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2019-11-17 15:44 by Karl Denninger
in Health Reform , 363 references Ignore this thread
[Comments enabled]

Gee, someone 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.

What was my number?  80% or more.  And that's without screwing a single person.

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.


Price tags also insure that everybody pays the same amount. We currently have a health-care system in which providers charge patients wildly different prices depending on their insurance. That injustice will end if we insist on legally mandated price tags and require that every patient be charged the same price.

It's not "injustice" -- it's too many felonies to list, all of which carry hard prison time for everyone involved.

It's extortion to threaten, whether by implication or statement, that unless you buy health insurance you'll be billed 10x as much for the same thing.  Yet that happens all the time.  It also constitutes an illegal tied sale (forcing you to buy another product or service, in this case health insurance, you don't want or you will be disadvantaged) -- this too is unlawful under anti-trust law.

In addition it implicates 15 USC Chapter 1, which carries a 10 year prison term, in that it is clearly an attempt to restrain trade -- how do you have competition when you can't get a price?

15 USC has been on the books for more than a century.  The medical industry has twice tried to get an exemption through the courts and lost both times.

As a side benefit, we will also see massively lower administrative costs. They are currently extremely high because once a doctor submits a bill to an insurance company, the insurance company works hard to deny or discount the claim. Thus begins a hideously costly and drawn-out negotiation that eventually yields the dollar amount that the doctor will get reimbursed. If you have price tags for every procedure and require that every patient be charged the same price, all of that bickering and chicanery goes away. As does the need for gargantuan bureaucracies to process claims.

This is why the politicians refuse to address this and the cops won't arrest.

We have added roughly 400,000 people a year since the crash to the "health care" sector in employment.  Yet a look at the statistics for doctors, nurses and other direct care-givers shows that doctors have barely moved in number and nurses, while they've increased, have only gone up by a few.

All told roughly ninety percent of the "employment" adds in this sector since the crash in 2008 never provide a single second of care to a single person and this did not start in 2008 either; it's been going on for at least the last two decades.

If you put a stop to the scam nearly all of those people instantly lose their jobs.  We're talking about roughly 15% of the economy that instantaneously evaporates.

Now it won't stay gone for long; with much lower costs the resulting economy progress that will follow will set records for years and those people will be hired to do something else.

But the immediate effect of doing this will be a 15% contraction in GDP and the loss of millions of jobs on an immediate basis; the papers will scream "Depression!" (because from the perspective of a classical economic basis it is) and the political blowback in the short term will be extreme.

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.

There's no need to do that but its an OK adjunct.  Why not?  Because I've got a better answer to that, although HSAs, as they already exist, are certainly a good thing and can be an effective part of the answer.

Oh, and before you say it won't work?

We know this to be true because while price tags and deductible security were invented in the United States, only one country has had the good sense to roll them out nationwide. By doing so, Singapore is able to deliver universal coverage and the best health outcomes in the world while spending 77% less per capita than the United States and about 60% less per capita than the United Kingdom, Canada, Japan, and other advanced industrial economies.

Note that Canada, Japan and the other economies are all socialist systems in whole or part.

I hope that politicians on both sides of the aisle will get behind these proven solutions. Washington should not be a place where good ideas go to die.

They will not unless the only alternative, as expressed by the people, is a gallows being erected on the National Mall or worse.

I've been tracking this trajectory since the 1990s when I was buying health insurance for my staff at MCSNet.  It was glaringly obvious what was going to happen, and I started raising Hell about it.  Nobody gave a wet crap.  Nobody has since.  Despite serving on the EC of the Florida Libertarian Party not one time did I manage to get that into the party platform nor did I manage to get one candidate to run on such a platform.  In my time before or since exactly zero politicians of either major party have done so.

Matt Gaetz (R-FL-01) lied to my face and that of a room full of Seniors at a town hall meeting here about a year ago, claiming that the Health Industry was exempt from 15 USC.  When challenged with the two USSC decisions that say otherwise he promised to get back to me and never did.  He is a liar and a fraud, just as are the rest of the politicians.

