Healthcare, Universal Suffering

iCanada’s Single-Payer Health Care System: A Cautionary Tale | National Review:

https://www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/#53dce0507d74

Healthcare is one of the most frustrating things to talk about. Some of the reasons include:

• We all have to use it, and none of us really want to use it, let alone pay for it. It is like having to fix your roof, plumbing or siding, only WORSE because it lets you feel your own mortality and vulnerability while spending money you would prefer not to spend. This sort of situation plays very well into our immature natures to throw up the hands and say "I just want this taken care of by SOMEBODY!".
• When we fall into the compliant "JUST FIX IT!" mode, politicians and other charlatans rub their hands with glee. The rubes are filing in the pen to be sheared -- there may be a lot of bleating as their funds are taken for little result, but when you are in the shearing of freedom and funds from the masses business, it doesn't really get any better than this!
• Like inflation, healthcare is tailor made for government control. They control all the statistics on costs and results, so unsurprisingly, they end up looking pretty darned good. (Hey, there is no inflation, so we don't need to give you a COLA on your FICA, nor any inflation adjustment on your "inflation protected bonds" ... trust us!) They will give you PLENTY of statistics to show you "beyond all shadow of doubt" how good a deal you are getting and how great the results are.  Go online for "rankings" and you will find "the gospel truth" from "non-partisan sources" like the Commonwealth Fund!

One primary factor that could start the journey back to America from BOistan is the old motto of IBM; "THINK!", or as put by Henry Ford "Thinking is the hardest work there is, which is probably why so few engage in it!"

Thinking about things that are HARD, and do not agree with our idea of pleasure, or even being on the PATH to pleasure, is especially difficult. When the majority of those around you decide to write off personal freedom and responsibility in favor of the herd, that can make it even tougher.

The two articles linked at the top provide some alternative views which I suspect we all know to be true if we just THINK rather than "feel or hope" for a few minutes ... here are the highlights. 

• The Canadian system has loads of problems, is way more expensive than is realized, and only really works because those that can afford it can go south -- Mayo in Rochester is one of the places they go. Canadian healthcare is trending just like BOistan FICA.
• Like in virtually everything else in the world, Switzerland is really number 1, and nobody on the left really wants to talk about that model very much ... lots of individual responsibility kinds of stuff. 

The Godzilla in the room that neither of the articles covers is the plight of the black population in the US. Essentially, they are living in the 3rd world, while the white population enjoys being essentially in Switzerland or Norway. I could also spend a lot of time on the fact that infant mortality is one of the big measures used for quality of healthcare, but it is also one of the areas where there are HUGE differences in how the statistics are done. This is an EXCELLENT article that points out those difficulties, however if you have already made up your mind for Universal Suffering, reading it would be too painful -- better to write it off. 

Oh, and in the interests of how bad being "taken care of by the government" works no matter what your race, it turns out that there is an epidemic of poor white people dying. Broken families, loss of community, leaving religion, welfare, not being employed, etc is just as as terminal if you are white as if you are black -- only time will tell if orientals have a stronger resistance! 

The bottom line here, that I really think we all know to be true if we calmly THINK for a few minutes is essentially this: 

• "Someone" is going to pay, and "someone" is going to decide on healthcare choices. Most of us are willing to keep up our homes and cars on our own dime and understand that the consequences of not doing so are grave. Inherently, we actually DO understand that health care is NO DIFFERENT, we just don't want to accept it!
• The majority of my acquaintances have not decided to hand over ALL of their retirement finances to the government ... nor their housing, transportation, food provisions, etc. That more of them are considering handing over their healthcare to the government is a strong sign that our ability to self govern is perilously low. In our hearts, we know that "outsourcing" really doesn't solve the problem, we just WISH it would.
• "Everyone else is doing it" is the saddest "argument" of all. In a nation that is supposed to rule itself, one of the reddest of red herring arguments would never be proffered by someone with over an 8th grade education. "Bandwagon argument", "Argumentum ad populum" -- it is such an obvious fallacy that it's use is mostly a marker for the sadness of the intellectual state of our nation. "97% of scientists agree" ... when even the fallacies become popular, you truly know that intelligent dialogue is dead.
• It has been often said that if you are not a liberal at 20 you have no heart, but if you are not a conservative by 40 you have no brain. A better way of looking at is that life used to tend to school people in reality a lot more than it does now. If you didn't work, things REALLY sucked, there were more accidents, diseases, etc that impinged on rosy views of reality -- at one time, almost everyone had to deal with the death of a child.
  
  In this vale of tears, EVERYTHING of mans creation has a dark side (not everything created by man has a light side though). Not having to live with as much pain is what we all desire, however as we are discovering with the immune system, not having to deal with as many pathogens as child results in a weaker immune system. Nietzsche was overboard on "That which does not kill you makes you stronger", but there is a nugget of real truth there. Without the struggle of escaping from the cocoon, the moisture is not worked out of the wings of the butterfly and they are unable to fly. Much of this world depends on struggle.
  
  Can human beings actually mature without adversity? Humans have both hearts and brains, and maturing both takes effort. To wish it were otherwise is to fail to understand our condition.

In my current line of work, one of the biggest mantras is NO FIXING. Our mental health system is loaded with people that have lost their ability to think independently. They have been so "fixed" by doctors, institutions, family and government that they no longer  believe they have any personal power remaining. They have stopped struggling. 

For most of those that read this blog, the struggle will not be given up -- yet. We will continue to live in private housing, tend our retirement funds, keep up our private transportation, and if the suffering of healthcare becomes "universal", we will opt out of that for a much more expensive private option as long as we can. 

Some of us may feel positive about that -- much like choosing to feel positive about paying into the giant FICA ponzi scheme in the same manner as the optimistic man having fallen off a 100 floor building yells out to the person on the 20th floor, "all good so far"! 

Does anyone with over a 100 IQ NOT understand all this? I personally don't believe that. I believe that in our bones, we totally "get it", just like we understand that we and our loved ones most certainly will die! However, we are masters of compartmentalization and when the whole government, media, education and entertainment is marketing to us to just settle back and enjoy the ride on the gravy train, it is EASY to do. 

It is easy, but of course it is deadly -- to people, to families, to nations, to civilizations. 

