Insanity On Health Care, Continued
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2017-05-27 13:20 by Karl Denninger
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Insanity On Health Care, Continued
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The last few days have brought into extraordinarily-stark relief why I believe there's no saving this nation.  Not personally for nearly everyone, and not collectively either.

I'll start with the "newsy" part of it, because it's topical and important.  Let's begin here:

It’s easy to use numbers to define health realities, but life is far different in the doctor’s office. What patients really want is access to basic health care, delivered by a doctor they can trust at an affordable price. Patients want choices, not narrow networks of providers and services and deductibles so high they never reach them. They don’t want to be forced to buy an insurance plan that promises them services that we doctors just can’t deliver.

Mr. Siegel may be a M.D. but he doesn't understand insurance.  He should, having gone to post-secondary school for 8 years or more, but apparently he missed a first-semester statistics class somewhere in there.

An insurance policy that "covers" something that doctors cannot deliver (that is, which cannot be used) has no more cost than one that does not have such a provision in it, because the "p" (probability of use) of such a "feature" is zero.

It costs exactly zero to insure me, as a male, against ovarian cancer because I do not have ovaries.  Therefore the risk of such a condition ever afflicting me is zero and as a result the cost of such a "coverage" is also zero.

Second, they're not patients they're customers and while the first sentence of this paragraph is true the rest is false.

Patients want a chance to purchase affordable insurance that covers actual problems they may have. A new health law can deliver that and cover most, if not all, of the population if it offers as an option the kind of scaled-down coverage that patients would have chosen to buy under ObamaCare even if they weren’t forced to.

What "scaled down" coverage are we speaking of?  See, this is the problem with not calling someone or something what it is.  If you call someone a patient then you immediately get to take away all the connotations and expectations that someone who is a customer might have -- like the ability to see a ****ing price and agree to it before you start providing a good or service!

There are things you should be able to opt out of.  For example I would be happy to buy a health policy that explicitly excluded both addiction and mental health.  These can be very expensive problems to treat and the probability of either is not zero, so excluding them would materially change insurance costs.  Since I consider both to be outside of what I think of as insurable risk for myself I'm perfectly ok with a policy that excludes both.  Others will have a different view and should be free to make that choice -- and bear the cost.

But excluding certain problems from a policy just shoves the fat, ugly, abrasive uncle in the room into a closet and locks the door behind him instead of dealing with the apparent problem: Cost.

It's also doomed to fail because over time the list of conditions that you shove into the closet will inevitably increase.  

The usual response from the left on these sorts of problems is to say single payer.  But California has studied in some depth what it would take to do that under our present pricing system and what they found is that it would cost $400 billion a year just for their state alone which incidentally is more than double the ENTIRE current state budget!  They don't have that sort of money and can't raise it; you simply cannot soak the rich for $200 billion a year in that one state and believe that the rich actually have that much money.  They don't.

Utterly nobody wants to deal with the reality of health care cost because as soon as you do you're forced to deal with the fact that most of what is spent on "health care" is either wasted, extorted through various means or both.  In fact somewhere between 80-90% of all health spending falls into these categories!

I've written large on this now for close to 10 years; you can click the category at the top of this post to read backward in reverse-chronological order. Nobody, statistically speaking, cares to take this up and ram it down the throats of lawmakers.  Lawmakers and law-enforcers won't do it without you forcing them to do so by whatever means are necessary because if you collapse health care from 19.x% of the economy to 3-4% it will be the mother and father of all recessions until the economy adjusts and there are exactly zero politicians who will take such actions on their own initiative even if failing to do so will destroy the nation due to the exponential expansion of said "services" and our inability to fund them.

Since the people of this country and the readers of this column will not force the political class to the table and ram it down their throats we are ****ed, in short, and it's our fault as a society because the means to address the problem not only exists it's in existing law which can be applied in a literal day.

But what might even be worse is our refusal to hold so-called medical professionals accountable for their malfeasance and misfeasance with regard to the facts related to many diseases and conditions.  We refused at the origin of AIDS spreading like wildfire in the Bay Area of California to tell gay men that unprotected anal sex had a high probability of killing them and what's worse we intentionally left open the public bathhouses where they were engaged in same despite knowing that this was the vector that was killing people by the score!  That's a fact and yet exactly zero public employees were ever charged with the tens of thousands of counts of being an accessory to negligent homicide, charges they absolutely should have faced.

