Bill, last Sunday at 1.00am in the night this 75-year-old New Zealander had a medical emergency.
I called 111, and the free St. Johns ambulance showed up within 5-minutes.
The wonderfully trained young lady did a full series of tests in the brand-new Mercedes ambulance with all the modern gadgets. Including an EKG. My blood pressure was 240/120. Stroke territory.
She wired this to the hospital using her modem.
I was rushed to the hospital, and by 4.00am had the full gamut of tests done. Includer MRI
I was treated for 4-days in a new wing of the hospital - wired to God only knows what.
Treated for high blood pressure, and discharged after 4-days.
The hospital drove me home. Faxed my (3) new drugs to my pharmacy. Who delivered them to my home free of Charge.
The Social Worker went to the supermarket for me and stocked up my groceries.
This morning the doctor called me at home - to enquire how I was doing.
The Social service lady visited to see if I needed anything else.
The only paperwork - tell them my name at the hospital - I come up on their computer.
The only cost = $0.00
Is this why I retired back to New Zealand, my country of birth?
America is a rich country. You could have this also. It's just a matter of priorities.
EDIT: Btw, I had equal service in my working life in Seattle. But I was a highly paid professional. My healthcare was provided by my company as part of my compensation package. An enormous cost to my company - one of the reasons American companies are not competitive on the World Market.
Yes, exactly! Glad to hear you're doing better, Dennis.
Of course, health care in NZ isn't free. You Kiwis simply choose to spend your money on health care rather than dominating the world through an imperial military.
So, you're healthier than we are, but, dammit, we could bomb your country to smithereens, and that's really what matters, right?
“A nation that cannot control its borders is not a nation.”
― Ronald Reagan
Alex, in New Zealand you still have to prove you are New Zealand citizen to qualify for free healthcare. When I came back to New Zealand, after living 41-years in the States, I had to show my NZ birth certificate to get my new NH#.
Why could that not work in the States?
I'm not sure how tourists and "illegals" are treated? My guess is they get medical help irrespective. Nobody is going to be left to die in the streets in NZ. Who pays for it, I don't know.
Unfortunately one of our political parties (Democrats) has decided the way to a permanent majority is to wholesale import people from poorer countries and give them lots of free stuff (including health care) in exchange for their forever vote. The more this happens the more that party stays in power to give away more free stuff and the cycle continues. Eventually of course the country will go bankrupt but in the meantime they stay in power. And they will likely be in power even after bankruptcy.
Alex, It took me 15-months to get my green card. And I had an Engineering degree, and was married to an American. Every step I took at the America Embassy in Wellington, they just gave me another impossible hurdle.
Finally my wife's father who was working in Arkansas at the time, went to an Arkansas politician, and they arranged a fake letter offering me a job in Little Rock. That did the trick.
Upon entering the US for the first time in Honolulu, I was carrying a literal suitcase full of the forms I had completed in the 15-months and told that I needed. Including a chest X-Ray! To my shock, the Immigration Official said " What's all this sh*t? And threw it all in the trash. And made my green card.
I was employed by a Construction Company within a month. And worked my way up to being a Vice President
As you can see, I get can pretty wound up with this illegal alien debate. I was never given any FREE stuff, least of all healthcare. And paid plenty of State and Federal taxes.
Alex, ALL prescription drugs are imported to NZ by a government agency, PHARMAC. They shop the worlds manufacturer's and buy in bulk at the most favourable prices. Big pharma is willing to capture this small market - even at very low prices compared to the US, just to get this income.
These drugs are provided to the (10) national hospitals free of charge. Prescribed by the inside doctors who work for the hospital.
All out-patient prescriptions are written by private doctors working in their own practices. Their prescriptions are filled at private pharmacies, who get their drugs from PHARMAC. By law they charge $5 per prescription, and free for all refills. After so many drugs per year - all prescriptions are free.
Private hospitals, of which there a few for rich folks - (there are Insurance Companies in NZ) negotiate with PHARMAC for their in-patient drugs. Their out-patients are treated like all others NZ'ers.
This is how NZ keeps its prescription drug prices one of the lowest in the world.
We here in the states have to pay full price for drugs so the rest of the world can get a discount. I understand some FDA-mandated testing can run over a billion (yes, billion) dollars. So, enjoy! Glad you're feeling better.
HEALTH CARE FOR PROFIT - GOTTA' GO! We need REAL medical care in this country. Please support the new MEDICARE FOR ALL proposal and don't let pharmaceutical and insurance company lobbyists get in your way.
I've been reading about Robert F. Kennedy Jr. and he is very concerned abut health care. He would not renig on a pledge to work for Medicare for all, like Biden. Much of what is out there about RFKjr. is dishonest reporting because he was opposed to many of the gov't operations put forth on the whole covid situation. He is not opposed to vaccines and has had all his children vaccinated, he is opposed to vaccines that have not been thoroughly vetted for harm to the human body, and has written a NYT bestseller about it. Yes, it was a best seller despite the fact that the NYT and other rags REFUSED to review it!! How about them apples? The DNC is doing its best to discredit this brave man, and I hope all your readers Bill will not let them do that.
Jerry, MEDICAREFORALL has got to be the way to go! The system is already in place.
The Medicare for All Act, (aka the Expanded and Improved Medicare for All Act or United States National Health Care Act), is a bill first introduced in the United States House of Representatives in 2003. It has 116 co-sponsors still in the House at the time, or 49.8% of House Democrats.
The act would establish a US single-payer Universal health insurance system rough equivalent of Canada's Medicare and New Zealand's scheme. Under this single-payer system, medical care would be paid for by the federal government, ending the need for private health insurance and premiums. Private insurance companies would only be needed to provide supplemental coverage, and for non-essential care. The system would be paid through taxes replacing insurance premiums and by elimination of insurance company overhead and profits, and hospital billing costs.