It certainly happens to companies -- IBM was spiraling down in the late '80s, Gerstner leveled it off and gave a little uptick in the mid '90s, but the bureaucratic forces were too strong and all that remains is the corpse of a once great company. Much like here in BOistan, the corpse of something big can hang around a long while -- sure it stinks, but much like pumping hog manure, most people get used to it!

As we say in DBT, pain is inevitable, suffering is optional. By accepting basic truths like "80-90% of people have to pull their own weight in EVERYTHING ... food, shelter, transportation, clothing, healthcare, entertainment, etc" or the system is going to break at some point., we deal with the "pain" of that truth, but we avoid the suffering of the disaster when the truth is ignored. 

When systems go the way of the US and Europe, they become corrupt as more and more seek rent from the transfer of funds from the makers to the takers and the ranks of the makers dwindle while the takers swell. Naturally, the folks doing the transfers become greedy/wealthy, so they demand that their wealth rise (see Davos, Wall Street, 4 wealthiest counties in the US suburbs of DC), thus there is less and less for the swelling ranks of the takers, while the take from the makers has to ever rise ... thinning their ranks and making their lot less and less palatable. 

Universal Suffering -- the inevitable outcome of socialism of all types in all times and places. 

(other writing on the topic). 

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The Single Payer Attack

The road to single-payer health care: Charles Krauthammer | OregonLive.com:

"Single Payer" is one of the greatest oxymorons in the history of mankind -- right up there with "Military Intelligence" or "Government Benefits". The government provides precisely NOTHING -- they pay for it either with money they take from living people, or debt they accrue against future people.

Thus, the same people that pay for everything else -- those that work, create, invest, succeed; pay for the addition of a PUBLIC system. If you currently live in public housing, use nothing but public transportation and eat via SNAP and foodshelves, you will probably LOVE a public system.

If not, you will no doubt use the public system as much as you use the other public systems -- you will pay for it, but you will not use it. Rather, like many of us with schools, you will get your medical care from a private system with private insurers -- at least when it matters.

The objective of "Single Payer" is to make healthcare unaffordable to more people, thus increasing the number of people dependent on the government and willing to vote for candidates who promise to transfer ever larger amounts of money to the government so it can buy the votes of the folks clamoring for better care. "VA for over half the nation" -- once they are trapped on "The Party's" plantation, they have no choice but to demand ever larger payments for the declining working part of the population and the dwindling future generations -- the offical TP position is that that those brown illegal babies will solve all our problems (eventually).

Public medicine is popular because there are more healthy people than sick people, and because sick people often don't vote -- or not for long at least.

The rather odd thing that the election of Trump and now the failure to repeal BOcare has engendered is the "throw up the hands, declare healthcare a "right" and go ahead with the fiction of "single payer" among a lot of people that really ought to know better.

Acceptance of its major premise -- that no one be denied health care -- is more widespread than ever. Even House Speaker Paul Ryan avers that "our goal is to give every American access to quality, affordable health care," making universality an essential premise of his own reform. And look at how sensitive and defensive Republicans have been about the possibility of people losing coverage in any Obamacare repeal.

The fact of the real world is that there are ZERO "rights" to a good that takes effort to create. Air can be free becuase we don't have to work to create it. Water can be almost free -- although even water is increasingly expensive. Even though the tap is "close to free" people increasingly opt for the marketed version in plastic bottles.

Food, shelter, clothing, bourbon, Packers tickets, cars, healthcare ... NOPE.

Let's take shelter as an example. If there is a "right" to shelter, then let's define it. How about a college dorm room? Double occupancy 224 SQ feet, shared bathroom / showers , cafeteria, pizza night once a week, burger night once a week ... many of us have been there.

The military barrracks would be another -- you just lose the stalls around the shitters, and it is one big room with a bunch of bunks to sleep in. I never served, however I did get to spend some time in them on scouting trips.

The USSR essentially had this -- as did/does the US in major cities. Giant concrete mausaleums with broken windows and a urine / fecal stench in the stairwells that was rumored to be supremely memorable. It may not quite be the third world, but you can smell it from there -- get a little too far off the trail in Mexico and the pungent mix of sewage, diesel, cooking smoke, urine and rotting miscellany gives a hint of "universal humanity".

In public health wards in Europe, the optimum ward size is 6-10 beds, but many are now 18 and over. "Private and semi-private"? That would be in the PRIVATE system!

When we were kids, our parents would admonish us to have some backbone. "If everyone else jumps over a cliff, are you going to as well?" This is often the leading argument for "Universal Health Care" ... everyone else in the western world has it, we should too ...".

Freedom isn't free either -- it takes intelligence, backbone, attention to reality ... and yes, maybe even "arrogance" -- what "right" do we have to be free after all?

NONE! It takes constant vigillance and often violence to maintain it -- and BOistan clearly lacks even the appreciation for the concept!

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Solving The BOcare, Medical Care Crisis

http://www.hoover.org/research/how-cure-health-care-0

By the time you get to the end of this post, you will know how to fix the healthcare system.

This post is important -- we need a little background Friedman that PJ O'Rourke has enhanced to stick in our brains first relative to how money is spent. This is taken from his book "Don't Vote, It Just Encourages the Bastards!"

I think we all intrinsically understand the preceding -- it makes a REAL difference whose money any person is spending and it makes a real difference who it is being spent on!

Now on to Milton Friedman on healthcare (I recommend you read the whole linked column, but I'm doing cliff notes here in case you are not going to). Milton has astutely observed that as technology has advanced in medicine, people in the developed world have paid more and more for health care, yet are generally less satisfied. Advances in technology in other areas (cars, tv, cell phones, the internet) have produced LOWER costs and GREATER satisfaction!

Rapid technological advances have occurred repeatedly since the Industrial Revolution—in agriculture, steam engines, railroads, telephones, electricity, automobiles, radio, television, and, most recently, computers and telecommunication. The other two features seem unique to medicine. It is true that spending initially increased after non-medical technical advances, but the fraction of national income spent did not increase dramatically after the initial phase of widespread acceptance. On the contrary, technological development lowered cost, so that the fraction of national income spent on food, transportation, communication, and much more has gone down, releasing resources to produce new products or services. Similarly, there seems no counterpart in these other areas to the rising dissatisfaction with the delivery of medical care.