Today so-called medical professionals do the same thing every damn day.  Let me outline just two recent personal examples, of course without names or enough attribution to figure out who they are.

The first is an elderly woman who was Type II diabetic and just had a shunt put in for dialysis.  Her kidneys are essentially dead and diabetes was the cause.  She will be too; dialysis on a permanent basis doesn't work in addition to being hideously expensive and your body essentially "poisons itself" because the build-up of waste products can only be removed when you're on dialysis rather than continually as is the normal case.

You will note up above that I said was Type II diabetic.  She's now living with someone who takes care of preparing her meals for her and such and has essentially eliminated all fast carbs from her diet.  Her blood sugar is now normal.  That's right -- she's not diabetic any more.  Unfortunately kidneys do not grow back and what's worse is that it would appear, although I didn't and won't pry, that at no time during her being diabetic did her physician tell her that (1) she could be non-diabetic by changing what she ate and (2) if she didn't do that there was a good chance she'd wind up exactly where she is now.

The jackwad(s) responsible for that ought to be brought up on negligent homicide and grand theft charges for all the medication and now the surgical and dialysis charges she's incurring.  Every last ****ing nickel that said so-called "medical professionals" have should be confiscated to pay for every damn dime of expenditure she's had to and will endure and be forced to pay her back for all of that expense and then they should be thrown in prison as an accessory to her inevitable death which they had a hand in causing.

Again it won't happen because we won't demand that it does but you can't argue that the answer to this problem wasn't known because some one hundred years ago before we had drugs and similar for Type II diabetes it was not only known it was all over the medical literature -- either stop eating those things that convert to sugar in your body or die.  It was only when we "developed" the means to steal a half-million dollars in drug costs, surgeries and dialysis per customer, inevitably ending in the death of the customer, that the so-called "medical advice" changed.  That's not advancement it's intentional malfeasance and damn well ought to bring both criminal and civil ruin to everyone involved.

The second is a random someone I ran into.  He is also Type II and his kidneys are compromised but not yet dead, which he was quite up-front about when we got into a random conversation as I was munching on a near-zero-carb option -- meatballs -- in a local joint.  I told him he should try some as they were tasty and he said had already eaten both meatballs and spaghetti a few hours before.

I mentioned that he might want to try getting all the carbs out of his diet as it might well resolve the diabetes.  His answer was "I already know that won't work."  I asked him if he'd tried it and he said no.  Who told him it won't work and why hasn't his doctor told him it almost certainly will work and since he's already got compromised kidneys if he doesn't do it he's likely to die.

I swallowed hard, reminded myself that it wasn't his fault he was uninformed since the very people he trusted to tell him what was going on were actively lying to him while pushing pills-for-profit but I had to get out of there before I blew a gasket.  Here's a guy who by all appearances is a good and decent man and despite being on the road to ruin those people who he trusts and could advise him on a way to avoid it are instead choosing money from and misery to him by the wheelbarrow load.

Oh by the way best guess is that this crap in aggregate costs Medicare and Medicaid alone -- not including private expense -- some $400 billion a year.  If you stop it essentially the entire federal budget deficit disappears.

This **** needs to stop folks, and it needs to stop now.  Yeah, that's just two people but damnit you know it's everywhere at present and has been for decades.  The people in the so-called "medical profession" responsible for this, and that's most of them, need to be asset-stripped to their underwear and locked in the stocks for us to throw rotten tomatoes at.

It's our fault folks.  It's our fault that not only are people dying miserably by the boatload but our government is going to fail on a fiscal level within years if we don't demand it stop.

It's our fault because we won't hold people accountable for the misery and financial******they serve on all of us -- and the screwing it imposes on everyone both privately and through the federal government.

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User Info Insanity On Health Care, Continued in forum [Market-Ticker]
Posts: 195
Incept: 2009-10-06

Msumelle, Ar
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I don't think we will ever get anywhere on any kind of real reform on Health Care, it's cost, the Debt, the Deficit, or any number of real problems we have.

