The following post was originally posted about a year and a half ago. However, all of a sudden, it has rocketed up our tracking processes to become the most popular post over the past month or so. I really do not know why but can hypothesize why it has found a new popularity: as we get further and further into this vicious, never ending, lie-infested political cycle, we realize that as people who are supposedly living in a free country, we have less and less control over our personal destinies.
Corporate, union, PAC, and lobbyist money overwhelms our political processes. Those in positions of power turn out to not be leaders but simply greedy, selfish, small individuals who happened into politics as a career rather than a calling. Adulterers, liars, incompetents, and non-problem solvers seem to be their profile rather than integrity, leaders, and problem solvers. In the entire process, we are treated not as individuals, appreciated for our diversity, but merely voters to be cajoled or destroyed, depending on our political ideas and positions.
As a result, we seem to have less and less say about our futures and our destinies, as we reviewed about 18 months ago.
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Monday, February 14, 2011
"We Have Less and Less Say About the Shape Of Events Which Shape Our Future."
The title of this post comes from a longer quote that reads as follows:
"Every year, whether the Republican or Democratic Party is in office, more and more power drains away from the individual to feed vast reservoirs in far off places; and we have less and less say about the shape of events which shape our future."
Fascinating observation and how appropriate for life in America today. Many of us have an uneasy, gnawing feeling that we are no longer the land of the free, free to do as we please and to shape our future and the future of our families as we see fit. For a nation built on the principles of freedom, liberty, and personal responsibility, this is not a healthy condition.
Many times we have pointed out the numbing fact that American government, at all levels, confiscates over 40% of our earnings every year through taxes and fees, a confiscation level that:
1.Restricts our ability to seek out and pay for the best education for our kids.
2.Restricts our ability to expand or start our own business.
3.Restricts our ability to contribute to our favorite charities.
4.Restricts our ability to live and work where we would like.
5.Restricts our ability to spend our hard earned wealth any way we would like.
6.Restricts our freedom to live our lives as we see fit, not as some politician sees fit.
You cannot have personal freedom without economic freedom. Any type of restriction is a hit to our freedom and by taking so much or our spending power in the form of taxes and fees, liberty is restricted to unheard of levels. And what do we get for these restrictions, what "vast reservoirs in faraway places" are the beneficiaries of our restricted freedom? These reservoirs are now deep, diverse, wide spread, and largely ineffective:
•Why do we still spend billions of dollars a year to garrison tens of thousands of U.S. troops in Europe, over twenty years since the Iron Curtain fell?
•Why do we still spend billions of dollars a year to garrison tens of thousands of U.S. troops in Japan, sixty six years after Japan surrendered in World War II and who has been a solid democratic country, a friendly ally, with a strong economy for decades?
•Why do we still spend billions of dollars a year to garrison tens of thousands of U.S. troops in South Korea, a country with one of the strongest economies in the world and which requires mandatory military duty, thus, having more than enough assets to protect itself from North Korea?
•Why do we still spend billions of dollars a year to garrison troops in Iraq, especially since our current President promised, but failed, during his campaign to wind down our military presence in that country?
•Why do we still give away billions of dollars every year to the agriculture industry in this country, the vast majority of which does not go to "family farmers" but ends up in the coffers of the major agricultural corporations, most of which are now enjoying recording breaking profits as world wide demand for American food products increases?
•Why did we spend billions of dollars to bailout auto companies and financial institutions whose sloppy, stupid, short sighted management was punished by the market forces and who deserved the same fate as ill performing companies received in the past: termination.
•Why do we continue to spend billions of dollars a year for various "corporate welfare" political cronyism initiatives, initiatives that are little more than a re-election campaign donation source for incumbent politicians?
•Why do we continue to spend billions of dollars a year for a mammoth government bureaucracy that is redundant, wasteful, inefficient, and largely ineffective?
•Why have we allowed so much of our wealth and freedom to migrate to far away Washington D.C., a metro area that is now home to seven of the wealthiest counties in the country?
•Why do we continue to spend billions of dollars a year to support dictatorial regimes in faraway places who are faithful to us for as long as we pay for their loyalty, at the expense of freedom and liberty within their own borders?
Why, why, why? In total, the average American receives absolutely no benefit from sending their wealth to "feed vast reservoirs in far off places," whether these places are in the Far East, the Middle East, Europe, corporate and union boardrooms, or wherever. The only Americans who benefit are the politicians that control how and how much these reservoirs receive, usually in return for some help in funding their perpetual re-election campaigns.
Thus, our freedom gets a double hit when you think about it. By using our tax dollars to feed these reservoirs, we are less able to live our lives as we see fit to to our reduced economic independence.
Second, we are usually stuck with the same, non-performing politicians since they always have a head start on campaign funding, given their reciprocal arrangements with unions, auto companies, financial institutions, agricultural corporations, etc.: they pay out taxpayer money via budget processes and earmarks to the reservoirs and the reservoir recipients are more than willing, as proven by campaign fund raising tracking, to return the favor in the form of campaign donations. This reduces our freedom of choice when it comes to our elected representatives.
That is why the fifty steps to freedom outlined in "Love My Country, Loathe My Government" are so important if we are to drain these vast reservoirs of waste and start to shape events so that we can shape our own futures as we see fit, not as the political class sees fit. This is totally consistent with the insights embedded in the above quote.
By the way, who actually penned the quote above? Was it a member of the Tea Party who realized that government was draining our wealth and our liberty at the same time? Was it a contemporary journalist who recognized what is happening in this country today? Was it a courageous and current politician who understands first hand how wasteful government is today? No, the quote actually comes from William F. Buckley, Jr., and appeared in the November 21, 2010 issue of the Washington Post, but was written ALMOST FIFTY YEARS AGO.
