Rational Market Theory and Black Swans in Healthcare Reform

Whether you are a believer in the rational market theory or black swans, you could see that even former SEC Chairman Christopher Cox would have cause to blush at the healthcare marketplace. Cox was the champion non-interferer in charge of enforcing a level playing field for investors large and small.

So the question is can our current healthcare marketplace be modeled by rational market theory, black swans, or neither? Rational market theory is based on current security prices reflecting all available information. Perhaps the only more opaque marketplace than healthcare is derivatives. I’d call it a tie.

Patients cannot even get committed pricing from doctors and hospitals, let alone be on an equal footing to negotiate. Marcus Welby, M.D. television fans looking for a sympathetic doctor are stuck in the 1970s with their heads in the sand.

Those black swans, uninsurable patients, are left to go bankrupt or die. Private insurers have removed black swans from their membership. When they appear those member’s policies are rescinded. The only black swans that remain are either on Medicare, Medicaid, or employed by large self-insured companies and governmental entities.

So before any intelligent discourse can begin, opponents of healthcare reform must admit that a level playing field in the SEC sense cannot be developed unless every citizen is insured or no citizen is insured. And all must be insured at roughly the same level. You cannot have a cash market and an insured market at the same time. This has been the failure of Republican instituted high deductible insurance policies.

When conservatives argue that the private insurers cannot compete with the government, they should also argue that a cash market cannot compete with the private insurers. Cash buyers pay typically two to ten times the private insurer and government reimbursement rates. This alone is proof of my all or no one theorem. Individuals must pay ridiculously high premiums, with up to $5000 deductibles just to pay hospitals insurer negotiated rates. Even Cox would call this extortion.

I felt compelled to write this article after carefully reading Merck (MRK) and Schering-Plough’s (SGP) advertisement in my Sunday newspaper. The soon to be merged companies state in bold type: “Vytorin has not been shown to reduce heart attacks or strokes more than Zocor alone.” Zocor is already available as a generic, so you would have to be brain dead to believe that any participant in a rational free market would select Vytorin without adverse financial incentives to doctors and patients. And that’s without even considering the potential adverse effects of Vytorin.

As the rhetoric is getting hotter, I would like the opposition to either come to the table with rational cash market regulation or stop fighting minimum standards for the entire citizenry to be insured. The courts have been of little help in protecting patients against extorted prices. “Financial responsibility” contracts signed in the emergency room should certainly be viewed as “beyond the conscience” of the courts. Lawyers, please help me understand.

While Sarah Palin sings to the choir, other flamboyant orators will soon face burnout. Let Whole Foods CEO John Mackey tell me how all citizens can buy into his company’s health insurance to create a level playing field. Let FOX News tell me how to create a rational cash market.

Glenn Beck lectured before three cardboard cutouts Saturday night on how debasing our currency will lead to a fascist takeover of America similar to Germany in the 1930s. The implication being that President Obama is the new Hitler and healthcare reform is the mechanism for the revolt. Government will deny care to babies and grandmas that have little economic value to save money as the country is drowning in debt. And the green movement will kill the unborn to save the planet from overpopulation.

Not only is FOX News losing sponsors for Beck’s show, it also appears that top tier guests are refusing to participate. The Saturday show was loaded with public service announcements and promos for other FOX shows. I saw only one paid commercial per break. I am also seeing FOX News anchors only interviewing each other throughout the day on other shows.

Paid sponsors do matter. Sponsors temporarily removed syndicated radio celebrity Don Imus from the air for a racial snafu. And the lack of paying advertisers and real customers led to the end of the dot-com bubble. Eyeballs alone won’t save Glenn Beck.

The healthcare opponent rabble rousers already have sugar daddies. But what they share in common with Beck is the need to constantly raise the bar of outrageous commentary and behavior to keep the public’s interest. Sensationalism is like a drug to an addict; over time an ever increasing dose is required to keep the effect. Then the addict dies from overdose.

