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2020-01-12 09:30 by Karl Denninger
in Health Reform , 239 references Ignore this thread
Investment: Long Boiled Rope Futures
[Comments enabled]

Gee, what have I said for the last, oh, 20 years?

We over pay for medical care in all respects by as much as ten times.

I can take 80% off medical costs in an afternoon.

And now, here's another example:

That's close to 20 times the "billed price" that is actually demanded and due.

It is hard documentation of extortion, which is a serious criminal felony: "Buy this insurance or be ruined by something that we will bill you 20 times as much for."

This crap results in one dollar in five spent in the United States today!

Medicare For All will not resolve any of this.

Nor will Donald Trump or anyone else in the GOP.

Why not?  Because it is this, above and beyond everything else, that has resulted in all those "wonderful jobs reports"; on average some four hundred thousand people a year every year for the last decade totaling four million employed and 90% of them never provide a single second of care to a single person.

Let me remind you that last year we added about 1.2 million people to the workforce (defined as everyone 16 years of age or older.)  That's an excellent (100% accurate) proxy for the birth rate (+ immigration, both legal and otherwise) 16 years ago for obvious reasons.  The birth rate is lower today, incidentally, in no small part because of this sort of financial rape.

The claim made is that those 400,000 employed are "required"; this implies that for every care-giver there are only three people who receive care.  That's obvious bullcrap; every doctor and nurse in fact takes care of dozens if not hundreds of people; even in an intensive setting like a hospital a surgeon performs, on average, about 400 procedures a year.  The average person in a hospital likely requires one -- or less.

Almost every one of those "new hires" provides zero care to anyone; all they do is screw you, and this is one of the many felonious ways they do it -- by extorting you into purchasing a $1,000 a month "insurance policy" under the threat that if you don't they'll bill you twenty times as much money if something bad happens.

This a criminal racket and has been for decades; why in the Hell are you willing to put up with it?

The government will not stop this with "Medicare For All" because if they do the stock market crashes and they know it.

Ditto for the GOP.

Never mind that all of this is illegal.  It has been illegal for more than 100 years.  It is illegal to conspire to restrain trade, fix prices or stomp on competitors -- say much less run extortion schemes to force tied sales, the latter of which (forced tied sales) is also explicitly illegal.

Wake the **** up America; until the population makes clear that either this crap stop or boiled rope will be used this will not stop and you will not see real progress in your standard of living as it will all be absorbed and stolen by these brigands with the explicit support and cheering on by government itself.

Yes, the title of this article is to go long boiled rope futures.

But given the fact that absolutely nobody in this nation will stand up and demand that this crap stop the more-certain way to profit is to short those futures contracts instead, since nobody in this nation will, it appears, ever use or credibly threaten to use same whether in the form of lawful and peaceful means, such as a general strike, or otherwise.

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User Info Investment: Long Boiled Rope Futures in forum [Market-Ticker]
Jal
Posts: 826
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Everyone has their own reason to accept their own living condition.
We have all been conditioned to accept our social structures.
In other word, "don't rock the boat".
Even when you produce documentation, the programming from the enablers does not fail.
If you were to find the right button, to motivate people, then your readership would grow exponentially. Like really fast really quick.
Hot-dog-guy
Posts: 225
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State Farm just did steps 1-3 and are building ANOTHER massive shiny thing in Mesa.
Trying to figure out if corporations are the new citizens or the new nation states.

"I can be both."

Who said that?
Whitehat
Posts: 1503
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Gone West
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i am not going to promote the book, but suffice to say that it is targeted at men trying to recapture some sort of patriarchal role in their family relationships. well it of course gives advice.

one piece of advice for career is in healthcare administration. lucrative with dignified schedule, etc.

see it, too many people who know the scams do not protest them, but rather seek to get in on the action.

my father once told me that the first sign of getting bitter is wondering if one was stupid to play by the rules or only get involved in what is right and proper.

something comes to mind, perhaps it is best for the bar section. no, not violent or crass, just a philosophical take on the whole thing.