Even back then, the political class and the government it runs was already creating vast reservoirs and diverting our wealth and freedom to those reservoirs. Let us hope that their fifty year head start can still be overcome. If the Egyptian people, with no tradition or history of freedom, can overcome thirty years of oppression where their freedom was diverted into a vast reservoirs of a secret police state, I am sure that with our over two hundred year tradition of freedom we can eliminate our reservoirs that Buckley writes so elegantly about.
Our book, "Love My Country, Loathe My Government - Fifty First Steps To Restoring Our Freedom And Destroying The American Political Class" is now available at http://www.loathemygovernment.com/. It is also available online at Amazon and Barnes and Noble. Please pass our message of freedom onward. Let your friends and family know about our websites and blogs, ask your library to carry the book, and respect freedom for both yourselves and others everyday.
Please visit the following sites for freedom:
http://www.cato.org/
http://www.robertringer.com
http://realpolichick.blogspot.com
http://www.reason.com/
http://www.repealamendment
Wednesday, August 29, 2012
Tuesday, August 28, 2012
Why Medicare and Social Security Are Doomed - The $222 TRILLION Dollar Conversation Romney and Obama Should Be Having
We are still in the middle of what I call "silly season" when it comes to politics and elections. Politicians and their respective advocates in the media talk about trivia, inane issues and other silly stuff that really will have no impact on the lives of most Americans as we go forward.
The Washington Post two weeks ago did a 700 word article on the clothes that Paul Ryan wore at some campaign appearances that week and how well those clothes fit him. Joe Biden was put in political "time out" for a few weeks because he continues to have foot in mouth disease. The Obama camp insists that Romney release his tax returns while the President's school records continue to be a secret and the tax returns of most members of Congress are also a mystery.
Trivial matters in a time of dire national issues. Let's do a quick review of the country's economic straits that adults should be talking about vs. the relatively minor issues that our politicians talk about, issues that we have covered extensively in past posts:
http://lewrockwell.com/north/north1186.html
The following points from the analysis highlight our dangerous plight:
Consider some other factors that will contribute to our doom and gloom scenario:
- According to an article in the May 25, 2012 issue of The Week magazine, even with Obama Care in effect, a married couple on average can expect to pay $240,000 in their retirement years to pay for Medicare premiums, co-pays, deductibles and other health care expenses. This is a 4% increase over the previous year. Thus, it will be difficult to ask American households to cough up $1.9 million each to cover the $222 TRILLION in unfunded liabilities if they have to put up almost a quarter million dollars for their own health care.
- Still do not believe we are in the midst of gloom and doom regarding Social Security? Consider an article in the June 4, 2012 issue of Business Week, "A Massive Program On The Verge Of Collapse." Social Security also has a disability program in addition to its retirement fund. According to the article, the Social Security disability fund will go cash flow negative by 2016, at which time taxes collected will only cover about 79% of the need.
The article clearly points out that both major political parties have done nothing to much acknowledge the problem never mind resolving the issue. The article also points out that the government is so dysfunctional that it has been unable to clear a backlog of over 1 million potential fraud cases.
- A Moneynews article from August 16, 2012 reported on the most recent Treasury Department analysis which showed the following profile of our debt relative to international entities:
So, American households will have their own expenses to cover and cannot be relied on to raise $222 trillion of wealth. Our two biggest foreign bankrollers, China and Japan, will likely turn inward to service their aging populations and not continue funding our spending addiction. Our own wealthy cannot come close to funding these unfunded liabilities even if the Federal government confiscated all of their wealth and all of their earnings.
Our political class and media worry about ill fitting clothes, personal college records, personal income tax returns, and other extremely trivial issues. Real leaders would step forward and level with the America people: "The U.S. Federal government has made promises to you that are impossible to meet. Thus, as a nation, these are the steps that need to be taken, the sacrifices that need to be made to guarantee that those most in need of help get what we can afford to give them while the rest of America will have to do with less."
What are the odds that anyone in the current political class has the courage to stand up and make that statement and back it up with a cogent, fair, logical, and financially sound plan to get us through this dilemma? In my view, the odds of that not happening might actually exceed the size of the national debt these same people have created. Despicable from a leadership perspective.
But there might be a way to get through the gloom and doom. We would recommend starting with four steps from "Love My Country, Loathe My Government:"
Oh, yes, there is another way to avoid the gloom and doom. Do not get old and do not get sick. Have a nice day!
Please visit our Presidential website, "The United States Of Purple," at:
http://www.unitedstatesofpurple.com/
The United States of Purple is a new grass roots approach to filling the office of President of The United States by focusing on the restoration of freedom in the United States, focusing on problem solving skills and results vs. personal political enrichment, and imposing term limits on all future Federal politicians. No more red states, no more blue states, just one United States Of America under the banner of Purple.
Our book, "Love My Country, Loathe My Government - Fifty First Steps To Restoring Our Freedom And Destroying The American Political Class" is now available at http://www.loathemygovernment.com/. It is also available online at Amazon and Barnes and Noble. Please pass our message of freedom onward. Let your friends and family know about our websites and blogs, ask your library to carry the book, and respect freedom for both yourselves and others everyday.
Please visit the following sites for freedom:
http://www.cato.org/
http://www.robertringer.com/
http://realpolichick.blogspot.com/
http://www.flipcongress2010.com/
http://www.reason.com/
http://www.repealamendment/
The Washington Post two weeks ago did a 700 word article on the clothes that Paul Ryan wore at some campaign appearances that week and how well those clothes fit him. Joe Biden was put in political "time out" for a few weeks because he continues to have foot in mouth disease. The Obama camp insists that Romney release his tax returns while the President's school records continue to be a secret and the tax returns of most members of Congress are also a mystery.
