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2019-11-07 07:00 by Karl Denninger
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2020 year, 64 year old married couple in Wyoming with $68,000 a year in income (thus no subsidy.)

Of course in one more year both qualify for Medicare.

Now the current environment makes the "penalty" for not having ACA insurance zero.  But even if it wasn't zero, it would be for this couple, since that price is well beyond the limit of MAGI that allows you to say "no" and not get penalized.

Thus it comes into stark relief what I said back when Obamacare was proposed and passed, and which many people "poo pooed" at the time.

You have the following choices:

1. Intentionally stop producing so as to drop your income for a single person to around $22,000 a year (married couples are higher.)  This results in the maximum subsidy so you can obtain "coverage" at zero, or near-zero cost.  **** THE ECONOMY, **** PAYING TAXES, **** PROGRESS, **** BEING PRODUCTIVE.

2. If you qualify for an exemption and are healthy, or, since the tax changes made the penalty zero, give the finger to the system and buy nothing.

3. If you need medical care and especially if you need ongoing medical intervention then your only sane option is to choose to die rather than deal with this extortionate garbage, which is designed to and will bankrupt you.

3a. If you believe you will be punished for a retributive strike before you die, then die quietly.

3b. If you either don't believe in an afterlife or just don't give a flying **** if you're punished in it for said retributive strike then go hunting before you die and do so in a form and fashion that makes clear who you're doing and why you're doing them -- whether you choose to aim at the medical or political establishments.

Note that 3b is, of course, extremely illegal and thus I could not recommend such a course of action.  But there are millions of Americans who are in this exact box; they are faced with ruinously expensive "insurance" that they cannot pay for with deductibles and exclusions that make it worthless until they're bankrupted anyway.

What is for many people even worse is that in non-Medicaid expansion states if you make too little you also don't qualify for subsidies.  Young adults are frequently in this position.  They were also exempt from the now-zero penalty because the cost was too high relative to income, but this meant they had -- and have today -- no means to obtain coverage they can afford at all.  And God help you if you are anywhere near that lower-end cut-off and have any sort of instability with your income because if you sign up, take the subsidy and then lose your job partway through the year and thus your full-year income is below the lower boundary cut-off you're utterly rat****ed as when tax time comes you'll have to repay all of that subsidy at once, amounting to thousands of dollars and, of course, being in a lower income bracket and having lost your job you won't have it.

This is why I said your only realistic option was get rid of the extra body mass, stop eating carbs, do what you can to not need the medical system at all and tell them to go **** goats because you refuse to patronize them -- and when someone who works in that field wants something you produce, charge them 500% as much as you charge everyone else.

Most people either didn't or couldn't take that advice.  They either chose to keep the extra 100lbs, 30 points on their blood pressure and five points on their A1c, or were already screwed badly enough metabolically that there was nothing that could be done about it.  Oh well.

We as a body politic refused to demand that Trump keep his ****ing promise to break the medical monopolies -- all of them -- which would drop the cost of care by 80% and make this "insurance" both unnecessary and the care directly affordable.

Instead we did and still do scream "MAGA", "KAGA" or whatever it is today because, well, we wouldn't get off our fat asses when Black Jesus was President with his magic pen and phone either and we sure as hell won't do it today!

We let our State Attorneys General sit on their asses, our state and local cops sit on theirs, and our federal AG and FBI sit on theirs despite all of this pricing behavior being illegal for more than 100 years -- and not civilly illegal either, felony criminally illegal.

Oh well.

One percent of Americans amount to 3 million people.  That's three times the maximum crowd that has ever descended on the National Mall and Washington DC to demand something.  If that one percent had showed up when Obamacare was first debated, demanded that instead all the monopolists go to prison, and refused to leave until it happened, shutting Washington DC down entirely there wouldn't be a problem like this today.  Medical care would cost one fifth of what it costs right now.  I've had a plan out to do exactly that for years.

If one percent of Americans had done so the day after Trump's election, when he intentionally pulled all three of his campaign promises to do exactly that off his web site, never to be seen again, and likewise refused to leave until it happened there wouldn't be a problem like this today, and all the strum and furor about "repealing" the ACA, which we now know what a total load of bull**** from the entire Republican caucus that in fact loves ass-ramming you on a daily basis, would have not occurred and that time could have been spent on something productive.  But even now, three years in, when Trump has demonstrated that he doesn't give a wet crap if you go bankrupt or die at the hands of these criminals, fully half the nation still supports him.

Nor have the people done so, laying siege, to any of the state capitols -- but they could have.