60 plus years of serious and irresponsible Progressive Politics and have just about destroyed us. Couple that with all of the wanton Corruption in Government by both Political Parties and the fact that the needs of this country are suborned by the so called Elites and Globalists inside the Beltway what are we to do?

I have thought for a long time that the end game on Health Care by both parties is some sort of Single-Payor System.

Now that California has broached this and we can see the preliminary price tag then it's obvious that is can't work, no way to pay for it. To think that the estimate for California's plan is estimated at $400 Billion is probably way off, experience shows that the real cost for any government program can easily cost twice that, given that the California Plan seems to be wide open for anyone and everyone. So given that set of circumstances you can just imagine what the cost would be Nationwide, say $2 Trillion to start with.

There is no way to pay for it. The Democrats have already introduced a Bill for a $15 nation wide Minimum Wage. Well to try and pay for a Single-Payor then your looking at, at least, a 15% extra tax on top of Social Security, Medicare, etc., etc.. Draining more discretionary money from consumers.

The absolute last nail in the coffin for this country's finances. I can't wait for California to implement this, the State will hit total insolvency in the first couple of years and the Federal Government will not be able to bail them out.
Posts: 377
Incept: 2013-12-25

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My father-in-law used to say that doctors bury their mistakes and get away with it. I would add that we assist them.

Village Idiot
Posts: 3163
Incept: 2008-01-17

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Healthcare industry is too big. That is simply the problem. Doesn't matter what plan or scheme comes along. If it doesn't involve a 20-50% reduction in prices and subsequently the entire sector; it will be pointless.
Posts: 226
Incept: 2011-08-23

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Two things. First, I want to fervently thank Karl for urging his readers to check their A1c, rather than relying on blood glucose tests. Second, another form of medical malpractice - as Karl has pointed out - is the claim that whole grains are great for you and wont raise your blood sugar levels like processed grains do.

I was a strict vegan for 19 years, and then nearly vegan; not for health reasons (Ive never thought being vegan was likely to be wonderfully healthful), but out of pity for animals. I was not eating potato chips and the like; I was eating whole grains with plenty of vegetables; just as is recommended. According to my doctor, my glucose level was great. However, my father and brother are both diabetics on insulin, so I wondered if I was missing something. Per Karls recommendation, I took an A1c test. It was 5.7; pre diabetic. If I kept this up the trajectory was not going to be good.

So, I tried low carb vegetarian for three months, eating lots of dairy, and retested: my A1c was 5.2. I lost six pounds (I wasnt starting out overweight). I'll admit I wasnt happy about eating dairy products.

Now I had some data. So I tried high carb vegetarian (that is, whole grains plus dairy; this allowed me to eat less dairy) for three months. I retested: my A1c was 5.5. I gained 8 pounds.

If it werent for my brothers condition, I might leave it at that. But he is 54 years old (a year older than me), weighs over 400 pounds, has peripheral arterial disease, congestive heart failure, diabetic neuropathy, poor kidney function, and has needed several surgeries for the deep infections you get if your blood sugar is deranged. No, he isnt interested in a low carb diet; he is a college professor and wont listen to anyone.

So, I've returned to low carb vegetarian. I'm looking for ways to reduce the dairy component, but it seems that if you eat a monstrous pile of vegetables all at once that can itself raise your blood sugar via a particular route (due to hormones released when the small intestine is overly stretched, per Dr. Bernstein: the chinese restaurant effect). So gorging on veggies wouldnt work. I'm not expecting to lose weight since Im going to eat a lot of nuts, but my weight is okay.

So, if you know someone who thinks that their whole grain vegan diet is safe and healthful, tell them to have their A1c tested; Karl is quite right. Maybe they will be fine; some people can eat anything and not get diabetes. But maybe not.
Posts: 148942
Incept: 2007-06-26
A True American Patriot!
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Further, don't believe for a second that if you get away with it now and are 30 you'll get away with it for the next 20 years.

You probably won't; the metabolic insult damage takes time to screw you and is cumulative.

I ate entire PANS of Lasagna when I was in my teens and early 20s and never gained an ounce. The "mantra" from the medical profession is that it's "normal" to get heavier as one gets older.

