Health Care Cost Containment

Institutions have lost flexibility, the ability to adapt to changing conditions. The loss of flexibility comes from rules, laws, policies, taxes and regulation. The purposes of these phenomena vary, but range from addressing public health issues to increasing revenue to policing moral failings expressed in destructive business tactics.

The issues of human fragility, a lack of moral attentiveness, or a combative competitive urge towards anarchy has been dealt with by the creation of governments. A government is created at a point in time from then forward must use the system to meet new situations. The familiar situation will be the most easily solvable and the new variant situations will demand creativity and flexibility in order to survive the new conditions. Maintaining moral values must be imperative as the system morphs enough to meet changing conditions.

As a moral imperative to be honest and trustworthy apparently will not define the current moral atmosphere that if it is not defined as illegal then it is all right to proceed, no matter what earlier moral codes would have prohibited such action on the basis of good or evil. This malfunction of the economic system is a demonstration of a lack of adaptation to changing conditions and a failure of moral predictability. An economic system that is posited on the rule of law, growth and cheap resources worked well in the conditions of Manifest Destiny but may not function so well under population and resource buildout conditions.

The basic tenets of free enterprise were developed under frontier expansionism but were soon diluted by regulations within communities. Free enterprise is exactly that: an individual will have freedom to open a business using their property for that business, barring some public health concerns. Commercial areas are now long distances from the clients, must maintain huge parking lots and must pay exorbitant rent, pay higher taxes and buy insurance for employees. The small entrepreneur working out of a home is priced out of the market due to the money siphon to government assisted by big business. The recent economic downturn has closed down businesses, the city and county are raising taxes and the unemployment level is climbing. The system is so tied up in revenue enhancement, gigantic loan payments, fees and high taxes, all flexibility is lost.

The subprime scandal is an example of maladaptive behavior that some would view as criminal, as that self serving cynicism appeared to rule human behavior, rather than a well considered morality aimed at the good of society. Some confuse free enterprise with a free for all attitude resulting in personal gain without consideration of the peripheral damage. Free enterprise must have rules like chess in order to function. Eliminating competition through buying politicians to install high government fees and taxes on small businesses is not free enterprise. Competing should be based on quality service and quality goods, not manipulating the environment so no others exist. The current economic environment is regulated into sluggishness and rising unemployment, amid the crisis of confidence created by the subprime scandal.

The fewer choices people have, the less free enterprise functions. Government ordered expenditures from the earnings of citizens in the form of mandatory insurance results in price fixing and high prices plus an unwelcome power grab on the part of those anointed to sell this mandatory insurance that can be cancelled with no refund for you. Forcing citizens to buy insurance will tie up more money into the hands of a few.

So what kind of system do we here have? Private profit and subsidized losses for the financials immersed in the subprime morass? That did not please many citizens, whose losses were ignored as the ‘investments’ went under with the money long gone. The bailouts were disliked and resented at the grassroots as the scandal continued in bonus payments promised through the implementation of a business model that was aimed at selling specific debt derivatives to unwary investors, a goal that had nothing to do with the public good, only a short term profit for a few. And now taxpayer money subsidizes these people as they collect high salaries and ‘bonuses’ earned by bankrupting the company. Of course more regulation became reality as a result of this lack of social responsibility. So we have a system that takes from the taxpayer to give to the financials and insurance companies while also forcing the citizenry to buy services from insurance companies, entrusting them to make payments to our health care providers. We subsidize private sector insurance middlemen as required by law.

Using private enterprise to enforce public policy is contrary to the system of free enterprise. The government should not mandate that the citizenry buy from private enterprise or government. If private enterprise needs more clients, the services they are selling should be competitive, not mandated by the government. Free enterprise begins with the consumer and discretionary income and free choice to buy or not to buy. Free enterprise depends on the consumer having freedom of choice to patronize any given business. If discretionary income is so allotted to mandatory programs, fees and taxes, free enterprise suffers.

So are we a free enterprise society or not? The current health insurance debate seems to leave personal choice out of the picture. Bureaucrats and insurance executives have created a system that requires an ever larger percent of the income in order to function, a trend that is obviously unsustainable. Healthcare costs need to be lowered, tort reform accomplished, and voluntary individual insurance must be instituted in order to give the free enterprise system room to function. Competition among insurance companies for business from a captive audience is not to be confused with competition for individual patronage by a legitimate business serving the needs of the people. Let the healthcare providers compete for the peoples’ business by lowering prices. Allow the money to pay for healthcare to remain in the hands of the people and let the insurance companies and government compete for this business. The costs of health insurance and health care will be more affordable because competition and flexibility will be reinstituted into the system.