One guy waving a sign and writing columns does nothing.  100 dudes waving signs do nothing either.  I remind you that in 2008 when the US Government ****ed everyone in this nation to bail out a bunch of banksters I, Stef and Randy Jasky and a handful of others organized a demonstration in DC.  We drew under a hundred people and, of course, were ignored.

Three million Americans deciding that this crap will stop right now or Washington DC will stop until it does would be a different matter.  If it was 3% of Americans instead of 1% that would be ten million people -- an utterly impossible to disperse crowd as that is many multiples of the number of police in the United States and if the cops or politicians decided that a peaceful shutdown of everything in DC wasn't going to be "allowed" their decision to use violence would prove to be the biggest mistake ever made in the history of American politics.

But.... nope.

You'd rather argue over Orange Man Bad or Orange Man Good.

You'd rather argue over all manner of petty bull**** instead of this, which underpins the entire Federal deficit, the entire monetary shenanigan game in the US and more.

You'd rather bitch about stupid things like which bathroom someone should go******in even though the math on this has been clear for the last 30 years, the trajectory was clear then, it has stayed the same since and within the next five years it will blow up the federal and state budgets.

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Posts: 280
Incept: 2009-05-11

Davenport, Fl
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Prime example.

Someone I've known for 20 years visiting this week at the "theme-parks" here in Orlando. Guy is 450+, using a scooter to get around and has to go to Dialysis 3 times a week while he's here (actually he skipped that and took a 5 day cruise before he got here...)

Tells me he can't feel his legs, life "sucks" for him so much!

Then proceeds to tell me, he can't bother to wear his CPAP the 14 days it's required before they will qualify him for the weight loss surgery cause that's "To Hard" and still expects NY mediescam to pay for all his assorted drugs and orderly's and ass wipers that help him day to day. Glad I am out of that state!
Posts: 97
Incept: 2014-05-19

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I have stopped discussing the real issue because as you point out, most everybody wants to discuss the snowflake issues.

This new year we are switching from medicare part F hi deductible to medicare advantage and save 4500 a year which can be banked to a higher in network max out of pocket of 1300 or 4500 if out of network. I like those odds and i can afford to play that game.

My wife did not like the old plan f high deductible because our friends keep bragging about never paying for services.

After 3 years she finally understood that when our monthly premiums are 190 less than our friends, its far less expensive to pay the 2300 max out of pocket in ordinary years.

And thats why most of the people do not care.

Its a great plan that pays everything, at least until it brings the system down.

In illinois , most retired teachers pay next to nothing for their healthcare, and its not funded at all. And rely on a severely underfunded pension fund.

They still do not understand it, AND these are the people who taught the kids and we wonder why the kids are snoflakes?

Posts: 760
Incept: 2009-03-25

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" You have the following choices:"

Some people, (10%), have another choice which depends on their level of income.

4. Medical tourists for operations and treatments
5. Prescription tours
6. Expat
7. Do a "Trump Move" to a tax haven
Posts: 8
Incept: 2019-05-21

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Seems to me that everyone has seen protests at DC...

What if we call for protests at the hospitals where people got ripped of by the medical monopoly system?
- it is local and easy access
- it starts to change the message from Government comes save us, to these people are crooks

And I think what would be potentially powerful - is creating a space and let people tell their stories about their plight dealing with these institutions.

Use the power of story, and help the people currently insulated (those with good health insurance from jobs) to wake up to the fact of how broken things are. It also would indirectly reflect on the democratic platforms calling to go further with government healthcare programs.

This has potential to go viral.

I would think even a directory website, where the companies/institutions/places involved in them, could be tagged to the stories told.

I could create such a beast if folks here think it has legs... thoughts?
Posts: 9
Incept: 2018-05-23

Columbus, OH
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Not high enough. Incumbents in this country are reelected virtually everywhere. The leading Democratic nominee is a guy who has been a US senator since 1973 and a vice president for 8 years. This country has voted for Bushes, Clintons, Kennedys every time it had a chance. The average citizen cannot be bothered to care about all this, but can order by age the kardashian sisters. We're sheep and as such we let them milk us without complaining. As long as we get our low quality entertainment, we'll go along with it.
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Incept: 2017-06-26

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I couldn't help but laugh when I saw that $4K per month premium.

The first thought that comes to mind is how do you like the ACA (Affordable Care Act) now? Remember that woman who so wanted Obama to get elected and pass "free healthcare" that she yelled, "Tax me! Tax me! Tax me!" Stupidity funny.