So apparently, having 3rd parties -- employers, insurance companies and government buy our healthcare has provided us with a very expensive off color Yugo healthcare -- and we are surprised? But it's worse than that -- because government is involved.

Some years ago, the British physician Max Gammon, after an extensive study of the British system of socialized medicine, formulated what he called "the theory of bureaucratic displacement." He observed that in "a bureaucratic system . . . increase in expenditure will be matched by fall in production. . . . Such systems will act rather like ‘black holes,’ in the economic universe, simultaneously sucking in resources, and shrinking in terms of ‘emitted production.’" Gammon’s observations for the British system have their exact parallel in the partly socialized U.S. medical system. Here, too, input has been going up sharply relative to output.

Why is government different? It combines typical human hubris and incompetence with monopoly power -- in fact,  potentially total coercive power.  How to escape from this morass, now made much worse by BOcare? Well, the "perfect solution" would be:

The ideal way to do that would be to reverse past actions: repeal the tax exemption of employer-provided medical care; terminate Medicare and Medicaid; deregulate most insurance; and restrict the role of the government, preferably state and local rather than federal, to financing care for the hard cases. However, the vested interests that have grown up around the existing system, and the tyranny of the status quo, clearly make that solution not feasible politically. Yet it is worth stating the ideal as a guide to judging whether proposed incremental changes are in the right direction.

 So what does this all mean in simple easy to understand terms?

1. Like all goods, medical care WILL (and always has been) be "rationed" -- supply and demand are a form of rationing, as are long waits. The government decides on the waits, like having less MRI machines for the country than Mayo has with waits of 12 - 18 months. My wife would likely be a quad in Canada, but their healthy people LOVE their system! (the number of healthy people exceeds the number of sick people -- so socialized medicine is politically astute ...  note "insane evil pig" above )
   
2. 80/20 rule, 80%+ of medical care can be "WalMart, Target, Bloomies" levels of care -- basic physicals, high blood pressure, thyroid issues, diabetes, throat cultures, standard pregnancy/delivery -- People need to pay for 80% of their health care out of pocket, just like their groceries and gasoline.
   
   You buy the level you can afford when you are hurting -- and it is cheap because there is competition, and very limited liability. It is like buying normal groceries -- not steak, certainly not caviar. Just like when your car breaks or house needs a new roof, you either have savings to handle those "unexpected expenses", or you are forced to use credit. If you are really poor, you go seek state assistance, or to to the "medical shelf" (like the food shelf).
   
3. When really bad things happen -- cancer, trauma, heart attack, stroke, etc, "Cirrus Vision Medicine" kicks in -- note, I didn't say "Gulf Stream, Trump's plane, or Air Force One" level of medicine. The Cirrus Vision is a very advanced JET plane ... but it isn't "snotty". You can't afford the Cirrus level either, but just like fire insurance, you pay a premium for a policy so you are not RUINED ... it costs more than your fire insurance because the odds of you eventually getting bad sick are higher, and the care is going to cost more than replacing your house.
   
   You DO "notice it" -- Some number, say "20% of your net income" is yours to pay. Serious illness ought to be financially like having your home burn down -- a really bad thing (which it WILL be anyway, because serious health issues are MUCH more than just financial). 

A lot of this unfortunately assumes that we re-educate people on some of the basic facts of life that our political and educational system have hidden from us so they can shear us. 

1. "Single Payer" means that if you are a person that uses only public housing, public transportation, public health, etc today, you will likely LOVE it! If not -- like if you have your own home, car, etc, then you will also find that you need to have your own healthcare. You will pay dearly for the "public option", and THEN  unless you are REALLY wealthy, you will pay hyper-dearly for the "private option" that you actually use -- if you can afford it at all. Increasingly, many of us that bought into the old "American Dream" will finally fall into a frayed, stinking, 10-20 people to a ward slum of healthcare like the VA (the "public option" poster child), and find that we are dying in BOistan. 
2. Single Payer" isn't ... it is "paid by all taxpayers present and future". It is one stop lobbyist stop for those getting the money. They know who to pay off, take on junkets, provide good stuff for, etc. No need to deal with slimy "customers" (patients) anymore ... they are not paying anyway! If DC is happy, it's all good. If your business ever had a "large users group", imagine a "ONE users group"! How well did your business treat the customers that were not "large" compared to the big spenders? Imagine only a single real customer that determined your entire financial picture as a healthcare provider and you will start to get the idea. 
3. There is NO free lunch! Somebody is paying -- maybe not you, but somebody. Your neighbor, your kids, your grandkids, SOMEBODY (and likely not the "really rich guy" -- he has lawyers and tax accountants that he pays instead). When you don't understand that, most likely you AND everyone else is paying WAY more than you realize for your "free lunch", which is exactly the case for healthcare. "Free goods" are insanely expensive!
4. NEVER insure against losses that you can self-insure for! Yes, this means NEVER purchase the "extended warranty"! Assuming that the warranty is actually going to cover things that actually might happen (a BIG assumption!), someone is betting that they will make money by you purchasing the warranty, and they have LOTS more information than you have about the transaction and odds! Just like Vegas, they are "the house", and rule #1 is that the house wins! They have to, otherwise they would not be in business!
5. 
   Note, this applies DOUBLE to "don't have the (federal) government pay for people's food, car repairs, or basic medicine". The government is REALLY "the house", and they will take A LOT of pounds of your taxpaying flesh as they seek to pad their pockets and buy votes to stay in power! If government MUST be involved in chairity (it ought to be neighbors and churches), then it starts LOCALLY and as failure happens, the funding needs to take longer and longer expensive trips to the state and federal capitols so that 20-30-40 cents can return to do good deeds.
   
6. "The Government" is not "magic", and certainly not "god". Yes, it can promise to rob from your neighbor to give you things like healthcare, but it will also certainly charge a hefty fee for it's larceny "service". Since it is robbing though,  it WILL also rob from you, your children and your grandchildren as well. You asked it to be a robber, do you REALLY think it is going to be an "honest robber"?
7. Robbing for a "really good reason" is still robbery. If the reason is THAT good, reasonable people will want to invest in it, or even gift the money. The corruption engendered by deciding that it is morally OK to take money from others by force fits well with the "morality" that it is OK to take the life of another person for your own convenience. When you are willing to kill for convenience, or even allow such killing,  morality is over. (killing for convenience is another name for abortion -- as in the abortion of all moral standing, meaning that if you trust any person or organization (eg US Government) that supports abortion, you are insane and deserve whatever happens to you)
8. Once institutions are robbing people, there is no such thing as "reasonable", or "limited" because "institutions" ARE people  -- real imperfect standard issue people. Not "public servants", or some other sainted term. When your day to day job is robbing a set of people to hand the money to another set of people so they will keep you in power, you are going to want to keep some loot for yourself, and you will find a "legitimate" way ... or your union will.
   