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There are two ways to be rich: One is by acquiring much, and the other is by desiring little.
snow, seasons, distance and dirt roads: SSDD
"Be not deceived; G-d is not mocked; for whatsoever a man soweth, that shall he also reap" (Gal. 6:7)
Rollformer
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I was looking through some benefits reports at work the other day. One of the procedures where the stop-loss insurance kicked in. Uncomplicated c-section birth. 45k. This is a procedure that has been done for nearly 3,000 years, and it costs a breadwinner salary to do it now. Insane.
Franco
Posts: 91
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Yup, I recently received a medical bill where the billed amount was five times the allowed amount.
Mangymutt
Posts: 1271
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Vancouver WA
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Jal -
Quote:
If you were to find the right button, to motivate people, then your readership would grow exponentially. Like really fast really quick.


I do not dispute Americans have been indoctrinated to "don't rock the boat", as it goes hand in hand with public schools and the formation of the family. However how many times have you lost your keys, only to have them in your hand. Or misplaced your glasses only to have them on your forehead. Or even search for your car, only to discover it is right where you left it.

The button to motivate people (most)is already in that person's hand, on top of their forehead, or still sitting right where it was placed last. Yes, it would be great if American's pulled their collective heads from their collective asses. But they will not. And although Karl does a great job in laying out the Who, What, Where and even Whenish as to Why this "unrocked" boat will sink like concrete. He cannot tell them any more clearly and consistently to open their hand and look or look on top of their damn head.

He can not tell you or I or any of the other readership to go out and tell people - Look what is in your hand! Now use those keys to help get you out of the******room. And short of going out with a sandwich board and megaphone, (which will be silenced) I am not sure what more I can do to make people understand.

The message is clear, the message has been stated for years, and the message has been unchanged during those years. You, anyone reading Market-Ticker and myself need to carry that message out where we can tailor that message to them.

Good Luck!

Whitehat
Posts: 1503
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Gone West
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we have a very large and concentrated generation going into Medicare years of spending. one wonders if this whole ramp in medical costs is designed to capitalize on this demographic and perform the most epic asset stripping scheme in history.

every profession involved or specializing in elder this and that has been growing and promoting for the last twenty years big time.

assisted living, nursing homes, etc. are all targeted growth areas.

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There are two ways to be rich: One is by acquiring much, and the other is by desiring little.
snow, seasons, distance and dirt roads: SSDD
"Be not deceived; G-d is not mocked; for whatsoever a man soweth, that shall he also reap" (Gal. 6:7)
Aztrader
Posts: 8493
Incept: 2007-09-10

Scottsdale, AZ
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When are the seniors that vote for the left going to ask why they are paying massive premiums for medicare and supplemental insurance while the leech class gets it for free under Medicaid?
Tsherry
Posts: 2343
Incept: 2008-12-09

Spokane WA
Online
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>>one wonders if this whole ramp in medical costs is designed to capitalize on this demographic and perform the most epic asset stripping scheme in history.>>

I don't wonder one iota. It's right in front of our faces, with .gov and .med and .insurance scaring the **** out of the older population, who will spend anything and everything to pretend that they're not getting older; to be taken care of; and to get 'what they deserve.' The companies that own 'retirement facilities' hire us on occasion to window dress the overpriced 'care' facilities and pretend to include 'gardens' used for 'therapy' and 'wellness.' Sometimes the results meet the definitions of those words; often not though. Having the facility there, does not mean that the 350lb 70 y.o. on O2 will use it, but they like the fact that it's there. Having seen some of these people, I wonder how well-marbled their bodies are, or if the fat layer is just six inches thick on top of the basic human frame.

Well they (we) will sure as shooting get what is deserved. (shooting will not be optional).

Tom S.

