AMA Argues Against A Single Payer System

Medicare For All is a hot topic. To be clear, this is not a health care provider debate. It’s how health care is paid for, a single-payer system. These are two different (though related) things.

The AMA is against Medicare For All. The primary reasons for their opposition as they stated are:

Lack of choice for patients

Higher costs (taxes)

Choice.

The vast majority of us do not have choice in the current system. Our insurance companies dictate to us who we can see, what they can do, and how much we pay. In many places, we do not even have a choice of insurance companies. For our family, the only company in our area is BC/BS. That’s it.

We don’t really have a choice of services. When my doctor said I needed a brain MRI and a neurologist, I had to wait for a week before the insurance company to evaluate and give permission, then I could schedule the MRI. Think about that. Even our doctors’ choice in the course of diagnosis and treatment is subordinate to an insurance company’s dictates.

Cost

Taxes will go up. They’d go up as a replacement for our premiums. For our family, our premiums have just about doubled over 3 years, and we cover one less person. The argument against Medicare for All based on the idea that a single-payer system will cause an increase in costs assumes that costs have been steady with insurance companies. For most people, they haven’t. And for many that have, stable costs are the result of their company increasing the support, not stable prices.

In addition to skyrocketing premiums and higher deductibles, surprise medical bills are appearing all over the place. Some small, some huge.

Costs have been going up for decades. Since the ACA, insurance companies have had a stranglehold on our medical payment (and decision) process

If the AMA doesn’t want a single payer system, that’s fine. Their organization, their policy. But to argue that we’d “give up choice” when we don’t have any choice, or that costs will increase when they’ve been increasing dramatically under the current system rings hollow.

 

https://www.chicagotribune.com/business/ct-biz-american-medical-association-medicare-for-all-20190610-story.html

Brexit – the empty bucket

Brexit
 
A bunch of guys (politicians looking for an edge) got together and decided to convince the British populous that all their problems could be blamed on someone else… the “them.” And, if they simply pushed “them” out of their lives, everything would be great.
 
But, along the way, they forgot to mention all the things the “them” were doing for the populous.
 
And, another but, they didn’t actually have a plan to replace the “them” once they were kicked out.
 
The populous, moved forward by stump speeches, catchy slogans, and empty promises of a universally better life, agreed. They told the “them” to go screw off.
 
What did the bunch of guys do?
 
They sh!t their collective pants. “We won? The populous bought this crap? What do we do now?”
 
What they did was quit. Figuratively and literally, they, to a last, just quit.
 
Theresa May was left holding the bucket of emptiness trying to fill it with stuff that just doesn’t exist.
 
There are no simple answers to happiness or a better life. Most certainly the answer is not “them”.
 
 

Pork industry safety to be more self-regulated

The current administration is shifting the responsibility in the pork industry for food safety from the regulators to the companies.

The Obama administration made a similar move with poultry.

There is an interesting difference between the American perspective and the European perspective.

In the US, policies tend to be a “wait and see” if the industry will do “it”, whatever “it” is (be safe in this case).

In Europe, policies assume companies won’t “do it,” and enforce more regulations, or take action.

In Europe, before drugs or new foods are approved, they have to be proven safe. This is a burden on the companies.

In the US, drugs or new foods are more likely to be approved with lower/no safety standard and then pulled once proven to be dangerous. In other words, people have to get sick or die before the burden shifts to the company.

As a general mindset, the recent events with the Boeing 737 Max are a good example. The rest of the World grounded the plane immediately (nearly) until it could be proven safe (still hasn’t). The US waited as long as it could, until pressure was too much, to ground the plane.

As a priority, the US wanted to lessen the burden on the company where Europe wanted to protect the people.

In the US, we assume:
1) That companies have the same rights as people
2) That companies operate with a conscience and they won’t hurt people (perhaps because they are run by people?)
3) That business growth is the most important thing

With this as a premise, it is easier to accept a loose regulatory environment.

Unfortunately, history shows that companies are willing to literally kill people to expand profit. From the dawn of the industrial age to today, this holds true.

– Slaughterhouses in Chicago ca 1900
– Railroads importing and abusing immigrants 1850-1900
– Mills in the Northeast and East.
– Mines throughout the Southeast, even today
– Superfund sites across the country (residential areas too polluted and now abandoned). 1950-1970s
– Koch bothers pipelines blowing up and killing people
– Firestone 1996-2001, hiding defective tire issue (270 dead)
– Enron shutting down access to electricity in CA to drive up prices.
– Mortgage companies knowingly writing fraudulent loans and literally initiating a worldwide economic meltdown.
– Epipen hiking the price of life-saving drug 5x with no cost-basis, just profit.
– Pharma increases the price of insulin for greater profit.
– Boeing wanting to keep planes in the air despite knowing there was a lethal problem, even after a crash and many reports of problems.

