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2019-09-16 07:00 by Karl Denninger
in Health Reform , 183 references
[Comments enabled]  

C'mon folks, cut the crap.

Their money problems began when the University of Virginia Health System pursued the couple with a lawsuit and a lien on their home to recoup $164,000 in charges for Waldron’s emergency surgery in 2017.

The family has lots of company: Over six years ending in June 2018, the health system and its doctors sued former patients more than 36,000 times for over $106 million, seizing wages and bank accounts, putting liens on property and homes and forcing families into bankruptcy, a Kaiser Health News analysis has found.

The problem isn't that hospitals don't have a right to be paid for their work.

It's that they think they have a right to be paid 2, 3, 5 or even 10x as much if you don't have their "preferred" insurance plan and, in some cases, they affirmatively allow people not covered under such "insurance" to treat you when you're unable to choose to consent or not.

How is this sort of crap legal?  Refusing to give you a price up front and then charging you some multiple of the next guy over with the exact same problem simply because you didn't feed their favored monster first?

And let's not forget -- this is a taxpayer funded and state-supported institution -- not a "for-profit" company.

So it's the government itself that is screwing you after effectively extorting you to spend money on so-called "insurance."

There's no point in ever asking politely for a government or other agency -- private or not -- to quit hosing you.  Tyrants, no matter their form, only respond to a demand backed up with an effective "or else."

Well?

There are answers -- like here, for instance.

But until that sort of change is demanded, with an or else that is of at least equal threat to that posed by those who are engaged in this nonsense it is not going to go away.

I can only conclude that the American public likes the buttsexing that UVA and others impose on it.

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2019-08-27 07:00 by Karl Denninger
in Health Reform , 87 references
[Comments enabled]  

The lies are killing people.

More people, by far, than mass-shootings, which only claim 200 lives a year.

The medical monster and it's outrageously illegal behavior under 15 USC Chapter 1 manages to kill through negligence alone more than 250,000 every year -- that is, more than a thousand times as many.

The screaming of course has not stopped.  Pharma insists on being able to break the law.  15 USC Chapter 1 makes clear that any attempt to monopolize, restrain trade or fix prices is a criminal felony.  Yet pharma apologists say things like this:

Proposals include allowing the government to undermine patent rights, opening the door for generic versions to be made. Others propose eliminating patents on medical improvements like new dosing methods -- such as pills and injections -- and extended release formulations, which enable a treatment to be released into the body steadily over time, thereby reducing the number of doses a patient must take.

Americans fund virtually all new drugs.  The rest of the world gets them, effectively, for free.  This is illegal and has been for more than 100 years.  Any attempt to prevent the leveling of prices on an international basis (by, for example, you getting on a plane and filling a suitcase full of cheap drugs, then coming back here and selling them) is a felony.  Yet under the laws today you, not the pharmaceutical companies, will go to prison if you try that.

Further, the claim that there is some "medical miracle" that is commonly invented by these firms is also a lie.  Yes, there are some innovations -- real ones.  But there's also this:

But although gaps in the therapeutic armamentarium undoubtedly exist, research covering drug approvals since the 1970s suggests only a limited number of new drugs provide real advances over existing drugs. Most studies put the proportion of true innovation at under 15%, with no clear improvement over time.

What the other 85% of the drugs do is drive up price.

This shouldn't be possible in a market economy.  That is if you can't demonstrate real benefit over existing, cheap formulations you shouldn't be able to garner any price premium at all.  Nowhere in an actual functioning market for a scientifically-tested and documented product line can you get more money for equal or less efficacy.  That only happens in a market where intentional distortions are being introduced, all of which are violations of 100+ year old anti-trust law.

I get it -- there are a lot of people employed ripping people off.  There's a lot of "stock market points" made by ripping people off too.

But all of that "ripping off" is not only outrageous 15 USC Chapter 1 says it's felonious.

When will the people of this nation stop pissing into the wind about 200 dead people a year when the jackwads in the medical industry rip you off for three trillion dollars a year -- roughly $25/day/per-person in the US -- and at the same time kill a quarter million people each and every year due to avoidable "mistakes"?

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2019-08-26 11:44 by Karl Denninger
in Health Reform , 252 references
[Comments enabled]  

Gee, who else figured it out?

As the Democratic presidential candidates argue about “Medicare for All” versus a “public option,” two simple policy changes could slash U.S. health-care costs by 75% while increasing access and improving the quality of care.

These policies have been proven to work by ingenious companies like Whole Foods and innovative governments like the state of Indiana and Singapore. If they were rolled out nationally, the United States would save $2.4 trillion per year across individuals, businesses, and the government.

The first policy—price tags—is a necessary prerequisite for competition and efficiency. Under our current system, it’s nearly impossible for people with health insurance to find out in advance what anything covered by their insurance will end up costing. Patients have no way to comparison shop for procedures covered by insurance, and providers are under little pressure to lower costs.

....