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Omne mendacium est.
Jal
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ELDER ABUSE:

The elderly will need to make sure that they know how to treat their caregiver properly, if they wish to avoid diaper rash.
Dcsleeper
Posts: 522
Incept: 2012-10-11

Northern VA
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WhiteHat
<something comes to mind, perhaps it is best for the bar section. no, not violent or crass, just a philosophical take on the whole thing.>

My God, you guys ARE already filtering???
Jesjohn94
Posts: 19
Incept: 2019-05-07

Atlanta
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Lets assume the 80% is accurate. It seems to be logically correct. It is all clearly illegal so its only happening because some people are making out like bandits. It would be interesting to figure out who and how much people are making. It is trillions a year in total. I suspect the biggest numbers are #1 People who get free healthcare #2 People who have jobs they otherwise might not #3 The rest of the world getting cheap drugs the USA develops.

None of those 3 categories have the power to enable this to continue.
Hot-dog-guy
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I'm asked to look into the assisted living thing by some army buddies. Buddies who were in the army. Not like I was in there with them. But they got access to VA business loans burning holes in their pockets already.

The whole buzz on this industry is based on the observation that the boomers are getting old and THEY GOT MONEY.

I got the thing costed out pretty close. I got a grip on what various levels of facility cost. Getting down to the nitty gritty of the regulatory and admin burdens (binders the size of old school phone books), all that jazz. Caregivers themselves are the greatest expense besides the property.

Median price (although how you calculate median with the top end essentially being INFINITY) is tricky but it's often quoted as $3.5k/month. There's not much below $2k/month. Think of that as the "ala carte" version where a lot of things are extra.

Still dialing in on who or how this is paid for. Savings, investments, liquidation of assets, children, pensions, medicaid, insurance...meanwhile caregivers I talk to say some of their clients can only afford in-home visitation, not a facility.

There's something wrong in this picture. This should not be happening.
Nacnud62
Posts: 7
Incept: 2018-12-19

New Mexico
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Im a cardiac care nurse at a specialty heart hospital. I have updated my report sheet with
DM (diabetes mellitus) all Type 2
HTN (hypertension)
CAD (coronary artery disease)
PVD (peripheral vascular disease)
HLD (hyperlipidemia, cholesterol/triglycerides)
CKD/ESRD (chronic kidney disease/end stage renal disease)

Well over 90% of my patients have at least one of these, most have multiples. All of these are lifestyle diseases.
Elkad
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@Hotdog

Since you looked at it. How many man-hours/month per resident? The healthy-ish ones, who just need meals, handing out meds, and maybe a bit of maid service.
Acebarefoot
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Quote:
Well over 90% of my patients have at least one of these, most have multiples. All of these are lifestyle diseases.


Yep. And we are the bad guys for pointing out the obvious.

side note:

I have a friend who is over weight and needed neck surgery. Doc flat out told him he was too fat and that his chances of success were really low at this point. Get your weight down to XXX, by eating healthy which will also clean up your numbers on your blood work(beginning Diabetes) and I will do it. He didn't take it well, but thought about it and really wanted this Doc because of his success rate. He made a decision to start eating HFLC, lost 80 lbs, and feels so much better. His surgery is a week from today. I told him I was proud of him. He swears he isn't going back now that he has a new lease on life.
Jal
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" $3.5k/month. There's not much below $2k/month"

I agree. Canadian prices are similar.

Most care home are operated "for profit" by large companies.

Nobody would want to be poor, (only on gov. pension), and needing to get their diapers changed by overworked care givers in an overcrowded facilities.

Depending on the facilities, they will take your gov. pension, (approx. $1,000), and leave you with an allowance of a few dollars.
Tickerguy
Posts: 161139
Incept: 2007-06-26
A True American Patriot!
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If you find yourself in that situation, go postal. At least you leave with dignity.