These are just a few that I am aware of. Some were cases of people deliberately planning or covering up. Others were done in the name of profit over people.

Perhaps the pork & poultry industries will do a fine job self-regulating the quality and balancing profits w/ safety. Unfortunately, we won’t know until people get sick or die. Our own history shows us that we’re likely heading for trouble.

Europe passes online copyright rules, benefiting large publishers (they think)

Venture Beat published this article about the liability of linking to publisher content (or anyone’s really).
 
Two issues with the law
According to the new EU rules, which must be adopted by EU countries by 2021, sites must pay publishers to publish excerpts of their content.
 
Okay… not sure how much constitutes an excerpt. But, I get the notion. These are their words, creative property. If you can’t come up with your own words, then you shouldn’t take someone else’s (? even if you attribute it?).
 
But, here is the real kicker…
No Linking Without Payment
They have to pay them to even LINK TO THE CONTENT.
 
Under the copyright rules, as explained in the article, this very post that you are reading violates the new EU rules even if I don’t have images and the article title included, the very hyperlink above makes it a violation.
 
If this same content appears on Facebook,  I am not to be held liable. Facebook (or any other platform) holds the liability. 
 
Neutering the Internet
Google’s search platform is rendered as one huge copyright violation, as are virtually every social media platform or other search engines.
 
This law is akin to removing all the highways from the continent, disabling GPS, illegalizing printed maps, and then telling people to find their way to… anywhere.
 
Left as is, this law essentially means you will only find content that you already know exists and where it is. It kills the sharing of ideas in any broad sense. 
The Beneficiaries
One of the proponents says this says the rules modernize the internet. I am not sure how that conclusion fits. This ruling effectively negates the very core function of the internet and does so in the name of large publishers who simply could not keep up with the changing times.
I also wonder how shortsighted this is. Do the proponents/publishers believe Google or Bing users will simply come directly to their sites to find content?  If they dismiss the traffic driven by social media and search platforms as trivial, then why is the rule even necessary?
If this rule is not overturned, the biggest proponents will likely be the biggest sufferers in the short term.

Coffee Inhibits Prostate Cancer

More good news for coffee drinkers. This article in the New Atlas tells us that drinking coffee has been linked to a reduction in prostate.

The findings come from a study presented at https://uroweb.org/ conference in Barcelona. There are two compounds that the researchers linked to the effect of inhibiting prostate cancer in animals.

But, this aligns with observational studies over the years that have appeared to show a connection between coffee consumption and lower growth for prostate cancer in humans.

Coffee may reduce risk of lethal prostate cancer in men

https://www.sbs.com.au/news/study-finds-italian-coffee-cuts-prostate-cancer-risk

 

https://newatlas.com/prostate-cancer-coffee-compounds/58896/

 
So, drink up coffee lovers. You have one more reason to enjoy your morning brew.
 

Illinois to be First State to Tax Human Waste By Weight

Illinois legislators are taking up legislation to tax human waste.

The proposed measure will tax households based on the weight of the sewage discharge. Weight and consistency will be analyzed with new “smart waste sensors” installed at the junction where each residence waste discharge pipe joins with the municipal sewer system.

The legislation calls for the sensors to be installed by the fall of 2021. While the installation job will be put out to bid, the estimates range from $2 billion to $6 billion. A special Bond issue is expected to cover the cost of the new system.

When challenged about the effect of additional taxes on Illinois residents, the bill’s sponsors said the tax burden can be reduced quite easily by simply eating less. One legislator went so far as to suggest that taxing human waste will lead to less eating and healthier residents, therefore they are doing residents a great service by taxing their waste.

A satirical article on a fictional tax so close to our experience that people should be forgiven for believing it is real.

The Economy: The best thing the president can do is stay out of the way.

In the image, there are
– 3 ways of looking at unemployment
– The GDP
– Federal Budget Deficit

Since 2010, things have been improving.
The trend line from Obama through Trump term to date is steady.
The only difference so far is the deficit.

While the budget deficit can be, and is, drastically affected by the administration at the time (along with Congress), the economy does not follow nice, neat 4 year increments.

The presidents are neither to blame nor to be credited with the economy in any short period of time.

It is us, the American people who are responsible for the economy.

The best thing the president can do is stay out of the way.

BTW, the stock market is a terrible metric for our economic health. If it were a good metric, we would not see the bubbles or rallies and inexplicable big drops. The market is a speculators world and goes up and down accordingly.

economy

Administration changes formual for drug payments. Its not enough.