Trivial matters in a time of dire national issues. Let's do a quick review of the country's economic straits that adults should be talking about vs. the relatively minor issues that our politicians talk about, issues that we have covered extensively in past posts:
- Our national debt is about to hit $16 TRILLION. If spread out equally across all U.S. households, every American household would have to pay about $140,000 each to cover the debt nut. And under Obama, this debt is growing over a TRILLION dollars a year relative to a year's worth of government tax and fee collection.
- Social Security is currently in a negative cash flow situation and will continue in that situation for decades to come as the Baby Boomers retire. A negative cash flow situation means that the Social Security process is now, and will continue, to pay out more in benefits than it collects in tax revenue.
- The Social Security trust fund still does not exist as a source of wealth. It only exists as a cruel accounting hoax, a set of financial IOUs that the Treasury says it owes the Social Security Administration with no tangible assets of wealth to back up those IOUs.
- For the first time in the history of the Social Security program, and going forward, an average American will pay more into the Social Security process than he or she can expect to get back in benefits, making it one of the worst retirement programs imaginable.
- Medicare is quickly eating up more and more of the country's tax wealth and Obama Care will hasten the fiscal collapse of the program since it plans to arbitrarily reduce future Medicare budgets by over $700 billion, without resolving the underlying causes of our high health care costs as a nation.
- According to Forbes magazine, the total wealth of the 400 wealthiest Americans is just over $2 TRILLION, which means that confiscating the TOTAL wealth of the richest Americans will come nowhere close to significantly reducing the ever rising national debt or Social Security and Medicare shortfalls.
- According to the latest available IRS tax summary data, if the government taxed millionaire earners at 100% of their annual adjusted gross income, i.e. confiscating everything they earned, it would not come close to covering one year's worth of Obama's deficit spending budget.
- Of course, you could only do this confiscation once since no one in the country would ever work hard again if they knew the Federal government was going to confiscate everything they earned.
http://lewrockwell.com/north/north1186.html
The following points from the analysis highlight our dangerous plight:
- Professor Lawrence Kotlikoff of Boston University used data and statistics from the Congressional Budget Office relative to the financials of Social Security, Medicare, and our national debt in his analysis.
- Early this month, Kotlikoff and financial writer Scott Burns published their analysis of the unfunded liabilities of the Federal government.
- According to the figures issued by the Congressional Budget Office and Kotlikoff's analysis, he came to the conclusion that there had been a year over year increase in unfunded Federal liabilities of $11 trillion over the preceding twelve months.
- This is about ten times larger than the "official" Federal deficit in the past year, an official deficit that only measures the short term, annual shortfall of government revenue vs. government spending.
- Kotlikoff estimates the total liability of the Federal government to Americans that is not funded at the present time is now $222 trillion for the next 75 years, the official Medicare timeline for long term planning.
- Again, this is an increase of about $11 trillion in just the past year, according to Kotlikoff's analyses.
- His analysis means that the Federal government would have to set aside $222 trillion today, invest this money in projects that will pay a positive rate of return to cover the financing of this $222 trillion liability debt for the next 75 years.
- Thus, consider this dilemma: the Federal government is currently incurring annual deficits of about $1.2 trillion, it annually spends about $3.7 trillion but it needs to have $222 trillion immediately to invest in private markets to cover Social Security, Medicare, and other government debt.
- The math is not looking good, especially when you throw in the fact that the TOTAL production of wealth every year in the U.S. is only about $15 trillion.
- Consider this other dilemma: our political class was incapable of closing an annual operating deficit of just over a trillion dollars. How in the world can we expect them to close a $222 trillion liability shortfall?
- Another dilemma: If the Federal government actually wanted to set aside $222 trillion today to cover the promises it has made to every American, every American household would have to put up, on average, $1.9 million each. Not going to happen.
- Even if this analysis is off by half, that the unfunded liabilities are only $111 trillion, there is still no way, even with the size of our economy, that this country can fulfill the promises that past politicians have made.
Consider some other factors that will contribute to our doom and gloom scenario:
- According to an article in the May 25, 2012 issue of The Week magazine, even with Obama Care in effect, a married couple on average can expect to pay $240,000 in their retirement years to pay for Medicare premiums, co-pays, deductibles and other health care expenses. This is a 4% increase over the previous year. Thus, it will be difficult to ask American households to cough up $1.9 million each to cover the $222 TRILLION in unfunded liabilities if they have to put up almost a quarter million dollars for their own health care.
- Still do not believe we are in the midst of gloom and doom regarding Social Security? Consider an article in the June 4, 2012 issue of Business Week, "A Massive Program On The Verge Of Collapse." Social Security also has a disability program in addition to its retirement fund. According to the article, the Social Security disability fund will go cash flow negative by 2016, at which time taxes collected will only cover about 79% of the need.
The article clearly points out that both major political parties have done nothing to much acknowledge the problem never mind resolving the issue. The article also points out that the government is so dysfunctional that it has been unable to clear a backlog of over 1 million potential fraud cases.
- A Moneynews article from August 16, 2012 reported on the most recent Treasury Department analysis which showed the following profile of our debt relative to international entities:
- The amount of national debt owned by foreign entities was just over $5 TRILLION, about a 66% increase in just three years.
- The Chinese now hold $1.1643 trillion in U.S. government debt, which is down from $1.3149 trillion in just the past year.
- The Japanese ownership of our national debt is $1.1193 trillion.
So, American households will have their own expenses to cover and cannot be relied on to raise $222 trillion of wealth. Our two biggest foreign bankrollers, China and Japan, will likely turn inward to service their aging populations and not continue funding our spending addiction. Our own wealthy cannot come close to funding these unfunded liabilities even if the Federal government confiscated all of their wealth and all of their earnings.
