The most successful parasites are undetectable. Silently they feed on their host, drawing from its energy imperceptibly.
Take the adult hookworm, which lodges in the darkness of the bowels and feeds on its host's blood supply. In an ideal hookworm infection, the host never becomes weakened or anemic from blood loss. The hookworms take just enough to survive and grow. Weakening or killing their host by playing the short-term game of gobble-all-you-can-get threatens the hookworms' survival. So silently they sip, with their healthy host completely unaware of their existence.
Washington Democrats could learn a thing or two from hookworms.
Refusing to enact policies that would allow the creation of national wealth, Democrats propose bleeding the strong to fund federal initiatives. President Obama and the Democrats devise plans that further plunge the nation into debt, with tax hikes on the "rich" as their only means of funding.
After presiding over 2009 and its $1.75 trillion deficit (12% of the gross domestic product), President Obama has proposed a $3.6 trillion budget for 2010.
Prior to unveling the budget, the President said he would consider cutting taxes for Americans, but not for people like Warren Buffett. He must have Warren Buffett confused with someone else. His budget runs on new tax hikes on families making over $250,000 a year.
But how long will the host remain strong? The feeding frenzy is on. Democrats have forgotten the rules of successful parasitism. Never weaken the host.
Blood is flowing freely now.
Rusy Scalpel
Showing posts with label president obama. Show all posts
Showing posts with label president obama. Show all posts
Thursday, February 4, 2010
Saturday, October 3, 2009
True Solutions for America's "Status-Quo" Health Care
This is a piece originally written by Rusty Scalpel for publication on another site. Readers of Free Market Physician will recognize common themes accompanied by statistics that have not previously been published on this site. In particular we would point out the author's finding that 24-38 cents of every dollar paid for doctor's visits with health insurance is consumed by the billing process. This number was arrived at through extrapolation of data in a well-known New England Journal of Medicine article. To the best of our knowledge, this figure is not published anywhere else on the Internet.
President Obama says it is time to escape the status quo of the United States health care system. He proposes mandates and funding to provide health insurance for all Americans. Although such a plan may appear reasonable, it will only perpetuate the high costs that now make health care unaffordable. A real solution to high prices is eliminating insurance companies from the doctor-patient relationship. Health care can be made affordable through patients' direct management of their health care expenditures and direct payment for health care services.
Health care plus insurance is more expensive than health care on its own. The price of a health insurance policy is the price of health care, plus the cost of the health insurance industry itself: underwriting, facilities, legal fees, and the salaries of over 469,000 insurance company employees and 881,000 insurance-related employees. Americans pay for these costs, plus the cost of their health care, every time they pay for their health insurance policy. Health insurance cannot make health care cheaper- it inherently adds to the cost.
A classic study published in the New England Journal of Medicine illustrates this point. It shows an average overhead for American health insurance companies of 11.7%, as of 1999. Add to this a very reasonable industry average profit margin of 3.4% and we see that about 15% of money paid to insurers never reaches health care providers. Americans paying for health care with comprehensive health insurance are only using their money at 85% of its potential.
However, this is not the end of money wasted through the use of health insurance. Those involved in health care are acutely aware of how much time and money is spent billing Medicare, Medicaid, and insurance to receive reimbursement for services provided. Many clinics hire as many employees for the billing department as they have doctors and nurses, who also spend significant time in billing. This raises overhead costs, which are passed on to patients.
Doctors offices have an average overhead of 26.9%, according to the NEJM article. Of course, not all of this overhead is due to billing. But the study indicates that a minimum of 10.8% is due to insurance billing. So between 11 and 27 cents of every dollar paid by insurance companies to doctors offices is consumed by the billing process.
A little multiplication (not addition) to combine these losses with the 15% insurance company losses reveals that for every dollar the insured patient spends on health care, only 62 to 76 cents will be applied to true health care costs. The rest is lost in the handoffs between the patient and the insurance company and between the insurance company and the doctor.
This is why President Obama's plan will perpetuate the status quo. It ensures that all Americans will continue to pay into a health care pot that will leak 24 to 38% of the water put into it. His proposed regulations on the industry will not help the situation, either. Profit margins are not high enough to sustain the losses the stick-it-to-the-industry regulations will inflict. The most likely outcome of his health care plan will be the sinking of the insurance industry, with every single American chained to the deck.