60-years ago, health care was 5% of the U.S. economy. Under the current FOR PROFIT, and Insurance models it is now approaching 20%. New Zealand's is 9.7% and it's Medical Outcomes are better than in the USA,
According to a 2020 study in The Lancet, it was estimated to save more than US$450 billion annually, and save more than 68,500 lives every year. EG. About 25% of U.S. healthcare costs relate to administrative costs (e.g., billing and payment), versus 10-15% in other countries. On average in the US just 74 cents of every premium dollar for individual coverage goes to medical care.
But the US Healthcare Insurance Lobby is more powerful than the US Congress. And RFKJr, if elected, has an icebergs chance in hell getting it passed.
The Colonel smells a rat with the American health care system. He is correct. Unfortunately, he never identifies the culprit (hint: it's not profits) and his solution would be perfect for the Soviet Union (hint: bankrupt and defunct).
The reason why our health care is so expensive is the same reason our education system is so expensive: heavy government involvement. It is no coincidence that the cost of a college education began to rise dramatically at the same time the government started guaranteeing student loans. When you increase the demand for a product, be it health care or education, all other things being equal, the price will rise.
How do you increase the demand for a college education? You make tons of money available for it. How do you increase the demand for health care? You make it "free." Economist Milton Friedman identified four types of spending:
1) You spend your own money on yourself.
2) You spend your own money on someone else.
3) You spend someone else's money on yourself.
4)You spend someone else's money on someone else.
Which type of spending results in the most efficiency? You guessed it, number one. Why? Because when you are spending your own money you pay attention to quality AND price. What if someone else (like an insurance company) is paying for it (category 3)? If someone else was buying your dinner would you choose a grilled cheese sandwich or filet mignon? Most people would choose the latter. When you have health insurance and your doctor says you need a colonoscopy do you ask how much it will cost? No, you ask who is the best gastroenterologist. Filet mignon.
The result is massive price inflation. I am a health care provider (optometrist). Maybe one out of twenty of my patients pays cash. The rest have insurance. Older patients have Medicare, indigent patients have medicaid, working patients have some vision care plan. Often patients don't know exactly what insurance they have. Who has to figure that out? We do. My staff spends a lot of time helping patients figure out who will pay, what will be their copay, calling the insurance company to verify coverage, filing insurance claims, refiling denied claims, etc. Then if we miscalculated or the insurance company does not pay as expected, we must send the patient a bill. Occasionally the patient will not pay. We send another bill. Are you getting a sense of how much time our office spends explaining to patients how their insurance works, filing the claims, following up on claims, and billing when insurance does not pay? These costs are passed along to the patient. What if the patient paid cash instead? Yes, I could provide the same level of service at a lower cost. But, if I take Medicare (which I must to stay in business) by law I cannot charge a private pay patient less than I charge Medicare. The result is that people who pay cash must pay more than they otherwise would.
Why does every patient and their dog have health insurance? It all started back during WWII. The Franklin Roosevelt administration decided to impose wage caps during the war. Because many working age workers were off fighting a war there was a shortage of workers. FDR's solution? Cap wages. Because employers could not longer compete for workers by raising wages, they began giving benefits instead. One of those benefits was to provide workers with health insurance rather than increased wages. After the war the link between employment and health insurance was not broken (the government offered tax incentives to employers) and remains to this day. It is one of the many permanent distortions in the economy imposed by wars. Another permanent distortion is the withholding tax. Uncle Sam could not wait until the end of the year to extort your money; he needed it now.
What is the result of this link between health insurance and employment? If you lose your job you lose your health insurance. This is all thanks to the government policy during WWII. The bottom line to all this is that people now expect their health care costs to be paid by someone else. This is a recipe for price inflation and that is exactly the result.
The price inflation in health care is all the result of government involvement either though providing health insurance (Medicare/Medicaid), by providing tax incentives to employers to provide health insurance, or by excessive regulations (for example: you can't sell health insurance across state lines). In other words, the free market has not been allowed to operate due to government interference. And what is the solution the Colonel has offered? More government interference.
No, no, no! This shows a complete ignorance of economics. The way you fix price inflation is to put the spending back in the hands of the patient. How? Stop taking a good part of their paycheck out and sending it to insurance companies and give it to the worker instead. Now they have more money for unexpected expenses like health care. Health care insurance would still have a role; people would still need a catastrophic plan to pay for big ticket items like cancer or heart surgery. But catastrophic insurance would cost a lot less and the savings could be used to pay cash for minor expenses, such as broken arms or root canals. Yes, the price of root canals would plunge if people were paying cash.
What have we done here? We have moved the spending from category 3 (you spending other peoples money on yourself) to category 1 (you spending money on yourself). This is a recipe for price DEFLATION. A real world example is LASIK eye surgery. This surgery can correct the vision of many patients so that the need for glasses is either greatly reduced or eliminated. Since the surgery was first introduced about 20 years ago the quality of the surgery has improved and price has been reduced (especially inflation adjusted). How is that possible? Doesn't the cost of health care constantly rise? Not if you interject the free market. You see (pun intended), LASIK is not covered by insurance. People pay cash for the procedure. Market forces have been allowed to do their magic by increasing quality and decreasing cost. The same force could work with the whole of health care if the government would get out of the way. But it won't. And the politicians (like Bernie Sanders) will say that free market capitalism has failed. They will convince the economic illiterate (like the Colonel) that MORE government involvement is the cure. Now you know better.
p.s. Another example of the free market capping costs is breast augmentation surgery. You can call around a get a price for it because it is not covered by health insurance; it is much more affordable than surgeries covered by insurance. Don't try that with gall bladder surgery. Exception: The Surgery Center of Oklahoma. They don't take insurance and they give you the complete cost of the surgery, anesthesia, supplies, etc. up front. Complete transparency. That's why in the Obamacare bill the hospital lobby made damn sure no more clinics like it could be created. Canadians, with their "free" health care, frequent the clinic and pay cash willingly before they die.
We have the worst of two worlds. We have a corrupted government and an unfree market in collusion. Thus health care often becomes wealth care for the richest among us.