Our political class and media worry about ill fitting clothes, personal college records, personal income tax returns, and other extremely trivial issues. Real leaders would step forward and level with the America people: "The U.S. Federal government has made promises to you that are impossible to meet. Thus, as a nation, these are the steps that need to be taken, the sacrifices that need to be made to guarantee that those most in need of help get what we can afford to give them while the rest of America will have to do with less."
What are the odds that anyone in the current political class has the courage to stand up and make that statement and back it up with a cogent, fair, logical, and financially sound plan to get us through this dilemma? In my view, the odds of that not happening might actually exceed the size of the national debt these same people have created. Despicable from a leadership perspective.
But there might be a way to get through the gloom and doom. We would recommend starting with four steps from "Love My Country, Loathe My Government:"
- Step 10 would reduce the Social Security tax rate but uncap the maximum amount taxed and apply the tax to all forms of income in order to make the application of the tax fairer across all income levels.
- Step 11 would raise the retirement age to 70, with a hardship exception, to delay payments to Americans who can afford to wait a little while for their Social Security payments.
- Step 12 would block all Americans from receiving a Social Security check if their net worth, not income, exceeded $3 million. People like Trump, Gates, Buffet, etc. can afford to live comfortably without a Social Security check, enabling the system to better serve the truly needy.
- Step 1 would reduce government spending 10% a year for five straight years to finally get us to a balanced budget. You cannot start paying down your debt until you get to a balanced budget. We have discussed many, many ways and analyses that have already been put forth to accomplish this relatively easy task, assuming some courage on behalf of our politicians.
- Implement the National Bounty System as outlined in the following post:
- http://loathemygovernment.blogspot.com/2012/05/national-bounty-system-fixing.html, finally start tracking down and prosecuting the criminal elements that defraud Social Security, Medicare, and Medicaid of over $200 billion every year.
- Repeal Obama Care and start over, putting forth a rational, cost efficient plan that actually looks at the true root causes of our ever escalating health care costs rather than just creating another massive, expensive, and ineffective government bureaucracy like Obama Care.
- Find a way to overhaul Medicare that reduces costs and puts the health care decisions of individuals back into their own hands rather than the hands of unelected bureaucrats. A good starting point for an adult discussion would be with Paul Ryan's plan to overhaul Medicare.
Oh, yes, there is another way to avoid the gloom and doom. Do not get old and do not get sick. Have a nice day!
Please visit our Presidential website, "The United States Of Purple," at:
http://www.unitedstatesofpurple.com/
The United States of Purple is a new grass roots approach to filling the office of President of The United States by focusing on the restoration of freedom in the United States, focusing on problem solving skills and results vs. personal political enrichment, and imposing term limits on all future Federal politicians. No more red states, no more blue states, just one United States Of America under the banner of Purple.
Our book, "Love My Country, Loathe My Government - Fifty First Steps To Restoring Our Freedom And Destroying The American Political Class" is now available at http://www.loathemygovernment.com/. It is also available online at Amazon and Barnes and Noble. Please pass our message of freedom onward. Let your friends and family know about our websites and blogs, ask your library to carry the book, and respect freedom for both yourselves and others everyday.
Please visit the following sites for freedom:
http://www.cato.org/
http://www.robertringer.com/
http://realpolichick.blogspot.com/
http://www.flipcongress2010.com/
http://www.reason.com/
http://www.repealamendment/
Monday, August 27, 2012
Obama Care - Still Constitutional and Still a Disaster: Part 4 - Bifurcating Medical Care and Concierge Medicine
We have spent the past several days reviewing why Obama Care is such a disaster, discussions that we will summarize tomorrow as we wrap up this depressing four part series on the disaster that is Obama Care. The past two days have been my thoughts and analysis based on my reading, research, and understanding of what Obama Care is about to do to just about every American.
However, I am by no means an expert on health care, just an average American who cares about his own family's future health care needs, the health care of friends and other Americans, and the fiscal future of our country and democracy. Today, I will present some work that has been done by an expert in the field of health care, as reported in a recent edition of the Wall Street Journal.
John Goodman is president of the National Center for Policy Analysis and the author of: "Priceless: Curing the Healthcare Crisis" (Independent Institute, 2012). He wrote the following insightful analysis for the August 14, 2012 edition of the Wall Street Journal, "Why The Doctor Can't See You."
If you do not believe what I have been reviewing the past couple of days, take a look at what an expert thinks is going to happen under Obama Care and do two things for you own good:
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August 14, 2012, 7:19 p.m. ET
John C. Goodman: "Why the Doctor Can't See You"
The demand for health care under ObamaCare will increase dramatically. The supply of physicians won't. Get ready for a two-tier system of medical care.
Are you having trouble finding a doctor who will see you? If not, give it another year and a half. A doctor shortage is on its way.
Most provisions of the Obama health law kick in on Jan. 1, 2014. Within the decade after that, an additional 30 million people are expected to acquire health plans—and if the economic studies are correct, they will try to double their use of the health-care system.
Meanwhile, the administration never seems to tire of reminding seniors that they are entitled to a free annual checkup. Its new campaign is focused on women. Thanks to health reform, they are being told, they will have access to free breast and pelvic exams and even free contraceptives. Once ObamaCare fully takes effect, all of us will be entitled to a long list of preventive services—with no deductible or copayment.
Here is the problem: The health-care system can't possibly deliver on the huge increase in demand for primary-care services. The original ObamaCare bill actually had a line item for increased doctor training. But this provision was zeroed out before passage, probably to keep down the cost of health reform. The result will be gridlock.
Take preventive care. ObamaCare says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve? In the American Journal of Public Health (2003), scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary-care physician's time each year, or 7.4 hours per working day.
And all of this time is time spent searching for problems and talking about the search. If the screenings turn up a real problem, there will have to be more testing and more counseling. Bottom line: To meet the promise of free preventive care nationwide, every family doctor in America would have to work full-time delivering it, leaving no time for all the other things they need to do.