What then, is the solution to the status quo? Instead of moving toward a universally insured society, we should be moving to a sparsely insured society. Instead of mandating health insurance for all Americans, we should be liberating Americans to make their own health care decisions. We should allow them to decide whether or not they can afford the additional 24 to 38% they must pay to have health insurance services added to their health care.
Part of the solution requires a cultural shift. America must see health insurance for what it really is. Health insurance does not guarantee health, just as life insurance does not guarantee life. Health insurance is meant to protect finances against health expenditures that would cause a financial wipe out. Most consumers are looking for a plan to protect their finances from a major emergency. A catastrophic (high deductible) plan is what they need and can purchase for well under $100 a month.
Unfortunately, what most consumers purchase is comprehensive health insurance. This insurance costs hundreds of dollars a month. Instead of serving as a rainy-day account for emergencies, it becomes the account through which all health expenditures are paid. The insurance company determines a monthly payment that on average should cover all health expenses, plus operating costs. These plans are too expensive for most Americans. Instead of protecting finances from an emergency, comprehensive plans turn out to be a catastrophe all on their own.
Another part of the cultural shift involves health care providers. They too have fallen into the health insurance net. Involvement with insurance companies proves expensive and painful for them, just as it is for the patients. Not only must they participate in the costly and aggravating billing process, but insurance policies interfere with their treatment plans. Medication and treatment decisions are made not on the basis of patient need, but on the basis of insurance coverage.
The solution to patient problems was catastrophic insurance plans. The solution to doctors' headaches and additional expenses (which they must pass on to the patients) is fee-for-service, cash-only clinics. By eliminating third-party payers these clinics have incredible potential to save patients money. They bill patients directly at the time of service for services received. They restore the patient-doctor relationship. Doctors are able to prescribe and treat based on patients desires and ability to pay, not on insurance companies' payment plans.
Coupling catastrophic insurance plans with fee-for-service clinics can have profound financial effects for patients. Imagine if instead of paying into a comprehensive insurance plan every month, patients paid for catastrophic plans and then deposited the remainder of what would have gone into the comprehensive plan into a savings account. This account could be used to cover routine medical needs and cover the deductible should a true catastrophe occur. The money stays in patients' bank accounts instead of becoming part of the operating budget of the insurance company. Patients earn interest on the account and are actually able to maintain the assets in their accounts from year to year.
Not only are Americans free to grow richer by managing their own medical expenses, but they empower themselves in their relationships with health care providers. They now have bargaining leverage as individuals or groups because they, not insurance companies, are the payers. In addition, instead of getting every possible procedure after a deductible has been met, they become conservative spenders. They analyze whether a service has value to them and spend accordingly. They ration their own health care based on their needs instead of allowing insurance or government to do it for them.
In short, we turn patients into consumers. They are not beggars or government dependents to be seen at the leisure and pity of physicians, politicians and third-party payers. They are empowered American consumers. They are free men and women, masters of their own lives and their own property. Such liberty is not status quo. It is an American phenomenon and America's legacy. Let's not forfeit that legacy for President Obama's status quo government-controlled health insurance.
Rusty Scalpel
President Obama says it is time to escape the status quo of the United States health care system. He proposes mandates and funding to provide health insurance for all Americans. Although such a plan may appear reasonable, it will only perpetuate the high costs that now make health care unaffordable. A real solution to high prices is eliminating insurance companies from the doctor-patient relationship. Health care can be made affordable through patients' direct management of their health care expenditures and direct payment for health care services.
Health care plus insurance is more expensive than health care on its own. The price of a health insurance policy is the price of health care, plus the cost of the health insurance industry itself: underwriting, facilities, legal fees, and the salaries of over 469,000 insurance company employees and 881,000 insurance-related employees. Americans pay for these costs, plus the cost of their health care, every time they pay for their health insurance policy. Health insurance cannot make health care cheaper- it inherently adds to the cost.