The second policy—deductible security—pairs an insurance policy that has an annual deductible with a health savings account (HSA) that the policy’s sponsor funds each year with an amount equal to the annual deductible.

Again, from 2017:

  • All providers must post, in their offices and on a public web site without any requirement to sign in or otherwise identify oneself to access it, a full and complete price list which shall apply to every person.  This instantly allows customers to compare pricing between providers for services and products in the medical realm.

  • All customers must be billed for actual charges at the same price on a direct basis at the time the service or product is rendered to them.  This immediately and permanently decouples "insurance" from the provision of care.  The current system of an "explanation of benefits" that often features a "negotiated discount" of some 90% is nothing other than an extortion racket and is arguably felonious -- threatening to bankrupt someone if they don't buy your "insurance" through a threat to charge them ten times as much certainly appears to be a criminal enterprise and, given that more than one entity is involved, looks like it meets the definition of Racketeering.  Insurance coverage may well cover some, part or none of a given bill, and nothing prevents an insurer from telling you in advance of your visit how much they will pay (if anything) for a given procedure or drug.  Indeed you should demand that information from them and use it as part of choosing where to obtain treatment but the bill still has to be rendered to you, you have to be the one to file the claim and everyone must pay the same price to the same provider for the same kind and quantity of product or service.

And note the genesis of thiswhich was first posted 10 years ago on my blog -- in 2009:

All health providers must publish a price list and may not bill or accept payment at anything other than that price; doing so becomes a violation of Robinson-Patman and exposes the provider to civil suit for treble damages.  

There have been exactly zero politicians -- not Democrat, Republic, Libertarian or otherwise who have been willing to take this sort of plan up and run with it either as a campaign point or once in office in the form of a bill.  Not in this state, not in any other state and not federally.

Why not?

Because over the last 20+ years we've got a monstrously bloated racketeering enterprise that "employs" a huge number of people not to take care of whatever is wrong with you but rather to screw you out of every penny they can get their hands on.

ANY REFORM THAT ACTUALLY RESULTS IN REAL COST CHANGES IN THE DOWNWARD DIRECTION -- ESPECIALLY REFORMS LIKE THIS, WHICH THIS AUTHOR SAYS WILL COLLAPSE PRICES BY 75% (I argue it's 80% but at this point we're really picking at straws here as to who's right) ALSO RESULTS IN ALL OF THOSE RACKETEERING ENFORCERS BEING FIRED AS THERE IS NO MONEY TO PAY THEM WITH.

You can either insist that REAL reform happen, however, or the current path we're on will bankrupt the Federal and State Governments starting in just a few years from now -- in fact it appears that the "zero hour" is in 2024 if not earlier!

And when (not if) that happens you either get massively unstable markets and a trashed economy or worse, you get outright civil collapse when the government is unable to fund it's game-playing and the EBT cards stop working.

And no, The Fed cannot "print" its way out of this nor can Treasury.

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2019-07-01 07:00 by Karl Denninger
in Health Reform , 288 references
[Comments enabled]  

Watch this one folks.

$400 vials of insulin.

$25 for the very same vial in Canada.

CNN points out that the manufacturers, of which there are three, intentionally do not enter competing lines of business and thus there is no competition between providers.

On purpose.

Intentionally divvying up markets like this is a felony.  It has been a felony since the late 1800s -- more than 100 years.  The Sherman and Clayton acts, known as 15 USC Chapter 1, declare such practices or any attempt to engage in them federal criminal offenses carrying 10 years in prison for each person so-involved.

The number of criminal prosecutions in the medical and drug sector over these obvious, blatant criminal acts number zero.

The media calls this "greedy" as do "activists."

They do not call it what it is under more than 100 year old law: Felonious.

They do not ask: Where are the ******ned handcuffs and why aren't the executives in prison?

They do not call for prison terms -- right now.

They ignore, as do the activists, the clear statement of law found in 15 USC Chapter 1.

There is no "hard" problem here to solve.

You need only jail a few executives and all of this bullcrap will stop across the medical industry instantly.

Well?

If the government will not do its job then why do you sit back and whine and run "human interest" stories instead of storming the Halls of Congress and State AG offices, along with demanding that both the FBI and State Cops raid these firms and arrest all of the executives inside, shuttering the buildings and chaining the doors closed until this blatant and obvious lawless behavior stops?

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2018-06-11 07:01 by Karl Denninger
in Health Reform , 317 references
[Comments enabled]  

Well well Justice Roberts, I am writing your obituary right here and now, and should you precede me I'll publish it too, even if it costs me a lot of money to do it.

"Justice Roberts was single-handedly responsible for the destruction of the American Government via its Treasury via his idiotic and legally-infirm contortions in ruling the Affordable Care Act was in fact a tax, rather than a constitutionally impermissible command."

As I wrote at the time Roberts destroyed what little was left of the Supreme Court's legitimacy, putting the final nail into a coffin built since Wickard .v. Filburn.  He justified this in his opinion through what is really called by any means possible I shall torture the law to save it, in that he cited a claim that the Courts are required that any fair means of interpretation exists that leaves a law intact the courts are required to find it.