And Thank You. It is a real pleasure to get the insights of a practicing health care professional on Health Care in America in the 21st century.
And it is an even greater pleasure to hear a free market perspective on what has happened and is happening to Health Care [along with Education and many other activities and institutions] in America in the realms of and from the perspective of real-world economics and political economy. One doesn’t get that too often these days from the people running this government in Swampland, or who are candidates to run that government, or their mouthpieces in the MSM.
For those interested in learning more about Economics in general, and the negative impact of Government action in that realm in particular, permit me to recommend two books; the first published 77 years ago just after World War II, and the second published this year:
Balfour’s book is the closest thing i have found to a completely revised updating of Hazlitt’s classic, intended specifically for those Americans ~ particularly the Young ~ trying to figure out why everything in the realms of economics and political economy is so screwed up in America today as this nation approaches its 250th birthday on July 4, 2026.
The real questions confronting Americans at this stage of the game are: Whether or not their nation will survive to celebrate that birthday; and, if it does, if Americans will be in any mood or condition to celebrate anything.
Could not agree more on all counts, Bill. And yes, Biden, like Obama, absolutely let us down on healthcare.
A friend is a patient of an ophthalmologist at the world-[in]famous Cleveland Clinic, and his doctor relayed that the rule there is 7 patients per hour, including exam and write-up. How scary is THAT??
[BTW, I did draft my latest blog post before reading yours!]
Are Americans "increasingly sick, obese, depressed, tense, even suicidal" BECAUSE of this nation's Health Care system? Or because of something else? Does this nation's interaction with the rest of the Planet since 9/11 and its response and reaction to The COVID Event have anything to do with it?
[Note: One could also add "addicted to drugs, booze, and/or the internet/social media, prone to random acts of violence by crazies, common criminals, and/or cops, and other specific indicators of Americans' physical, mental, emotional, and spiritual health deterioration and decline, and thus this nation's demise."]
$3 BILLION ACCOUNTING ERROR MEANS THE PENTAGON CAN SEND MORE WEAPONS TO UKRAINE
by Tara Copp and Lolita C. Baldor / AP 051923
WASHINGTON (AP) — The Pentagon has overestimated the value of the weapons it has sent to Ukraine by at least $3 billion — an accounting error that could be a boon for the war effort because it will allow the Defense Department to send more weapons now without asking Congress for more money.
The acknowledgment Thursday comes at a time when Pentagon is under increased pressure by Congress to show accountability for the billions of dollars it has sent in weapons, ammunition and equipment to Ukraine and as some lawmakers question whether that level of support should continue.
It also could free up more money for critical weapons as Ukraine is on the verge of a much anticipated counteroffensive — which will require as much military aid as they can get. Ukrainian President Volodymyr Zelenskyy has previously said the offensive was delayed because they did not yet have everything they needed.
One of the most important aspects of this whole issue of a national, universal health care system in America is that it raises some questions that very few Americans ~ including particularly their “leaders” in government, those “leaders” owners and operators/commanders and controllers in America’s Ruling Political Class, and those “leaders’” and their bosses’ media ~ have given serious thought to:
~ 1. What is the purpose and function of government? Is it to meet the Human social and economic Needs and/or to satisfy the Human social and economic Wants of the population? Or is it to protect the Human Rights of that population, and to facilitate the fulfillment of the Human Responsibilities of that population? Which leads immediately to…
~ 2. Is Health Care a Human Right? Or is it a Human Need and Want? The same question could be asked about Education, Employment, Housing, Economic Security in the face of old age, illness or injury, and/or unemployment, Leisure, access to the Internet, etc . Which leads ultimately to one of, if not The most important questions that nobody is asking…
~ 3. What is the difference between Human Needs and Human Wants, on the one hand, and Human Rights and Responsibilities, on the other?
A true right does not have to be provided by others, such as freedom of speech and the right to bear arms or the right to breathe. If you think you have a right to health care, it implies that someone else must be obligated (enslaved) to provide it for you.
You are absolutely, totally, and completely correct, Liberty Man Van.
An individual’s Human Rights can only be taken away by other human beings and their individual acts of crime, or their collective actions, primarily thru Governments.
Human Rights do not come from Governments, but from the fact of being born a Human Being. And the only legitimate way those Rights can be violated or taken away is when the perpetrator violates or takes away the Rights of other Humans.
And an individual’s Human Needs and Wants can only be met by successfully purposeful, productive human action at the individual and/or collective levels.
The simple fact of the matter is that the only way Governments can meet the Human Needs and satisfy the Human Wants of some of its Citizens is to violate the Human Rights of other of its Citizens.
The single most important question that needs to be asked of and answered by proponents of a national, universal health care system in America is: “Who is going to pay for it, and how?”
Paying for such a system will require either: 1] an increase in federal taxes; or 2] a decrease in federal spending in some area outside of health care; or 3] some combination of both. A fourth alternative is to not worry about who is going to pay for it and how, and simply pile the new expenditures on to America’s current $31.8 trillion national, sovereign Debt, and its $187.6 trillion in Unfunded Liabilities [Social Security, Medicare Parts A, B, and D, Federal Debt held by the Public, and Federal Employee and Veterans Benefits]. Source: https://usdebtclock.org/ .
An obvious candidate for a reduction in spending as a way to pay for universal health care is, of course, America’s national “defense” and “surveillance/security/safety” budgets. What does anybody reading this figure that the odds are of that happening any time soon, what with Cold War II getting hotter every day?
If sufficient federal program budgets aren’t cut, then which individuals, families, organizations, and institutions will have to pay increased taxes to make up the shortfall, so as to keep the Debt and Unfunded Liabilities from increasing even more than they already are?
These are the sort of questions that our “leaders” ~ the elected politicians, entrenched bureaucrats, and anointed appointees ~ do not like to be asked, let alone be required to answer. But at some point, they will be asked because they must be; even if none of those folks have an answer.