Leverage, my book which was published in 2011, pointed out all of these facts and numbers.

Since then I've published a whole series of articles on Health Reform, many of which remain available.  You can get the reverse-chronology reading list right here.

specific legislative proposal to solve the problem can be found here; it contains a link at the end that goes to a second article that describes how implementation would look.  It resolves all of these scams.  Part of it can be done by Executive Order or simply by starting to prosecute providers, insurers and drug companies under 100+ year old criminal felony law.  The rest needs Congress.

Oh by the way doing this eliminates the entire Federal Deficit and the government runs a surplus.

I'm not kidding -- it really does and it really will; that's the math.

So why won't the politicians take this on?

Simple: If you do it nearly all of those 4 million people employed robbing the public lose their jobs and the stock prices of the firms who have made all their money ripping people off, never mind all the billionaires who have done so in the medical and drug industry lose much or even all of their value.

I remind you that Obama claimed he was going to fix this.  He lied.  Trump had three bullet points on his campaign web page that, in effect, would implement most of this.  I said during the election season that I didn't believe a word of it as it all sounded good but lacked the sort of detailed exposition that indicated he really meant it and had studied it.  All three points disappeared on the night of the election as soon as it was called for him; his recent "proposal" has no teeth in that it carries a trivial $300 fine for non-compliance.  He's a known serial liar when it comes to this issue as is every single GOP member in the House and Senate.  The Democrats, for their part, want to enlarge their control over this part of the economy even more than exists now.  When they can't pay for it, which will occur within the next five years, the government will collapse or if you actually need health care you will be left out in the cold to die

I suppose the Democrats consider that "reasonably safe" in that someone ill enough that they'll expire without their "health care" probably is too sick to be able to mount a revolt, never mind that "one nut at a time", which is exactly how the press will present it to you, just gets themselves either arrested or dead.

Again, from the above:

The immediate effect of doing this will be a 15% contraction in GDP and the loss of millions of jobs on an immediate basis; the papers will scream "Depression!" (because from the perspective of a classical economic basis it is) and the political blowback in the short term will be extreme.

Thus the only way this will happen is if the people of this nation as a whole, not a few "nuts", make clear that not implementing this change is worse.

What's worse than losing your job to a politician?

Only one thing: Losing your head.

Thus the people of this nation must make clear as a whole, not a handful nor a fringe group, that either this policy change is implemented or a literal ejection and replacement of the entire government of this nation by whatever means are necessary, up to and including through the use of force, will occur -- a literal "second act" of 1776.

If the people of this nation will not rise and make that demand as a body politic then it will never happen.  In fact, a number of years ago when I met with Senate staffers to discuss exactly this that was what was communicated to me; they had no intention of doing anything like this from both sides of the aisle and the reason was they knew they'd get voted out of office if they did.

Therefore the only means of obtaining that outcome is for the people of this nation to insist that it happens under penalty of worse than being voted out of office.

You don't have to like logic and where it takes you; I certainly don't like where logic leads in this instance.  But whether I like it or not is immaterial to the facts; it is what it is.

All governments exist only with the consent of the governed.  That is the lesson of 1776 and our Constitution.  This fact is clearly stated, in plain English, in the Declaration of Independence.

Our economy currently has one dollar in five spent on health care and 80%, approximately, of that is stolen through these schemes.

The medical and "health insurance" system in this nation is the largest criminal enterprise and organized racket, extracting more money from more people, than any other in the history of mankind.  It personally costs each and every citizen in this nation, man, woman and child, in excess of $10,000 per year and is expanding at a rate of approximately 8% every year, far beyond economic growth and the ability to pay.

The continued existence of this scam is an existential threat to the United States.

It must be stopped here and now.

Whether it is, or whether we instead all go down the toilet together, is collectively up to you.

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