A classic study published in the New England Journal of Medicine illustrates this point. It shows an average overhead for American health insurance companies of 11.7%, as of 1999. Add to this a very reasonable industry average profit margin of 3.4% and we see that about 15% of money paid to insurers never reaches health care providers. Americans paying for health care with comprehensive health insurance are only using their money at 85% of its potential.
However, this is not the end of money wasted through the use of health insurance. Those involved in health care are acutely aware of how much time and money is spent billing Medicare, Medicaid, and insurance to receive reimbursement for services provided. Many clinics hire as many employees for the billing department as they have doctors and nurses, who also spend significant time in billing. This raises overhead costs, which are passed on to patients.
Doctors offices have an average overhead of 26.9%, according to the NEJM article. Of course, not all of this overhead is due to billing. But the study indicates that a minimum of 10.8% is due to insurance billing. So between 11 and 27 cents of every dollar paid by insurance companies to doctors offices is consumed by the billing process.
A little multiplication (not addition) to combine these losses with the 15% insurance company losses reveals that for every dollar the insured patient spends on health care, only 62 to 76 cents will be applied to true health care costs. The rest is lost in the handoffs between the patient and the insurance company and between the insurance company and the doctor.
This is why President Obama's plan will perpetuate the status quo. It ensures that all Americans will continue to pay into a health care pot that will leak 24 to 38% of the water put into it. His proposed regulations on the industry will not help the situation, either. Profit margins are not high enough to sustain the losses the stick-it-to-the-industry regulations will inflict. The most likely outcome of his health care plan will be the sinking of the insurance industry, with every single American chained to the deck.
What then, is the solution to the status quo? Instead of moving toward a universally insured society, we should be moving to a sparsely insured society. Instead of mandating health insurance for all Americans, we should be liberating Americans to make their own health care decisions. We should allow them to decide whether or not they can afford the additional 24 to 38% they must pay to have health insurance services added to their health care.
Part of the solution requires a cultural shift. America must see health insurance for what it really is. Health insurance does not guarantee health, just as life insurance does not guarantee life. Health insurance is meant to protect finances against health expenditures that would cause a financial wipe out. Most consumers are looking for a plan to protect their finances from a major emergency. A catastrophic (high deductible) plan is what they need and can purchase for well under $100 a month.
Unfortunately, what most consumers purchase is comprehensive health insurance. This insurance costs hundreds of dollars a month. Instead of serving as a rainy-day account for emergencies, it becomes the account through which all health expenditures are paid. The insurance company determines a monthly payment that on average should cover all health expenses, plus operating costs. These plans are too expensive for most Americans. Instead of protecting finances from an emergency, comprehensive plans turn out to be a catastrophe all on their own.
Another part of the cultural shift involves health care providers. They too have fallen into the health insurance net. Involvement with insurance companies proves expensive and painful for them, just as it is for the patients. Not only must they participate in the costly and aggravating billing process, but insurance policies interfere with their treatment plans. Medication and treatment decisions are made not on the basis of patient need, but on the basis of insurance coverage.
The solution to patient problems was catastrophic insurance plans. The solution to doctors' headaches and additional expenses (which they must pass on to the patients) is fee-for-service, cash-only clinics. By eliminating third-party payers these clinics have incredible potential to save patients money. They bill patients directly at the time of service for services received. They restore the patient-doctor relationship. Doctors are able to prescribe and treat based on patients desires and ability to pay, not on insurance companies' payment plans.
Coupling catastrophic insurance plans with fee-for-service clinics can have profound financial effects for patients. Imagine if instead of paying into a comprehensive insurance plan every month, patients paid for catastrophic plans and then deposited the remainder of what would have gone into the comprehensive plan into a savings account. This account could be used to cover routine medical needs and cover the deductible should a true catastrophe occur. The money stays in patients' bank accounts instead of becoming part of the operating budget of the insurance company. Patients earn interest on the account and are actually able to maintain the assets in their accounts from year to year.
Not only are Americans free to grow richer by managing their own medical expenses, but they empower themselves in their relationships with health care providers. They now have bargaining leverage as individuals or groups because they, not insurance companies, are the payers. In addition, instead of getting every possible procedure after a deductible has been met, they become conservative spenders. They analyze whether a service has value to them and spend accordingly. They ration their own health care based on their needs instead of allowing insurance or government to do it for them.