I expect that some of the White suckers who voted for Obama The White Hating Muhammadian are feeling played right now. Or maybe not, because some White people are really that ****ing stupid.

For most people I expect that 4K might as well be 400k because it's all (Un)Affordable Health Care. Period. The End.

Tax me! Tax me! Tax me! Yep, more of that is coming. No end to that. According to some people Elisabeth The Transgender Indian's healthcare plan is going to run over 50T.... I laughed when I saw that, too.
Posts: 94
Incept: 2014-09-09

New Hampshire
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I've dropped the extra weight and picked up prying eyes and actions from the opposite sex. I've taught my kids to eat right and they are both in great shape and healthy (knock on wood). I've talked about this issue till I'm blue in the face with family and friends and co-workers and am now considered a conspiracy theorist and government hater. I'm done. F&%$ everyone. I'm stacking and paying down debts. When the **** hits the fan, I hope to be far away from the ****hole cities and neighborhoods who will take part in the purge. My immediate family will be protected as best that I can but that's all I'm worrying about.
Posts: 159974
Incept: 2007-06-26
A True American Patriot!
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@Jal - #7 doesn't work when it comes to this issue. It MIGHT keep you out of a collapsing city (e.g. Chitcago) but that does you no good at all. If you've got Trump style "**** you" money then you don't care about health "insurance" in the first place as even a catastrophic, million-dollar event doesn't break you.

Winding it down.
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Incept: 2017-06-26

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"****-you money"

For those who don't have ****-you money and a ****-you place to hide, parsimony is probably the only way to go. Soon the hunt for money (especially White money) and assets shall commence.

Like you said, Karl, get into a position where your income only registers at a poverty level and don't live byond your means.

Posts: 159974
Incept: 2007-06-26
A True American Patriot!
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Yep. And BTW "**** you" money isn't a couple million bucks either; one bad incident can wipe that out. It's well into the double or even triple figure millions, unencumbered and able to be liquidated.

VERY FEW people have that sort of financial resource.

Winding it down.

Posts: 8455
Incept: 2007-09-10

Scottsdale, AZ
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Currently have a grandfathered Blue cross policy that just went up to a $1000 a month with a $5000 deductible. Was actually going to check and see what a ACA policy would have provided in my state but realized with this post that even if I got a better rate this year, I still have 5 years until Medicare(if it still exists) and they could potentially******me hard during that time. When I saw that $4k premium, I crapped the chair. How in hell can anyone expect to be able to survive in this country with bills like that?
We are all in jail with this BS and the people that can fix it simply don't want to. Trump wants to wait until after the election to send this to the Supreme court and by the way things are looking, he isn't getting reelected.
I just tweeted this blog to him directly. They need to wake up because it's already too late.
Posts: 1983
Incept: 2009-01-20

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Ole Mickey likes it. Keeps signing up for it. Eat another bowl of cereal!

The faults of the burglar are the qualities of the financier.
- George Bernard Shaw
Posts: 484
Incept: 2010-05-31

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There will be a breaking point which will create both massive winners and massive losers. Im watching the Medical AI space closely because a database will have better access to data and trends than the best doctor. Meanwhile bad doctors are screwing people up all the time -> statins + dont lift over 10 pounds.
Posts: 399
Incept: 2016-02-11

Pacific Northwest
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Nobody will lay siege to anything. The 'poor' get their coverage for free. Public employees get their gold plated coverage for free. Nobody gives a crap about the middle class.

My medical expenses-- premiums and out-of-pocket care-- are $20k this year. I can afford it, but few people can absorb the ****ing they are getting. The expenses are so high it makes me contemplate the wisdom of some of my recreational activities-- BJJ, so easy to get injured, and those injuries become old friends/enemies; jogging-- slipped on some gravel, was worried I tore a ligament; etc etc. Everything works fine now and I don't want artificial joints in 20 years.

Might have to consider going to church-- so I can join Medishare or Samaritan.

Parsimony-- don't have alot of ****, and learn how to repair it. Get out of debt. Learn to cook well, so no temptation to eat out. Get a nice coffee machine so you won't be tempted to frequent $tarbuck$. And if you're a younger dude-- do not get married.
Posts: 564
Incept: 2008-02-16

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"We are all in jail with this BS "

That's another option. If your going to go hunting do it in a state with no death penalty and you solve two problems at the same time :)
Posts: 161
Incept: 2008-10-22

Bay Area, CA
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Why does everyone pay these extortionate fees? We currently use a "health sharing organization" and it has worked out extremely well for us.
Posts: 162
Incept: 2009-03-30

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"And if you're a younger dude-- do not get married."