Trinity of Power

Health Care

Health Care Delivery and Payment System Reform

Much is being said but I am not certain those with the highest volume are speaking for their constituencies or for the donor interests possibly aiming at short term profits for themselves at the expense of the actual constituency. If this proves to be the case, then a reevaluation of qualifications is in order.

Individual choice is glibly paid homage to by saying these are the allowed possibilities and you have your freedom to choose by choosing among these. This is not freedom. True freedom would allow for all the choices the individual could imagine or research for the spending of hard earned cash. Being told to buy something created by others for their own profit and using their definition of greater good for all is not freedom.

Money is earned and taxes are paid and insurance is another mandated tax? Or should that insurance money be in the hands of the earner for discretionary spending in healthcare? Discretionary money is the key to competition. Competition eliminated by mandatory insurance and subsequent price fixing has resulted in high prices for the services and huge administrative costs while rates rise and rise, like ticks. Who benefits?

The series of siphons on this insurance money is supporting an edifice of personnel who want to keep their control over the insurance premium money. These people are hiring lobbyists and donating to campaigns. How about health care paid for in cash by people on a discretionary basis? That means cash and competition, which lowers prices. The issue is availability of health care, which I translate as the cost of health care. If the cost for routine care is low, people can afford health care. Sell insurance at a high deductable for catastrophes and if somebody does not buy it and needs specialization, they are referred to social services. Catastrophic insurance should be freely chosen and of low cost.

Tort reform is another need. How about individuals carrying their own insurance against malpractice on a discretionary basis per procedure? Individuals would then only pay for the actual instance involving them, rather than subsidizing high insurance rates. Doctors would be relieved of the burden of malpractice insurance, since the patient would have personal insurance. We should have the right to choose discretionary spending on health care at a reasonable price over mandatory insurance programs with ever rising costs.

Stimulus money could be used to establish clinics in neighborhoods, which would employ people and provide health care at a reasonable cost. Don’t forget that health care is not synonymous with health insurance. We need affordable health care.

Kindle

Musings on the Kindle


Wonderful feature is the instant download of emergency book supplies and the readable format. I can read faster on the Kindle and find it light and easy to handle.

A download containing charts and graphs had good text quality but the figures were unreadable. This book is formatted for print media. An alternative would be to autoformat the charts into a larger font size. Formatting for Kindle would contain the chart or graph on one frame along with the caption, in a readable font size.

Learning from experience formatting for the Kindle, I came up with the following formula to produce a readable product:

For e-mail or Kindle format

Set line spacing at 1.5

Under Format:
Paragraph Paragraph spacing set at Before=12 or 6, check sample
Set line spacing at 1.5
General Alignment Left, Outline level Body Text

This will produce a readable copy for Kindle, with 1.5 line spacing and more than that between unindented paragraphs

Ask For an FBI/CIA Investigation

A criminal investigation into the ascendency of certain brokerage/bank institutions is merited by the emerging knowledge that the housing economic bubble was based on wholesale fraud made possible by well intentioned individuals who thought the poor should have a chance at home ownership.

If somebody cannot pay for a debt incurred then that individual should not be loaned money. Seems logical but the optimal outcome for this housing loan activity was only to be able to market the debt at an instant profit for the broker, not to ensure eventual repayment of the loan. Nobody gave a shit if the loans were repaid. These kinds of loans were then bundled together and sold as AAA rated ‘securities’ to investors looking for safe investments. Two more frauds added to the original appraisal fraud, liars at the loan company, loans with inconsistent payments, inflated housing prices, a triumvirate of developer, broker and lender all cooperating to drive housing prices up and sell more housing by enabling incompetent buyers. Who cashed out?

Yet the USA taxpayer is bailing out all these people who perpetuated and made money on this fraud. Why not just give the towns and states and retirement funds and private accounts their principals back? This would stimulate the economy by aiding distressed states. Stop the AIG, CITI etc. payouts. Let them sue for the money. Did they think the insurance on the debt they bought should bail them out of a bad investment? Or was the insurance on the CDOs (collateralized debt obligations) known to pay off due to the poor quality of the mortgages all this was based on? You and me been had. Why would the SEC allow mortgage derivatives they did not understand?