When demand exceeds supply in a normal market, the price rises until it reaches a market-clearing level. But in this country, as in other developed nations, Americans do not primarily pay for care with their own money. They pay with time.
How long does it take you on the phone to make an appointment to see a doctor? How many days do you have to wait before she can see you? How long does it take to get to the doctor's office? Once there, how long do you have to wait before being seen? These are all non-price barriers to care, and there is substantial evidence that they are more important in deterring care than the fee the doctor charges, even for low-income patients.
For example, the average wait to see a new family doctor in this country is just under three weeks, according to a 2009 survey by medical consultancy Merritt Hawkins. But in Boston, Mass.—which enacted a law under Gov. Mitt Romney that established near-universal coverage—the wait is about two months.
When people cannot find a primary-care physician who will see them in a reasonable length of time, all too often they go to hospital emergency rooms. Yet a 2007 study of California in the Annals of Emergency Medicine showed that up to 20% of the patients who entered an emergency room left without ever seeing a doctor, because they got tired of waiting. Be prepared for that situation to get worse.
When demand exceeds supply, doctors have a great deal of flexibility about who they see and when they see them. Not surprisingly, they tend to see those patients first who pay the highest fees. A New York Times survey of dermatologists in 2008 for example, found an extensive two-tiered system. For patients in need of services covered by Medicare, the typical wait to see a doctor was two or three weeks, and the appointments were made by answering machine.
However, for Botox and other treatments not covered by Medicare (and for which patients pay the market price out of pocket), appointments to see those same doctors were often available on the same day, and they were made by live receptionists.
As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare's newly created health insurance exchanges.
Their wait will only become longer as more and more Americans turn to concierge medicine for their care. Although the model differs from region to region and doctor to doctor, concierge medicine basically means that patients pay doctors to be their agents, rather than the agents of third-party-payers such as insurance companies or government bureaucracies.
For a fee of roughly $1,500 to $2,000, for example, a Medicare patient can form a new relationship with a doctor. This usually includes same day or next-day appointments. It also usually means that patients can talk with their physicians by telephone and email. The physician helps the patient obtain tests, make appointments with specialists and in other ways negotiate an increasingly bureaucratic health-care system.
Here is the problem. A typical primary-care physician has about 2,500 patients (according to a 2009 study by the Centers for Disease Control and Prevention), but when he opens a concierge practice, he'll typically take about 500 patients with him (according to MDVIP, the largest organization of concierge doctors): That's about all he can handle, given the extra time and attention those patients are going to expect. But the 2,000 patients left behind now must find another physician. So in general, as concierge care grows, the strain on the rest of the system will become greater.
I predict that in the next several years concierge medicine will grow rapidly, and every senior who can afford one will have a concierge doctor. A lot of non-seniors will as well. We will quickly evolve into a two-tiered health-care system, with those who can afford it getting more care and better care.
In the meantime, the most vulnerable populations will have less access to care than they had before ObamaCare became law.
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Don't think this will happen? Consider an August 6, 2012 article from the Washington Post. It discusses the research and analysis of Sandra Decker, an economist with the Center for Disease Control. She went through the 2011 National Ambulatory Medical Care Survey, which asks thousands of doctors whether they would accept new Medicaid patients.
What she found could could reinforce the concept discussed above: 31% of the doctors in the survey said they will not be accepting new Medicaid patients, significantly higher than the percentage who said they will not be accepting new private insurance or Medicare patients.
Ms. Decker found that there is a somewhat strong relationship between doctors' willingness to take on Medicaid patients and the amount of money they get from Medicaid to take on these patients. In other words, doctors that get paid more to handle these types of patients are more likely to see these types of patients. Obvious.
Thus, this marketing rationing is already going on and will likely get worse and devolve into the two tier system described above.
Again, EVERYONE in this country should be able to get reasonably priced and reasonably available health care. Unfortunately, given how poorly Obama Care was thought out and written, this goal is not going to happen as a result of this legislation.
We invite all readers of this blog to visit our new website, "The United States Of Purple," at:
http://www.unitedstatesofpurple.com/
The United States of Purple is a new grass roots approach to filling the office of President of The United States by focusing on the restoration of freedom in the United States, focusing on problem solving skills and results vs. personal political enrichment, and imposing term limits on all future Federal politicians. No more red states, no more blue states, just one United States Of America under the banner of Purple.
The United States Of Purple's website also provides you the formal opportunity to sign a petition to begin the process of implementing a Constitutional amendment to impose fixed term limits on all Federally elected politicians. Only by turning out the existing political class can we have a chance of addressing and finally resolving the major issues of or times.
Our book, "Love My Country, Loathe My Government - Fifty First Steps To Restoring Our Freedom And Destroying The American Political Class" is now available at www.loathemygovernment.com. It is also available online at Amazon and Barnes and Noble. Please pass our message of freedom onward. Let your friends and family know about our websites and blogs, ask your library to carry the book, and respect freedom for both yourselves and others everyday.
Please visit the following sites for freedom:
http://www.cato.org/
http://www.robertringer.com/
http://realpolichick.blogspot.com/
http://www.flipcongress2010.com/
http://www.reason.com/
http://www.repealamendment/
However, I am by no means an expert on health care, just an average American who cares about his own family's future health care needs, the health care of friends and other Americans, and the fiscal future of our country and democracy. Today, I will present some work that has been done by an expert in the field of health care, as reported in a recent edition of the Wall Street Journal.
John Goodman is president of the National Center for Policy Analysis and the author of: "Priceless: Curing the Healthcare Crisis" (Independent Institute, 2012). He wrote the following insightful analysis for the August 14, 2012 edition of the Wall Street Journal, "Why The Doctor Can't See You."
If you do not believe what I have been reviewing the past couple of days, take a look at what an expert thinks is going to happen under Obama Care and do two things for you own good:
- Don't ever get sick.
