evan37

evan37
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  • Diversify With Silver As Set To 'Increase 400% In 3 Years'  [View article]
    I believe PMs will gradually increase in value until faith in the big reserve currencies starts to drop off (Yen, Euro, USD), then they will explode in value.

    With a negative money multiplier, QE serves to keep banks' reserves flush without causing much inflation. In Japan this phenomonen can be seen as the BOJ has pumped almost 200T Yen into the banks over the past 4 years with persistently low yields on bonds and low inflation.

    QE tends to cause malinvestment so I doubt we'll see the money multiplier go very positive in the near future. My bet is on investors and banks suddenly and unexpectantly "running" from currency dominated debt causing hyperinflation. When this occurs is difficult to say, maybe 2014 or 2015, depending on how long Japan and the EZ can stay glued together.
    Nov 14, 2012. 12:10 PM | Likes Like |Link to Comment
  • Socialism And Debasement Of Currency  [View article]
    effort doesn't matter, opportunity cost matters. In a market system supply/demand dictates the value of a good or service. Production is only positive for an economy if it meets a demand. It's not really fair, but that's how the world and free markets work.

    Karl Marx based his writings on the labor theory of value, he was wrong.
    Nov 14, 2012. 11:37 AM | Likes Like |Link to Comment
  • Dysfunctional Euro Finance Ministers Send Currency Traders To Seek Safe Havens  [View article]
    "...the low rates in Japan, and BOJ assurance they will remain low, make the yen attractive as a funding currency."

    The Japanese now have a budget deficit, coupled with desaving and a demographic problem. Their debt will surely accelerate upwards. The BOJ will surely be the major buyer of their debt going forward. How long can the BOJ keep yields low? Can a sovereign currency last in a country with debt:GDP > 300%, 400%, 500%???
    Nov 13, 2012. 06:02 PM | Likes Like |Link to Comment
  • European Ponzi Is Perpetuated: Greece Sells Bills, German Sentiment Dips  [View article]
    And we've guaranteed dollar liquidity through central bank swaps through Feb 2013. So, we're all in this together now!
    Nov 13, 2012. 05:49 PM | 2 Likes Like |Link to Comment
  • Effects Of Obamacare On Employment  [View article]
    springfiledlp,
    sadly, I agree
    Nov 13, 2012. 04:19 PM | Likes Like |Link to Comment
  • Socialism And Debasement Of Currency  [View article]
    Charles,
    the labor theory of money (Marx) is outdated. I could dig a hole and fill it back up all day (lots of labor), but I haven't generated any wealth to society by doing so. On the other hand, If I come up with an easy way to contain fission, I'll will have provided unspeakable wealth to the world.

    read about opportunity cost
    Nov 13, 2012. 04:17 PM | 1 Like Like |Link to Comment
  • A Sober Wake-Up Call The Morning After  [View article]
    Every time the regulators bring another rule down on us, it creates inefficiency and massive unintended consequences (MORAL HAZARD). Doctors and local hospitals/medical professionals should be practicing medicine the way we think is best, we should not be directed from the Federal level.
    My solution would be injecting free market principles into a govt subsidized program. An oversimplification: if you make 30k/yr the government would reimburse 80% of your healthcare cost. If you make 60K/yr the govt would repay maybe 50%, and if you make > 200k/yr the govt would repay maybe 20%. Then allow patients to buy catastrophic, low premium/high deductible insurance in case of accidents or unexpected illness (just like car insurance, most car insurance doesn't pay for gas, tire rotations, and oil changes). Of course this is an oversimplification. But you can't completely divorce consumers from the cost of a good or service (in this case healthcare), without the price going up (e.g. look at college tuition in light of heavy subsidy). This way a patient and his doctor could review the risk:benefit and price of tests/meds/consults and they could make an informed decision; the patient could decide if it was worth it to him to go on Hemodialysis or start taking Dabigatran instead of Warfarin.

    We can't throw homeless people out regardless of EMTALA, we would loose our med licenses, go to jail, and violate the Hippocratic Oath. A doc would be blackballed and fired for doing that, ethical stds/committees are still required at hospitals. EMTALA was a pure payment issue, the Univ hospitals felt they were getting shafted, but they are the ones with the Not for profit status that took all the subsidy anyway! So the fairness of the issue is still very much a contention especially in small private hospitals who are now forced to treat the uninsured and have no access or limited access to the subsidies. The state won't make us whole if we loose money by treating too many uninsured, we will just go under.