   Since you have already convinced yourself that charging people vastly different rates based on income for redistribution is "moral", "progressive" even, it is much easier to see how you absolutely "deserve" a higher salary, cushy benefits like super health care yourself, full salary retirement at a young age "indexed for inflation", shorter work hours, more vacation, total job security, etc, etc) ... all of these are either "in" or "in sight" for unionized government workers see (AFSCME) 

The whole Friedman article is WELL worth reading. We COULD solve our healthcare issues in the next year or two -- I only hope that Trump and his advisors are looking at this sort of information! 

Medicine, Coded for Disaster

http://www.cato.org/publications/commentary/how-government-killed-medical-profession

Pretty much all institutions, crafts, professions and pursuits go through a number of cyclical forces. At a high level we have things like centralized control vs decentralized, process vs art/craft, public / private, big factory "assembly line" sorts of approaches vs skilled craftsmen --- we could go on.

Writing computer code went from a highly individualized "art" prior to say "the 1970's" and then became an increasingly heavyweight "Design - review - Code - review - Test - review, with tracked "defects" at each phase with plenty of "metrics" to make the "Waterfall" a one shot through a supposedly constantly improving process. The process got way too heavy.

Then came the Internet and Open Source and it all blew up to free-lance "super coders" throwing source across the net with abandon  and rapid cycling new versions constantly. "Design" largely died and even "specifications". The coders took back control of software -- and it went pretty much back to being an "art" rather than a "profession".

Medicine has been both an art and very much a profession for at least hundreds if not thousands of years. It is the most personal and intimate of "personal services", with the level of trust required in your dealings with your doctor exceeding all other relationships in your life when the combination of trusting in both their care / concern / focus / wisdom / confidentiality / character AND highly skilled technical expertise as a package in a single person.

Much like religion, a government that seeks to entirely control your life cannot allow this sort of relationship to NOT be mediated by government and kept under strict control of government. The linked article gives a lot of detail of how we have slid into the hole we are now in, and how it is nearly certain to get MUCH worse.

Before long, these codes were attached to a fee schedule based upon the amount of time a medical professional had to devote to each patient, a concept perilously close to another Marxist relic: the labor theory of value. Named the Resource-Based Relative Value System (RBRVS), each procedure code was assigned a specific value, by a panel of experts, based supposedly upon the amount of time and labor it required. It didn’t matter if an operation was being performed by a renowned surgical expert—perhaps the inventor of the procedure—or by a doctor just out of residency doing the operation for the first time. They both got paid the same.

"Process" attempts to convert humans into plug compatible "parts". That was bad enough with programmers -- in which the best are able to produce 10-100x the "output" of the "average".  Measuring that output is exceedingly difficult -- "lines of code" are often used, but most assuredly "more is NOT better". As in writing, the tightest, best performing, most free of problems, easiest to understand, extendable, maintainable ... etc, etc makes programmers FAR from "plug compatible".

Doctors, having MUCH larger requirements relative to knowledge, skill, judgement, decision making, diagnostic acumen,  very personal communication / interaction, etc, etc are far far less "compatible" than programmers. I did a blog post discussing the difference between the pilots that crashed a plane in Buffalo a few years back and "Sully" Sullenberger who dead sticked an Airbus into the Hudson with no loss of life. Paying doctors "all the same" is insane  -- as is thinking that converting medicine into an "assembly line" with a bunch of "codes and process" is somehow going to "improve" it. What it does is shift power and renumeration to bureaucrats and devalues the unique skills of doctors.

So what we end up with is this:

In other words, we’re about to experience the two-tiered system that already exists in most parts of the world that provide “universal coverage.” Those who have the financial means will still be able to get prompt, courteous, personalized, state-of-the-art health care from providers who consider themselves professionals. But the majority can expect long lines, mediocre and impersonal care from shift-working providers, subtle but definite rationing, and slowly deteriorating outcomes.

The best doctors will end up in the private system, and a lot of solid doctors the next echelon down will just leave medicine because it is no longer a profession and they are professionals. What 90% of the population is increasingly left with is best described in this from Ayn Rand's "Atlas Shrugged".

“Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”

AA, BOcare, Drugs

The Irrationality of Alcoholics Anonymous - The Atlantic:

Reading through this I find a couple of threads:

1. BOcare has mandated that all insurance policies include 30 days of treatment for alcohol, so there is more money in the alcohol treatment bucket than ever before. Money as always is "good and bad". True, more people may get treatment -- OTOH, it is likely there will be a bunch of "standards" that may or may not be that helpful to people that need help -- but they will certainly direct money to "the right pockets" as determined by politics. 
2. Folks like the Atlantic HATE anything that smacks of "higher powers", so AA makes them VERY uncomfortable! 

That said, I can't imagine anything outside of God that can't be improved. It turns out there are a couple of drugs that are approved for treatment of alcohol abuse. 

I researched this article, I wondered what it would be like to try naltrexone, which the U.S. Food and Drug Administration approved for alcohol-abuse treatment in 1994.

Perhaps even worse is the pace of research on drugs to treat alcohol-use disorder. The FDA has approved just three: Antabuse, the drug twhat induces nausea and dizziness when taken with alcohol; acamprosate, which has been shown to be helpful in quelling cravings; and naltrexone. (There is also Vivitrol, the injectable form of naltrexone.)

AA, because of the "anonymous" part can at least seem somewhat secretive, and at least some of the AA people tend to be "anti-substance" -- as in "if you are taking ANY drug, that is "the same" as being addicted to alcohol". Of course, that is an oversimplification -- any relatively loose organization like AA is going to have SOMEBODY that says damned near anything.

I don't draw any conclusions from this. Alcohol is a drug, so it doesn't seem impossible that some drugs might help reduce cravings for it. As a fat guy, I noted with more than a little interest that naltrexone might curb cravings for food.

