Rich Doctors say Tax Them More to Help Fund the Canadian ‘Obamacare’ System that Makes them Rich

Posted by PITHOCRATES - March 25th, 2012

Week in Review

People distrust rich people.  That’s why they want to tax them more.  Because they have more than enough money.  No matter what they say about earning their money or how they invest their wealth to create jobs.  People don’t want to hear any of this.  For they ‘know’ that these rich fat cats are lying just to keep from having to ‘share’ their wealth.  But whenever a rich guy says ‘tax us rich people more’ everyone hangs on to their every last word.  For if they are talking about raising taxes on the rich then these are not your typical rich.  They’re the good kind.  Like these doctors in Canada (see Tax us more, doctors urge (Are the lawyers listening?) by Michael Babad posted 3/22/2012 on The Globe and Mail).

A group of doctors is taking a page from Warren Buffett’s tax-the-rich call, urging the Canadian and Ontario governments to tax higher-income earners more…

Doctors for Fair Taxation plan to announce their scheme in Toronto this afternoon, calling for additional taxes on people earning more than $100,000. You’d be hit with an additional 1 per cent if you earn between $100,000 and $170,000, 2 per cent if you earn up to $640,000, and 3 per cent for up to $1.85-million. Above that it would be 6 per cent.

“We feel that this is a moral argument,” Dr. Michael Rachlis, who founded the group that so far boasts more than 50 physicians, told The Canadian Press.

“We cannot talk about throwing people out of work and cutting needed programs for people,” said Dr. Rachlis, an associate professor at the University of Toronto.

Wow.  Sounds very selfless, doesn’t it?  These rich guys asking to be taxed more to help their country?  At least on the surface it does.  But the question that begs to be asked is what are they spending so much money on that they have to raise taxes?  And when you learn what that is it puts these doctors into a different light.

Here’s an article from 2010.  About two years ago.  Talking about a budget crisis.  Where spending is out of control.  Spending that the Canadians just can’t sustain.  And where is this out of control spending?  Why, it just happens to be in the industry that pays these doctors.  Canada’s single-payer health care system.  Talk about coincidences.  These doctors asking rich people everywhere to help pay the nation’s bills.  Where the biggest bill is the one that pays these doctors (see Soaring costs force Canada to reassess health model by Claire Sibonney posted 3/31/2010 on Reuters).

Pressured by an aging population and the need to rein in budget deficits, Canada’s provinces are taking tough measures to curb healthcare costs, a trend that could erode the principles of the popular state-funded system.

Ontario, Canada’s most populous province, kicked off a fierce battle with drug companies and pharmacies when it said earlier this year it would halve generic drug prices and eliminate “incentive fees” to generic drug manufacturers.

British Columbia is replacing block grants to hospitals with fee-for-procedure payments and Quebec has a new flat health tax and a proposal for payments on each medical visit — an idea that critics say is an illegal user fee.

And a few provinces are also experimenting with private funding for procedures such as hip, knee and cataract surgery.

It’s likely just a start as the provinces, responsible for delivering healthcare, cope with the demands of a retiring baby-boom generation. Official figures show that senior citizens will make up 25 percent of the population by 2036.

Proponents of national health care in America blame the private health insurers, the pharmaceuticals and the hospitals for out of control health care costs.  What they say we need is a system like Canada.  Where they put people before profits.  And yet here they are.  The Canadians.  With a health care system suffering from out of control costs.  Which they are trying to fix with higher taxes.  Additional fees.  Even a little Americanization (that is, privatization).  Makes you wonder why we’re going forward with Obamacare while the Canadians are finding that type of a system is unsustainable.  Especially when our retiring baby boomers outnumber their retiring baby boomers. 

Canada, fretting over budget strains, wants to prune its system, while the United States, worrying about an army of uninsured, aims to create a state-backed safety net.

Healthcare in Canada is delivered through a publicly funded system, which covers all “medically necessary” hospital and physician care and curbs the role of private medicine. It ate up about 40 percent of provincial budgets, or some C$183 billion ($174 billion) last year.

Spending has been rising 6 percent a year under a deal that added C$41.3 billion of federal funding over 10 years.

But that deal ends in 2013, and the federal government is unlikely to be as generous in future, especially for one-off projects.

Wow.  Look at that.  Almost half of provincial budgets pay for the ‘free’ health care of Canadians.  Which is causing budget deficits at the provincial level.  And at the national level.  Well, up until 2013, that is.  When the national government is going to address their budget deficits by cutting their health care payments to the provinces.  Increasing the provincial budget deficits in the process.  Leaving the provincial governments to tax and spend more.  Or ration care and cut spending more.  Including doctor pay.  Could this have anything to do with those selfless physicians asking that their government tax the rich more?  Perhaps.

Brian Golden, a professor at University of Toronto’s Rotman School of Business, said provinces are weighing new sources of funding, including “means-testing” and moving toward evidence-based and pay-for-performance models.

“Why are we paying more or the same for cataract surgery when it costs substantially less today than it did 10 years ago? There’s going to be a finer look at what we’re paying for and, more importantly, what we’re getting for it,” he said.

Other problems include trying to control independently set salaries for top hospital executives and doctors and rein in spiraling costs for new medical technologies and drugs.

Ontario says healthcare could eat up 70 percent of its budget in 12 years, if all these costs are left unchecked…

The province has introduced legislation that ties hospital chief executive pay with the quality of patient care and says it wants to put more physicians on salary to save money.

In a report released last week, TD Bank said Ontario should consider other proposals to help cut costs, including scaling back drug coverage for affluent seniors and paying doctors according to quality and efficiency of care.