The Government, despite being the largest payer for meds, does not negotiate price. We simply agree to pay the average going rate in the U.S.

We passed laws that prevent the Government from negotiating drug prices in Medicare and Medicaid. Guess who pushed that law?

Since the U.S. has the highest drug prices in the world, the Gov pays a lot (we pay a lot).

The Trump administration says it plans to change how Medicare pays for some expensive drugs to bring the costs more in line with the prices paid in Europe. This is a good first step.

But, we are only factoring in their costs, not trying to meet or beat it. For a country that says “we always win”, this sounds like we’re giving up pretty easily.

This has been going on for decades now; Rep and Dem administrations and Legislatures. The drug companies got their law, and “our” representatives seem fine with it. Yes, they complain about drug prices, but they don’t take the very simple step of overturning the 2003 law (or at least part of it) and allow the biggest payer of drug prescriptions to use its power to lower the cost.

“For decades, other countries have rigged the system so that American patients are charged much more,” President Trump said Thursday

While the president says other countries “rigged the system” (in his tendency to play the victim), the reality is that the U.S. removed itself from the equation a long time ago.

The proposed changes are small but more than we’ve done before. I only hope it leads to someone taking up the next step of letting the government negotiate the cost of the drugs for which we all pay.

Firearms and the legislation

In view of the discussion around gun control, I looked back a bit to see what some of the milestones regarding gun control were.  Today we argue about our founding fathers being of the mind to allow anything, we argue about the “new push” for gun control, we argue about what people 50 years ago believed (popular are quotes from Reagan on personal responsibility).

 

Militia Acts of 1792

The 1792 federal law mandated every eligible man to purchase a military-style gun and ammunition for his service in the citizen militia. The weapon types were explicitly outlined. Such men had to report for frequent musters—where their guns would be inspected and registered on public rolls.

1866 march to the 14th Amendment – the real gun ownership amendment.

Following the civil war, there was a glut of firearms in the north. There also remained an intrinsic threat to black people. President Lincoln pushed for individuals, including and especially black people, to be allowed to retain their weapons from the service. This was seen as necessary for their personal defense in view of the threat still posed by racists.

In the south, blacks were barred from owning guns. Laws were implemented following a concept of the  “Black Code”, which explicitly denied blacks the same rights as whites, and more specifically, with regards to ownership of property; guns were a deniable properly. This left blacks in the south more vulnerable to the continued threats of their white neighbors.

Congress pushed for and passed the 14th amendment, which codified every free person’s rights to equal access to the benefits granted by the Constitution. While guns were not explicitly identified, they were intended to be and in fact covered under the concept of property.

This was the first recognition of the individual’s rights to own a gun. It was not granted under the second amendment but under the 14th. In the view of the leaders of that time, the issue was not access or no access to firearms, but if there was access to firearms, the same access must be granted to all.

 “too much freedom?”

1934

National Firearms Act of 1934, the first federal gun-control law, which levies a restrictive $200 tax on the manufacture or sale of machine guns and sawed-off shotguns. All sales were to be recorded in a national registry

1938

Roosevelt wins approval of the National Firearms Act of 1938, which requires the licensing of interstate gun dealers, who must record their sales. It prohibits sales to individuals under indictment or convicted of crimes of violence.

1968

Governor Reagan told reporters that afternoon that he saw “no reason why on the street today a citizen should be carrying loaded weapons.” He called guns a “ridiculous way to solve problems that have to be solved among people of good will.” In a later press conference, Reagan said he didn’t “know of any sportsman who leaves his home with a gun to go out into the field to hunt or for target shooting who carries that gun loaded.”

This was in response to the Black Panthers using “civilian patrol” to counter police brutality. The patrollers were armed and openly challenged the police with threats of counter-force should the police use their weapons. The Republicans lead the charge for gun control.

Omnibus Crime Control and Safe Streets Act of 1968 and the Gun Control Act of 1968: federal laws regulating firearms. It prohibits all convicted felons, drug users and the mentally ill from buying guns; raises the age to purchase handguns from a federally licensed dealer to 21; and expands the licensing requirements to more gun dealers and requires more detailed record-keeping.

1986

Firearm Owners Protection Act of 1986. Limits ATF inspections of gun dealers. And it banned civilian ownership of machine guns manufactured after May 19, 1986. Guns made before then were allowed.

1994

The Violent Crime Control and Law Enforcement Act : The law specifies 19 weapons that have the features of assault rifles, including the AR-15, certain versions of the AK-47, the TEC-9, the MAC-10 and the Uzi, several of which had become the preferred weapon of violent drug gangs. The act also bans large-capacity ammunition magazines, limiting them to 10 rounds. The law does not apply to weapons that were already in legal possession, and there are easy ways to adapt new weapons to avoid the prohibitions.