Personal aside. Apparently a guy that I have known for around a decade committed suicide over the weekend -- not local, not completely sure, friendship had been reduced to FB except for me seeing him on my long motorcycle trip in 2013. Few other things going on -- my Dad's issues being one.

Girl Scout Cookies were brought into the house. I resisted them for a couple of days, but in the presence of nice cold milk mid-afternoon, I succumbed. End damage, a row short of a whole box. I really had no intent of eating that many, it was purely "one more ... oh, there is some milk left ... oh, I need more milk ... and ... repeat".

The snake brain is a scary scary thing -- given the right circumstances I am DEFINITELY powerless against Girl Scout Cookies. I once heard of someone who could eat ONE -- she ought either be killed or put in  control of the universe,  I'm not qualified to state which!

Keep the damned things OUT OF THE HOUSE! ... there but for the grace of God!

Anyway, "addictive behavior" --- food, video games, drugs, alcohol, smoking, gambling --- is certainly part of the human condition. The drugs and alcohol are currently at epidemic proportions and killing over 50K people a YEAR.


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MNsure, "Free" Still Not Free

Some shocked by estate claims after signing up with MNsure | Duluth News Tribune:

Since we live under the rule of bureaucracy, reading the whole linked article is probably worth it, though it is longer than it needs to be.

Bottom line, in the machinations of BOcare, MNsure and Minnesota Care, the "asset test" for MNsure was taken away because there is none for BOcare and you are REQUIRED to purchase health insurance by law now.

But Minnesota failed to add a form to the tall stack of forms that lets you know that they are putting a lien on any assets you have for the cost of your "free insurance".

My Dad is in a nursing home for at least awhile -- got to sit through a discharge from one facility under Medicare and into another where a "supplemental" was involved. Stacks of papers, lots and lots of questions -- the wheels of government grind the lives and fortunes of us all, but they make sure they gather a lot of data while they do it.

Freedom has never been free -- and the cost of tyranny is still infinite.

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Socialism, When Your Grandchild Dies

Drug Shortages Forcing Hard Decisions on Rationing Treatments - The New York Times:

If we were still a nation that was able to understand enough to self-govern, this is a story that ALL ought read and at least have the tradeoffs explained. In a conservative or engineering universe, EVERYTHING has a cost, and there are ALWAYS tradeoffs. When you vote in socialism you give up your ability to have any control in trying to make life better for those you hold most dear -- in my case, my granddaughter, but you can pick your own. You "outsource" your power and responsibility.

In a "liberal" or utopian universe, "all things are possible" -- perfection is always one more program, tax, regulation, law or "blue ribbon committee" away. The only thing really holding up nirvana are those damned reactionary conservatives!

“It was painful,” said Dr. Yoram Unguru, an oncologist at the Children’s Hospital at Sinai in Baltimore and a faculty member at the Berman Institute of Bioethics at Johns Hopkins University. “We kept coming back to wow, we’ve got that tragic choice: two kids in front of you, you only have enough for one. How do you choose?”

The article makes it clear that we are ALREADY at "triage" for even critical drugs for children in medicine. We have regulated, "negotiated", "optimized", drug manufacture to the point where profit margins are razor thin (at best).  Before the move to socialized medicine got it's first purchase in the US with the advent of Medicare in the '60s, the rest of the world could do socialized medicine and have the US as a "market driven backup". That backup is on life support at best now.

The canary is dead folks. (they used to use a canary in coal mines ... if the canary died, it was time to make like a priest and get the flock out of there!).

We have had AMPLE warnings on how socialized anything works. East / West Germany, USSR vs US, current Venezuela, current N vs S Korea. The US was the huge "backstop" that allowed Japan and Europe to go socialist without having to "go gulag". When "regulation" fails to produce what is required, shortages result, and there is no market operating anywhere, then the ONLY choice is "forced labor". The government must FORCE some company to produce the drug at some stated price (to start) ... but after a bit, why should they pay them anything? FORCE them to produce what has been declared as "required" by the centralized power. We KNOW how that "works" ... it doesn't.

When you see critical drugs being rationed for children HERE, then you have NO EXCUSE to not realize that the effects of socialism are not changed by some magic of being applied in this area of N America!

Vote BS, but hoard toilet paper!

In recent years, shortages of all sorts of drugs — anesthetics, painkillers,antibiotics, cancer treatments — have become the new normal in American medicine. The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs and therapeutics, for reasons ranging from manufacturing problems to federal safety crackdowns to drugmakers abandoning low-profit products. But while such shortages have periodically drawn attention, the rationing that results from them has been largely hidden from patients and the public.

The NY Times naturally LOVES socialism, they are not going to go ALL the way to making the connection for you, but that paragraph does pretty well. The next one adds a bit more ... "economic incentives" ... we are still more fascist than socialist, so those are still involved. Why not just FORCE them to produce what is required? That would get us to "real socialism", which is basically communism. Remember gas lines? Carter was going to "control the price" -- which naturally controls the SUPPLY as well!

Many drugs are made by only one manufacturer, so production or safety problems at a single plant can have big effects. For another company to begin making the products and getting them approved by regulators requires the right combination of manufacturing capabilities and economic incentives.

So, when socialism produces shortages, as it always does, then what is needed is "fairer / more expert / "enlightened" allocation of the now scarce resource. Oh, and they "advised" it ought to be "made public".  Potentially, while there is still enough private pharmaceutical industry left to blame things on, that might be a political winner, but when the last vestige of that is gone and we all KNOW that it is the government making all these production / rationing decisions? Hillary's e-mails are WAY more "public" than that information will be then!

The effort, led by Dr. Unguru, the Baltimore oncologist, recommended that the drugs be rationed based on the ability to save lives or years of life, including curability of a child’s cancer and the importance of the drug in improving the chances. It also recommended that children participating in clinical research should not get priority over those who are not, because of concerns about coercing families into trials. The group also advised that allocation decisions be public.

"The banality of evil" rears it's head again -- THIS is how socialism works! "The vagaries of distribution" indeed! Profit is the price paid for supply meeting demand! Regulate that away and numbers coursing their way through an endless myriad of bureaucratic "clearing houses", "agencies", "offices" and "czars" are supposed to match supply to demand, but never do. Eventually, those "numbers" are people, and they are dispensed with using the same cold logic and pseudo "efficiency" as mere numbers.