Finally, I am perplexed as to why President Obama is being blamed for debasing the currency and not Federal Reserve Chairman Bernanke. It is Bernanke who is actually monetizing the country’s debt, not the President. You see, this is not a battle about healthcare – it is an attempt to destroy the President. In this context no rational discussion of the marketplace can proceed.

While the opposition protesters appear far less sincere than the civil rights and antiwar movements of the past, I have never seen a President so dedicated to accomplishing his goals as Obama. This President is the most aggressive that I’ve seen in my lifetime. That is what really scares the opposition.

No disclosures.

Comments

[svosavvy:]

sdt993- To compare medicaid, medicare, and the va to private insurance is a farce. For one thing you only go on medicaid if you are "poor" you only go on medicare if you are "old" and the VA if you have been there lately you would see broken people who fought your wars for you...

Private insurance has a pool of people who need care and healthy but still pay because they might. A good cross section much like any other kind of insurance. The crucial difference is the gov't agencies are full of people who need care. It's probably not just a little because private agencies shovel sick people out of their roles much like the shoveling of sh*t out of a dirty cowbarn. Maybe if the gov't agencies had a few healthy people under their wing paying a premium we could go back to normal vis a vis pre 1990 healthcare. What we have now is hell-thcare. I don't care if it is a public or private option, affordable healthcare is a mirage in this country.

The proof is in the pudding look at the bottom line of cigna, aetna, unh. How come we get pissed when we are robbed blind at the gas pump, but, not at the hospital. Why, I say it is psychology, it is hard to get mad when someone is providing care for you no matter that it is bankrupting you.

Combo drugs are a briliant ploy to combat the onslaught of generics. You can have 2 generics that are commonly available, but, if you combine them you have a patent drug. So, instead of prescribing both generics, you can have a drug rep go to the doctor and sign him up for a "conference" in some nice location where the doc can get a bj and play 18 holes, and "learn" about this new wonder drug. Then we can put that bad boy on tv and get people to want it like cereal commercials on saturday morning tv. Because you don't know any better you "ask your doctor". Your doctor doesn't care for obvious reasons and bingo lets make a deal. It used to be illegal to advertise prescription drugs on tv until there was a gaping hole left by the outlawing of cigarettes on tv.

Aug 18 11:10 AM

[Buckoux:]

Amen, brother. Amen.


On Aug 17 10:15 AM Emerald wrote:

> As a self insured investor, I can tell you that the private market
> for health insurance is outrageously expensive and the author is
> correct.
>
> How about a true competitive market that is not controlled by lobbyists
> for Big Pharma and the insurers? People are screaming for capitalism.
> Me too. Oligopolies are not a fair and competitive market. As an
> investor, As a citizen, I don't like being exploited.

Aug 18 11:14 AM

[Duude:]

While you make some good points about the much higher expense of the cash market versus private insurance, the reform that Obama has supported thus far is no fix at all. The administration and Congress has pushed Medicare as an example of fiscal austerity. While medical expenses have continued to rise with Medicare, it has grown much more slowly than with either private healthcare plans or the cash market. Simply government dictates prices paid for any specific procedure under both Medicare and Medicaid. Hospitals have the option of not serving these patients but under emergency situations if they so desire. In fact, they have done exactly this with Medicaid. Medicare paying more than Medicaid is the difference. But hospitals often complain of losing money with Medicare. They make it up by pushing costs onto both private health insurance and the cash market. The government option would be enacted just like Medicare. As government dictates prices paid, more and more expense will fall upon private health insurance and the cash market. The government can also easily subsidize the government option to the point of eliminating all competition. This is the whole point of the government option. Its very anti-competitive. Employers will most certainly drop private health insurance for the cheaper government option. Eventually, hospitals will have nowhere to pass on costs. That's when lines get long and rationing begins.

Aug 18 11:14 AM

[Buckoux:]

"Life isn't fair but that is no reason to take away peoples liberty and freedom."

No it's not, but that's not a reason to allow insurance companies, and the politicians in their pockets, to take your market choices away. And that is what they do. Obscene health insurance premiums are not the result of a free and open market, but the tampering by government and business interests that are contrary to a free country, individual liberty and free market choices. The US has had a form of socialized medicine since 1947 and it's not working.

