A Free Market Critique of Medicare

What exactly is the fiscal problem with Medicare? It has an almost complete monopoly over both eligible beneficiaries and service providers. Every medical procedure and device is coded and priced and must be justified by documentation. Yet the more closely the system has been controlled over the years, the more costly it has become. Check the link for the answer.  

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Are Humans Just Animals?

I know a lot about biology. I am familiar with taxonomy and comparative anatomy. Evolutionary theory sounds very reasonable in general especially when one sees the progressive relationship of various branches of the animal kingdom and when one studies fossil history. But some things about the concept of humans being simply just another animal with a bigger brain, a development in the chain of primates, puzzle me.

Humans protect themselves from the elements by devising clothing and constructing shelters. Are those developments simply adaptations to new environments? But don't all humans adapt some sort of clothing and construct some sort of shelters. Where is the perfect environment for humans that allow them to live without clothing or shelter like other animals?

And if humans adapt to new environments by making clothing and shelter why don't the smarter animals do the same, at least on a primitive level. If hominids adapted to their environment by these means where are the great apes that do at least a little bit of the same to adapt to a new environment where it might be safer or where more food might be available. Why are animals so enslaved to their inherited behavior that they never seem to want to make themselves a little warmer or a little more protected.

And why do humans cook their food? Is is simply an evolutionary adaptation to availability of different types of food in different environments? But other animals eat their meat warm from the kill and their grains right off the husk. Other animals are omnivorous but don't need food preparation. Certainly other smarter animals after millions of years have been exposed to meat cooked by accidental fires and yet they don't try to reproduce the finding.

In general why is human behavior so variable while animals keep doing the same thing over and over from one generation to another for millions of years.

There are many other similar questions but these suffice. Anybody have answers?

Letter to Krauthammer on Social Security

From: Anthony Perry <amperrymd@gmail.com>
Date: Sat, Sep 17, 2011 at 5:09 AM
Subject: Ponzi shemes do matter!!!
To: "letters@charleskrauthammer.com" <letters@charleskrauthammer.com>

Charles

I am always interested in your opinions. I watch Special Report especially to hear yours. However, I am a 73 year old MD who is still working and using social security for my green fees and you are a young whippersnapper. Allow me to give you my opinion about why we should get rid of the Ponzi scheme and convert to a system of individual retirement accounts.

Is social security a retirement program or a government program to help elderly poor from being destitute. It's been sold as both which is part of the confusion.

If it's to keep poor elderly from dying in the streets then leave the rest of us out, use the general tax funds (which is what the present system is tantamount to) and it will be much cheaper.

But if it's a retirement program it's a lousy one. A Ponzi scheme eliminates the benefit of compound interest. The money you set aside is not put to work in something productive but is used by government for its various wasted efforts. And the government owns the money you set aside so that when you die it is the beneficiery. Social Security is a defined benefit plan which is great in the good times, but as everyone now knows, is not so great in bad times when the owner of the plan cannot pay the benefits promised. Then the shell is switched and suddenly the benefit is reduced or elimiated. A worse scheme could not be devised and would in this day and age obviously not be a hot product for any commercial retirement plan seller.

If, compared to the next guy, I'm going to spend more of my precious life hours working and more of my brain power thinking about productivity, then I deserve more return, not only in income while working, but also in my lifestyle when it comes time to stop or slow down. Shouldn't the work I've done and the amount I've contributed be the main determining factors in the benefits I receive, rather than the financial status I've achieved as a result of my work?

And when should I stop or slow down? When the government bureaucrats decide I should based on longevity tables? Or when I decide I should based on the demands of my work and the available resources. What kind of retirement program is it that only pays off those forturnate enough to live longer than the average. (For those of us who are group-thinkers -- doesn't this discriminate against minorities?).

Wait until you get there, young man, and then see how you feel about it.

Is Romney reneging on the individual mandate?

I haven't seen where Romney was criticizing the mandate. The article gave no reference. I heard him defending the Mass plan, although he says he was obligated to agree to aspects he didn't like. I do hear much negative about it, including major criticism from the Lt governor at the time, who is now running for governor. He was a Dem and has switched to Ind. All agree that coverage met expectations, but cost has increased, not decreased and the Mass budget is accordingly in big trouble. Furthermore payments have decreased and several hospitals are sueing the state because of it and may go out of business. I talked to one internist I know who is retired. He was not a supporter but says he hasn't heard much complaint from his doctor friends.