The vagaries in distribution and inconsistencies in rationing have led to calls for change. Doctors and others have suggested the creation of a clearinghouse of scarce drugs and voluntary sharing to promote equitable access for patients. Others argue that there should be a registry of patients given nonstandard treatments so the results can be tracked.

Dr. Lurie, the federal health official in charge of emergency preparedness and response, said that the government was working to encourage hospitals to conserve and substitute drugs to avoid a crisis and trying to fill gaps in manufacturing. Steps taken by the Food and Drug Administration have also helped reduce the number of shortages, she said.

IF any Sanders supporters have read this far, I'm sure they are saying, "yeah, sure ... and "capitalism", "freedom", etc are PERFECT!

NO, THEY ARE NOT! That is precisely the point -- they admit that they are NOT PERFECT, but at least they don't institutionalize evil! They KNOW and admit that. The market doesn't have to "wait 4 years to make a change" and you get to "vote" (by buying and selling) typically many times a day!

Gay Healthcare

It’s almost over for Hillary: This election is a mass insurrection against a rigged system - Salon.com:

Remember the "Vote No!" campaign on the marriage amendment in MN? We were assured over and over that "Nobody has any plans to make gay "marriage" legal in MN, that is simply a lie created by fearful and bigoted people".

They made gay "marriage" legal the year after the amendment failed. One of the advantages that evil has is that there are NO RESTRICTIONS on the methods you can use to win -- when there is no such thing as truth, what would a lie be?

Similarly, BOcare was "not socialized medicine", and "If you liked your healthcare, you could keep it". What it is is WEALTH TRANSFER!

Here we have a quote from this fine article:

As for the notion that voters can’t see that paying $1,000 in taxes beats paying $5,000 in health insurance premiums, it is an insult to the American people.

Note, this is AFTER those of us who managed to work long and hard to get some tiny chance of few years of a decent retirement have ALREADY suffered INCREASES in healthcare costs on the order of $5-$10K!!!!  BOcare has already increased our out of pocket costs by 5-10 TIMES, although a lot of that is due to it sitting in accounts as "pre-spent". Having been or currently being a "maker" vs a "taker" in the US is like being a Christian in a country that recently went Islamic -- you are getting a lot of raw deals, but there isn't any choice, and it only looks to get worse in the future. 

"American people" for Salon are the 50-60%  of Americans that already pay at most $1K in taxes TOTAL. In fact, the bottom 40% of the country already gets more than HALF of their income FROM the government!

So where do we go from here?

Twenty years on, Hillary still sees the world through the rose-colored glasses of that ’90s consensus. Not Bernie. He sees that in 2016 rising tides don’t even lift most boats, that growth comes at a steep price when it comes at all, and that new technology cost more jobs than it creates. He understands that when jobs flow to countries with weak governments and low wages, the American middle class can’t get a raise. He sees that public-private partnership meant pay-to-play politics, and that the whole system runs not on innovation but corruption. My guess is the middle class sees what he sees and wants what he wants: a revolution. If he can continue to drive the debate, they may get one.

Ah, "Revolution" ... ah, to WHAT?

Well, the Reagan - 2006 growth wasn't good enough! The "consensus" in the '90s wasn't right. Technology isn't the answer. "Public-private partnership" doesn't work. SO??

Well, it would seem to me that the "only choice" that folks like Salon can see is complete Socialism ... or Fascism. Either government takeover of the means of production, or leave the capital ostensively in the hands of "private", but completely regulate it and 100% state what salaries, benefits, "profits", etc are. So much for "partnerships" -- it would seem that FORCE is the "only answer".

Why is it again that anyone is supposed to somehow "trust" the left? They avow no morals, they claim that truth does not even exist.

Pretty much everything in this country seems to be heading to be as fecund as a gay "marriage"! 

'via Blog this'

Strib MinnesotaCare

MinnesotaCare was great, until the invoices dried up - StarTribune.com:

One can't expect a lefty leaning person to really learn from experience, but if a corporation provided service this bad the Star Trib would almost certainly be demanding lawsuits, government action, etc.

Of course MinnesoataCare **IS** the government, and "they are here to help" ... but you would never know it from the phone exchange below (there is more in the top linked article):

I called often but the result was always the same: “We’re experiencing a high rate of calls. Please call again later.” **Click**. 

I was foiled online as well, my MNsure account disabled by the usual cyberscape bouncer, System Administrator. On rare occasions I pierced the cones of silence that hung over their help desks. “Wait! I’m here!” I croaked. My throat dusty, forming words like a Bedouin straggling in from the Sahara. “I have copies of checks … Tax info …“They don’t match our records,” said the voice. 

“How can you have records if you don’t send us invoices?” 

“Mail in your payments anyway, without the invoice,” said the voice. 

“I tried that, you guys applied them to the wrong account.” 

“Mail them anyway.” 

“You want me to mail money blindly, with no paperwork, to an agency I can’t call or contact?” 

“Just put your ID number on the check,” said the voice. 

“You mean this one?” I read the number. 

“That’s not your number.” 

“That’s my ID number from the last invoice you sent me. It says right here: ID number.”

I've heard a full crowd of lefties on MPR try to sort out why we have MinnesotaCare + MNsure, and how that all relates to BOcare, and it was obvious they were very confused, some of THEM even wanted to get rid of MNsure ... but naturally, since they were all lefties, there were a couple that were CERTAIN that MinnesotaCare's many problems (that they all agreed it had) would be worked out "soon". I believe I heard that last spring.

Here is another article on the subject ... "Faulty Billing Costs State $44 million".

But who really cares? It is ONLY $44 Million, I mean it isn't like some CEO got that for a salary or the Koch brothers gave it to some campaign or something!

'via Blog this'

BOcare, Wealth Transfer And Lies

Jonathan Gruber’s ‘Stupid’ Budget Tricks - WSJ - WSJ:

A Republican President that had a single attempted program that benefited say business, or families, or energy, or hard work, or thrift -- any of the horrors of existence that the left rails against, and was somehow exposed as having knowingly used subterfuge to accomplish it would have been removed from office within a year of the discovery.

