Trans Fats

For years people chose margarine over butter for health reasons.  It's like the Woody Allen movie where he awakes in the future and is told that chocolate and steaks is so much better than health food.  The truth is that it is.

Mad Money's Jim Cramer

It's a shame the administration did not use the smart team they put together for the election to roll out the health care program.  According to Cramer, the Obama-care webpage is a CRM (Customer Relations Manager) that could have used Salesforce.com as the off the shelf application,  Google searching and verifying among the various data sets and Amazon running the system with it's IT utility services.
Barack Obama ought to can Sibelius as Secretary of Health and Human Services and put Jim in charge instead.

Obamacare, Retooled

Professor Tyler Cowen's proposals in today's New York Times lack some free market trust busting ideas that an Economist at George Mason University might want to consider.  How about lowering entry barriers for health providers so that a walk in walk out surgical procedure in a clinic is more reasonable than $50,000 at a clip? How about demanding out of patent drugs be used in all instances where public subsidy of cost is required.  Otherwise and extraordinary drug's expense is for the patient and his non subsidized insurer to shoulder.  I am sure there are other ideas to control costs, so let the market develop them easily.   

Drug Prices Soar

What the consumers need is a Walmart buying and distributing drugs with everyday cheaper prices instead of a system of rent seeking pharmaceutical companies protected to price at exorbitant levels as described in this linked article from the New York Times.

Obamacare

As a Libertarian I should be against Obamacare and I would be if it were not for the Stupid Old Party making it their cause celebre. So in that frame of mind I am supporting it's enactment and hope to shape it's direction in the future.  I recognize that medicine as presently organized is not an economic good that works under Adam Smith's free market construct.  Some things are truly wrong in the system and stupidity is not the answer.    

CVS Mini Clinics

This appears to be a free market solution to the upward ratcheting costs of health care whereby we get low cost providers and gatekeepers.  Health providers to prevent and for those on the other side suffering from a diagnosed and prescribed for chronic disease to maintain.  Gatekeeping to reduce entry into a very expensive system.

The 10,000 percent Solution

Today's article in the Science Section of the New York Times brings to mind the Milton Friedman quadrant of efficient transactions where the cost benefit is rated.  Quadrant one, the most optimal, is where the purchase is done for the benefit of purchaser with the purchaser's own money.  The second less optimal  quadrant is where the purchase is for someone else using the purchaser's money, a gift for example. The third quadrant is way down the optimal scale where the purchase is for the purchaser's benefit, but using other people's money. This is where a Rolls Royce is bought because money is no object. As inefficient as the buy is, at least the purchaser is greatly satisfied. Not so in the cellar where the fourth quadrant resides and where the purchase is made for someone else's benefit with someone else's money. This quadrant doesn't necessarily satisfy the receiver nor make purchasing sense. This is where the thousand dollar saline solution is invoiced by the hospital system. 

Hospital keep costs a secret

Wall Street needs transparency to correctly price complex derivatives.  They fight and scream to keep the advantage on their side against the customers they are raping and pillaging.  It appears that hospital's are doing the same thing as per Sunday's Editorial in the New York Times "The Cure for the $1,000 Toothbrush."  This article has several noteworthy resources for investigation, otherwise it's "If it's Tuesday we must be in Belgium" medical tourism for me and my family.

August 20 Postscript.
Listening to NPR where Doctors in Alaska are doing circumcisions in house because of the $2100 mastercharge  of the local hospital just for the room!  Word is getting around.

The American way of Birth - Costliest in the World

The more I experience and read about our sky rocketing health care costs the more  I believe that the insurance protection we need are from the hospitals.  Doctor's fees have not gone ballistic, but the clinic's operating room used for three hours and billed at $25,000 has.  I want just to be covered for the hospital and clinic care and I would pay out of pocket the doctor's and midwifes who would keep me from using those services.

This article in today's New York Times is so far from our experience thirty years ago that I fear for my children's financial well being when we become grandparents.

The American way of Birth - Costliest in the World

Healthy Chat

I attended the Access Health CT event in Danbury this past week covering an Insurance Exchange in development. It is expected to open for placing medical insurance programs this October for policies taking effect the 1^st of January next year. It is quickly apparent that this exchange's core mission is to direct state subsidies to the ten percent of the population that is un-insured so that they become insured.

At this juncture it is difficult to criticize since the various insurance plans have not yet been submitted, reviewed and approved. But it is disheartening to see the very limited mandate to explore ways to reduce health expenditures. I heard from the panel that they wanted to protect the public from plans that had a high deductible! In other words the plan I was looking for.

I want a plan that let's me see and pay directly the doctor I choose and that just protects me from the Master Charge list of the Hospitals and clinics that my doctors choose to use when they require such a facility. It is apparent that a plan such as that will not be allowed in or out of the exchange.

The Charge Master

Time Magazine's Steven Brill just answered my question about my bare bones $26,000 three hour clinic operating room cost.

Medical bill review

The bill mentioned earlier arrived and with it a detailing that is truly mind boggling.  The $40,500 bill is  for a clinic operation for a broken ankle. $26,500 of the bill covered three hours for the use of the operating room. The remainder of the bill was for incidentals. The Orthopedic surgeon's fee was $5000 and apart from the clinic's bill.  Now let's see, a super way over the top luxury hotel suite might be $5000 for twenty four hours.  So, it is five times that for a three hour soiree at a clinic in Stamford Connecticut? Is it a surprise that the country is at risk of being swallowed whole by medical expenses?
I am not naive enough to believe that the bill's pricing is real.  Insurance companies are sure to lower it drastically, but can it it be drastic enough?  $5000 for the room strikes me as being exorbitant so five times that is a tough height from which to negotiate down to reasonable.  

$40,000 for a 6 hour clinic?

The Orthopedic Surgeon $5000, the anesthesiologist $2,000 and the clinic is $40,000?  Something is completely out of whack here in Stamford Connecticut.

The bills are coming in

The bills are coming for my broken collar bone repaired last November and I am in shock.  So much so that I can't think for the moment.  The principal problem is that cost is never asked.  It's Milton Friedman's third quadrant where the one receiving a good from other people's money at least gets to pick a Ferrari versus a Rolls Royce so that now its pushed into the fourth and worst quadrant where some one selects the good for another while using other people's money.  It's certain ruin for the country.

Who should pay for a Hip Replacement

My mother just had one. She is elderly so that government subsidized most of the cost through Medicare, which is great for her but not so great for our economy and it's ballooning medical care costs.  I say this because of how it hits Milton Friedman's least economic 3rd quadrant where someone else pays for something you receive. If some one else pays, why not go for the Rolls Royce instead of the used Toyota?  My point is that yes my mother is greatly relieved and got excellent service, but would she had done it if she had to pay for it completely?  Possibly not when the cost was considered.
When debating health care it should be asked if it is right to make society pay for everyone to get a Rolls Royce in medical care.  The only way I see to make this work is to have society subsidize health care early on when the cost benefit ratio is high and then to let go as we age and let us depend on private insurance plans or direct payment by the individual; similar to how a closed community, like the Amish, would arrange among themselves.