In short, we turn patients into consumers. They are not beggars or government dependents to be seen at the leisure and pity of physicians, politicians and third-party payers. They are empowered American consumers. They are free men and women, masters of their own lives and their own property. Such liberty is not status quo. It is an American phenomenon and America's legacy. Let's not forfeit that legacy for President Obama's status quo government-controlled health insurance.
Rusty Scalpel
Friday, August 14, 2009
Boogeyman, Wild Misrepresentations, and Blatant Falsehoods
David Axelrod, the Senior White House Advisor, recently sent out an email meant to calm public outrage and 'dispel myths' about health care reform. In it he quoted President Obama at a recent town hall meeting saying, “Where we do disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that's actually been proposed.”
Here is my disagreement with the President and his staff and the whole Democratic Party. I object to the President and Legislators enslaving an entire industry, stripping Americans of their rights and livelihood, and putting them at the mercy of the government for survival. This may sound like one of the President's 'wild misrepresentations,' but it is a very real claim and the essence of the legislation that the President is promoting. For evidence I quote Mr. Axelrod's email (material also available here) under the heading "8 ways reform provides security and stability to those with or without coverage".
1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.
After years of immersion in liberal philosophy, the above proposals may sound like a good thing. Discrimination for pre-existing conditions may be considered unjust. Incomplete coverage due to chronic illness because of lifetime caps may seem unfair. But let's use regular language to explain what the government is trying to do to the insurance industry. Uncle Sam is telling the men and women who make a living by selling insurance policies the following:
You must sell policies to everyone for the same price, no matter how much money you know you will lose in the process (points 1 and 5). You must bear the full burden of their care to extent that the Legislature deems necessary, irregardless of how much it will cost you (points 2 and 3). No matter how much money you lose on the customer, even if it sends your company to bankruptcy and your family to bread lines, you may not decline them coverage (points 4, 6, and 8). Despite the fact your customers are paying much less for their polices than the actual cost of the medical care, you may not increase their out-of-pocket expenses (point 2). Oh, and you've got to cover their adult children too (point 7).
This is slavery. Slavery is what the legislature is proposing for the insurance industry. Imagine such rules being implemented in any other industry. Imagine, for example, if you had the job of mowing lawns and these regulations were established in the lawn mowing industry: Imagine that you were told that you must mow everyone's lawn for the same price, regardless of how many hours it takes to mow or how big the lawn is. Imagine being told you have to accept every customer that came your way for that price, even if you knew you would lose money on the contract. Imagine being told that you had to mow your customers lawn as often as they wanted without charging them any extra. Imagine being told that not only did these customers had lifetime contracts with you, but so did their children. From here it's easy to imagine quitting the business or shooting yourself in the head.
Americans are intelligent enough to realize that the insurance industry cannot continue to exist under the proposed policies. If a company is not allowed to compensate for increased costs by raising prices, what will happen to it? It will cease to exist. Instead of coverage for all, there will be coverage for none. But of course, that may be the true purpose of the legislation- setting our path for true socialization of the entire health care industry.
President Obama and the opponents of freedom in the Legislature figure that Americans won't stir against such abject tyranny because they are picking on a despised industry. President Obama points out that the insurance industry profits have been 'too high.' Apparently he believes it is the job of the government to make sure we don't make too much money. We all have had beefs with insurance companies, so he and our representatives figure we won't mind if the government takes over their jobs. Here they are wrong.
Health insurance providers have been collectively written off as an evil industry in an effort to dehumanize them. We don't think of the reform bill affecting fellow Americans, but that it will punish a greedy profit-seeking industry. But that industry is privately owned and provides employment for over 400,000 Americans who count on those profits to feed their families. They are no different than Americans in any other industry, all of which are profit-seeking. Why should we expect or allow them to roll over and become a national sacrifice?