And if you're a young lady, get married ASAP to the highest bidder. ;)
Posts: 347
Incept: 2009-10-06

Msumelle, Ar
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@the lazer

Your friend must have a death wish. Every health problem that guy has is self-inflicted and he doesn't even do anything to help himself, not even the minimum.

Yet he he is getting first rate health care to stay alive even though his life is miserable. My take is he is not long for this world. If he tried, even at the stage he is, it would make a difference and maybe he could get a kidney transplant but not in the condition he is now. It's just too hard!
Posts: 14
Incept: 2019-05-26

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call the Health Care Industry in the US what it really is ...... The Final Solution !
Posts: 152
Incept: 2015-02-26

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All the docs me or my family have used seem to simply follow a flow chart for diagnosis. Just give me the damn flowchart and I can follow it myself for most things.

That will be the extent of AI in this space anyway. Its only as good as the training you give it. AI doesnt reason on its own - it recognizes patterns its seen before.

Also the current docs are prescription happy. I have lower back issues. Told me before I had an xray I needed to try a script of Gabapentin. Before filling the script looked up drug, side effects, etc. That **** ****s with your neurological system and brain. Side effects include suicide. **** that. Tore up the script and healed myself through stretching and core strengthening. Most docs arent worth ****, IMHO.
Posts: 5667
Incept: 2009-02-28

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Didn't Trump sign an executive order requiring the disclosure of prices?

I'm going to step around this and state the fact. Both parties state different policies, but both are working in the same direction. Then we have the swamp, the regulators, bureaucrats and the lobbyists. They are all working to separate us from our money. The system has a significant number of people flat on their backs and DC loses its power, if this situation ends.

Trump has been under a constant barrage of fake swamp created scandals. Imagine a 2 year grilling over a made up story, then another grilling over trying to find out who made up the story and why it had the power. The screw you in health care is institutionalized.

Listen to Warrens plan or Bernie's plan. Do you get any cost reduction? No, it goes up. The Democrat Party's base is the free **** army, bureaucrats and unions. In some form, they are all blood suckers. What do we have in healthcare? SEIU, which is a mob institution and a nationwide health bureaucracy. Then we have the drug business, which includes the pharmacies and the drug makers. Note that every grocery store of any size had a pharmacy. I used to go to one that I suspected made more money off dealing drugs than they made off groceries.

I believe Trump's plan would look more like KD's plan. Remember, the Republican Party, aka Paul Ryan, stepped in to screw the game and McCain, who was up to his neck in all kinds of ****, stepped in to stop anything. The truth is there isn't any benefit to a single payer, if it is going to result in the costs that are being pushed out in current data. It is merely another plan to screw us all in favor of a massive, nationwide constituency, known as the medical bureaucracy.

People are infected with free. There isn't any free. Whether it is a public or a private plan, we pay every dime and much of it goes down the drain. Prescription plans are really created to screw us. They allow the pharmacies to run double or triple price structures and they incur costs on both ends of the transaction. This needs to be eliminated and replaced with something that pays a narrower class of drugs, which are exactly the drugs that these plans don't pay. Then we have doctor visits. Why should there be paperwork on both ends to pay something that generally is less than $100? Specialists could be moved to another class, just like the drugs.

Then we have the hospital bureaucrats. This is a big problem and a huge lobby, maybe at a distance. What Congressional district doesn't have a hospital, most full of highly paid bureaucrats? Any competitive hospital system would require most of them being kicked out, just like corporate America downsized between 1985 and 2010. The cost of the head administrator puts a sizable chunk on the cost of a room. throw in the structure and what we have is pigs feeding at the trough. I read something that put the cost of these people at $800 billion a year. That is $5000 per American job.

I like to point out everything in a per job basis, because it reveals what is being drown out of the pockets of the average working person, when looked at in government spending. If government pays half of medical care, then the additional is around $12,500 per job. This is heaped on top of the $25,000 per job the Federal government is spending. Neither figure is sustainable, as ones theoretical fair share on these 2 items above the income of a large number of workers. And, we haven't even touched state and local taxes.

So, the new tactic is tax the rich. The rich derive their income from the working class buying their products. Thus, we are either faced with paying more for goods and services to pay the tax or the removal of many goods and services from the shelves, which would massively reduce employment and increase more the effect of these costs.

