US Health Care Woes

US Health Care Overhaul Bill Withdrawn by Trump, by Matt Sedensky.

Some Americans breathed a sigh of relief, others bubbled with frustration, and nearly all resigned themselves to the prospect that the latest chapter in the never-ending national debate over health care would not be the last.

The withdrawal of the Republican-sponsored health bill in the face of likely defeat Friday in the U.S. House seemed to ensure that the deep divisions over the Affordable Care Act and its possible replacement will continue to simmer.

As news spread, Americans fell into familiar camps, either happy to see a Democratic effort live another day, or eager to see Republicans regroup and follow through with their “repeal Obamacare” promises.

President Trump called my cellphone to say that the health-care bill was dead, by Robert Costa.

“Hello, Bob,” Trump began. “So, we just pulled it.”

Trump was speaking, of course, of the Republican plan to overhaul the Affordable Care Act [Obamacare], a plan that had been languishing for days amid unrest throughout the party as the president and his allies courted members and pushed for a vote. …

The Democrats, he said, were to blame.

“We couldn’t get one Democratic vote, and we were a little bit shy, very little, but it was still a little bit shy, so we pulled it,” Trump said.

Trump said he would not put the bill on the floor in the coming weeks. He is willing to wait and watch the current law continue and, in his view, encounter problems. And he believes that Democrats will eventually want to work with him on some kind of legislative fix to Obamacare, although he did not say when that would be.

“As you know, I’ve been saying for years that the best thing is to let Obamacare explode and then go make a deal with the Democrats and have one unified deal. And they will come to us; we won’t have to come to them,” he said. “After Obamacare explodes.”

“The beauty,” Trump continued, “is that they own Obamacare. So when it explodes, they come to us, and we make one beautiful deal for the people.”

The real problem with US health care is that it just costs too much. It is not who pays the insurance — which is what Obamacare and the current Republican bill are about — but the huge cost of healthcare in the US because of monopolies and lack of competition. Lower the costs down towards what other western countries pay per person, and the insurance issue will largely fix itself because it will be much smaller.

Go Ahead — You Own It, by Karl Denninger.

The Federal Government spent $1,417 billion last fiscal year on Medicare and Medicaid, up from $380 billion in 1998, which … was 37% of all federal spending last year — and it’s accelerating at ~8-9% a year as it has been for the last several decades …

At this rate it will cross $2,000 billion, or more than half (by a good margin) of the current federal budget within 5 years. …

[Like Obamacare, the Republican bill] is an outrageous and open fraud upon the public since it will not address cost … but will further advance the collapse of our federal government’s ability to fund itself, and thus operate! …

While health care counts toward GDP, and is nearly 20% of it today (up from about 3% 30ish years ago) most of it doesn’t produce anything. Not one car, one house, one television set.  Oh sure, it might allow someone to keep making those things — maybe — but at what cost?  …

The ugly part is that much medical care is actually negative to GDP.  Why?  Consider the drug addict who mainlines opiates and destroys his heart valves. “Fixing” it costs upward of $500,000, all said and done. Will that person ever produce more value than that with their remaining life?  Definitely not if they keep using drugs; they’ll die. The sad reality is that most of them do exactly that.

How about the Type II diabetic that winds up running through a quarter-million bucks in drugs, amputations, dialysis, blindness and death because they won’t change their food intake and stop eating carbohydrates? How far does he or she go before the ability to produce is destroyed, at which point they’re on disability and go from producing something to a net consumer of everyone else’s production? …

The answer to the problem cannot lie in “more insurance” or “restructuring” health insurance … The answer to the problem is, and can only be, a return of the medical industry to its historical 3-4% of GDP.

How? Enforce the damn law — specifically, 15 USC and State Consumer Protection laws.

You need just one simple requirement to be enforced against every medical provider of any kind: Everyone must post a price and everyone pays the same price; any sort of hiding, collusion, cost-shifting or similar is met with indictments, prosecution and prison for consumer fraud and racketeering along with violations of the Sherman, Clayton and Robinson-Patman acts. …

Medical costs will instantly drop like a stone.  How much?  Let me point out that from one “direct concierge care” site we have some examples of what market prices for common services and drugs look like – $4 for an A1c test, $3.13 for a CBC (complete blood count), $7 for a PSA screen, $275 for an MRI (damn close to what you can buy it for in Japan – cash, of course), $37 for an X-ray and $167 for a CAT scan. On drugs how about $1.98 for 90 Prozac pills, or $1.44 for 30 Prilosecs? …

Why would you need “health insurance” to cover routine medical care and prescriptions if you could buy services and drugs at prices like that — or at a 20% markup from them with a bunch of competitors in a given area? …

The known pricing we will obtain if we were to do this is, for most treatments and drugs, 80 to 90% LESS than paid today.

With so many vested interests pocketing huge rivers of cash (an extra 17% of GDP!), don’t expect an outbreak of common sense until the system buckles.