Aug 18 11:25 AM

[Buckoux:]

Advertising drugs on TV is like shouting "Fire!" in a theater.
But then, considering the expert morons that we voters send to Wash DC and our states capitals and our courts, what do we expect? They advertise on TV too. Man, we've got lots'a problems, and I've got a headache!


On Aug 18 11:10 AM svosavvy wrote:

> "It used to be illegal to advertise prescription drugs on tv until there was a > gaping hole left by the outlawing of cigarettes on tv...."

Aug 18 11:36 AM

[BRUCE E. W.:]

insurance ideally is intended to distribute the risk and cost of an otherwise catastophic event; and in absorbing the cost/loss ratio it improves efficiency overall. When medical/cost ratio was added to the insurance formula, it was not just "black swan" exclusion but all medical cost revenue that was targeted. The problem is compounded in that the capital pool artificially created by the collective strategy of distribution becomes a feeding frenzy in a market that is redefined around profits instead of medical necessity itself. Perverse incentives drive the private insurance industry to diversify into financial investment strategies (of which they have a disasterous recorded history; raising premiums to cover bad decisions in the long run). Ultimately, the insurance process targets the distribution of risk and cost in financing the profit sector as its primary goal (claiming they owe their stockholders their primary loyalty; a truism that is too self servicing). In the end we have instruments like credit default swaps and derivatives as such to meet the diversified needs of the industry in a competitive financial environment that is otherworldly hostile. Financialization and meical neccessity are opposite spectrum animals in this real world. Profit making on desparation is a whole different story, but we should not forget that the original intensions were not profiteering in grossly controled markets where you never meet your victims. Rationalizations are ripe, but there is no rational choice here except in directions that are totally contradictory. Perhaps cherry picking might have suited your critical readers better, but your discernments are crisp and clear. Nice job; please follow your impulses to express the realities that confront us more frequently. BW

Aug 18 11:38 AM

[BRUCE E. W.:]

www.alternet.org/blogs.../

WORTH VIEWING:

JAMA, August 13, 2003- Vol 290 No. 6:pp798-805
Physicians%20ProposalJ...

Aug 18 11:58 AM

[BRUCE E. W.:]

JUST ONE MORE CRITICAL POINT. RATIONAL CHOICE THEORY (for what it is worth) ONLY WORKS WHEN YOU ARE USING YOUR OWN MONEY. INSURANCE USES OTHER PEOPLES MONEY, AND WE ALL KNOW WHERE THAT PRIMROSE PATH WILL LEAD.

Aug 18 12:02 PM

[sorsorday:]

Black swan has a lot of properties, but the important one is that it's an unlikely event. Another important one is that the event happens is independent of its possibility to happen again, so the author used stock traders as an example. However, a patient who has existing condition is likely to get sick and needs more medical expense in the future, this is not a black swan. Insurance is not a medical coverage right for people, it's a deal between the insurance company and the individuals. Individuals get protected from an unexpected event while the insurance company get the premiums by taking the risk. This is a fair deal. When an individual has existing condition like cancer, there will be tremendous medical expense ahead. Insurance company would be insane to enter a deal with that individual because it's a 100% loser game. Government insurance means forcing the government, thus the tax payers to enter a loser game.


On Aug 17 01:09 PM Michael Steinberg wrote:

> Black swan is appropriate because the insurer does not know which
> specific policy holder will turn bad, just like a bank does not which
> specific or how many borrowers will be affected by an outlier event.
> The difference is that despite actuarial and underwriting work in
> both scenarios, only health insurers can rescind policies; banks
> can only foreclose. In essence, private health insurers can pick
> off their black swans one by one. They are removing risk after the
> fact.
>
> The uninsurable should be given credit for credible coverage by the
> insurance system as a whole. While not black swans at the time they
> become uninsurable, they were for the most part black swans at birth.