- Be very, very scared.
*******************************************
August 14, 2012, 7:19 p.m. ET
John C. Goodman: "Why the Doctor Can't See You"
The demand for health care under ObamaCare will increase dramatically. The supply of physicians won't. Get ready for a two-tier system of medical care.
Are you having trouble finding a doctor who will see you? If not, give it another year and a half. A doctor shortage is on its way.
Most provisions of the Obama health law kick in on Jan. 1, 2014. Within the decade after that, an additional 30 million people are expected to acquire health plans—and if the economic studies are correct, they will try to double their use of the health-care system.
Meanwhile, the administration never seems to tire of reminding seniors that they are entitled to a free annual checkup. Its new campaign is focused on women. Thanks to health reform, they are being told, they will have access to free breast and pelvic exams and even free contraceptives. Once ObamaCare fully takes effect, all of us will be entitled to a long list of preventive services—with no deductible or copayment.
Here is the problem: The health-care system can't possibly deliver on the huge increase in demand for primary-care services. The original ObamaCare bill actually had a line item for increased doctor training. But this provision was zeroed out before passage, probably to keep down the cost of health reform. The result will be gridlock.
Take preventive care. ObamaCare says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve? In the American Journal of Public Health (2003), scholars at Duke University calculated that arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary-care physician's time each year, or 7.4 hours per working day.
And all of this time is time spent searching for problems and talking about the search. If the screenings turn up a real problem, there will have to be more testing and more counseling. Bottom line: To meet the promise of free preventive care nationwide, every family doctor in America would have to work full-time delivering it, leaving no time for all the other things they need to do.
When demand exceeds supply in a normal market, the price rises until it reaches a market-clearing level. But in this country, as in other developed nations, Americans do not primarily pay for care with their own money. They pay with time.
How long does it take you on the phone to make an appointment to see a doctor? How many days do you have to wait before she can see you? How long does it take to get to the doctor's office? Once there, how long do you have to wait before being seen? These are all non-price barriers to care, and there is substantial evidence that they are more important in deterring care than the fee the doctor charges, even for low-income patients.
For example, the average wait to see a new family doctor in this country is just under three weeks, according to a 2009 survey by medical consultancy Merritt Hawkins. But in Boston, Mass.—which enacted a law under Gov. Mitt Romney that established near-universal coverage—the wait is about two months.
When people cannot find a primary-care physician who will see them in a reasonable length of time, all too often they go to hospital emergency rooms. Yet a 2007 study of California in the Annals of Emergency Medicine showed that up to 20% of the patients who entered an emergency room left without ever seeing a doctor, because they got tired of waiting. Be prepared for that situation to get worse.
When demand exceeds supply, doctors have a great deal of flexibility about who they see and when they see them. Not surprisingly, they tend to see those patients first who pay the highest fees. A New York Times survey of dermatologists in 2008 for example, found an extensive two-tiered system. For patients in need of services covered by Medicare, the typical wait to see a doctor was two or three weeks, and the appointments were made by answering machine.
However, for Botox and other treatments not covered by Medicare (and for which patients pay the market price out of pocket), appointments to see those same doctors were often available on the same day, and they were made by live receptionists.
As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare's newly created health insurance exchanges.
Their wait will only become longer as more and more Americans turn to concierge medicine for their care. Although the model differs from region to region and doctor to doctor, concierge medicine basically means that patients pay doctors to be their agents, rather than the agents of third-party-payers such as insurance companies or government bureaucracies.
For a fee of roughly $1,500 to $2,000, for example, a Medicare patient can form a new relationship with a doctor. This usually includes same day or next-day appointments. It also usually means that patients can talk with their physicians by telephone and email. The physician helps the patient obtain tests, make appointments with specialists and in other ways negotiate an increasingly bureaucratic health-care system.
Here is the problem. A typical primary-care physician has about 2,500 patients (according to a 2009 study by the Centers for Disease Control and Prevention), but when he opens a concierge practice, he'll typically take about 500 patients with him (according to MDVIP, the largest organization of concierge doctors): That's about all he can handle, given the extra time and attention those patients are going to expect. But the 2,000 patients left behind now must find another physician. So in general, as concierge care grows, the strain on the rest of the system will become greater.
I predict that in the next several years concierge medicine will grow rapidly, and every senior who can afford one will have a concierge doctor. A lot of non-seniors will as well. We will quickly evolve into a two-tiered health-care system, with those who can afford it getting more care and better care.
In the meantime, the most vulnerable populations will have less access to care than they had before ObamaCare became law.
****************************************
Don't think this will happen? Consider an August 6, 2012 article from the Washington Post. It discusses the research and analysis of Sandra Decker, an economist with the Center for Disease Control. She went through the 2011 National Ambulatory Medical Care Survey, which asks thousands of doctors whether they would accept new Medicaid patients.
What she found could could reinforce the concept discussed above: 31% of the doctors in the survey said they will not be accepting new Medicaid patients, significantly higher than the percentage who said they will not be accepting new private insurance or Medicare patients.
Ms. Decker found that there is a somewhat strong relationship between doctors' willingness to take on Medicaid patients and the amount of money they get from Medicaid to take on these patients. In other words, doctors that get paid more to handle these types of patients are more likely to see these types of patients. Obvious.
Thus, this marketing rationing is already going on and will likely get worse and devolve into the two tier system described above.
Again, EVERYONE in this country should be able to get reasonably priced and reasonably available health care. Unfortunately, given how poorly Obama Care was thought out and written, this goal is not going to happen as a result of this legislation.
We invite all readers of this blog to visit our new website, "The United States Of Purple," at:
http://www.unitedstatesofpurple.com/
The United States of Purple is a new grass roots approach to filling the office of President of The United States by focusing on the restoration of freedom in the United States, focusing on problem solving skills and results vs. personal political enrichment, and imposing term limits on all future Federal politicians. No more red states, no more blue states, just one United States Of America under the banner of Purple.