Of course there was no such "fair means" which he also set forth in his own opinion, stating clearly that the statute reads as a command to buy insurance ("enter into a regulated activity") and that the Constitution prohibits that.

Indeed the Congressional record on the drafting and debate makes clear (if you bother to read it, which Roberts clearly did and then intentionally ignored it, which I also pointed out in a further article) that Congress knew they could not draft the PPACA as a tax because direct taxation on other than strict capitation is unconstitutional.

In other words the US Government can assess a $10 per person tax, per person, but they may not condition the amount of the tax or its imposition on anything other than being a person.  The 16th Amendment makes legal the imposition of taxes on income.  Indeed multiple other attempts to impose such a tax without a Constitutional Amendment had been previously struck as unconstitutional, so there's not only a legislative record but a judicial one as well.

Roberts didn't care.  I've often mused if someone has a video of him buggering a little boy and used it get him to write that "opinion."

But what Roberts didn't have, because he couldn't, is the ability to time travel.  And when Congress passed the TCJA reducing the penalty for not having coverage to zero starting January 1st of next year they destroyed the Constitutionality of both guaranteed issue and community rating, since both were by the Congressional record inextricably tied to the imposition of the penalty and thus are non-severable, as is specifically stated in the Congressional record.

Without the penalty there is no tax since the inherent property of a tax is that it raises revenue.  That's now gone and it was the sole pillar on which the Roberts court decision rested.

The problem is that the rest of the law isn't inseverable and the way law works is that except where severance is specifically declared inapplicable it applies unless the result would be nonsense.

That the result of non-severance will bankrupt you does not enter in the analysis.

Thus the brief referenced herein argues that both community rating and guaranteed issue are Constitutionally infirm and thus void come January 1st.  This is a winning argument, and if there is anything approaching a justice who can actually read it wins by declaratory judgment since the precedent to judge it by is in the original opinion and as a result there is no legal ground to cover in presentation of a case or argument before the court!

But once you do that both Treasury and private industry are irrevocably and instantly ****ed.

Without community rating and guaranteed issue anyone with a pre-existing condition who becomes unemployed becomes permanently unemployable as they are uninsurable without destroying the business they go to work for.  Further, they can't engage in entrepreneurial activity either because there is no possible way for them to buy health insurance.  And finally, since the cost of that care has more than doubled since this problem was allegedly "addressed" by Obamacare they have no other option available.

I have often written about the utter necessity of getting rid of the medical monopolies as a political imperative, and for individuals to do everything in their power to get off the medical teat, which for most people means you damn well better not not be overweight or obese, you better have normal blood sugar which means no damned carbs to any material extent in your diet and it certainly means that intentional high-risk behavior like butt****ing, IV drug use or drinking to excess is an instant economic death sentence.

Of course what has occurred in the decade since Obama came to office and Pelosi and her pals rammed through their "vision" is that all of that has gone downhill in statistical terms for America.  There are more obese and abnormal-insulin and blood-sugar level people in this country than ever before, including a shocking number of teens for whom such was unheard of as recently as 30 years ago.  There has been an explosion of IV drug use including heroin and fentanyl.  And we have removed not just legal strictures but have mandated "tolerance and acceptance" under the law for extraordinarily-high risk social behaviors and in no small part covered that up with expensive, lifetime drug regimes that are utterly dependent on public financing to remain "affordable" for the vast majority of people.

The social issues are real but the cost issues exist only because neither Congress nor any State or Federal executive will take their justice departments and prosecute, throwing in jail, the medical monopolists.  Instead they kowtow to their lobbying, whining and claims of "necessity" to continue the trend of taking medical expense from 4% of GDP to nearly 20% today and beyond into the future.

Well, now the scheme is about to blow up in everyone's face.  As of January 1st those who are healthy do not need to participate and most will not.  I won't.  The "donut hole" where $25,000 - $50,000 in income has an effective tax rate of more than 80% everywhere (and close to 100% in high-tax states) is gone if you simply stick up the middle finger.

But without some means of forcing transfer payments from "someone" (the taxpayer across the entire population) to fork up $900 a month for someone like me, who needs zero routine and chronic medical care so that someone else can run up $5,000 a month prescription drug bills the latter's bill becomes unfundable.

Mr. Roberts will burn in Hell for this, as had he not tortured the Constitution in 2012 Congress would have been forced to deal with the medical monopolists and so would have Obama's administration, saving the US Government and taxpayer several trillion dollars.  You'd also be able to pay cash for virtually any medical situation, save an immediate crisis for which (if you chose to do so) reasonably-priced insurance would be available.  We're talking $100 a month or less here folks, because even the "really awful" stuff would cost one fifth of what it does now.

But all that money has now been stolen and it's gone, while the nuclear fiscal bomb left behind by Robert's outrageous twisting of reality on the back of Obama and Pelosi's intentional set of actions is now about to detonate in his, and everyone else's, face.

smiley

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