It’s time for an investigation and indictments in the private and public sector…..this public/private partnership did not benefit the taxpayers, who worry about medical costs while these frauds receive billions and more.

Why are all these contracts and ‘securities’ legally binding when it was all based on fraud? Who made the decision to cover this free enterprise bilking by going through the lenders and brokers doing the bilking? The people being bilked, the bilkees should have first shot at the bailout money, not the moneylenders. Let these institutions built up too big to fail on fraudulent schemes based on subprime loans go under. Work with the investors and forget propping up these people who caused the problem. This will get actual money in circulation instead of tying it up. Local lenders who also service the loans can loan to locals to buy homes. No more mortgage derivatives. Mortgage derivatives are like an exported disease and bailout money proves that it isn’t free enterprise either. Let’s separate the housing/loan market from the debt export scene. The purpose of housing is housing, not to be used as a gambling chip.

Free enterprise when profitable but socialized when taking bailout money. Private profit and bailout for losses. Good odds for somebody while the rest of us pay and pay and pay. This horseshit began under President Bush and is happily continuing under President Obama.

MANDATORY INSURANCE RIPOFF!

The rush to insurance during this healthcare summit seems to make many presumptions, such as that price fixing is good for one industry but not good for another. I am sure that the lobbyists are leading the charge to mandatory insurance for individuals and businesses, letting Congress take control of providing customers for these private businesses through mandates that take civil rights away from the taxpayers.

Being forced to buy anything is not freedom. Price fixing with a guaranteed ever increasing percent of income in perpetuity for insurance companies will not bring health care costs down. Allowing government and insurance companies an automatic draw on paychecks will not bring health care costs down. Freedom of choice and cash in hand will bring health care costs down.

Oh, but the debt load on the medical profession is huge and there is all that malpractice insurance to pay for and these payments must continue….Perhaps more structured bankrupt medical debtors this time, instead of just auto manufacturers. Where is the debt load? Who are the creditors? Should foreign companies be able to own our insurance pools?

Establish low cost clinics in neighborhoods for routine medical visits covered or not by insurance. Reasonable, available low cost health care, payment in cash or card or insurance, but always at a low cost, payment now or jump through social services hoops.

Facilities for these clinics exist in many cities in the form of unused commercial space, empty government buildings, repossessed homes and unused school space.

Insurance companies are tying up huge sums and then using these sums to get tax money to pay off their gambling losses. Now they want to mandate the continuance of this forced obligation so they can take even more money out of the system. Let government, and private enterprise offer non-mandatory insurance choices and allow the individual to seek out low cost heath care on the open market. Use stimulus money to establish the clinics and man them. Give the people the right to buy or not to buy.

Figure it out! A small clinic operating 24 hours a day would see a patient every half hour average @ $10 a visit, $4800 would be generated or $9,600 @ $20 a visit. Enough money to pay a small staff and what a boon to the neighborhood it would be.

Give the people a real chance to choose healthcare, not a series of predesigned choices that enrich others. This is far more important than more roads.

Womens Rights and Mandatory Insurance

Mr. President: I am pleased that you are an advocate of civil rights, including those of women. My mother was born before suffrage for women in the USA and I came to adulthood amid prejudice against women. I learned along the way to make my own choices, sometimes at odds with male dominated society. Forced choices do not freedom make.

In regards to insurance, I remember disliking Ms. Clinton because she would mandate I buy something, anything, but in this case it was insurance. As a free market advocate, the price fixing brought in by mandatory insurance is dangerous for the economy. As a parallel, possibly it would be decided that all must buy a car, with the prices set by the industry and the government. Let the assessments begin.

Government insurance? Go for it!
Private insurance? Let’s have it!
Mandatory insurance? Cancel it! Let the prices of health care fall to the housing levels. Use stimulus money to establish low cost clinics in neighborhoods.

A post boom-time pullback in expenditures per item. All sectors are influenced by the assumed derivative debt, not just housing. Propping up outlandish medical charges and huge outlays for malpractice insurance by mandating insurance while not allowing the direct pay preference is allowing a few to control huge sums of cash. Direct pay at a low cost in local conditions would free up all the cash held by insurance firms into the economy. Let the free market work.