The United States Of Purple's website also provides you the formal opportunity to sign a petition to begin the process of implementing a Constitutional amendment to impose fixed term limits on all Federally elected politicians. Only by turning out the existing political class can we have a chance of addressing and finally resolving the major issues of or times.
Our book, "Love My Country, Loathe My Government - Fifty First Steps To Restoring Our Freedom And Destroying The American Political Class" is now available at www.loathemygovernment.com. It is also available online at Amazon and Barnes and Noble. Please pass our message of freedom onward. Let your friends and family know about our websites and blogs, ask your library to carry the book, and respect freedom for both yourselves and others everyday.
Please visit the following sites for freedom:
http://www.cato.org/
http://www.robertringer.com/
http://realpolichick.blogspot.com/
http://www.flipcongress2010.com/
http://www.reason.com/
http://www.repealamendment/
Friday, August 24, 2012
Obama Care - Still Constitutional and Still A Disaster: Part 3 - Taxes, Taxes and More Taxes
We have spent the past few days reviewing the fact that while Obama Care is Constitutional, it is still a disaster along so many dimensions:
- Obama Care applies a new 2.3% tax on the sales of medical devices. These devices range from MRI and X-ray machines to syringes and stethoscopes to prosthetics, artificial arms and limbs. As with any tax, disposable income is reduced and market demand and economic growth are dampened.
According to research by the Heritage Foundation, layoffs of workers have already occurred at some manufacturers that have anticipated the tax’s impact on their medical devices businesses. Most notably Stryker Corporation of Kalamazoo, Michigan, which has already announced it will lay off about 1,000 workers—about 5 percent of its workforce—because of the tax. Also, picture the fact that many of our brave soldiers who lost limbs in Iraq and Afghanistan will be hit with this tax.
- Obama Care imposes a new Medicare tax increase on those Americans earning over $200,000 a year and applies that increase and the base tax not only to wages but all forms of income. This will also take disposable income out of the marketplace, suppressing economic growth while not solving the base health care cost issue in the country. The danger with this step is that when Obama Care starts to run a deficit, which is it highly likely to do, you can be sure that the $200,000 threshold will be lowered to feed the beast, eventually affecting not just the "rich."
- Although not a government tax, Papa John's Pizza Chairman, John Schnatter, told CBS News on August 8, 2012 that Obama Care will result in Papa John's having to raise the price of its pizzas to cover the costs imposed on it by Obama Care. Now, if you assume that Papa John's is not unique in that it needs to raise prices to cover the cost of Obama Care taxes, we could expect to pay more for our movie tickets, our supermarket forays, our auto purchases, etc. as other industries adjust their prices to their higher Obama Care tax costs.
- If the image of veterans paying more for their prosthetic devices is not bad enough, consider the impact that Obama Care will have on Flexible Spending Accounts (FSAs). FSAs can and have often been used by families with special needs students to help pay the special education costs for those special needs kids. Obama Care imposes cap on FSAs of $2500 vs. the unlimited ceiling that exists today. The imposition of a cap will place severe financial strain on the education costs of these special needs kids regardless of how "rich" their parents are.
These are just a handful of ways that Obama Care taxes will impact many, many Americans' lives. Rich or not so rich, we are all likely to pay more in taxes for a solution that will never work and that is the biggest sin and transgression of all, Obama Care will not work.
An old saying goes as follows: "Just because you can, does not mean you should." Just because Obama Care could get passed and is Constitutional does not mean it should have been passed. The past three days are evidence of the wisdom of this saying.
Which is not to be confused with the recent wise words of another famous American, which pretty much summarizes in a few sentences what took us three days to cover:
Let me get this straight . . .We’re going to be “gifted” with a health care plan we are forced to purchase and fined if we don’t! Which purportedly covers at least ten million more people without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman says he doesn’t understand it, passed by a Congress that didn’t read it but exempted themselves from it, [personal attack phrase removed]with funding administered by a treasury chief who didn’t pay his taxes, for which we’ll be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese , and financed by a country that’s broke!!!!!
‘What the hell could possibly go wrong?’
We invite all readers of this blog to visit our new website, "The United States Of Purple," at:
http://www.unitedstatesofpurple.com/
The United States of Purple is a new grass roots approach to filling the office of President of The United States by focusing on the restoration of freedom in the United States, focusing on problem solving skills and results vs. personal political enrichment, and imposing term limits on all future Federal politicians. No more red states, no more blue states, just one United States Of America under the banner of Purple.
The United States Of Purple's website also provides you the formal opportunity to sign a petition to begin the process of implementing a Constitutional amendment to impose fixed term limits on all Federally elected politicians. Only by turning out the existing political class can we have a chance of addressing and finally resolving the major issues of or times.
Our book, "Love My Country, Loathe My Government - Fifty First Steps To Restoring Our Freedom And Destroying The American Political Class" is now available at www.loathemygovernment.com. It is also available online at Amazon and Barnes and Noble. Please pass our message of freedom onward. Let your friends and family know about our websites and blogs, ask your library to carry the book, and respect freedom for both yourselves and others everyday.
Please visit the following sites for freedom:
http://www.cato.org/
http://www.robertringer.com/
http://realpolichick.blogspot.com/
http://www.flipcongress2010.com/
http://www.reason.com/
http://www.repealamendment/
- It never addressed the real root causes of our escalating high health care costs including America's bad eating habits, bad smoking habits, bad exercise habits and how government actions and subsidy programs encourage these bad habits.
- It never addressed the aging of America nor the costs and increases in aging diseases that are likely to occur.
- It never addressed the issue of medical tort reform, an avenue that has been highly successful at the state level.