We know this. We witnessed the level of media outrage over W's supposed shortcomings as a fighter pilot 30 years prior to taking office, the absolute meta-falsehood of "Bush lied, people died" where at worst he merely took action on information at the time, and has since been proved correct, and even the complete farce of Valerie Plame -- the "secret agent" who drove to work each day at CIA HQ ("Deep Cover")!

As I've said, none of this is new -- it's been exposed since before the bill was passed. It is absolutely clear that Americans were lied to big time by BO, the MSM and Democrats in general, but what is new? I can only assume that most Americans are OK with that -- although they may not like actually having their elite "experts" call them stupid to their face. Anyone that doesn't realize that the lefty elites think of them that way is either willfully not paying attention, simply doesn't care, or is actually stupid. "Bitter Clingers" anyone?

“this bill was written in a tortured way to make sure CBO did not score the mandate as taxes. If CBO scored the mandate as taxes, the bill dies.”

Yes, BOcare was always and still is a massive tax increase largely on the middle class and young to transfer dollars to those that failed to insure in the past and are now stuck with no insurance and existing conditions.

So it is all old news, but is there actually a limit to how much voters will put up with? The first mistake that folks like myself and likely readers of this blog make is that something like a "majority" of voters are actually aware of this -- I doubt it is covered on Jon Stewart, I've not heard it on MPR (I don't listen 24x7, but a casual listener certainly could have missed their coverage), and I'm certain it is sparse to non-existent on MSNBC, Huffpo, etc. I suppose some of their folks take the Pelosi dodge of "he didn't write it, I never knew him" ... followed by, OOOPS, big praise for him!

Such admissions aren’t revelations, since the truth has long been obvious to anyone curious enough to look. We and other critics wrote about ObamaCare’s budget gimmicks during the debate, and Rep. Paul Ryan exposed them at the 2010 “health summit.” President Obama changed the subject. 

But rarely are liberal intellectuals as full frontal as Mr. Gruber about the accounting fraud ingrained in ObamaCare. Also notable are his do-what-you-gotta-do apologetics: “I’d rather have this law than not,” he says.

Yes, BOcare is nothing but a gigantic wealth transfer fraud perpetrated on the American people, but will a DIRECT ADMISSION made by one of their own have any effect on the discussion?

So they used a decade of taxes to fund merely six years of insurance subsidies. They made-believe that Medicare payments to hospitals will some day fall below Medicaid rates. A since-repealed program for long-term care front-loaded taxes but back-loaded spending, meant to gradually go broke by design. Remember the spectacle of Democrats waiting for the white smoke to come up from CBO and deliver the holy scripture verdict.

The "savings"? A lie! The cost control?  Also a lie!

Then again, Mr. Gruber told a Holy Cross audience in 2010 that although ObamaCare “is 90% health insurance coverage and 10% about cost control, all you ever hear people talk about is cost control. How it’s going to lower the cost of health care, that’s all they talk about. Why? Because that’s what people want to hear about because a majority of Americans care about health-care costs.”

It's 90% wealth transfer, but people want to hear "lower costs", so they faked the numbers and lied about the particulars of the bill so that the MSM would make claims that BOcare "controlled costs".

The only way it "controls costs" is by putting middle class people like myself that formerly had good coverage into high deductible Vegas Style HSA plans so we use less healthcare!

We certainly made a horrible choice to allow BOcare to pass -- was it because of not paying attention, being lied to, or being stupid? I suspect there are plenty of each in the mix.

'via Blog this'

Boston Tea Party

Scott Brown Beats Martha Coakley - WSJ.com

Massachusetts passed a prototype of the Obama plan in 2006, and residents have since watched as their insurance premiums have risen to the highest in the nation, budget costs have soared, and bureaucrats are planning far more draconian regulation of medical practice. Mr. Brown accurately said the national sequel would be too expensive and reduce the quality of care, and that it would be a "raw deal" forcing Massachusetts taxpayers to subsidize all other states.

Why do I need to read this buried in an article only AFTER the special election? I've certainly been aware of what the MA plan has caused because I'm the kind of idiot that wastes my time running off and finding such things. What I just don't get is why ANY news outlet that actually cares about outcomes for the country would NOT want to look into what has been wrought by a plan that even far lefties have identified as being "very much like the moderate Senate bill". (See Paul Krugman)

The fact is that the Senate bill is a centrist document, which moderate Republicans should find entirely acceptable. In fact, it’s very similar to the plan Mitt Romney introduced in Massachusetts just a few years ago.

The voters of a state that PASSED something very equivalent to the MOST CONSERVATIVE version of what is being shoved down our throats now have resoundingly spoken on what they think of essentially the health care bill that they now have EXPERIENCE with going national, and NOBODY CARES? Having STATES pass new laws that are controversial and then observing the outcomes is exactly what the US was supposed to be about. Our Founding Fathers unerstood the principles of "Agile Development" over 200 years before it became the rage in software.

How can we possibly govern ourselves if we are not reality and outcome based?

Goodbye to Your Health Insurance

RealClearPolitics - You Will Lose Your Private Health Insurance

Do you believe it is an accident that suddenly no mammograms are required at less than 50 years of age? Expect many rulings of this sort in the months and years to come, but rest assured that the STATISTICS on health will continue to look better and better. The fox is in charge of the hen house, he has declared the hens are all fine and happy!

So there we have the real essence of this bill. It restricts our choice of which insurance to buy and pushes us into more expensive plans. At the same time, it destroys the economic incentive to purchase insurance in the first place and replaces insurance with a free-floating tax on one's very existence.

Essentially, this bill forces the insurance companies to cover everyone at the same rate without regard to pre-existing conditions, demands that the coverage cover every little thing (thus making sure that health costs go up), and removes any prospects of profit for the insurance industry.

The part I think I "love" the most is the part that Al Franken was bragging about on MPR today -- insurance companies MUST put 90% of premiums paid into payments for medical care. ONLY 10% can be spent on administration, management, advertising, etc. Isn't that sweet? So what incentive do we have here? Let's see, if I have $1,000 premiums today, I can make only $100, but if I get to $10,000 in premiums, I can make $1,000. Do you think the medical community would like to get that extra $9,000, or do you think they would turn it down?