You forgot 4] Jeff, switch the system to MEDICAREFORALL. Under this single-payer system, medical care would be paid for by the federal government, ending the need for private health insurance and premiums. And saving families US$450 billion annually. Families tax increase to fund MEDICAREFORALL would be less than the insurance premiums they are paying the blood-sucking Insurance companies.
Increasing federal taxes. Make Google, Apple, Microsoft et al pay their fair share of taxes. Apple transfers most of its profit to tax haven countries and takes advantage of loopholes, the US Government has in its tax-paying system.
Stop funding these forever proxy wars and wars. What happens in the Ukraine and in China/Taiwan is none of the US's business. The US should not be burdened with this cost.
Close the loophole of "hiding "Capital Gains Tax on stock market dividends inside a traditional IRA. IRA's are tax-deferred, and tax-free if you have a Roth IRA. Dividends and capital gains on stocks in a regular brokerage account typically aren’t. Once money is in your 401(k), and as long as the money remains in the account, you pay no taxes on investment growth, interest, dividends or investment gains.
BTW Social Security is not an unfunded liability. It is funded by deductions from worker's paychecks. The bottom-line message from the 2016 Trustees report for current and future Social Security beneficiaries: Social Security isn’t running out of money. Even if the trust fund becomes depleted (a huge "if" that presupposes Congress doesn't take steps to shore it up by increasing the tax cap), annual revenues from the dedicated payroll tax and taxation of Social Security benefits will be enough to fund 74% of scheduled benefits through 2090. Social Security is very well funded by American workers. The federal government is the unfunded liability but covers this liability by stealing the retirement investments of workers.
The Social Security Trustees also made a forecast for the health insurance program that covers more than 55 million Americans (mostly 65 and older). The Trustees now predict Medicare will exhaust its reserves by 2028. Here, too, changes could be made to stave off the forecasted doomsday. Like gradually increasing the Medicare eligibility age from 65 to 67 for people born after 1960 (matching Social Security). And providing beneficiaries with a fixed dollar subsidy to buy their Medicare coverage.
Donald Trump doesn’t buy into the conservative canon. He likes Social Security (and Medicare) as they are just fine. “We should not touch Social Security,” he writes in Crippled America: How to Make America Great Again. “It’s off the table.”
These are all staring the US in its face! Why don't they do it?
The US Healthcare Insurance Lobby, Wall Street and Big Business Lobbies are more powerful than the US Congress. Citizens are nor represented by any Lobby in Congress.
Dennis: Do You have any reports on Social Security's looming bankruptcy that is dated later than 2016? Quite a bit has changed about everything since then.
"After 2034, Social Security could still pay about three-quarters of scheduled benefits using its tax income even if policymakers took no steps to shore up the program. Those who claim that Social Security won’t be around at all when today’s young adults retire and that young workers will receive no benefits either misunderstand or misrepresent the trustees’ projections."
"The federal government now includes Social Security in its debt portfolio, not because the program is insolvent or ever was, and not because the Federal government has to fund it in any sense (SS is funded by your investments) but because the Federal government has stolen so much money from the fund, then sold special treasury securities on those stolen funds to countries like China to finance the massive debt accruing across the board. Since there is no chance the national debt can ever be repaid, the Fed is now in the position of finagling the discharge of internal debt from the books.
Most of the American public is totally clueless as to the deceptive accounting practices being used to fool them, and most still have no idea that the budget presented to the public is the simplified budget and only includes carefully presented revenues and expenses meant to portray a specific picture of the nations financial dealings. And many more of us are totally unaware that there is another budget referred to as the “unified budget” which shows all revenues from every source and every expense of any kind and a budget which, if we were to view it and understand the true implications, would most likely scare the beetlejuice out of most of us.
The stolen SS funds are now approaching 3 trillion. That is 3 trillion dollars of FICA taxes gleaned from generations of workers for a specific purpose that the federal government stole and then sold special treasury notes on. This is a debt owed by the federal government (USA Corp) to the investors (all you workers) that they never had any intention of paying back and is why it is referred to as an “unfunded liability”. It is a massive cash liability for a debt owed to generations of working Americans. As the amount stolen from the investments of workers grows so does the unfunded liability incurred."
Bill, last Sunday at 1.00am in the night this 75-year-old New Zealander had a medical emergency.
I called 111, and the free St. Johns ambulance showed up within 5-minutes.
The wonderfully trained young lady did a full series of tests in the brand-new Mercedes ambulance with all the modern gadgets. Including an EKG. My blood pressure was 240/120. Stroke territory.
She wired this to the hospital using her modem.
I was rushed to the hospital, and by 4.00am had the full gamut of tests done. Includer MRI
I was treated for 4-days in a new wing of the hospital - wired to God only knows what.
Treated for high blood pressure, and discharged after 4-days.
The hospital drove me home. Faxed my (3) new drugs to my pharmacy. Who delivered them to my home free of Charge.
The Social Worker went to the supermarket for me and stocked up my groceries.
This morning the doctor called me at home - to enquire how I was doing.
The Social service lady visited to see if I needed anything else.
The only paperwork - tell them my name at the hospital - I come up on their computer.
The only cost = $0.00
Is this why I retired back to New Zealand, my country of birth?
America is a rich country. You could have this also. It's just a matter of priorities.
EDIT: Btw, I had equal service in my working life in Seattle. But I was a highly paid professional. My healthcare was provided by my company as part of my compensation package. An enormous cost to my company - one of the reasons American companies are not competitive on the World Market.
Yes, exactly! Glad to hear you're doing better, Dennis.
Of course, health care in NZ isn't free. You Kiwis simply choose to spend your money on health care rather than dominating the world through an imperial military.
So, you're healthier than we are, but, dammit, we could bomb your country to smithereens, and that's really what matters, right?
You're describing nirvana, Dennis. The care you received sounds incredible, from where I sit.
Glad to hear you're better!
Not sure that would work in a country with an open border with another, poorer country.
“A nation that cannot control its borders is not a nation.”