    By the way, I'm a Libertarian, I voted for Gary Johnson. The Republicans are evil warmongering social dinosaurs. The Democrats are just stupid. Together it is like dumb and dumber running the federal government.

    And I still think you are unwise to have such strong opinions about an industry of which you know so little about; it is hard to see the inefficiency and corruption of the system until you've been through residency and practiced in the real world for a few years. I will not speak out about the free market's ability to make engineering better as apposed to heavy government controls, if you feel like more federal government control over engineering is in order then I would listen to your expertise with an open mind. Thanks for the reply.
    Nov 13, 2012. 03:59 PM | 4 Likes Like |Link to Comment
  • A Sober Wake-Up Call The Morning After  [View article]
    Luckycharlie,
    I will be happy to have a nice conversation with you about this issue, and will try to give you a picture of things from my perspective. You are, of course entitled to your own political opinions on the matter. This healthcare issue is a big problem that government, especially CMS, is making much worse.
    The problems: First of all, the medical profession is very much over-regulated. I spend about 75% of my working day doing charting and paperwork in order to adequately bill insurance companies and Medicare to keep the hospital afloat. I spend way less than half of my day doing actual patient care, physically interacting with my patients. The inordinate paperwork results from high liability (have to document everything in case of getting sued), and from CMS rules regarding reimbursement. CMS literally audits the charts and counts the number of things you've documented (History, Past Medical, exam, ect, ect) to make sure you're not committing insurance fraud. The CMS rules are always changing and we have to spend a lot of time trying to learn the rules to get reimbursement. If the charting is not done properly, we don't get paid, the hospital goes belly up. Obamacare will make this problem much worse by making us document a ton of other stuff (quality measures) that will take even more of our time from our patients. An example, If Mrs. Smith comes into the hospital with heart failure and gets better, then comes back to the hospital 29 days later with anything (pneumonia, a broken hip, whatever), we don't get paid. CMS says I didn't do my job properly because the the patient "bounced back" to the hospital within 30 days. So doctors and hospitals who take care of the elderly/sick are punshed. Another example, CMS requires a patient to be admitted to their inpatient bed within 4 hours of "the decision to admit." The intention is to decrease ER wait times. The consequence is we end up having to transfer pts out of the ER and into floor beds before they're ready or have been adequately stabilized putting much more pressure on ICU beds. Another example, CMS/Obamacare penalized us for choosing "incorrect" antibiotics for pneumonia based on a patient's physcial location in the hosptial. So if they NEED dual Pseudomonal Coverage and are on the floor I can't give those antibiotics to the patient without special documentation (taking more time away from the patients). So it has evolved into a huge GAME with CMS and the insurance companies. Them looking for asinine reasons to withhold reimbursement from us (their excuse being patient safety, but the real reason that they're going bankrupt), while us spending more and more time charting things like, "I believe this patient has acute on chronic diastolic congestive heart failure, present on admission with secondary volume overload and acute on chronic respiratory failure secondary to the above which was present upon admission with low/intermediate/high risk for gram negative bacterial organisms causing pneumonia," just so we can bill! In the old days you could write "CHF/PNA exac." All the docs/nurses know what you're talking about but we had to HIRE chart review specialists to follow behind us and review our charting to make sure we are putting all of this crap in so the hospital can get paid. All the while, I just want to see my patients, then the patients wonder why it took me 2 hours to get in to see them but have no idea how much shit you had to put in the hard and order on the computer to comply with the regulation nazis. Obamacare is taking this crap to a whole new level with their BEST PRACTICES, and quality core measures. Believe me, this is NOT making medicine better, it is making it worse.
    EMTALA, another great example of moral hazard. The intention, just as you said, was to prevent providers from shipping patients without insurance to other hospitals (usually not for profit hosptials). Unfortunately, this kind of thing probably did happen in the 1980s, probably as an attempt by some bad apples to protect their bottom lines. The EMTALA rule has not been reimbursed properly, as you mentioned, and it opens the door to all kinds of abuse. For example, at the last 2 ERs I've worked in, guess what our reimbursement rate was? 16% at MUSC and 24% at BJC in St. Louis! So basically we were collecting less than a quarter of our billing. Tons of people without insurance know they can just show up at the ER whenever they want and the hospital will eat the cost, they have to be seen for whatever problem. This cost is dispersed to those who DO pay and you have seen the premium raised over the past 20 years, insane!