2003

Congress passes the Tiahrt Amendment to a federal spending bill. The amendment, proposed by Rep. Todd Tiahrt (R-Kan.), prohibits law enforcement from publicly releasing data showing where criminals bought their firearms.

2004

Asault weapons ban lapses and is not renewed by congress.

 

https://www.washingtonpost.com/national/history-of-gun-control-legislation/2012/12/22/80c8d624-4ad3-11e2-9a42-d1ce6d0ed278_story.html?utm_term=.87cf2490d303

My issues with the GOP tax plans are twofold

1) we knowingly grow the deficit, even eagerly do so under the two plans.

2) individuals are being sold a lie re individual tax cuts for them. They will phase out.

The cuts for corporations and for pass-through income (S-Corps, one of the income drivers for very wealthy people) remain.

As for lower taxes on companies benefiting people…

They aren’t investing because they have more cash. We’ve seen this with prior cuts as well as with the cash buildup following the crisis.

With these lower corporate tax rates, we need to stop the revenue transfer that takes place. (create a “license” agreement to use a product name in your Ireland division. Then “license” the name and rights to sell related products to the US division for absurd fees that literally shift all profit to Ireland). These are tactics openly discussed during earning calls.

If we say we should simply match the international average tax for corporations, then we also need to look at matching the relative expenditures of these countries’ governments as well.

Military budgets – we spend 8-10 times that of any European country and 4+ times that of China (the next largest military budget).

https://en.wikipedia.org/wiki/Military_budget

There are only 3 countries that spend more per capita on the military than us. Israel and Saudi Arabia (for understandable and similar reasons), and Singapore (an outlier that is baffling).

https://en.wikipedia.org/wiki/List_of_countries_by_military_expenditures


While the US has the highest cost per capita in healthcare, the government’s share of that is not nearly the highest (as a percent and in absolute dollars). We are lower than some and right in line with most developed nations.

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

Social Spending (basically helping people), we ranked about 20th relative to domestic GDP.

The United States doesn’t even make it into the top 10 for infrastructure expenditure per capita. The overall state of infrastructure didn’t even rank in the top 15 of nations.

https://gizmodo.com/heres-how-much-americas-infrastructure-is-worth-compar-1739382781

https://aneconomicsense.org/2014/07/28/americas-underinvestment-in-public-infrastructure/


I’m not a “tax them till it hurts” guy. I just have an issue with cutting revenue and not cutting expenses at all.

If we can implement a simplified tax code that says everyone pay x% and still afford to run the country, that’d be great.  However, I can handle 15 – 20 % tax, someone making $25k a year may not be able to handle that and still put a roof over their head, get clothing and food. I don’t know what to do about that end of it because you then start getting into deductions again.

The $1T average is a bit misleading.

We ran a surplus at the end of the 90s into the Bush Admin.

Then we had tax cuts and initiated a war in Iraq.

Then we had the financial meltdown.

The 1.3 – 1.4T deficits for a few of those years were widely believed by economists and those on both side of the aisle as necessary to prevent a complete collapse of the economy.

 

Year    Def     Debt Chg  %GDP   Reason

1998 ($69) $113  (0.8%) LTCM crisis

1999 ($126) $130  (1.3%) Glass-Steagall repealed

2000 ($236) $18  (2.3%) Surplus.

2001 ($128) $133  (1.2%) 9/11 attacks. EGTRRA

2002 $158 $421   1.4% War on Terror.

2003 $378 $555   3.2% JGTRRA

2004 $413 $596   3.3%

2005 $318 $554   2.4% Katrina. Bankruptcy Act.

2006 $248 $574   1.8% Bernanke chairs Fed.

2007 $161 $501   1.1% Iraq War cost

2008 $459 $1,017   3.1% Bank bailout. QE.

2009 $1,413 $1,632   9.8% Stimulus Act

2010 $1,294 $1,905   8.6% Obama tax cuts. ACA. Simpson-Bowles.

2011 $1,300 $1,229   8.3% Debt crisis.

2012 $1,087 $1,276   6.7% Fiscal cliff.

2013 $679 $672   4.1% Sequester. Government shutdown.

2014 $485 $1,086   2.8% Debt ceiling.

2015 $438 $327   2.4% Defense = $736.4 b.

2016  $585 $1,423   3.1% Defense = $767.3 b.

2017 $666 $672   3.4%

It’s one thing to get hit with a crisis. It’s another to plan a deficit.