Tag Archives: American capitalism

Republicans Aim to Cut Medicare, Medicaid and the Affordable Care Act. Meanwhile:

As a new year and presidential election approach, Americans face a worsening crisis: the affordability of healthcare. More Americans than ever, about 92%, now have health insurance – and simultaneously face enormous bills.”

“Over the last decade, insurers and employers have pushed more cost-sharing onto individuals and families. Now, squeezed by medical costs and inflation, more than 100 million Americans have medical debt and roughly the same proportion report avoiding a prescription because of it.”

Medicynical Note: Americans pay more for healthcare, by a wide margin, than folks in any other industrialized nation. We pay more for doctor visits, hospital stays, medications, medical devices, insurance, everything.

We are also the only industrialized nation where there is medical debt. Why? It’s not rocket science. In a for-profit healthcare system everyone involved wants to make……. a profit.

Why doesn’t the “marketplace” in our for-profit healthcare system work to control prices? Here, for a variety of reasons providers don’t have to compete on price, i.e. efficiency and value. And in any case, prices are not advertised or easily accessed. When you ask a hospital how much an operation or procedure will cost you will get a vague mostly inaccurate estimate or be told it “varies.” You literally can’t get an accurate total price for care. And lastly health care is not descretionary. When you really need it, you don’t have time, ability or motivation to shop for the “best” most economical option.

Adding insult to injury, one political party is planning make things worse and cut the already limited government supported health insurance programs if they win the next presidential election. They literally have no alternative plan for health care. Hint. That political party’s logo is an elephant.

Liberia Makes the U.S. into a Banana Republic

Liberian President George Weah has been hailed for his sportsmanship for conceding to his rival in the presidential race – from across the political divide and the region.

Medicynical Note: Meanwhile in the U.S. our former President and current, oh so very devout, Speaker of the House continue to refuse to say that he lost the last election. This, despite the fact that he lost by several million votes; despite the fact that he also convincingly lost the electoral count; despite the fact that his attempted coup d’etat failed; and despite that fact that he lost over 60 cases in various courts contesting the election.

And that former president despite the fact that a Colorado Court recently ruled that he led an insurrection against the government of the United States is not in jail and is running again for the presidency.

What is more Banana Republic/Third World than that! (Apologies to all Third World nations)

Leading Cause of Accidental Deaths of Children in the US? GUNs

I guess the founders, in their wisdom, as interpreted by Thomas, Alito, Gorsuch and others have achieved their finest hour. We have guns available literally everywhere, for everyone.

Their crowning achievement however is that gun deaths are now the leading cause of childhood accidental deaths in the United States. No other industrialized country can make this claim.

Medicynical Note: I’m sure the writers of the constitution in the era of the flint lock rifle did not anticipate handy little Berettas and Glocks or the world of UZIs and AK47’s. Our Supreme Court in their wisdom believes the founders would approve of easy access by literally everyone to those weapons. And now American children bear the consequences.

Meanwhile those same Supreme Court Justices claim they need more protection from protesters who march near their homes because one might be carrying those same handy murderous weapons that are killing our kids.

America is an amazing place.

Healthcare: Deceptive Pricing

I recently had an outpatient medical ultrasound procedure. It took all of 30 minutes and was performed by a skilled technician. The bill came to something like $3900.

I don’t know how to value such a procedure but apparently my insurer does.

Below is the accounting of payments and “adjustments” to the price.:

Medicynical Note: Pricing of healthcare in the U.S. is more opaque and difficult to understand than the pricing at a new or used car lot. My sincere apology to car salesmen for the comparison.

Actually, hospital pricing makes the car dealers look good. But, unlike a car purchase, healthcare is not a discretionary expense and when needed, shopping for the best “price” is impossible because of time constraints and because the bottom line price is obscured.

In this case my insurer paid a total of around $900. The rest of the balance, something like $3,000 was an adjustment/discount. My total co-pay was $50.

A person without insurance, however, would have been billed the full $3,900 and would have had to pay that total or enter into some type of bargaining. I may be wrong but I doubt that the hospital would offer the same magnitude of discount even if a patient was savvy enough to ask for it.

In this case the medical facility used was one of the Catholic “non-profit” PeaceHealth facilities in the Northwest.

I’ve noted similar huge adjustments to bills ($25,000 bill discounted to $12,000 for example) in the past. These “adjustments” appear to be the standard operating procedure in hospitals in America.

Ground Hog Day: Again and Again and Again and Again……. Only in America

According to the Supreme Court murder and mayhem were the founders desire. This happens again and again and again only in the United States of America. Every other industrialized country seems to understand that it’s not the doors or mental health or high criminality or not enough hopes and prayers. It’s the guns and everyone knows it

Medicynical Note: Families devastated, lives lost and the Republican Party is concerned only with voiding any limit to gun ownership. Every day again and again and again until we get it right.

The murder abetting Republican dominated Conservative Supreme Court sits above it all with some members in hiding because someone near their homes might be legally carrying a weapon or because of their own personal, open for all to see, corruption (yes Justice Thomas, you). They blame it all on the slave owning founders. Amazing what has become of the once civil society of America.

Santos: A Republican Icon……

It’s hard to believe he’s still in congress. He lied about literally everything during his election campaign and was still elected to the U.S. House of Representatives. This was known at the time of his installation as a member of the house but the Republican leader of the house allowed him to be seated. While somewhat shocking it should not come as a surprise as the leaders of his party regularly suborn perjury and encourage lies whether speaking of the outcome of the 2020 election, the January 6 attempted insurrection, the previous president’s performance, or the causes of the budget deficit.

