Healthcare...what COULD work, if we let it.

 Everyone wants health care. Medicare-Medicaid.....a damn expensive mess. We simply can't keep going the way we have in the past with Medicare and Medicaid !! They are bankrupting the country ! Seniors were " promised" this !?! Ok, so anyone 55 or over SHOULD get to keep it more or less as is if they want it  However, in order for it to survive I think we need to look at SOME sort of realistic changes to the system beginning with anyone 54 or younger. ( As a disclosure statement...I, John Galt/Mr. Know it All am younger than 55, so would potentially face whatever changes that are made). For the purposes of THIS blog I am mainly going to talk about health care for people NOT of retirement age.  Some people can't seem to get insurance at any price.  However, I find MOST people CAN find health care, they just don't like the price and/or don't know where to look. For example in Texas people should try (  http://www.txhealthpool.org/)  Texas has a pool for those who have had SOME insurance in the recent past but not now AND thanks to Obama Care every state is supposed to have a pool for anyone not having ANY insurance during the last 6 months EVEN if they have" existing conditions" . One last disclaimer before I tackle this subject. Some health care procedures are INSANELY expensive !! Every year Medical Science finds new ways to cure people...but these procedures are often very expensive .Transplants for instance. If you have insurance and have had it for some time...you are probably going to be more or less ok. However, if you don't have it and haven't had insurance and haven't really TRIED to have it...you MAY end up screwed !! No insurance company is eager to insure someone who needs to rack up $250K in bills and we just discovered yesterday we need a transplant or other expensive procedure. I guess what I am saying is...heartless but true. The " rich" or those not so rich but willing to sell their home or do whatever it takes to raise the money.....will probably always have access to health care that the " poor" won't have access to.So, what changes COULD possibly work to offer Better health care at better prices?? I think the best answer is a two part one. The first part involves " Supply and Demand". The second part involves High Deductible insurance and something called a" Health Savings Account".
    Ok, so how can Supply and Demand work NOW...when it clearly hasn't worked in the last 50 years. Oddly enough, most Americans didn't WANT it to work....even those who thought they did. Or perhaps, rather, they wanted it to work...but didn't make the choices that would CAUSE it to work. Up until the mid-1900s most people had NO insurance at all!! If you were sick..great-grandpa would sell a cow or something OR talk to his local church elders or whatever and the money was raised and the person was taken care of. Of course...many of the truly costly health care procedures didn't even exist back then!! Good Ol Dr. Melburn Stone would set a broken arm or help with child birth....but MRI machines...transplants...non of that stuff ( which is crazy expensive ) even existed. Oh...and if your local Dr. screwed up....you were pissed...and maybe you jumped him in the alley on a dark night..but no one filed a lawsuit...ever !! No malpractice, so lower costs. ( People talked...a couple of obvious screw ups and said Dr. was either run out of town....or " disappeared" .) Because health care was limited due to no technology and everything being cash up front ( or chicken or cow) Drs. actually had time to make house calls !!! Thats right...they came to your house ! ( I had a house call when I was 5, first and only time) However, new and life saving procedures have been found over the years. People started demanding health insurance !! Pay a little...see a Dr. Of course.....now MORE people saw the Drs because they had insurance...bye bye to house calls. By the late 60's  a rather high percentage of people had insurance. The insurance wasn't that expensive and for a long time insurance companies didn't charge extra for pre-existing conditions.Since coverage was basically good and cheap relative to value....we didn't even think about costs too often. Of course, their were ALWAYS some without healthcare. However, it wasn't always the media-political hot button issue.  I know this is crazy but for the first 175 years or so people of this nation didn't generally think that health care ( insurance) was some kind of god given right that should be mandated-supplied by the govt. Some people were poor.....since the beginning of time the poor had less....that's just life. Since the people who DID have insurance were generally happy....there was no supply and demand issues to speak of. People paid a small amount for insurance. Company costs weren't too high..so they offered insurance plans that did a lot for a little ( Now often called " Cadillac" plans by congress) and all was happy. Except....since the insurance was, there...and we were certainly entitled to use it, we did !! Without ever asking what it cost....or was the test/procedure even needed. As a result....there were rising costs !! Always rising !!  