We will not allow their sacrifice because we know that freedoms taken away from one group of Americans means a loss of freedom for all Americans. If we begin to sacrifice the unalienable rights of some for our comforts and commodities, then our rights will never be safe again. Once we find ourselves outside of the majority interest, we too will find our rights forfeited for the 'good of society.' And so we will fiercely and passionately fight, since our own God-given liberties are at stake, for the rights of the men and women of the insurance industry. We see all too clearly that if they go down, we may find ourselves next on the chopping block of socialism.
Rusty Scalpel
This blog can be submitted for White House correction at http://www.whitehouse.gov/realitycheck/contact
Here is my disagreement with the President and his staff and the whole Democratic Party. I object to the President and Legislators enslaving an entire industry, stripping Americans of their rights and livelihood, and putting them at the mercy of the government for survival. This may sound like one of the President's 'wild misrepresentations,' but it is a very real claim and the essence of the legislation that the President is promoting. For evidence I quote Mr. Axelrod's email (material also available here) under the heading "8 ways reform provides security and stability to those with or without coverage".
1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.
After years of immersion in liberal philosophy, the above proposals may sound like a good thing. Discrimination for pre-existing conditions may be considered unjust. Incomplete coverage due to chronic illness because of lifetime caps may seem unfair. But let's use regular language to explain what the government is trying to do to the insurance industry. Uncle Sam is telling the men and women who make a living by selling insurance policies the following:
You must sell policies to everyone for the same price, no matter how much money you know you will lose in the process (points 1 and 5). You must bear the full burden of their care to extent that the Legislature deems necessary, irregardless of how much it will cost you (points 2 and 3). No matter how much money you lose on the customer, even if it sends your company to bankruptcy and your family to bread lines, you may not decline them coverage (points 4, 6, and 8). Despite the fact your customers are paying much less for their polices than the actual cost of the medical care, you may not increase their out-of-pocket expenses (point 2). Oh, and you've got to cover their adult children too (point 7).
This is slavery. Slavery is what the legislature is proposing for the insurance industry. Imagine such rules being implemented in any other industry. Imagine, for example, if you had the job of mowing lawns and these regulations were established in the lawn mowing industry: Imagine that you were told that you must mow everyone's lawn for the same price, regardless of how many hours it takes to mow or how big the lawn is. Imagine being told you have to accept every customer that came your way for that price, even if you knew you would lose money on the contract. Imagine being told that you had to mow your customers lawn as often as they wanted without charging them any extra. Imagine being told that not only did these customers had lifetime contracts with you, but so did their children. From here it's easy to imagine quitting the business or shooting yourself in the head.
Americans are intelligent enough to realize that the insurance industry cannot continue to exist under the proposed policies. If a company is not allowed to compensate for increased costs by raising prices, what will happen to it? It will cease to exist. Instead of coverage for all, there will be coverage for none. But of course, that may be the true purpose of the legislation- setting our path for true socialization of the entire health care industry.
President Obama and the opponents of freedom in the Legislature figure that Americans won't stir against such abject tyranny because they are picking on a despised industry. President Obama points out that the insurance industry profits have been 'too high.' Apparently he believes it is the job of the government to make sure we don't make too much money. We all have had beefs with insurance companies, so he and our representatives figure we won't mind if the government takes over their jobs. Here they are wrong.
Health insurance providers have been collectively written off as an evil industry in an effort to dehumanize them. We don't think of the reform bill affecting fellow Americans, but that it will punish a greedy profit-seeking industry. But that industry is privately owned and provides employment for over 400,000 Americans who count on those profits to feed their families. They are no different than Americans in any other industry, all of which are profit-seeking. Why should we expect or allow them to roll over and become a national sacrifice?
We will not allow their sacrifice because we know that freedoms taken away from one group of Americans means a loss of freedom for all Americans. If we begin to sacrifice the unalienable rights of some for our comforts and commodities, then our rights will never be safe again. Once we find ourselves outside of the majority interest, we too will find our rights forfeited for the 'good of society.' And so we will fiercely and passionately fight, since our own God-given liberties are at stake, for the rights of the men and women of the insurance industry. We see all too clearly that if they go down, we may find ourselves next on the chopping block of socialism.
Rusty Scalpel
This blog can be submitted for White House correction at http://www.whitehouse.gov/realitycheck/contact
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