    Nov 13, 2012. 03:36 PM | 3 Likes Like |Link to Comment
  • Socialism And Debasement Of Currency  [View article]
    Capitalism creates wealth and economic inequality
    Socialism creats economic equality and poverty
    Capitalism cannot last in a democracy with significant inequality, the "have nots" will vote themselves the money.
    Soicalism cannot last in a democracy with significant poverty, the poverty will cause revolt and overthrow of the government.
    -Pick your posion
    Nov 12, 2012. 06:12 PM | 3 Likes Like |Link to Comment
  • The Negative 10% GDP Growth Unmasked  [View article]
    What do you think about John Williams and his shadow government stats? Do you think his assesment of CPI is more in line with what you have found? And, aren't food prices high from the drought driving up food commodity speculation? Thanks for this article.
    Nov 12, 2012. 03:46 PM | 1 Like Like |Link to Comment
  • Effects Of Obamacare On Employment  [View article]
    Obamacare, attempts to put many more uninsured into the pool by penalizing those who don't purchase insurance or punishing employers that don't provide insurance with taxes ect. Getting more people into the pool is the right idea, but doing this through a federal program is a bad idea for many reasons, some of which I outlined in my initial comment, but the most obvious of which is the trajectory of insolvency we see in the existing programs Medicare and Medicaid.
    The health care industry in this country is broken as it stands now. Medicare is insolvent, only 40% of docs will accept Medicaid now because is reimburses so poorly. The Privates just adjust their reimbursements to be slightly higher than Medicare because they know we all have to take Medicare to stay solvent (85% of docs or so still accept Medicare, but that number is also dropping quickly with the extra hassles, paperwork, and decreased reimbursements).
    To make medicine sustainable you have to inject free market principles into the system. I would even be in favor of heavy govt subsidies that pay a percentage of the medical bill for everyone. For example if you make 30K/yr the govt would reimburse 80% of your bill, if you make 100K/yr the govt would reimburse 40%, if you make > $200k maybe 15%, ect ect. Of course it wouldn't be this simple. But at least there would be free market forces putting downward pressure on the cost of medicine. Consumers would ask what their money is going towards and could make informed decisions with their doctors about what testing and procedures are worth it to them. Also, doctors wouldn't have the incentive to order extra tests, extra consults, extra meds, ect.
    Under this scenario, insurance could be deregulated and used for catastrophic or unexpected illness only, not for routine care (similar to car insurance). Perhaps a govt subsidy for the needy in this scenario as well.
    We must somehow harness the free market's magnificent ability of increasing innovation, productivity, efficiency, and putting downward pressures on costs through competition while still helping the needy get healthcare. This is just an idea, but I think would be the right direction. My guess is, CMS and the AMA, would not give up their monopoly so easily.
    Nov 12, 2012. 03:21 PM | 1 Like Like |Link to Comment
  • Effects Of Obamacare On Employment  [View article]
    Remember, health care used to be affordable before the forced government subsidies and third party payers started dominating reimbursements. Our hospital runs an AR (accounts receivable) ratio of about 50%, meaning we collect about 50% of what we bill. Medicare usually reimburses around 50%, the Privates adjust their reimbursement to be in line and slightly higher (usually about 60% of what you bill). The hospital looses money on anyone on Medicaid or "free care/charity care" (those who use the ER/hospital and have NO insurance, no money, no way to pay). The hospital has to eat that cost which is deferred to all of those with Private insurance.
    Nov 12, 2012. 03:02 PM | 1 Like Like |Link to Comment
  • The Catch-22 Of Quantitative Easing, And Why The Market Will Correct  [View article]
    Thanks for the good article. Do you think the recent increase in housing starts is due to QE3? What do you think will happen to housing prices/equity when the effect wears off?
    Nov 12, 2012. 12:08 PM | Likes Like |Link to Comment
  • Has Tokyo Finally Neutered The BOJ?  [View article]
    thanks for your thoughts on this issue, I tend to very much agree with you
    Nov 12, 2012. 11:53 AM | Likes Like |Link to Comment
  • Even With A Fiscal Cliff Deal, Stocks And The U.S. Economy Will Unravel In 2013  [View article]
    Sadly, I agree
    Nov 11, 2012. 04:23 PM | Likes Like |Link to Comment
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