Still, for many many years we didn't really feel the pinch !! Your money for insurance was taken out of your check....many people didn't REALLY miss it or demand better accounting from the insurance people OR shop around . For many years companies picked up most of the cost increases....and what they passed on....well, it was only a few dollars more a month...right?? So?? There was no REAL competition in the market place !!Eventually things began to change. Costs were truly out of hand !! NOW...suddenly people wanted cheaper insurance !!  Even while they continued to go to the Dr. ever time they sniffled. ( It was their right !! They had paid for insurance.) The Drs. often pretended to go along with it and would prescribe antibiotics when people came in for every little runny nose or cough. The thing is, antibiotics are generally good for infections NOT caused by viruses....and colds/flue are generally caused by....viruses !! However, the Drs. knew we weren't going to stand for being told....sorry....gotta tough this one out. So they gave us meds that didn't REALLY help most times all that much. ( Take these pills for 7 days and you will get better....never mind that you would get better in a week to 10days if you took nothing)This added to health care costs !!! Multiply this times millions of patients...insurance costs sky rocket!!
  Ok "Mr. Know it All" we all knew this stuff !! Yes, most people do know it. They just choose to not think about it. We also choose to not think about how our Govt is generally run by a bunch of weasels!! Our govt wanted to get re-elected !! More than anything else !! So the routinely traded bet on short term gains despite long term disaster!! Medicare and Medicaid were generally underfunded. Even as the govt ( generally) kept trying to add more people to the "free govt" health roles. Now our elected officials would tell you they " meant well" and they were trying to serve the people. However, for many of them, they were simply buying todays vote...knowing or at least hoping they would be out of office before things became so costly the govt couldn't afford it any more !! At the same time the Govt in many ways were making things WORSE !! If someone who PAYS for insurance RARELY asks Drs. or Pharmacists about Costs....someone who gets it for FREE or really reduced cost from the govt is for sure not going to ask about cost !!! This is from their govt right !??!! They are entitled to use it !! Whenever and however they want !!
  All right...now we all know/remember the broad general way we got here. What does ANY of this have to do with Supply and Demand ?? Simple. Before , their was supply ( Drs. and PharmD) and Demand....well, the sick who somehow managed to pay. Usually through insurance . However, the ability to PAY was causing serious problems. Now we get ( finally ) to the important part! In the last 5 years or so, the market has begun to correct itself in some cases, or perhaps to be more accurate NEW markets have formed as a response to dissatisfaction.  As Drs. and Pharmacies tried to get profitable they noticed...wow our ( previous ) customers are more and more going to Mexico for cheap meds and cheap medical procedures. As the word spread ( before the gang violence down there) people flocked to Mexico !! Down there...different rules. Meds are cheap and easily available. Health Care down there is often on a CASH basis....so people shop around. Costs for most surgeries etc are about 1/3 of the cost in the US. ( Of course you don't get to file a lawsuit at the drop of hat down there either !! So , buyer beware...and yet...generally very good care at affordable rates). So?? The medical profession in the US , in general, have been looking at ways to attract customers back.
One way the health care market has changed is marketing by the big Pharmacies. Some of this was brought on by big-boys like Walmart realizing they could charge as little as $3-$4 for many generic prescriptions and still come out ok. This was HUGE !! For the first time in a very long time this was the market responding and costs going DOWN!! By a lot !! A small step but an important one !!
 More recently their have been even larger changes!! For example. In larger cities...and coming to ever smaller ones....pharmacies often have small, drop-in health care. Chances are you will see a Physicians assistant or a Nurse Practitioner rather than a Dr. However, these micro clinics can handle most routine medical treatments and they are offered at a fraction of the cost!!! Before you sneer at seeing " only " a PA or NP...at many Drs. offices or clinics ( surprise) you will see an NP or a PA more often than not!! In addition , being the hypochondriac nation that we are, in many many cities you can virtually schedule yourself for all sorts of medical tests and screens...even CAT scans. Maybe something" runs in the family" or your neighbor has had a procedure....and of course YOU are worried now too!! The thing is...whether its a self proscribed test for diabetes or having your heart checked or whatever...these tests tend to be done at a GREATLY reduced price compared to walking