Aug 18 01:32 PM

[sdt993:]

I agree that we have some degree of socialized medicine - ie Medicare/Medicaid etc... and that portion of the market underpays for services thus driving up the cost to everyone else. When you say "obscene" health insurance premiums, you are merely repeating the mantra of the politicians who seek to create enemies for political purposes. You are their ideal target as you clearly buy it. Pretax margins for the large health insurers have generally ranged between 3% and 11% over the past 10 years. This is hardly profiteering. Health insurance is expensive because healthcare is expensive. Training good doctors is expensive. Inventing new drugs is exceedingly expensive. Clearly, some drugs are me-too and add little value. But, your much despised health insurance company is well aware of that and puts in place formularies and incentives NOT to use me-too drugs. Then of course, you complain when they limit your choice. You can't have unlimited choice, high quality, and low cost. Something has to give. The system that you claim is "not working" has an approval level exceeding 80% in this country! Obama, Pelosi, and Reid combined can't say that.


On Aug 18 11:25 AM Buckoux wrote:

> "Life isn't fair but that is no reason to take away peoples liberty
> and freedom."
>
> No it's not, but that's not a reason to allow insurance companies,
> and the politicians in their pockets, to take your market choices
> away. And that is what they do. Obscene health insurance premiums
> are not the result of a free and open market, but the tampering by
> government and business interests that are contrary to a free country,
> individual liberty and free market choices. The US has had a form
> of socialized medicine since 1947 and it's not working.

Aug 18 01:52 PM

[Wisdom vs. ...:]

europe and japan subsidize health care "for business" and what is the state of small business and middle class income there? theoretical arguements are interesting ONLY if they have not already been proven to be INCORRECT. not even arguable! when costs and regulation increase, fewer people risk their assets to create new capital, period, end of story. if you are too much of a wuss to open your own biz b/c you want health care do not cry to the politicians, admit your weakness and keep working for the evil empire-- while small business owners like me fight the idiotic politicians you have ALREADY elected. you crybabies perceive a televised, comfortable reality you have been sold which does not exist.

europe and japan spend more for each health care service because government spending inherently destroys capital as a result of administrative inefficiency: they spend less money total because they offer fewer services, get that through your thick, silly heads. if you fail to perceive reality you will continue to be manipulated by the federalists and corporate overlords who claim to help you

Aug 18 02:09 PM

[milkchaser:]

I think we are in agreement about making it illegal to rescind a policy -- after a certain standstill or probationary period during which time the accuracy of the application is reviewed. This, of course, does not require the creation of a gov't insurer.


On Aug 18 10:17 AM YoYoMama wrote:

> The "standstill" period already exists. It's called a probationary
> period, and it lasts about 3 months after the policy is in place.
>
>
> The problem is not that the insurance companies are not aware of
> pre-existing conditions. It's that it is perfectly legal to be arbitrary
> and even invent reasons for the insurance company to rescind a policy.
> It is well known that many insurers will instigate investigations
> only AFTER a an illness or accident.
>
> The only way to fix the problem is to make rescinding policies illegal.
> Period.
>

Aug 18 02:29 PM

[milkchaser:]

It is not clear to me how we are being used by allying ourselves with FreedomWorks to oppose Obamacare. FreedomWorks did not charter the bus we are taking this Saturday to Orlando, and each of the riders will pay his way ($17 each).

It is not clear to me that AT&T and Verizon have a stake in the health care fight, nor is it clear to me that they would oppose it. They ally with FreedomWorks over a different issue (net neutrality) which is irrelevant.

Non-profit groups must raise money. AARP gets a lot of money via insurance sales, as did FreedomWorks at one time to a far lesser extent. The money FreedomWorks gained from such insurance sales (for HSA accounts, as a matter of fact) averaged $120K out of an annual $7 million budget. Every little bit helps, but FreedomWorks is largely funded by individual contributions, something that the Wikipedia article failed to mention.

The typical Obamacare protester does not know or care who is helping us organize. They are drawn by the issue.