Medicynical Note: Not only is he still a congressman but he is running for re-election. And the Republican Party………. missing inaction.

Tesla….. the China Option

Being a patriot true only to himself Elon decides to bulk up the industrial base and the battery production capacity of…………. China.

Medicynical Note: A citizen of three countries (Canada, South Africa and the the U.S.) Elon, the good capitalist, is only loyal….. to himself. In the midst of the American vs Chinese economic wars he hedges his bets and expands in China. I guess he doesn’t buy into this made in America and hiring Americans stuff. His interest as always is doing well rather than doing good.

End Stage Capitalism: Sinema…. Lies

In Yiddish it’s called chutzpah. (Wikipedia: “Chutzpah (/ˈxʊtspə, ˈhʊt-/)[1][2] is the quality of audacity, for good or (as in this case) for bad.”)

Ms. Sinema was in congress since the Obama years. She has strongly supported deregulating the banking industry.

“Before she went from the U.S. House of Representatives to the U.S. Senate, Sinema was party to an early effort by the banks to undo the provisions of the 2010 Dodd-Frank Wall Street Reform and Consumer Protection Act that was passed in the wake of the 2007-2008 financial crisis.”

She also voted for the Trump loosening of the Dodd-Frank banking regulations in 2018. “After Trump became president, Sinema and a majority of the House Financial Services Committee supported the far more extensive Economic Growth, Regulatory Relief, and Consumer Protection Act of 2018. Sinema sponsored unrelated accompanying measures protecting children from identity theft and seniors from scammers. The immediate effect was to divert attention from the bill’s ultimate intention, which was to let the banks do whatever they want.”

So after voting for the deregulation of the industry and encouraging bankers to take more risk she’s back. Wondering what happened.

Medicynical Note: We’re watching the slow disintegration of democracy.

A Supreme Court that is supremely unconcerned about voting rights; that appears to support a state religion; that wants to reinstitute the laws of 1776 rather than adjust to the 21st century.

An octogenarian president who, while in my view is an upgrade from the last guy, wants re-election. Someone in their mid 80’s leading the country? Not a good idea.

We also have a House of Representatives led by (third in line for the presidency) a hapless compromised speaker who sold his soul to the most radical conservative faction of his party and who supported the Jan. 6 attempt to overthrow the election.

And now a self proclaimed independent, one of the prime movers to deregulate banking , wonders what caused two banks to fail over the weekend and wants accountability. With such a feckless leadership what could possibly go …………right?

American Health Care…… isn’t

Understanding health care coverage and costs requires a PhD. The folks in today’s health care fiasco bought coverage from a company that for two years doesn’t cover “pre-existing” problems…. and got burned.

‘The plans are often faith-based, whatever that means, and have surged in popularity in recent years because they can be cheaper than traditional insurance — the Kings said their plan cost $534 a month, plus an additional $118 a month to join a direct primary care medical practice.”

“But the sharing plans offer fewer protections than insurance and come with provisos. The Kings said their plan did not fully cover preexisting conditions like Jeff’s heart condition for the first two years of coverage — and he needed the surgery after 16 months.”

In this case the couple found they were liable were for the entire $160,000 billing.

Medicynical Note: Healthcare has become worse than buying a used car, in part because the car purchase is discretionary while in health care one’s very existence may be involved……..and, in part because the amount of money involved in healthcare is so much more.

The article notes: “Hospital charges are generally understood by health economists to bear little resemblance to the actual prices that are typically paid. Instead, they are more of an opening salvo in the high-stakes negotiations between hospitals trying to get as much money as they can for providing care and insurance companies trying to pay as little as possible.”

In this case after billing $160,000 the hospital knocked off $107,000 from their original pricing. This for a non-surgical Cath-lab procedure that probably required only an overnight stay. And FYI the hospital involved had a net revenue of over 800 million dollars and net income (2020) of over 57 million dollars. Not bad for a “non-profit.”

It’s sadly true in America that in America healthcare companies are more interested in income than outcomes.

Healthcare in America: Income over Outcomes!

America has a system of revenue generation that it calls healthcare. Many of it’s “healthcare” corporations work more diligently to improve revenue and income than on improving patient access, affordability and outcomes. That’s American private healthcare even if the company involved is supposedly “non-profit.” This article documents some of the actions of a large non-profit church run hospital system. In reality it is a cash cow that launders hospital income into huge privately held investments.

As noted in the article “But The Times this year has documented how large chains of nonprofit hospitals have moved away from their charitable missions.”

“Some have skimped on free care for the poor, illegally saddling tens of thousands of patients with debts. Others have plowed resources into affluent suburbs while siphoning money from poorer areas.’

And: “Today, Ascension operates in 19 states, mostly in the South and the Midwest. It serves about six million patients.”

“By many measures, Ascension is rich.”

“In addition to its billions in cash, it runs an investment company that manages more than $41 billion. Last year it paid its chief executive, Joseph Impicciche, $13 million.”

“Because of its nonprofit status, Ascension avoids more than $1 billion a year in federal, state and local taxes, according to the Lown Institute, a health care think tank.”

Medicynical Note: In large areas of the country, because of the tax advantage from their non-profit and church related status, hospitals like Ascensions’ have become the only provider of health care, dominating both inpatient and outpatient services. Besides scrimping on staffing and services to maximize return they also enforce health care religious proscriptions on their non-practicing patients and staff.

In the end America has a revenue generating rather than a health generating system of care. It’s interest is more in income than outcomes. Sad but true.