― Ronald Reagan
Alex, in New Zealand you still have to prove you are New Zealand citizen to qualify for free healthcare. When I came back to New Zealand, after living 41-years in the States, I had to show my NZ birth certificate to get my new NH#.
Why could that not work in the States?
I'm not sure how tourists and "illegals" are treated? My guess is they get medical help irrespective. Nobody is going to be left to die in the streets in NZ. Who pays for it, I don't know.
Unfortunately one of our political parties (Democrats) has decided the way to a permanent majority is to wholesale import people from poorer countries and give them lots of free stuff (including health care) in exchange for their forever vote. The more this happens the more that party stays in power to give away more free stuff and the cycle continues. Eventually of course the country will go bankrupt but in the meantime they stay in power. And they will likely be in power even after bankruptcy.
Alex, It took me 15-months to get my green card. And I had an Engineering degree, and was married to an American. Every step I took at the America Embassy in Wellington, they just gave me another impossible hurdle.
Finally my wife's father who was working in Arkansas at the time, went to an Arkansas politician, and they arranged a fake letter offering me a job in Little Rock. That did the trick.
Upon entering the US for the first time in Honolulu, I was carrying a literal suitcase full of the forms I had completed in the 15-months and told that I needed. Including a chest X-Ray! To my shock, the Immigration Official said " What's all this sh*t? And threw it all in the trash. And made my green card.
I was employed by a Construction Company within a month. And worked my way up to being a Vice President
As you can see, I get can pretty wound up with this illegal alien debate. I was never given any FREE stuff, least of all healthcare. And paid plenty of State and Federal taxes.
Alex, ALL prescription drugs are imported to NZ by a government agency, PHARMAC. They shop the worlds manufacturer's and buy in bulk at the most favourable prices. Big pharma is willing to capture this small market - even at very low prices compared to the US, just to get this income.
These drugs are provided to the (10) national hospitals free of charge. Prescribed by the inside doctors who work for the hospital.
All out-patient prescriptions are written by private doctors working in their own practices. Their prescriptions are filled at private pharmacies, who get their drugs from PHARMAC. By law they charge $5 per prescription, and free for all refills. After so many drugs per year - all prescriptions are free.
Private hospitals, of which there a few for rich folks - (there are Insurance Companies in NZ) negotiate with PHARMAC for their in-patient drugs. Their out-patients are treated like all others NZ'ers.
This is how NZ keeps its prescription drug prices one of the lowest in the world.
We here in the states have to pay full price for drugs so the rest of the world can get a discount. I understand some FDA-mandated testing can run over a billion (yes, billion) dollars. So, enjoy! Glad you're feeling better.
Thanks Ray. To be fair I developed Lymphoma cancer in Seattle.
Thanks to the wonderful doctors at the Fred Hutchison Cancer Center in Seattle.
I was cured by the very latest research. Thats 45-years ago now!
I was treated like a King, and never spent a dime out of my own pocket!
The moto to this story I guess: If you are rich, the USA is the best place to get very ill.
only thing more imminently dangerous to life and limb is war machines bought for profit.
HEALTH CARE FOR PROFIT - GOTTA' GO! We need REAL medical care in this country. Please support the new MEDICARE FOR ALL proposal and don't let pharmaceutical and insurance company lobbyists get in your way.
I've been reading about Robert F. Kennedy Jr. and he is very concerned abut health care. He would not renig on a pledge to work for Medicare for all, like Biden. Much of what is out there about RFKjr. is dishonest reporting because he was opposed to many of the gov't operations put forth on the whole covid situation. He is not opposed to vaccines and has had all his children vaccinated, he is opposed to vaccines that have not been thoroughly vetted for harm to the human body, and has written a NYT bestseller about it. Yes, it was a best seller despite the fact that the NYT and other rags REFUSED to review it!! How about them apples? The DNC is doing its best to discredit this brave man, and I hope all your readers Bill will not let them do that.
Jerry, MEDICAREFORALL has got to be the way to go! The system is already in place.
The Medicare for All Act, (aka the Expanded and Improved Medicare for All Act or United States National Health Care Act), is a bill first introduced in the United States House of Representatives in 2003. It has 116 co-sponsors still in the House at the time, or 49.8% of House Democrats.
The act would establish a US single-payer Universal health insurance system rough equivalent of Canada's Medicare and New Zealand's scheme. Under this single-payer system, medical care would be paid for by the federal government, ending the need for private health insurance and premiums. Private insurance companies would only be needed to provide supplemental coverage, and for non-essential care. The system would be paid through taxes replacing insurance premiums and by elimination of insurance company overhead and profits, and hospital billing costs.
60-years ago, health care was 5% of the U.S. economy. Under the current FOR PROFIT, and Insurance models it is now approaching 20%. New Zealand's is 9.7% and it's Medical Outcomes are better than in the USA,
According to a 2020 study in The Lancet, it was estimated to save more than US$450 billion annually, and save more than 68,500 lives every year. EG. About 25% of U.S. healthcare costs relate to administrative costs (e.g., billing and payment), versus 10-15% in other countries. On average in the US just 74 cents of every premium dollar for individual coverage goes to medical care.
But the US Healthcare Insurance Lobby is more powerful than the US Congress. And RFKJr, if elected, has an icebergs chance in hell getting it passed.
Do I have this right?
The Colonel smells a rat with the American health care system. He is correct. Unfortunately, he never identifies the culprit (hint: it's not profits) and his solution would be perfect for the Soviet Union (hint: bankrupt and defunct).
The reason why our health care is so expensive is the same reason our education system is so expensive: heavy government involvement. It is no coincidence that the cost of a college education began to rise dramatically at the same time the government started guaranteeing student loans. When you increase the demand for a product, be it health care or education, all other things being equal, the price will rise.
How do you increase the demand for a college education? You make tons of money available for it. How do you increase the demand for health care? You make it "free." Economist Milton Friedman identified four types of spending:
1) You spend your own money on yourself.
2) You spend your own money on someone else.
3) You spend someone else's money on yourself.