into a traditional Dr. office and then having the tests" ordered". The point is....just as we are all losing our minds over health costs.....new markets are forming and it looks possible that new markets combined with supply-demand will mean...our long standing system will actually finally WORK!! Instead of paying for all of your insurance/health care costs BEFORE your paycheck is even cut....in a manner that causes MOST people to not notice the true costs...now you pay as you go !! You DO notice the true health care costs !! So you shop around !! However, emerging markets are responding by greatly LOWERING costs !! ( That is, the markets will work and are starting to work.....if the govt doesn't mandate GOVT health care and change the rules making the new markets unprofitable).
  Wait , wait , wait !! Thats all fine and good ! However, how are we going to cover surgery? Cancer treatments?? Even broken arms and legs....are at least for now expensive to treat !! How is THAT going to be taken care of?? So called new market procedures won't bring costs down for EVERYTHING and even if they do...they won't bring it down enough!! True enough !! However, there is a little know one-two punch combination called....High .Deductible insurance and  Health Savings Accounts !!! High Deductible insurance is just what it sounds like .A person takes out insurance. Its gives coverage. However, maybe the first  $5 or $10K of coverage is deductible.  What you are REALLY covering is expensive procedures like having an tonsils  out or even more.....having a new heart valve put in.  So out of that $100K hospital procedure the High Deductible insurance picks up everything or at least most costs other than the deductible. Well, I don't know about any of you. However, I often go DECADES without needing any expensive procedures. So far, insuring me has been a good bet for insurance companies. Insuring myself with a high deductible plan would have been a potential money saving deal for ME as well !!! Wait , wait, wait !! What about covering colds, broken arms....smaller expenses !! You say you aren't good at putting away money in a " rainy day" fund. You say , I need medical treatments NOW and I'm broke !! I didn't save enough etc !! Well, Mr. Know it All can certainly sympathize with that one !! So you have High Deductible insurance but can't afford to pay for smaller procedures not otherwise covered. Well....there is something new....or not so new but something most people don't know about. Its called " Health Savings Account". Basically, a " Health Savings Account" is a sort of savings account where you deposit money in ( pre-tax even) from your paycheck . When you need the money, for medical procedures, its already there. So, lets say you put $20 a week into a health savings account. If you are like Mr. Know It All and don't tend to use that money....in  5 years you could easily have $4K-$5K saved up. Remember, in my personal example, I stated I often go DECADES without having major procedures !! That means for myself and indeed for most people it would be EASY to save enough to cover the HIGH Deductible if/when that needed expensive procedure comes along !!! In the mean time...the money would be in the account and growing !! There when I NEED it !! If a smaller procedure comes along I can see my local Dr. or clinic  ( remember...new mini-clinics inside or near pharmacies...for example) . Now , however, I have the money already saved up and waiting!!  Many Health Savings Accounts actually come with a special "debt" card. So , you have the procedure...pay for it...keep a copy for your receipts just in case the IRS wants to see it...and you are soon fixed up and good to go !! This Health Savings Account ( unlike the OLD ones) now rolls over from year to year. Meaning if you don't use it ( again unlike the old accounts) it just builds and builds. This became available when it was signed into law by President George Bush in Dec. 2003 . I must tell you this kind of makes my head hurt. You see, I must admit I didn't know about this until recently. Clearly this is a fantastic option for most people!! As far as I can tell it is usable by anyone. The money sets in the account until needed. If you draw the money out for NON-medical use you may suffer a tax penalty...like drawing out your IRA or 401K early. However, after you turn 65 you can pretty much do whatever you want without penalty. I personally think the biggest thing keeping more people from using it is....hardly anyone seems to have heard about it !! ( The OLD style accounts...you had to spend all money by years end. A hassle and not really worth it....when anyone talked about this NEW style accounts...my eyes glazed over because I didn't realize they were talking about something different/new). So that's it !! I admit I am still looking into several possibilities I think for the foreseeable future most people would be far better off if they Started a Health Savings Account and shopped around for decent High Deductible insurance. Oh....and read the print. Even High deductible insurance generally covers at least some things like wellness checkups without any co-pay ! 