On Aug 18 10:40 AM Bob 123 wrote:

> I believe you that you are not being paid. You are being used.<br/>Do
> you really know the "FreedomWorks" group and who controls it? <br/>Self-funded
> my ass. You are a tool being fooled into working against your own
> interest. For nothing.
>
> From Wikipedia:
> FreedomWorks has received funding from Verizon and SBC (now AT&amp;T).
> [6]Other FreedomWorks funders have included MetLife, Philip Morris
> and foundations controlled by the archconservative Scaife family,
> according to tax filings and other records. [7] It also receives
> funding through the sale of insurance policies through which policyholders
> automatically become FreedomWorks' members. [8] FreedomWorks is closely
> tied to its founder, corporate lobbyist and former Republican Congressman
> Dick Armey, whose former lobbying firm DLA Piper that he resigned
> in August 2009, represents Bristol Myers Squibb, among other pharmaceutical
> companies.

Aug 18 03:14 PM

[BRUCE E. W.:]

www.prwatch.org/node/8482
80% is a figure thrown around by insurance PR data. It actually comes from their own demographics. What it represents is that as an epidemiological consideration, 80% of the population is healthy and do not require serious medical attention and therefore do not incur any catastrophic consequences either physical or financial. What is also noted in financial evaluations is that out of the other 20% only 2% of the gross demographic will actually take on a significant cost /care projection out of the norm. A surprising majority of the 80% meanwhile go without insurance because they can't afford it. Of the rest of those 80% used to demonstrate satisfaction are the people who are fundamentally problem free. Of course they love the system. As far as Government intervention goes, you do not hear the insurance companies complaining about mandatory health care paycheck withdrawals from businesses that are large enough to handle the cost load. Many of the people who "love" the system have it as entitlements from their occupations. They believe they have choices because people like you keep repeating that misinformation. When all these stats are provided they are not calibrated to reflect authentic proportions of reality. Worse case scenarios are used as models when in reality simple procedures are obstructed routinely to effect the cost/medical ration
(opps,... did I say RATION...of course I meant Ratio). "Obscene profit does exist especially at administrative levels and anyone who works in the medical sector knows that the process has become a tax on Physicians and patients alike. You would do well to look at some real figures and seek out some real victims. Your reductive attitude seems to imply that greed is good and is therefore justifiably rewarded while victims are troublemakers who simply are the downside of the market balance. What a perverse distortion of American Capitalism. Here's some information on truth, Justice and the American Way:

www.prwatch.org/node/8482

seekingalpha.com/artic... (
.(MAIN PAGE GOOGLE) search.aol.com/aol/sea...

(THIS IS THE 2003 "PROPOSAL" PRINTED IN JAMA)
jama.ama-assn.org/cgi/...
PROPOSAL OF THE PHYSICIANS WORKING GROUP FOR SINGLE PAYER NATIONAL HEALTH INSURANCE. JAMA, AUGUST 13, 2003-VOL. 290, NO. 6: PP.798-805

DO YOUR HOMEWORK SON.


On Aug 18 01:52 PM sdt993 wrote:

> I agree that we have some degree of socialized medicine - ie Medicare/Medicaid
> etc... and that portion of the market underpays for services thus
> driving up the cost to everyone else. When you say "obscene" health
> insurance premiums, you are merely repeating the mantra of the politicians
> who seek to create enemies for political purposes. You are their
> ideal target as you clearly buy it. Pretax margins for the large
> health insurers have generally ranged between 3% and 11% over the
> past 10 years. This is hardly profiteering. Health insurance is expensive
> because healthcare is expensive. Training good doctors is expensive.
> Inventing new drugs is exceedingly expensive. Clearly, some drugs
> are me-too and add little value. But, your much despised health insurance
> company is well aware of that and puts in place formularies and incentives
> NOT to use me-too drugs. Then of course, you complain when they limit
> your choice. You can't have unlimited choice, high quality, and low
> cost. Something has to give. The system that you claim is "not working"
> has an approval level exceeding 80% in this country! Obama, Pelosi,
> and Reid combined can't say that.