- It never broke down the barriers of insurance company competition across state lines that would increase competition and decrease costs.
- It never "followed the money" to find out and understand where all of these escalating health care costs go and what parties benefit and profit from these increased costs.
- It never anticipated the obvious fact that companies would turn full time employees into part time employees because these companies could not afford the increased Obama Care costs that would be imposed on them.
- It never anticipated that companies would terminate their employee and retiree health care plans because it would be cheaper not to offer them and pay a small fine under Obama Care than to continue with them in place.
- It never anticipated or planned for the fact that the country would become critically short of doctors once more people had access to health care insurance.
- It never understood that robbing Medicare of hundreds of billions of dollars to pay Obama Care's costs would endanger existing health care support and services for existing and future elderly Americans and yet not solve the escalating health care cost problem in this country, it only moves the cost problem around within the Federal bureaucracy.
- It never understood that by not solving the underlying root causes, hundreds of billions of dollars will be added to the national debt.
- It never understood that the penalty for not obeying the Obama Care mandate to purchase insurance was mostly an unenforceable infraction, rendering the individual mandate mostly toothless from an enforcement perspective.
- It never understood that today the IRS is failing miserably to collect the taxes owed to the Federal government today and will likely be unable to effectively collect and enforce the additional 47 taxation tenets introduced under Obama Care.
- It never understood that the half a billion dollars Obama is giving to the IRS to collect the enforcement mandate under Obama Care would be far better spent tracking down and prosecuting the criminal elements that bilk Medicare and Medicaid out of over $100 billion a year.
- Obama Care applies a new 2.3% tax on the sales of medical devices. These devices range from MRI and X-ray machines to syringes and stethoscopes to prosthetics, artificial arms and limbs. As with any tax, disposable income is reduced and market demand and economic growth are dampened.
According to research by the Heritage Foundation, layoffs of workers have already occurred at some manufacturers that have anticipated the tax’s impact on their medical devices businesses. Most notably Stryker Corporation of Kalamazoo, Michigan, which has already announced it will lay off about 1,000 workers—about 5 percent of its workforce—because of the tax. Also, picture the fact that many of our brave soldiers who lost limbs in Iraq and Afghanistan will be hit with this tax.
- Obama Care imposes a new Medicare tax increase on those Americans earning over $200,000 a year and applies that increase and the base tax not only to wages but all forms of income. This will also take disposable income out of the marketplace, suppressing economic growth while not solving the base health care cost issue in the country. The danger with this step is that when Obama Care starts to run a deficit, which is it highly likely to do, you can be sure that the $200,000 threshold will be lowered to feed the beast, eventually affecting not just the "rich."
- Although not a government tax, Papa John's Pizza Chairman, John Schnatter, told CBS News on August 8, 2012 that Obama Care will result in Papa John's having to raise the price of its pizzas to cover the costs imposed on it by Obama Care. Now, if you assume that Papa John's is not unique in that it needs to raise prices to cover the cost of Obama Care taxes, we could expect to pay more for our movie tickets, our supermarket forays, our auto purchases, etc. as other industries adjust their prices to their higher Obama Care tax costs.
- If the image of veterans paying more for their prosthetic devices is not bad enough, consider the impact that Obama Care will have on Flexible Spending Accounts (FSAs). FSAs can and have often been used by families with special needs students to help pay the special education costs for those special needs kids. Obama Care imposes cap on FSAs of $2500 vs. the unlimited ceiling that exists today. The imposition of a cap will place severe financial strain on the education costs of these special needs kids regardless of how "rich" their parents are.
These are just a handful of ways that Obama Care taxes will impact many, many Americans' lives. Rich or not so rich, we are all likely to pay more in taxes for a solution that will never work and that is the biggest sin and transgression of all, Obama Care will not work.
An old saying goes as follows: "Just because you can, does not mean you should." Just because Obama Care could get passed and is Constitutional does not mean it should have been passed. The past three days are evidence of the wisdom of this saying.
Which is not to be confused with the recent wise words of another famous American, which pretty much summarizes in a few sentences what took us three days to cover:
Let me get this straight . . .We’re going to be “gifted” with a health care plan we are forced to purchase and fined if we don’t! Which purportedly covers at least ten million more people without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman says he doesn’t understand it, passed by a Congress that didn’t read it but exempted themselves from it, [personal attack phrase removed]with funding administered by a treasury chief who didn’t pay his taxes, for which we’ll be taxed for four years before any benefits take effect, by a government which has already bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese , and financed by a country that’s broke!!!!!
‘What the hell could possibly go wrong?’
We invite all readers of this blog to visit our new website, "The United States Of Purple," at:
http://www.unitedstatesofpurple.com/
The United States of Purple is a new grass roots approach to filling the office of President of The United States by focusing on the restoration of freedom in the United States, focusing on problem solving skills and results vs. personal political enrichment, and imposing term limits on all future Federal politicians. No more red states, no more blue states, just one United States Of America under the banner of Purple.
The United States Of Purple's website also provides you the formal opportunity to sign a petition to begin the process of implementing a Constitutional amendment to impose fixed term limits on all Federally elected politicians. Only by turning out the existing political class can we have a chance of addressing and finally resolving the major issues of or times.
Our book, "Love My Country, Loathe My Government - Fifty First Steps To Restoring Our Freedom And Destroying The American Political Class" is now available at www.loathemygovernment.com. It is also available online at Amazon and Barnes and Noble. Please pass our message of freedom onward. Let your friends and family know about our websites and blogs, ask your library to carry the book, and respect freedom for both yourselves and others everyday.
Please visit the following sites for freedom:
http://www.cato.org/
http://www.robertringer.com/
http://realpolichick.blogspot.com/
http://www.flipcongress2010.com/
http://www.reason.com/
http://www.repealamendment/
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