4)You spend someone else's money on someone else.
Which type of spending results in the most efficiency? You guessed it, number one. Why? Because when you are spending your own money you pay attention to quality AND price. What if someone else (like an insurance company) is paying for it (category 3)? If someone else was buying your dinner would you choose a grilled cheese sandwich or filet mignon? Most people would choose the latter. When you have health insurance and your doctor says you need a colonoscopy do you ask how much it will cost? No, you ask who is the best gastroenterologist. Filet mignon.
The result is massive price inflation. I am a health care provider (optometrist). Maybe one out of twenty of my patients pays cash. The rest have insurance. Older patients have Medicare, indigent patients have medicaid, working patients have some vision care plan. Often patients don't know exactly what insurance they have. Who has to figure that out? We do. My staff spends a lot of time helping patients figure out who will pay, what will be their copay, calling the insurance company to verify coverage, filing insurance claims, refiling denied claims, etc. Then if we miscalculated or the insurance company does not pay as expected, we must send the patient a bill. Occasionally the patient will not pay. We send another bill. Are you getting a sense of how much time our office spends explaining to patients how their insurance works, filing the claims, following up on claims, and billing when insurance does not pay? These costs are passed along to the patient. What if the patient paid cash instead? Yes, I could provide the same level of service at a lower cost. But, if I take Medicare (which I must to stay in business) by law I cannot charge a private pay patient less than I charge Medicare. The result is that people who pay cash must pay more than they otherwise would.
Why does every patient and their dog have health insurance? It all started back during WWII. The Franklin Roosevelt administration decided to impose wage caps during the war. Because many working age workers were off fighting a war there was a shortage of workers. FDR's solution? Cap wages. Because employers could not longer compete for workers by raising wages, they began giving benefits instead. One of those benefits was to provide workers with health insurance rather than increased wages. After the war the link between employment and health insurance was not broken (the government offered tax incentives to employers) and remains to this day. It is one of the many permanent distortions in the economy imposed by wars. Another permanent distortion is the withholding tax. Uncle Sam could not wait until the end of the year to extort your money; he needed it now.
What is the result of this link between health insurance and employment? If you lose your job you lose your health insurance. This is all thanks to the government policy during WWII. The bottom line to all this is that people now expect their health care costs to be paid by someone else. This is a recipe for price inflation and that is exactly the result.
The price inflation in health care is all the result of government involvement either though providing health insurance (Medicare/Medicaid), by providing tax incentives to employers to provide health insurance, or by excessive regulations (for example: you can't sell health insurance across state lines). In other words, the free market has not been allowed to operate due to government interference. And what is the solution the Colonel has offered? More government interference.
No, no, no! This shows a complete ignorance of economics. The way you fix price inflation is to put the spending back in the hands of the patient. How? Stop taking a good part of their paycheck out and sending it to insurance companies and give it to the worker instead. Now they have more money for unexpected expenses like health care. Health care insurance would still have a role; people would still need a catastrophic plan to pay for big ticket items like cancer or heart surgery. But catastrophic insurance would cost a lot less and the savings could be used to pay cash for minor expenses, such as broken arms or root canals. Yes, the price of root canals would plunge if people were paying cash.
What have we done here? We have moved the spending from category 3 (you spending other peoples money on yourself) to category 1 (you spending money on yourself). This is a recipe for price DEFLATION. A real world example is LASIK eye surgery. This surgery can correct the vision of many patients so that the need for glasses is either greatly reduced or eliminated. Since the surgery was first introduced about 20 years ago the quality of the surgery has improved and price has been reduced (especially inflation adjusted). How is that possible? Doesn't the cost of health care constantly rise? Not if you interject the free market. You see (pun intended), LASIK is not covered by insurance. People pay cash for the procedure. Market forces have been allowed to do their magic by increasing quality and decreasing cost. The same force could work with the whole of health care if the government would get out of the way. But it won't. And the politicians (like Bernie Sanders) will say that free market capitalism has failed. They will convince the economic illiterate (like the Colonel) that MORE government involvement is the cure. Now you know better.
p.s. Another example of the free market capping costs is breast augmentation surgery. You can call around a get a price for it because it is not covered by health insurance; it is much more affordable than surgeries covered by insurance. Don't try that with gall bladder surgery. Exception: The Surgery Center of Oklahoma. They don't take insurance and they give you the complete cost of the surgery, anesthesia, supplies, etc. up front. Complete transparency. That's why in the Obamacare bill the hospital lobby made damn sure no more clinics like it could be created. Canadians, with their "free" health care, frequent the clinic and pay cash willingly before they die.
We have the worst of two worlds. We have a corrupted government and an unfree market in collusion. Thus health care often becomes wealth care for the richest among us.
You nailed it again, Liberty Man Van. Completely.
And Thank You. It is a real pleasure to get the insights of a practicing health care professional on Health Care in America in the 21st century.
And it is an even greater pleasure to hear a free market perspective on what has happened and is happening to Health Care [along with Education and many other activities and institutions] in America in the realms of and from the perspective of real-world economics and political economy. One doesn’t get that too often these days from the people running this government in Swampland, or who are candidates to run that government, or their mouthpieces in the MSM.
For those interested in learning more about Economics in general, and the negative impact of Government action in that realm in particular, permit me to recommend two books; the first published 77 years ago just after World War II, and the second published this year:
~ ECONOMICS IN ONE LESSON: The Shortest and Surest Way to Understand Basic Economics, by Henry Hazlitt. Available at https://www.amazon.com/Economics-One-Lesson-Shortest-Understand/dp/0517548232 ; or free PDF download from the Foundation for Economic Education at https://fee.org/resources/economics-in-one-lesson/ . For a very complete overview, see https://en.wikipedia.org/wiki/Economics_in_One_Lesson .