I do not think it inconsistant at all to have an overall positive attitude about this plan applied in Massachusetts but to be against a national plan with a mandate, although I'm sure all the libs will spin it that way. Mass did not have a true mandate ala Obamacare. The Mass plan says that you must have insurance or proof of available funds to cover yourself in case of emergency. I'm not sure the mechanism or the amount required to assure this. That's much more American. Obamacare says you must buy insurance and you must buy insurance with a particular type of coverage. This is not in keeping with American political ideas of personal freedom and that is one big reason why it's so unpopular.

Whether it is working in Mass or not, the medical environment there is drastically different there than in other parts of the country and this universal plan is foolishness. The program in Indiana for the state employees that is based on HSA's is supposed to be popular and working well, and saving money. If one has a business or residence in a state with regulations you consider oppressive, you can always move your business or residence. Obamacare is inescapable and is the stuff of Socialism. Another major, major difference is that Romney had real transparency and worked with input from all political segments to craft the plan. He obviously had to include the liberal Dem politicians but the Heritage Foundation was a major advisor. Obamacare is polarizing and unpopular. It is ignoring the will of at least 1/2 of the citizens. It is also experimental. Neither Obama, or Pelosi or anyone else knows how it is going to come out and it may contribute to major economic problems for the US. Obama and his friends theorize that it will not but they are taking a major risk with the welfare of this country and shame on them for doing it.

Romney has major executive experience, both inside government and in the private sector. He is smart and thoughtful and has his personal act together. Read his book. It is excellent and not just a political screed like all the other spate of political books from left and right. It is real political philosophy and not a navel-gazing autobiography like Obama's books. Objection to him because of his religion is ignorant and no different than opposing Kennedy because of his Catholicism.

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Marrch 24, 2010

Flashback of the Day

"Some of my libertarian friends balk at what looks like an individual mandate. But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian."

-- Mitt Romney, defending the individual mandate to buy health care in the Wall Street Journal back in 2006. Romney now criticizes the same mandate in the recently passed national legislation.

The real meaning of Obamacare

Here is the reaction of one liberal Democrat with whom I debate, a physician unbelievably. It provides some insight into the mindset of these people. First of all how sick is the paternalistic view of the government and its relationship to the individual citizens, as if the government ever produced or provided anything that it doesn't take from us. The italicized part (my italics) tells you all you need to know about the intentions of this group to take over and control medical care. Watch out everyone else, you're next.

"We will no longer be the only nation in the first world that does not provide health coverage to its population. Now we can begin to weed out the practitioners who dupe their patients into demanding unnecessary and/or ineffective treatments at great expense to all of us. It will take time, but it will be worth it."

The fate of medicine under Obamacare

Subject: The fate of medicine

Looks like government controlled medical care is on the way. The Democrats are taking advantage of their temporary total control of the federal government to start a new "entitlement" and take another step toward their vision of the benevolent world of socialism. One has to hand it to them. They are more persistant and determined than the Republicans when they were in the same position. Of course Bush had the little problem of 9/11 to contend with.

I view the struggle of medicine to progress in the face of government control in the last couple of decades as a metaphor of a man trying to make his way across a bog with his feet mired in mud that sucks back with each step forward. We watch in horror as we begin to see him finally tire and falter.

Fixing healthcare

Insurance is a mechanism for controlling risk for unlikely but high cost events. Using insurance as a payment mechanism for low cost everyday occurrances such as doctor visits is preposterous and the only reason we do it is that someone else is paying the premium.

Medical insurers are not the problem. They are simply offering a product for which there is a demand. For their work they make a reasonable profit which is in line with other service industries. Profit is not a problem. It is what rewards a business for a good product and efficiency. The reason that just about any government service you can name is impersonal and inefficient is the lack of profit motive. Giving over control of payment for medical care to the government on the theory that elimination of profit will produce lower cost is nonsense. Non-profit medical insurance companies are certainly no more efficient or less costly than for profit companies and they do not provide lower cost policies. If we want to make insurers even more efficient we must arrange for more competition.

Whichever way you slice the problem, medical care costs money. Medical personnel, prodedures and treatments must be paid for. The public will pay the bill either through taxes or as part of their work compensation. If we continue to insist on paying indirectly through government or through "insurance" arranged by employers, there will be higher cost, more wasteful, less appropriate and more inefficient results.

Medical care is certainly a right. What is not a right is demanding that someone else pay for it. In a wealthy and generous country it is proper that we help those who are unfortunate and deserving get proper medical care. That can be done through private charity and through government assistance. That problem does not call for government involvement to any other extent.