Aug 18 03:59 PM

[sdt993:]

Uh, Brucie boy, I'm not your son, so don't you dare talk down to me like that. Second, i will virtually guarantee you I've done 10X the homework you have as I am a professional money manager following the healthcare industry. This is my gig 24/7/365. Third, your writing is nearly incomprehensible and the following quote demonstrates your math is on the level with my 4 year old son:

"A surprising majority of the 80% meanwhile go without insurance because they can't afford it. Of the rest of those 80% used to demonstrate satisfaction are the people who are fundamentally problem free."

What?? A majority of the 80% go without insurance? So of the 80% i said were satisfied you are saying at least 41% dont have insurance. How can you be satisfied with your insurance if you dont have it? You are a complete fool.

Here is an independent source:

www.rasmussenreports.c...

This particular poll says 70% rate their coverage as good or excellent. There are other INDEPENDENT polls that put it north of 80%.

The single payer drivel you cite clearly reflects where you are coming from. There are plenty of countries with single payer. I suggest you move to one of them or at least run across the border to get your care when you become ill. Let me know how that works out for you.


On Aug 18 03:59 PM BRUCE E. W. wrote:

> www.prwatch.org/node/8482
> 80% is a figure thrown around by insurance PR data. It actually comes
> from their own demographics. What it represents is that as an epidemiological
> consideration, 80% of the population is healthy and do not require
> serious medical attention and therefore do not incur any catastrophic
> consequences either physical or financial. What is also noted in
> financial evaluations is that out of the other 20% only 2% of the
> gross demographic will actually take on a significant cost /care
> projection out of the norm. A surprising majority of the 80% meanwhile
> go without insurance because they can't afford it. Of the rest of
> those 80% used to demonstrate satisfaction are the people who are
> fundamentally problem free. Of course they love the system. As far
> as Government intervention goes, you do not hear the insurance companies
> complaining about mandatory health care paycheck withdrawals from
> businesses that are large enough to handle the cost load. Many of
> the people who "love" the system have it as entitlements from their
> occupations. They believe they have choices because people like you
> keep repeating that misinformation. When all these stats are provided
> they are not calibrated to reflect authentic proportions of reality.
> Worse case scenarios are used as models when in reality simple procedures
> are obstructed routinely to effect the cost/medical ration
> (opps,... did I say RATION...of course I meant Ratio). "Obscene profit
> does exist especially at administrative levels and anyone who works
> in the medical sector knows that the process has become a tax on
> Physicians and patients alike. You would do well to look at some
> real figures and seek out some real victims. Your reductive attitude
> seems to imply that greed is good and is therefore justifiably rewarded
> while victims are troublemakers who simply are the downside of the
> market balance. What a perverse distortion of American Capitalism.
> Here's some information on truth, Justice and the American Way:
>
>
> www.prwatch.org/node/8482
>
> seekingalpha.com/artic...
> (
> .(MAIN PAGE GOOGLE) search.aol.com/aol/sea...;s_it=keyword_rollover
>
>
> (THIS IS THE 2003 "PROPOSAL" PRINTED IN JAMA)
> jama.ama-assn.org/cgi/...
> PROPOSAL OF THE PHYSICIANS WORKING GROUP FOR SINGLE PAYER NATIONAL
> HEALTH INSURANCE. JAMA, AUGUST 13, 2003-VOL. 290, NO. 6: PP.798-805
>
>
> DO YOUR HOMEWORK SON.

Aug 18 05:01 PM

[Confederacy...:]

This article makes some valid points about the lack of coverage for patients with serious preexisting medical conditions, but it also demonstrates a bias in favor of universal payor healthcare and a primitive understanding of market forces in healthcare.

The distortions in the healthcare marketplace are almost all traceable to government intervention: Medicare acting as a proxy pricing mechanism for insurance companies, lobbyists from the American Hospital Association, Big Pharma, the AMA, the insurance industry, and the parasite trial lawyers, getting special dispensation to avoid transparency, real competition, portability, price controls, elimination of competition (Specialty Hospitals owned by physicians for example), and the default scenario in malpractice torts, which any rational analysis by any standard other than a lottery operator is a disaster.

