of the two welfare programs. Don't like the actual cost (plus a small profit margin)? Then ration both programs. Hard decisions need to be made but politicians will not make them under any circumstances.
Supertruckertom
Posts: 1306
Incept: 2010-11-07

USA
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They fail to realize that if it goes single payer, they will never get true market pricing and will have to live with what Medicaid declares the pay scale to be.

Even worse will be the attitudes of the patients demanding service that they feel entitled to.

Wait for the balance billing Oldno7.
A younger person would see the $418.47 bill.
That is the scam.
It needs to be $418, $28 or some published price for everyone regardless of the method of payment.
Not telling you the price up front is the scam.

Dante, what are your prices and are they the same for everyone regardless of the insurance they carry?


How much are you worth in your mind verses in a free market where you have to compete with publicly published prices?
What underlying debt structure and fixed costs per month does a GP have to service?
Most of us here have either been self employed at one time or are in management where we work.

Is competition for patients considered rude among doctors?

There used to be the no advertising thing between lawyers.
Slip and Fall lawyers ended that.
Plastic surgeons kind of blew that out of the water as well because they have to compete in a cash market.


The Republican leadership once again proves how corrupt and stupid they are.
No goals other than re-election and continue the theft.

The Democrats have a goal in mind and are willing to do anything to achieve it.












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Preparing to go Hunting.
Susanjbear
Posts: 778
Incept: 2010-06-10

Salt Lake City, Utah
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Not for lack of trying Karl. Just mailed a 4 page letter to my Senator with many of your points on health care costs, enforcement of anti-trust laws, etc pleading with him to end the $20,000 bruises and $80,000 scorpion stings.

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Susan
Nonsensical
Posts: 24
Incept: 2017-06-16

La Verne, CA
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Seinfeld: a show about nothing.

The co-creater (along with Jerry Seinfeld himself) made an assessment of what he saw coming in the 1980s and 90s. The 1990s is what the writer David Foster-Wallace called the me-culture.

Seinfeld was a very dark comedy, with no redeeming values in any of the characters. They're all self centered narcissists and the only time they're "friends" is when they have an obviously shared interest. All the characters seek to achieve their goals reap the rewards, and pass the costs on to each other, not really caring in particular who gets the cost, as long as it's not them. They don't even consider the consequences, short or long terms, the thinking of the characters doesn't go any further than cost shifting.

When it comes to the health care issue, it's really hard for me to find an issue that involves more narcissism -- even the tech industry would be hard pressed to be more narcissistic.

All parties involved, that is the recipients, the producers, the middle men, the politicians, all exhibit an extreme.narassisc, a sociopath narassiscism even. As groups, everyone is trying to shift the coast to others while reaping the rewards themselves and not even asking, or even caring, whether it's morally right, but even if it's sustainable, not even in the short term. They simply don't care beyond themselves.

Karl is one of the few that I've come across that publicly at least tries to see it in reasonable terms that isn't simply a sociopath narassist. There's probably about four others in the United States in a country of 300 million that see this issue beyond their own petty selves.
Mangymutt
Posts: 404
Incept: 2015-05-03

Vancouver WA
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Dantes - **** YOU!!!!

You say "There is no relation between cost of care and reimbursement, which is decided simply by numbers and what someone thinks it should cost."

You are obliviously (spelled correctly) too smart to have taken the time to actually read Market-Ticker, as Karl has taken the time on numerous occasions to state - NO ONE would order a pizza or any other product without first knowing what the basic cost was.

Except that is common treatment when dealing with medical issues.

There are many people who post here that have given countless examples of how they were expected to reimburse the cost of care that was simply decided by what someone thought the cost should be.

What is it the people who have posted their stories about being financially raped don't get?

What is it Karl doesn't get?

You say "You don't get it."

Really??? You state exactly what Karl has been saying for years and somehow he doesn't get it?

What, is he stupid? Does that make me stupid too, I do agree with him.

What about all the other people who agree with him, they too stupid to get it too?

Because of government programs you say "Your solution is a non starter."