Oh, I know, there will be a "government regulator" -- guess what, there always have been PLENTY of "government regulators" at SEC, HEW, USDA, etc, etc, and billions of dollars are wasted, skimmed or just flat out missing all the time. Did you hear of anyone at SEC losing their job over the Sub-Prime meltdown? A couple real high level guys at FANNIE and FREDDIE got canned, but they got picked up in the BO campaign. One needs a crisis before one can be sure it doesn't "go to waste". We are set up for a "crisis" a minute now.

The real purpose of this bill is to run up the cost of insurance for everyone as a prelude to government takeover. There isn't a lot left between this level of mendacity and cynicism and the gulag. Merry Christmas, Comrade.

How Disaster Happens

RealClearPolitics - Can Dems Rescue ObamaCare?

It is hard to say whether the BOcare debacle will be ended quite the way Krauthammer suggests here, but it will likely have similar results in any case.

(5) Promise nothing but pleasure -- for now. Make health insurance universal and permanently protected. Tear up the existing bills and write a clean one -- Obamacare 2.0 -- promulgating draconian health-insurance regulation that prohibits (a) denying coverage for pre-existing conditions, (b) dropping coverage if the client gets sick, and (c) capping insurance company reimbursement.

What's not to like? If you have insurance, you'll never lose it. Nor will your children ever be denied coverage for pre-existing conditions.

The regulated insurance companies will get two things in return. Government will impose an individual mandate that will force the purchase of health insurance on the millions of healthy young people who today forgo it. And government will subsidize all the others who are too poor to buy health insurance. The result? Two enormous new revenue streams created by government for the insurance companies.

This "plan" is WAY more detailed than "Coverage for all, cheaper, better with more choice"!! This "plan" actually has something about HOW!!! But, like all things in this world that are "only pleasure" ....

Isn't there a catch? Of course, there is. This scheme is the ultimate bait-and-switch. The pleasure comes now, the pain later. Government-subsidized universal and virtually unlimited coverage will vastly compound already out-of-control government spending on health care. The financial and budgetary consequences will be catastrophic.

However, they will not appear immediately. And when they do, the only solution will be rationing. That's when the liberals will give the FCCCER regulatory power and give you end-of-life counseling.

But by then, resistance will be feeble. Why? Because at that point the only remaining option will be to give up the benefits we will have become accustomed to. Once granted, guaranteed universal health care is not relinquished. Look at Canada. Look at Britain. They got hooked; now they ration. So will we.

Government is a lot like drugs, smoking, gambling or other vices. When you "start", it seems "all good" -- it is just after you have been in it for awhile, realize how dependent you have become, how few other choices you now have, and how much power you have given up to your addiction, that you realize "they've got me". Then, as intended in the beginning, it is too late!!

Simple Truth

Remove the complexity and often the truth is quite simple!

Questions For BOcare

RealClearPolitics - 10 Questions for Supporters of 'ObamaCare'

Not that supporters of "hope and change", now currently in the guise of BOcare are likely to be either the question asking or answering type, but in case there is anyone that is starting to wonder if "not all change is positive change", these would be some reasonable questions to want to get answered before going many more trillions in the hole.

If a slick car dealer came up to you and said that he was going to get you a cheaper and better car and get some other guy to pay for it, would you believe him? Would you believe him if he read everything to you off a teleprompter?? If not, it would REALLY be a good idea to think just a little more deeply about BOcare.

Hearts, Minds and Calcium

In the process of my physical for age 50 I was treated to a Cardiac CT scan. The procedure is relatively easy as medical tests go. You lay on a slab that moves you in and out of the big CT donut with some leads attached to your chest. The technology allows a calcium score to be calculated that is considered a new indicator for the potential of a cardiac event. Calcium in the arteries is "atherosclerosis" or "hardening of the arteries". It ISN'T "blockage", but they believe that it is a precursor to blockage. I managed to fail it very well with a score for my age that would put only 6 people out of 100 being worse off.

The test was a week ago Thursday, with the results the following day, so I got a full week to enjoy "limbo" relative to how bad this really is. Friday AM I took a stress test, which fortunately I passed with flying colors. A good hour was spent in the PM talking to a couple of I'm sure very high priced Mayo cardiologists. The bottom line is "it is another risk factor, but it is too early to give a solid % of exactly how bad it is". What it means for sure is "Lipitor, low cholesterol diet, lose weight, more medication to reduce blood pressure and be sure to keep up all the exercise".

Interestingly, we don't really have the technology to predict "sudden death heart attacks", although the Cardiac CT is often oversold as just that. At least at Mayo, the next test after the Cardiac CT is the stress test, and they have no inclination to do a Angiogram where they put a probe into the heart unless there is chest pain and/or a negative indicator on a stress test. Putting a probe into the heart is not without risk, and unless someone is 50% blocked or greater, they aren't going to stent it anyway. They will proceed with the same drug therapies that I'm now on in hopes of some level of reversal, or at least slowing the deposits so that the rest of the population catches up with the patient.

Everyone over "40 or so" carries around an increasing risk that "something will go wrong" and a piece of plaque (that nearly everyone that age has some of) will break off and lodge in the wrong place. When it does, things go bad in a hurry and life is in danger. They have a lot of theories about the mechanism; inflammation is a leading guess, and they check the blood for something called "C-reactive protein", yet another risk factor which was fortunately normal in my case.

So, I embark on an attempt to radically change my weight profile ... even though a relatively svelte Moose at 6'4" 280lbs, it is time to work toward the lower bounds of "lost Moosehood" in the lower 200lb register. Some nut claims that even for 6'4" and "massively boned" (size 14 ring) something like an anorexic 240 is "obese". "Living" seems a better idea than "living large", so a smaller feedbag is already in evidence.

Certainly I would have preferred a great score and no need to make any changes, but being given the opportunity to make changes and hopefully avoid a heart attack seems like a blessing that should be looked at positively. The "easy week" of weight loss is behind me with 6lbs down. It ALWAYS seems easy for the first week ... but when 10% of your bodyweight is 28lbs, it ought to be ;-(

I'm thinking that the logical thing is to "blame the skinny" and lay some sort of a "skinny tax" on them. I've seen some of those high metabolism types eat like there was no tomorrow and not put on weight. Such things are simply "not fair", and any decent Government would find some way to put those folks in their places as fast as possible! It must be Bush's fault that it hasn't been done already!