Plus there is the de rigeur liberal diatribe against Fox News. If Fox News is so lame, why do you all spend so much time fighting it? Nobody beats a dead horse. You have some sort of fetish obsession with anybody who disagrees with your pie - in -the -sky, girl scout cookie sale approach to social problems?

As a practicing surgeon, it's dismaying to me to see the arrogance of policy wonks who who jack-diddly about healthcare explaining a very complicated scenario in a simplistic, inaccurate way. Unfortunately the AMA is useless and there is at the moment no viable alternative representing the opinions of physicians in the media. But my feelings are similar to those about the Pope and birth control: You don't play the game. You don't make the rules.

Aug 18 05:15 PM

[alaskaeagle:]

This comment nailed it also. It is another entitlement. S.S. and Medicare are entitlements. The government always screws with entitlements to make them more costly and then they run out of money. S.S. would have worked if they did not add so many things to it. They, then, used the S.S. money that should have been invested to make money for the budget short falls.


On Aug 18 10:07 AM gu econ wrote:

> Ebworthen nailed it: patients are not directly responsible for managing
> and paying for their own health care. To correct, third parties
> (gov't, employer, insurance company, HMO) get involved to act as
> a governor to control costs, which otherwise the go totally out of
> control.
>
> Correcting would require some unpopular changes, starting with things
> like taxing employer provided healthcare and getting rid of Medicare.
> These are just subsidies that throw fantastic amounts of money into
> the system. A better system would be high deductible HSAs with catastrophic
> insurance on top, probably with some rules prohibiting coverage denials
> for pre-existing conditions (that aspect of healthcare would become
> socialized). What Whole Foods CEO Mackay has proposed is worth considering.
>
>
> No one really likes the current system, but Congress has shown itself
> to be utterly incapable of controlling the growth of middle class
> entitlement programs. All they do is pile on more benefits, a la
> the Medicare drug benefit. Social Security will run out of money
> in 2037 and Medicare will be out of money in 2017 (latest Administration
> projections). Who wants to saddle our children with another crushing
> entitlement progam?
>
> Does anybody really believe the U.S. government is up to this task?
> Is this the same US gov't that was going to protect us from Bernie
> Madoff? Please!

Aug 18 06:07 PM

[milkchaser:]

I take the author's point that those who pay cash for health care are at an unfair disadvantage, as are those who cannot afford health care insurance, but are not poor enough to qualify for Medicaid. I feel for those whose policies were rescinded when they most needed it, or who otherwise lost coverage and cannot now regain it due to a pre-existing condition.

But where is the evidence that a gov't program would best solve this? Why the utlimatum that if all of these problems are not immediately solved, we must accede to a plan designed and run by people with a poor track record with such things. In the light of incompletely funded gov't programs such as Social Security, Medicare and Medicaid, it seems irrational to expand gov't responsibility even further.

When we feel compassion for those in need, why do some people think that there ought to be a governmental fix? What I want to ask these people is just how much they contributed to The Shriners last year? Do they leave their change for the Ronald McDonald house or pocket it? How many dimes did they send to the March of Dimes?

As we know from the aftermath of 9/11, Katrina and the 2004 tsunami, when the need is there, Americans are very generous.

Aug 18 07:16 PM

[sethmcs:]

Medical care provided by hospitals is practically a monopoly in most communities and should be regulated as such. No patient should be charged more than another patient for simular service and caps should be placed on mark-ups of supplys and medicines. I was looking at a bill received by a co-worker's father for neck surgery. $149,000 of which $100,000 was for supplies! And that did not even include the doctors bill! Society has to realize that a sick person is in no position to negotate a fair price for health care in an emergency situtation therefore rates should be set by a regulator like utilities or railroads.

Aug 19 01:34 AM

[kaisersoze:]

Compare the increase in wages over the last 5 years to the increase in health insurance premiums.

Try finding a doctor that accepts the insurance you carry.

Try finding a doctor that accepts your insurance that is accepting new patients.

Something has to be done....

Aug 19 06:27 AM