And you excuse your behavior by saying "Don't blame us doctors."

You doctors ARE part of the problem. One of the main themes on Market Ticker is personal responsibility, not how to deflect responsibility. So you are a doctor, in a corrupt system and you do not want to be blamed BAHAHAHAHAHAHA!!!!

**** YOU Dantes.
Lobo
Posts: 385
Incept: 2013-12-25

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Dantes wrote..
So they have to make up the difference by charging private patients more money.

Translation: Damn the laws, we must get paid moar.

Quote:
Don't blame us doctors.

Translation: We are all just victims of the evil reptile people from Niburu. We have no choice.

Quote:
As a result, in Butte MT, there are 75% fewer physicians in private practice than 10 years ago. The rest have left or are employed by hospital or Community Health Center.


Medical Economics had an article, "Monopolizing medicine: Why hospital consolidation may increase healthcare costs" in 2014. From the article:
Quote:
"The consolidation trend has been promoted by reform efforts seeking to reduce waste and reward value instead of volume, but these monopolizing forces are contributing to a rise in cost, according to recent studies."

In the article hospital consolidation includes hospitals buying up individual practices.

So your claim that the grant money is responsible for 75% fewer physicians in private practice in Butte is BS. This is happening everywhere in the US. See also the Congressional Research Service Report: "Physician Practices: Background, Organization, and Market Consolidation" from 2013.

Quote:
Doctors pay taxes, have to work within a budget, etc.

Translation: No one else pays taxes or lives within a budget. Just us poor, sniff, underpaid, overworked physicians who only want to help people. (Cue the violins.)

What you don't address, Dantes, is this from Karl's "A One-Sentence Bill To Force The Health-Care Issue":
Genesis wrote..
I remind you that Medicare is required to set pay rates by law at a level that in fact are profitable -- that is, above cost by a modest amount -- for everything it covers. Further, those pay rates are audited regularly to prove that they in fact are above cost.

If that isn't true, please provide some evidence beyond your comment:
Quote:
There is no relation between cost of care and reimbursement, which is decided simply by numbers and what someone thinks it should cost.


KD, I hope you're keeping your shoulders loose and your arms limber. I suspect that you will get an upper body workout soon.

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Village Idiot
Flappingeagle
Posts: 2621
Incept: 2011-04-14

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Quote:
Wife gets stiches pulled out which took a nurse about 10 minutes. Dermatologist charged $418.47 and Medicare approved amount was $28.30 which they had to accept because they accepted the Medicare assignment. So can someone tell me how they are scamming the people by charging $418 and know they only get $28. What do they do write this off as a loss? There has to be a scam in here somewhere.


Ok, here's how part of the scam works. Suppose that instead of Medicare you had regular insurance with a $1000 deductible. This is where the $418 comes in, you get charged the full $418 and you HAVE TO PAY IT OR GET SUED. So, you have just kicked an extra $418 to your insurance company minus the Dr's cut, which, making up a number could be $100.

So, $418 - $100 = $318. Your insurance company just made an extra $318 off of you, and they get to keep doing this all year long until you've paid your $1000. If you don't go over $1000 the insurance company pays nothing and just collected however much you paid all year for doing nothing.

Thus, the big numbers for small procedures. It's a RACKET between the Drs, hospitals, and insurance companies. You know, the one they are not getting prosecuted for...

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...
Ponzi_unit
Posts: 9142
Incept: 2007-09-05

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@Dantes - it sounds as if you're blowing the whistle and by the responses you know how well honest opinions about the billing racket are received.

As taxpayers, we look for simple solutions and what would you imagine happens to billing schemes were the following to be enacted?

Quote:
"Notwithstanding any other provision in state or federal law, a person who presents themselves while uninsured to any provider of a medical good or service shall not be charged a price greater than that which Medicare pays for the same drug, device, service or combination thereof."



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Taxpayers witnessed a crime and stayed around long enough to get charged with it.
Analog
Posts: 1423
Incept: 2010-12-29

arkansas ozarks
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When you get on Medicare you really see the disparity in billing.