Oh really? Then tell me why I'm at basically the same body mass now that I was when I was 17.... but I sure as hell wasn't, and would be even FATTER had I not changed what went down the pie hole.

Winding it down.

Posts: 26
Incept: 2015-11-17

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This is off topic a bit, but since the Steve Jobs articles have rolled off, i've been trying to recall your thoughts on pancreatic cancer and carbs. If sugars feed cancer, then is that why pancreatic cancer is so deadly?

Have a family member diagnosed with the jobs type.
Posts: 5089
Incept: 2009-06-08

Hampton Roads, VA
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You just made me remember something Karl.

First, as a contrast, I want to mention that when I was a child, I had a couple friends whose dads were type 1 diabetics. When I went to their homes, I noticed they were very careful about what they ate, little carbs.

Fast forward to a few years back when I was hospitalized and spent a couple months in rehab. MY roommate in rehab was a diabetic, I am guessing type 2. I wouldnt understand why the heck they were serving her pasta and mashed potatoes and breads with her meals? It made no sense to me. I remeber thinkin, they are trying to kill this woman. Still checking her sugar level a half dozen times a day and giving her shots.

I didnt realize at the time what a racket it had become.

"The strongest memory is weaker than the palest ink" Chinese proverb
"The enemy of my enemy is my candidate" Random commenter
"Kennedy put a man on the moon. Obama put a man in the ladies room"
Posts: 7783
Incept: 2007-09-10

Scottsdale, AZ
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Got into a discussion with my home health nurse on Friday regarding single payer and she is for it. I raised all the questions to how do you support such a system when over half don't contribute. She raved about the Canadian system and how wonderful it was. I then asked her if in Canada would a nursing company like hers get to charge me $125.00 an hour and she didn't know.
The left is always ragging about discrimination and in healthcare, that same discrimination in aimed at the healthy people. Stop forcing hospitals to take non-emergency cases from illegals and deadbeats and see what happens.
Posts: 5713
Incept: 2007-10-08

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I think single payer is a great idea, as long as the patient/customer is the single payer and there are no middle money handlers (insurance/govt/lobbyists/politicians/banks) siphoning off a cut driving up costs.
Posts: 249
Incept: 2013-01-11

Western PA
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Next up in the "get someone else to pay for it" paradigm of the ever-expanding nanny state:

More than half of older Americans -56 percent - think the federal government should devote a great deal or a lot of effort to helping people with the costs of long-term care, and another 30 percent think it should make a moderate effort to do so. According to the poll, 56 percent of Americans age 40 and over think Medicare should have a major role in paying for ongoing living assistance, up from 39 percent who said so in 2013. Majorities of both Democrats and Republicans now think Medicare should bear a large part of the burden.....

more here:
Posts: 1803
Incept: 2009-06-03

East of Sheol
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Oh by the way best guess is that this crap in aggregate costs Medicare and Medicaid alone -- not including private expense -- some $400 billion a year. If you stop it essentially the entire federal budget deficit disappears.

And lets not also forget those so called governmental food nutrition programs as SNAP that allows for things purchased with those dollars - carbohydrate laden and junk foods including sugary sweet colas. It used to be dessert was something served rarely at meal - at least with my family. Now you can get dessert at will in a bottle and most people don't think about that issue.

Now where the hell is the nutrition in a bottle of Coke - more governmental lies.

Want to take a bite out of childhood obesity and those on governmental medical assistance especially among the so called poor?- then eliminate carbohydrate laden foods from SNAP (Supplemental Nutrition Assistance Program). This stuff is NOT food. Not only should the doctors be jailed but the legislative pimps that voted for this "poison to the nation" bill as well as every FDA/USDA secretary. One bad governmental decision feeds into a myriad of other bad governmental decisions with exponentially escalating costs.

The end result is that this program (SNAP) is now priming kids for diabetic, orthopedic, and other medical care and to shove more bodies into the purposefully overburdened and increasingly outrageous cost system to further feed this scam called medicine.

It is simply amazing how the hacks without conscious can create a revolving cycle of debt and misery to feed the cronies of the Washington establishment.

No mercy for Washington...

"Mass intelligence does not mean intelligent masses."
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