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Winding it down.
Hot-dog-guy
Posts: 225
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@Elkad That's a trickier question than it sounds like. Actual hands-on time from a caregiver amounts to 2 hours. Getting a decent independent caregiver to come by your house is $25-35/hour, 2 hour minimum here. But meds can be a 12 or even 24 hour regime. You just passed $.25M/year for in home service. In a group home setting, caregiver time is more like $hr / how many residents. We'd also look at reducing caregiver time because there has to be a house manager involved on location. The sheer amount of logs and reports will probably amount to 2-3 man hours/day.

A good strategy is turning the guest room into the caregiver quarters and leaving them time in the day to work with other clients. Back out their rent and meals. Another one I don't see people doing is getting together with life long friends and building your own facility or moving in with whoever has the biggest house. Grab a local young person and pay to have them certified.

Here's a gag. Arizona pays people to foster kids. Good news kid, we got you a nice safe house AND you get a career in health care! Completely free!

Once again, slave labor rescues the business model.

Jal
Posts: 826
Incept: 2009-03-25

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"people doing is getting together with life long friends and building your own facility or moving in with whoever has the biggest house."

I've seen it being tried. It didn't work.

Many reason for conflict and why it didn't work.
Too many opiniated seniors that know what is true and know that they are right.

Wa9jml
Posts: 463
Incept: 2017-04-29

DeKalb, Illinois
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My 101 year old Dad is now in the DeKalb County Rehab and Nursing Center. They have a large bureaucratic structure imposed on them by state and federal regulations. I see the nurses staying at least 2 hours after their shift ends just to write up all of the required reports.

The nurses there are generally superb, and the CNAs are too. So the residents get at least decent care, despite the efforts of the state and federal regulators.

One of my friends is the now retired head of the Dementia Ward there, and she regularly butted heads with the state inspectors. The inspectors insisted that proper hand sanitation required that any time a resident shook hands with a caregiver, that the latter was required to use hand sanitizer. Then, there was the requirement that any resident taking a cookie from the cookie jar was required to put on a plastic glove. There was a hand painted sign on the exit doors proclaiming them to be exit doors, but that was not according to state code, either. Deb told the state inspectors that the residents had dementia, but they were not stupid. The implication of the caregiver's regulation on hand sanitizer, implied that the residents were dirty, and that was a quality of life issue. I had her give 3 guest lectures in my public policy courses, and she gave a great guest lecture each time. Immediately after she finished her presentation, the line started forming. "My mother is doing this, and my grandfather is showing the symptoms of dementia, what do I do?" And since she has worked in this area for several decades, she would give them sage advice.
Elkad
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@Hot-Dog-Guy.

I'm thinking more along the lines of Independent Living, to the beginnings of Assisted Living.

Long-term hotel style. Chow hall serves 3 hots a day, in the dining room only. Accessible rooms with panic buttons. Sick call every morning, so the nurse can tell me if the weird sores on my ass are from the chlamydia making it's way around the building, or from playing World of Warcraft 19 hours a day.

When I can't **** on my own any more, you kick me out.

Can you profit off that for $50/day at some reasonable building size? Less? More?

And if you are building/remodeling now, wire Ethernet to every room. Not too many years until crotchety old people will be bitching because they can't stream to Twitch in 4k60.
Megamomo
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It's sad that I don't find that bill remarkable or out of the ordinary in any way. My daughter's bill from an appendicitis over Thanksgiving just arrived. Billed over $70K of which $66K was simply listed as room & board.
Hot-dog-guy
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@Elkad Look North but it's starting to look like there's a lot of demand on the lower end. Actually it's looking like there's a lot of people who can't really afford anything.

I'm pleased to offer updates on this project. Seems we all have an interest. Mostly due to my own schedule, this spring/summer are optimal for me to actually launch this one. This means I really have to make sure of my numbers and whip up a marketing campaign out of the thin air.

I don't know how to predict cost of acquisition (filling beds). That one just glares at me. There's a question mark on the spreadsheet.
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