~ ECONOMICS IN ACTION by Brian Balfour. For an overview and review, see “A Book to Help Young Americans Understand Economics: Economics in Action by Brian Balfour” by George Leef at https://www.aier.org/article/a-book-to-help-young-americans-understand-economics-economics-in-action-by-brian-balfour/ . The book is available at https://www.amazon.com/gp/product/B0C47JL9N7/ref=ox_sc_act_image_1?smid=ATVPDKIKX0DER&psc=1 .
Balfour’s book is the closest thing i have found to a completely revised updating of Hazlitt’s classic, intended specifically for those Americans ~ particularly the Young ~ trying to figure out why everything in the realms of economics and political economy is so screwed up in America today as this nation approaches its 250th birthday on July 4, 2026.
The real questions confronting Americans at this stage of the game are: Whether or not their nation will survive to celebrate that birthday; and, if it does, if Americans will be in any mood or condition to celebrate anything.
Thanks again, and have a Great day. ~ jeff
Could not agree more on all counts, Bill. And yes, Biden, like Obama, absolutely let us down on healthcare.
A friend is a patient of an ophthalmologist at the world-[in]famous Cleveland Clinic, and his doctor relayed that the rule there is 7 patients per hour, including exam and write-up. How scary is THAT??
[BTW, I did draft my latest blog post before reading yours!]
Nice ad in the Times, by the way, Bill. What does something like that set you people back?
I don't know, Alex. Too much, I'd wager.
Got a question for You, Bill.
Are Americans "increasingly sick, obese, depressed, tense, even suicidal" BECAUSE of this nation's Health Care system? Or because of something else? Does this nation's interaction with the rest of the Planet since 9/11 and its response and reaction to The COVID Event have anything to do with it?
[Note: One could also add "addicted to drugs, booze, and/or the internet/social media, prone to random acts of violence by crazies, common criminals, and/or cops, and other specific indicators of Americans' physical, mental, emotional, and spiritual health deterioration and decline, and thus this nation's demise."]
Hey, Bill, you made the papers: https://consortiumnews.com/2023/05/18/us-national-security-experts-call-for-peace-in-ukraine How does it feel to be a national security expert?
Yes, that's me! :-)
My hero.
“Well, how CONVENIENT…,” as The Church Lady would have once put it. [An intro to The Church Lady is at https://www.facebook.com/watch/?v=366567245330309 ]
$3 BILLION ACCOUNTING ERROR MEANS THE PENTAGON CAN SEND MORE WEAPONS TO UKRAINE
by Tara Copp and Lolita C. Baldor / AP 051923
WASHINGTON (AP) — The Pentagon has overestimated the value of the weapons it has sent to Ukraine by at least $3 billion — an accounting error that could be a boon for the war effort because it will allow the Defense Department to send more weapons now without asking Congress for more money.
The acknowledgment Thursday comes at a time when Pentagon is under increased pressure by Congress to show accountability for the billions of dollars it has sent in weapons, ammunition and equipment to Ukraine and as some lawmakers question whether that level of support should continue.
It also could free up more money for critical weapons as Ukraine is on the verge of a much anticipated counteroffensive — which will require as much military aid as they can get. Ukrainian President Volodymyr Zelenskyy has previously said the offensive was delayed because they did not yet have everything they needed.
Continued at https://apnews.com/article/ukraine-costs-war-russia-weapons-884a9eefe32eee9ec611771cfe2a4642
One of the most important aspects of this whole issue of a national, universal health care system in America is that it raises some questions that very few Americans ~ including particularly their “leaders” in government, those “leaders” owners and operators/commanders and controllers in America’s Ruling Political Class, and those “leaders’” and their bosses’ media ~ have given serious thought to:
~ 1. What is the purpose and function of government? Is it to meet the Human social and economic Needs and/or to satisfy the Human social and economic Wants of the population? Or is it to protect the Human Rights of that population, and to facilitate the fulfillment of the Human Responsibilities of that population? Which leads immediately to…
~ 2. Is Health Care a Human Right? Or is it a Human Need and Want? The same question could be asked about Education, Employment, Housing, Economic Security in the face of old age, illness or injury, and/or unemployment, Leisure, access to the Internet, etc . Which leads ultimately to one of, if not The most important questions that nobody is asking…
~ 3. What is the difference between Human Needs and Human Wants, on the one hand, and Human Rights and Responsibilities, on the other?
A true right does not have to be provided by others, such as freedom of speech and the right to bear arms or the right to breathe. If you think you have a right to health care, it implies that someone else must be obligated (enslaved) to provide it for you.
You are absolutely, totally, and completely correct, Liberty Man Van.
An individual’s Human Rights can only be taken away by other human beings and their individual acts of crime, or their collective actions, primarily thru Governments.
Human Rights do not come from Governments, but from the fact of being born a Human Being. And the only legitimate way those Rights can be violated or taken away is when the perpetrator violates or takes away the Rights of other Humans.
And an individual’s Human Needs and Wants can only be met by successfully purposeful, productive human action at the individual and/or collective levels.
The simple fact of the matter is that the only way Governments can meet the Human Needs and satisfy the Human Wants of some of its Citizens is to violate the Human Rights of other of its Citizens.
The single most important question that needs to be asked of and answered by proponents of a national, universal health care system in America is: “Who is going to pay for it, and how?”
Paying for such a system will require either: 1] an increase in federal taxes; or 2] a decrease in federal spending in some area outside of health care; or 3] some combination of both. A fourth alternative is to not worry about who is going to pay for it and how, and simply pile the new expenditures on to America’s current $31.8 trillion national, sovereign Debt, and its $187.6 trillion in Unfunded Liabilities [Social Security, Medicare Parts A, B, and D, Federal Debt held by the Public, and Federal Employee and Veterans Benefits]. Source: https://usdebtclock.org/ .
An obvious candidate for a reduction in spending as a way to pay for universal health care is, of course, America’s national “defense” and “surveillance/security/safety” budgets. What does anybody reading this figure that the odds are of that happening any time soon, what with Cold War II getting hotter every day?
If sufficient federal program budgets aren’t cut, then which individuals, families, organizations, and institutions will have to pay increased taxes to make up the shortfall, so as to keep the Debt and Unfunded Liabilities from increasing even more than they already are?