I don't understand the entire game. The American public has been enslaved by the medical cartel. Cost of $13,000 per capita? Why even participate? Most life expectancy has been achieved by 3 things, safer working conditions, sanitation and antibiotics. A refrigeration engineer told me about 30 years ago that the home refrigerator saved more lives than any other modern achievement. Who the hell would give up 20% of their earnings to buy a couple of years at the end of their lives, even if it could be proven? Many people just fall over dead, meaning a doctor doesn't help. Are we being sold for a bowl of porridge?

The government has built a monster and it won't be easy to dismantle it. The biggest problem with the hospital system is the costs have been institutionalized and if they continue to be institutionalized, it will be hard to achieve any cost improvements, other than to force them to post prices. As long as a sizable amount of the population is shielded from paying the bill, there can be almost no competition. Even under anti-trust, the costs have been institutionalized. If the $800 billion figure is correct, we are looking at 20% of health costs going to sustain a bureaucratic party. This isn't much difference from the total costs KD proposes.

The system is supposedly geared so we can see and get the advice and treatment of a doctor. How much of a doctor does anyone ever see, compared to how many other people are involved? My guess is maybe 10%. You lay in the hospital for a day, the doctor comes in for 10 minutes, if you are lucky. Go to the office, sit in the waiting room for 30 minutes to an hour, fill out papers, see the nurse, sitting in a small room for 20 minutes and the doctor comes in for 7 minutes. What a screw job.

I suspect the one person who isn't overpaid is the doctor. Some are set up to run mills where they get rich, but most of those people earn their money. Who the hell would even think of using their intellect and 10 years of their lives to earn a blue collar wage? I don't know how many doctors there are, but if there are 1 per 1000 people, $200 or $300 per capita isn't unreasonable. Even $500, if you want to get extreme. That is a small slice of the $13,000 or so per capita we are currently being billed. And, isn't that why you go in the first place?

Ask yourself, if you are under 65, how many years you have used $13,000 in health services? I have had 2 auto accidents that might have touched that figure. A gallbladder attack, which at OK Surgical Center, would have cost around $6000 and 2 eye lens replacements that I paid around $10,000 in cost. I broke a arm when I was 7 years old. Everything else had been pretty minor. So, maybe 3 times have I touched the annual average for health care. The bills for the wrecks were maybe $4000 each, but they occurred in 1983 and 1990.

Simple math would put my lifetime bills at around $750,000, to date. Maybe I have tallied $100,000. Where did the other $650,000 go? I don't care to collect it going forward. I have never used an insurance policy as an adult.

The only function of economic forecasting is to make astrology look respectable.---John Kenneth Galbraith
Posts: 8455
Incept: 2007-09-10

Scottsdale, AZ
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The ACA mandates have screwed the hell out of everyone while we watch the Healthcare stocks explode higher. We have folks paying insane premiums while getting almost none or no coverage until their deductible is met. Who in their right mind would pass a bill that gives unlimited cost increases to the insurance companies while at the same time allowing them to slash coverage until an insane deductible is met? Since over 65% of the country can't come up with $1000 on short notice, this would be a real problem for most folks.
Trump can take the ACA to the Supreme court and get it trashed removing all the ludicrous rules under the ACA removed. The worst was the extortion mandate and now it's the pre-existing condition mandate. Stop forcing everyone to cover the drug addicts, drunks and those folks that poison themselves by eating crap.
If you buy insurance, you should be covered in some way without forking out thousands before they even look at your claim. Only the idiot democrats could come up with a plan that allows insurance companies to******the hell out of their policy holders in order to give free coverage to the leeches of society.
The ACA was designed to impoverish the middle class and turn them into leeches (democrats). This was obvious from the onset and has reached a peak right now. If you have any real insurance no matter what the cost, applying for the ACA could be financial suicide unless you can keep your income down.
We now have every democrat candidate screaming for national healthcare for FREE with no way to pay for it. The brain dead minions out there are soaking it up like they did when Obama pushed the ACA with nothing but lies. That clown was reelected on the ACA promises and when they didn't come true, millions of Americans simply cut their incomes or quit working to avoid the insane premiums.
This whole economy is a farce and there are millions of Americans that should be working, but are not because of the ACA. Kill this pig now and watch the money flow back into the real economy rather then the black hole of the insurance industry.
Posts: 1418
Incept: 2008-02-23

Canton, GA
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Ask yourself, if you are under 65, how many years you have used $13,000 in health services?

I turned 67 in October. There have been exactly zero years I have ever used $13,000 in health services. I've never even come close. I haven't had to see a doctor since I started Medicare, but that's still cheap (part B) . . . for now.
Posts: 399
Incept: 2016-02-11

Pacific Northwest
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@Toledo-- which organisation do you use?

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