Category Archives: General Cynicism

Those favoring unleashing and deregulating markets in health care should consider the July 2,  Planet Money episode – The Little Lie that Rocked the Banks.  More here on July 7.

The episode involves Barclay Bank’s and likely other bank’s manipulation of the LIBOR which is the basis for lending money between banks and to consumers around the world. A little manipulation can lead to a lot of profit.

You would think that after 2007, when banks were deeply involved in the fraud and manipulation of the bank/market meltdown, that they would be scrupulously honest.   But no,  the instinct is to take advantage wherever you can.  Well you might then say “that’s the beauty of free markets.”  Find a weakness and take advantage.  But, again as in 2007,  it involves lying and cheating consumers—which sadly also appears to be part of unregulated  markets.

Medicynical Note:  Free markets are driven by the “need” to maximize return.  The game is not to provide the best service (in the LIBOR case an honestly derived interest rate) but rather to maximize return, even if you need to manipulate the “system.”  Regulation is anathema to “free markets” because it interferes with the game. 

In health care this partially explains our inefficiency and high costs.   As it is we have health insurers who do their best to not insure sick people so as to maximize return.  We have suppliers whose goal is to pad their bottom line, not benefit the health and well-being of patients.  And lastly we have a well developed non-system that allows and, in some ways, encourages conflicts of interest at every level. 

If we value health care rather than profits we need a regulated health system whose aim is universal access and affordable cost.  More here.

Interesting look at bubbles and capitalism.  The article is ostensibly about the views of Jeremy Grantham (a manager of a global investment firm) and notes his hypothesis that there are 10 bubbles slowly destroying capitalism.

Flash forward: in Grantham’s early 2012 newsletter he saw a bigger train accelerating: When he focused on the “common good, it became quickly apparent that capitalism in general has no sense of ethics or conscience. And probably its greatest weakness is its absolute inability to process the finiteness of resources and the mathematical impossibility of maintaining rapid growth in physical output.”

This we call the Myth of Perpetual Growth, the pseudo-scientific justification for modern capitalism.

Grantham concludes that capitalism’s flaws are so deadly that while it does “a thousand things better than other systems,” it fails in those three crucial areas. And “unfortunately for us all, even a single one of these failings may bring capitalism down and us with it.

Number one on the bubbles list: is “the Health-care Bubble: Forget court, elections — health care will implode.”  It’s unsustainable.

Read the article for the others.

Medicynical Note:  We’ve long postulated that we have no system of health care in the U.S.  (Here and Here) The facts seems to bear this out:  50 million without insurance; New drugs that cost more the average and median income;  Hospital bills in the hundreds of thousands of dollars; Our (the U.S.) Cost/capita for health care twice that of many other industrialized nations.   

It’s not rocket science.   Our non-system is broke.

Drew was reportedly on the GlaxoSmithKline payroll:

In June 1999, popular radio personality Dr. Drew Pinsky used the airwaves to extol the virtues of GlaxoSmithKline PLC’s antidepressant Wellbutrin, telling listeners he prescribes it and other medications to depressed patients because it “may enhance or at least not suppress sexual arousal” as much as other antidepressants do.

But one thing listeners didn’t know was that, two months before the program aired, Dr. Pinsky—who gained fame as “Dr. Drew” during years co-hosting a popular radio sex-advice show “Lovelines”—received the second of two payments from Glaxo totaling $275,000 for “services for Wellbutrin.”

Read the article for more details….other doctors received more in payments to shill for the drug company.

Medicynical Note:  Sadly my profession has been corrupted by it’s conflicts of interest.  Some inevitable because of the nature of medical care.  Doctors earn more by “doing” more.  Other conflicts are optional and apparently more remunerative, as indicated in the article.  This too needs reform.

Maybe I should add a post category for medical corruption?

1.  The freedom from going bankrupt from health care costs.  (Bankruptcy from health care expenses is unknown in other industrialized countries)

2.  The freedom from being denied health insurance because of pre-existing illness. (Only a sadist could conceive of a system that  denied coverage when a person becomes sick?)

3.  The freedom from having health care insurance costs increase because of illness. (Ditto)

4.  The freedom from not having health care coverage because it’s too expensive (The U.S. leads the world in health care costs.  This is a step to controlling expenditures)

5.  The freedom from  delaying health care because of a lack of health care coverage. (Worry about costs is a common cause of patients not seeking care for problems)

6.  The freedom from having to go to an emergency room for  care because you don’t have the money to see a family doctor  (We currently require ER’s to provide care to anyone who needs it.  Admirable, but ER care is the most expensive, most inefficient and in some ways least effective care there is)

7. The freedom from not being able to afford your child’s health care. (Assured coverage for all citizens is a reasonable goal for the “most advanced” country in the world—that’s not socialism but rather is common humanity—sense too)

8.  The freedom from religious institutions interfering with health care coverage  (Coverage should be guided by a person’s needs not someone else’s belief system)

9.  The freedom to have a patient doctor relationship (Without health insurance most people cannot afford care)

10.  The freedom of being able to survive a medical emergency without financial worry. (No explanation necessary)

The 2011 National Health Insurance Interview Survey note:

• Once each year, this quarterly report presents health insurance coverage rates for selected states. In 2011, the percentage of persons who were uninsured at the time of interview among the 32 states shown ranged from 3.9% in Massachusetts to 22.6% in Nevada.
• In 2011, 46.3 million persons of all ages (15.1%) were uninsured at the time of interview, 58.7 million (19.2%) had been uninsured for at least part of the year prior to interview, and 34.2 million (11.2%) had been uninsured for more than a year at the time of interview.
• In 2011, the percentage of children under age 18 years who were uninsured at the time of interview was 7.0%.
• Among adults aged 19–25, the percentage uninsured at the time of interview decreased from 33.9% (10 million persons) in 2010 to 27.9% (8.4 million) in 2011.
• Among adults aged 19–25, 56.2% were covered by a private plan in 2011, an increase from 2010 (51.0%).
• In 2011, 29.0% of persons under age 65 with private health insurance at the time of interview were enrolled in a high deductible health plan (HDHP), including 9.2% who were enrolled in a consumer directed health plan (CDHP). More than 50% of persons with a private plan obtained by means other than through employment were enrolled in an HDHP. An estimated 21.4% of persons with private health insurance were in a family with a flexible spending account (FSA) for medical expenses.

Medicynical Note:  The positive aspects of the survey are in part due to the coverage extended to young adults (coverage through their parent’s plan) by the health reform package supported by the President and currently under review by the Supreme Court.  Amazingly it and the other extensions of coverage to uninsured people will be obliterated by an adverse Supreme Court review.  Only in America could this myopia be sustained!