These are the sort of questions that our “leaders” ~ the elected politicians, entrenched bureaucrats, and anointed appointees ~ do not like to be asked, let alone be required to answer. But at some point, they will be asked because they must be; even if none of those folks have an answer.
You forgot 4] Jeff, switch the system to MEDICAREFORALL. Under this single-payer system, medical care would be paid for by the federal government, ending the need for private health insurance and premiums. And saving families US$450 billion annually. Families tax increase to fund MEDICAREFORALL would be less than the insurance premiums they are paying the blood-sucking Insurance companies.
Increasing federal taxes. Make Google, Apple, Microsoft et al pay their fair share of taxes. Apple transfers most of its profit to tax haven countries and takes advantage of loopholes, the US Government has in its tax-paying system.
https://startuptalky.com/apple-tax-avoidance-strategy/
Stop funding these forever proxy wars and wars. What happens in the Ukraine and in China/Taiwan is none of the US's business. The US should not be burdened with this cost.
Close the loophole of "hiding "Capital Gains Tax on stock market dividends inside a traditional IRA. IRA's are tax-deferred, and tax-free if you have a Roth IRA. Dividends and capital gains on stocks in a regular brokerage account typically aren’t. Once money is in your 401(k), and as long as the money remains in the account, you pay no taxes on investment growth, interest, dividends or investment gains.
BTW Social Security is not an unfunded liability. It is funded by deductions from worker's paychecks. The bottom-line message from the 2016 Trustees report for current and future Social Security beneficiaries: Social Security isn’t running out of money. Even if the trust fund becomes depleted (a huge "if" that presupposes Congress doesn't take steps to shore it up by increasing the tax cap), annual revenues from the dedicated payroll tax and taxation of Social Security benefits will be enough to fund 74% of scheduled benefits through 2090. Social Security is very well funded by American workers. The federal government is the unfunded liability but covers this liability by stealing the retirement investments of workers.
https://ppjg.me/2011/02/17/social-security-is-not-an-entitlement-program/#:~:text=Social%20Security%20is%20NOT%20an%20unfunded%20liability.%20Social,liability%20by%20stealing%20the%20retirement%20investments%20of%20workers.
The Social Security Trustees also made a forecast for the health insurance program that covers more than 55 million Americans (mostly 65 and older). The Trustees now predict Medicare will exhaust its reserves by 2028. Here, too, changes could be made to stave off the forecasted doomsday. Like gradually increasing the Medicare eligibility age from 65 to 67 for people born after 1960 (matching Social Security). And providing beneficiaries with a fixed dollar subsidy to buy their Medicare coverage.
Donald Trump doesn’t buy into the conservative canon. He likes Social Security (and Medicare) as they are just fine. “We should not touch Social Security,” he writes in Crippled America: How to Make America Great Again. “It’s off the table.”
https://www.forbes.com/sites/nextavenue/2016/06/24/the-truth-about-social-securitys-solvency-and-you/?sh=4bb6b34b2199
These are all staring the US in its face! Why don't they do it?
The US Healthcare Insurance Lobby, Wall Street and Big Business Lobbies are more powerful than the US Congress. Citizens are nor represented by any Lobby in Congress.
Do I have this all wrong?
Dennis: Do You have any reports on Social Security's looming bankruptcy that is dated later than 2016? Quite a bit has changed about everything since then.
Here are some more current appraisals:
https://www.heritage.org/social-security/commentary/social-securitys-unfunded-obligations-getting-worse
https://www.cbpp.org/research/social-security/what-the-2021-trustees-report-shows-about-social-security
https://www.forbes.com/sites/johngoodman/2023/02/25/the-real-federal-deficit-social-security-and-medicare/?sh=1964a6575679
"After 2034, Social Security could still pay about three-quarters of scheduled benefits using its tax income even if policymakers took no steps to shore up the program. Those who claim that Social Security won’t be around at all when today’s young adults retire and that young workers will receive no benefits either misunderstand or misrepresent the trustees’ projections."
https://www.cbpp.org/research/social-security/what-the-2021-trustees-report-shows-about-social-security
"The federal government now includes Social Security in its debt portfolio, not because the program is insolvent or ever was, and not because the Federal government has to fund it in any sense (SS is funded by your investments) but because the Federal government has stolen so much money from the fund, then sold special treasury securities on those stolen funds to countries like China to finance the massive debt accruing across the board. Since there is no chance the national debt can ever be repaid, the Fed is now in the position of finagling the discharge of internal debt from the books.
Most of the American public is totally clueless as to the deceptive accounting practices being used to fool them, and most still have no idea that the budget presented to the public is the simplified budget and only includes carefully presented revenues and expenses meant to portray a specific picture of the nations financial dealings. And many more of us are totally unaware that there is another budget referred to as the “unified budget” which shows all revenues from every source and every expense of any kind and a budget which, if we were to view it and understand the true implications, would most likely scare the beetlejuice out of most of us.
The stolen SS funds are now approaching 3 trillion. That is 3 trillion dollars of FICA taxes gleaned from generations of workers for a specific purpose that the federal government stole and then sold special treasury notes on. This is a debt owed by the federal government (USA Corp) to the investors (all you workers) that they never had any intention of paying back and is why it is referred to as an “unfunded liability”. It is a massive cash liability for a debt owed to generations of working Americans. As the amount stolen from the investments of workers grows so does the unfunded liability incurred."
https://ppjg.me/2011/02/17/social-security-is-not-an-entitlement-program/#:~:text=Social%20Security%20is%20NOT%20an%20unfunded%20liability.%20Social,liability%20by%20stealing%20the%20retirement%20investments%20of%20workers
And that "report" is from 2011. Again, do You have anything more current on this issue than from 7 and 12 years ago?
https://www.cbpp.org/research/social-security/what-the-2021-trustees-report-shows-about-social-security
Ahhh. One of my referenced links. And what does that report say?