My recent angioplasty & stents was billed at $89 K .
Insurance paid $1.3K which is the 20% Medicare didn't cover. That means they settled for around $6.5K .

Billed / actual = 89K / 6.5K = 13.7 X ,
they settle with Medicare for 1/13.7 = seven and one third cents on the dollar.

Compare that to the lush payments by private insurance.
Young folks:
Look at the EOB from your most recent medical encounter .
I wager the insurance/medical/pharma complex got a lot more than 7.3 % out of you.
You're financing a fatcat orgy.


When i hear kids complain about seniors draining the treasury via Medicare, i say:
"Blame the insurance industry. They rip you off during your healthy years and when you get to age they might actually have to pay out something, Medicare comes to their rescue. Insurance industry bought the politicians and arranged it that way. "

Even with that expensive procedure my Medicare supplement provider just about breaks even on me this year.

Medicare's purpose is to get insurance industry off the hook.
Karl's one line law would get rid of the hook.

a.

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Never trust a computer with anything important.
Nonsensical
Posts: 24
Incept: 2017-06-16

La Verne, CA
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@azengrcat. In the case of the tobacco industry, the lawyers who did get paid out big time though were representing states, primarily the states that filed their claims early. So it's nice to have a big money client when fighting these huge battles, and no one has more money than governments.

In the case of antitrust law, the real money is representing the defendant against the government, as since the defendant is likely a monopoly, they tend to have deep pockets.

Let's say some average person wanted to sue for damages against a particular medical company based on antitrust law. First, you'd have to establish that that particular company has a commanding market position. Obviously it's unlikely you'll be able to demonstrate that a particular hospital has market domination to be deemed a monopoly. Because it's the field itself, not a particular company, that's causing the monopolistic practices.

This is why Karl's two points are so vital, 1. Collusion. I don't know the medical field in detail, but likely this would have to be aimed at the AMA, the American Medical Association, which have lost antitrust cases in the past, primarily their barring or chiropractors. But the collusion is vital.

Then there's damages, and that's a tough thing to establish, hence the second point: price transparency. Then damages can be objectively established.

In a situation like this, you'd need the resources of the government to tackle this on and I'm sure the AMA has turned themselves into a labyrinth.

But there's always people that do fight for these things, but there's really no money to be made, for the most part. These people do it out of a sense of moral outrage.

For example, the Center for Digital Democracy, run by Jeffrey Chester, has been fighting tooth and nail to handcuff Google, now Alphabet. Chester has many issues with Google, but primarily he focuses on privacy as that's likely the only issue the public might understand or care about. But in 2007, he pressed the FTC to reject Google's proposed merger with Double Click. Obviously in the end it failed. Alphabet is a company with about $90 billion in annual revenue. The Center for Digital Democracy has an annual budget of about $600,000. Any guess as to which side to be on to make money.and as for a name, who and the hell has heard of Jeffery Chester?

So I agree with Karl the only realistic solution is a political one where the power of the government has to intervene since they have the resources. As for the fame of it, well, that's for the public to decide on whether they'll put pressure on the government to do anything.

Politicians and these monopolies are closely tied, but that's because the monopolies are an active power. Politicians will side with wherever their power base comes from. So if the public turned on the politicians and forced their hands to keep their own power, sure they'll do it, in the end, what do the politicians care as long as they stay in power.

Same with the banks. You want that stopped, well, once the public threatens to put Mitch McConnell's and Paul Ryan's head on a platter they'll turn around and figure out how to put Diamond's and Blankfien's head on that platter instead.

But I don't know, I don't hold much faith in the public doing anything. The comedian Bill Burr was asked whether he thought there'd be some kind of social revolution because Americans have been pushed too far and he said no. Then he was asked, what would convince him a revolution was coming. He said, when the average American loses forty pounds.

Supposedly the public is outraged over ISIS, well, YouTube still allows ISIS produced videos to appear, which of course Google says it's technically very difficult to stop it....except, how much porn do you see on youtube...exactly.
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