Euro slips in value....as Greece thinks about possible default

Ok, http://news.yahoo.com/s/nm/20110525/bs_nm/us_markets_global the Euro is slipping in value against the dollar. Think about how remarkable that is. First, The US is currently trillions of dollars in debt. Second the Euro has been worth more than the dollar for some time. However, Greece is now openly talking about defaulting on its debt....even though it was bailed out once already. If Greece defaults...that will push the Euro down sharply. Frankly, Greece is running out of options. The country is already falling apart.....every time the govt tries to deal with it the Greek unions go on strike....causing even more chaos!! You see, the unions in Europe long ago learned something the US has been struggling with. In order for a union to remain in power in a company it must constantly try to increase benefits to its employees EVEN IF this action causes damage to the company that can lead to the company closing !!! A union that doesn't come up with always better wages and benefits will see a loss in membership. Now what the US unions didn't follow thru on was this. In order for a union to have political pull it needs its members to vote the way they are told by union managers/leaders. The unions, in turn...( after getting out the vote) need to get benefits from the GOVT in office ( thanks to the Union) ! If the Unions do that they become serious power brokers. The final thing the unions need to do at that point is to have grid-locking strikes every so often to remind the politicians who is the " REAL" power. Once the unions have that strong of political power they can then vote in...or rather have voted in for them...any benefit, wage, or law they want !! Always more and more of course. More vacation....higher minimum wages....health care, mandatory 1 month worth of vacation time....etc etc.  When the unions of Greece says jump...the govt usually does. In the United States....most unions can't count on their members moving in lock-step. Since they can't get out the vote as well as they should , the power of unions in the US is greatly diminished compared to its European cousins. To be sure , the US political parties " get it" that a percentage of voters can be " bought" by higher " entitlements" and other benefits. This is a serious long range problem for the US. Our very freedom.....democracy....is also our greatest weakness....as our political parties have learned they can always vote a raise for themselves and their constituents...even when their is no realistic way to pay for these increased benefits.

Gene Simmons gets it !!

KISS' Gene Simmons: Obama "Has No F***ing Idea What The World Is Like"

For a president to be sitting in Washington, D.C., and saying, “Go back to your 67 borders in Israel,” how about you live there and try to defend an indefensible border nine miles wide? On one side you’ve got hundreds of millions of people who hate your guts, on the other side you’ve got the Mediterranean. Unless you control, in Israel, unless you control those Golan Heights, it’s an indefensible position.

Read more: http://newsbusters.org/blogs/noel-sheppard/2011/05/21/israeli-born-kiss-guitarist-gene-simmons-67-borders-obama-has-no-f-ki#ixzz1N8iRfcmZ

"The most pathetic body on the face of the planet." Simmons called the U.N. a "paper tiger" that allows dictators to spread propaganda. (H/T Newsbuster)

Rep. Cantor: Palestinians "Infused With Resentment And Hatred"

The Hill reports: Speaking to thousands of pro-Israel activists assembled in Washington for the annual gathering of the American Israel Public Affairs Committee (AIPAC), Cantor told the tale of an unnamed Palestinian woman who traveled from Gaza to an Israeli hospital for life-saving treatment. Some time later, he said, she returned with intentions of attacking the same hospital in a suicide bombing.

"What kind of culture leads one to do that? Sadly, it is a culture infused with resentment and hatred," said Cantor, one of just two Jewish Republicans in Congress. "It is this culture that underlies the Palestinians' and the broader Arab world's refusal to accept Israel's right to exist as a Jewish state.

 

     I think this is a very realistic bit of commentary ! Too many elected officials don't live in the real world. They are surrounded by Yes men, and party hacks !! What works ( both left and right) often work  in theory....and not in real life. I think that is part of the reason ObamaCare is now granting " exceptions" to so very many companies. Its a well meaning idea....but some parts are just unworkable !

  As to the UN....it is a great idea....and is a JOKE in real life !! It has no real power...and all to often puts 2 bit dictators as committee chairs !