So the power of government inserted into the health care system has done nothing to lower the cost of medical procedures in Canada.  Makes you scratch your head, doesn’t it?  Because the proponents of Obamacare say that’s exactly what the power of government can do.  But in practice it has failed to do what these theorists say it can do.  Cut costs.  Through bureaucratic management.  And ‘turning of the screws’ on the medical device and drug manufacturers.  Despite this very practice NOT working in Canada.  Which means that the proponents of Obamacare think the Canadian bureaucrats simply aren’t smart enough to make their health care system work efficiently.  That the system of government-managed health care is a flawed system when it comes to costs and efficiency.  Or that government-managed health care is not about costs or efficiency.  But about the bureaucracy itself.  The control and power it offers the politicians.  And the votes it can buy them.

“Many of the advances in healthcare and life expectancy are due to the pharmaceutical industry so we should never demonize them,” said U of T’s Golden. “We need to ensure that they maintain a profitable business but our ability to make it very very profitable is constrained right now.”

Scotia Capital’s Webb said one cost-saving idea may be to make patients aware of how much it costs each time they visit a healthcare professional. “(The public) will use the services more wisely if they know how much it’s costing,” she said.

Wait a minute.  To fix the government-managed system they need to make the patients aware of the costs so they can choose wisely?  There’s a name for such a system.  We call it capitalism.  The very thing missing from government-managed health care.  And the very reason why government-managed systems (the Canadian health care system, the American Medicare/Medicaid programs, the UK’s National Health Service, etc.) fail to control costs.  And why Obamacare will fail to control costs.  Because they exclude the one thing that controls costs best from government-managed systems.  Capitalism.  Where people make spending decisions based on cost.  Which will never happen when someone other than the patient pays for the costs for the medical services a patient receives.  For no one ever asks ‘how much’ when they’re not paying the bill.

So when a rich doctor says to tax the rich more is this selfless?  Or selfish?  You decide.

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It’s the Lack of Capitalism in Health Care that Makes it so Expensive and Inaccessible

Posted by PITHOCRATES - November 6th, 2011

Week in Review

Why is health care so expensive in the U.S.?  Apparently it’s because of doctors and insurance companies.  Not the people who set the rules doctors and insurance companies must play by (see Health insurance in America: Obamacare is making health insurers bigger posted 10/29/2011 on The Economist).

Good, cheap health care has long eluded America. Doctors are paid for each service, so they deliver as many as possible, necessary or not. Insurers protect margins by micromanaging claims and hiking premiums.  These perverse incentives are addressed, faintly, by Obamacare. For example, there are pilots to reward hospitals for the quality rather than the quantity of their care. Mostly, however, the reform deals with the symptoms of muddled incentives: high premiums and poor access.

Yes, these are perverse incentives.  But this is what happens when you exclude capitalism from health care.

All of the problems, and I mean ALL of the problems, of health care go back to one fatal flaw in how we pay for health care.  We don’t.  That is, we don’t pay for our own health care.  Others do.  And when the recipient of services rendered doesn’t pay for the services rendered you can’t help but to have these perverse incentives.

When you buy a new fridge you don’t let the salesman sell you the most expensive one with the most features if you can’t afford it.  Because you’re going to say no.  Because you can’t afford it.  Those features are nice.  But they’re not necessary for a happy and healthy life of refrigerating stuff.

But if someone else is paying the bill, guess what?  You’re probably going to get the best.  Because it won’t cost you anymore.

Just like people with good prescription coverage don’t buy generics.  Because it doesn’t cost them any more to buy the name brand.

This is what happens when you don’t pay for what you buy.  This is why health care costs are out of control.  And fixing this problem by making the original problem bigger, having other people pay for your health care, as in Obamacare, won’t do a thing to cut costs or provide more access.  What will happen is what has happened in nations with national health care.  Higher taxes and a rationing of services.  To pay for the out of control rise of costs.  Which, surprise surprise, keep rising.  Even in these countries that have ‘solved’ the problem of out of control costs.

If you want to control costs you have to increase the amount of capitalism in the system.  Not reduce it.  Because this is what capitalism does.  And what bureaucrats can’t do.

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Broke and Inefficient: Medicare, Social Security, Liberalism and (soon to be) Obamacare

Posted by PITHOCRATES - November 15th, 2010

The Washington Post Thinks President Obama can be Great.  If he Quits being President.

The Washington Post says the American people have rejected President Obama and his policies.  But they still think he’s the bee’s knees.  The great man can still be great.  If he quits (see Opinion | One and done: To be a great president, Obama should not seek reelection in 2012 by Douglas E. Schoen and Patrick H. Caddell posted 11/14/2010 on The Washington Post).

Obama himself once said to Diane Sawyer: “I’d rather be a really good one-term president than a mediocre two-term president.” He now has the chance to deliver on that idea.

In the 2008 presidential campaign, Obama spoke repeatedly of his desire to end the red-state-blue-state divisions in America and to change the way Washington works. This was a central reason he was elected; such aspirations struck a deep chord with the polarized electorate.

But that’s not the reason the people elected him.  They simply didn’t know any better.  No one knew anything about him.  He had no track record.  No experience.  A barren resume.  Questionable associations with radicals.  And he went to church run by a racist and anti-American pastor. 

The liberal mainstream media simply failed to vet this candidate.  And now that he has governed as one would expect with such a past, the people have rejected him at the 2010 midterm elections.  As they would have during the campaign.  Had the media vetted him like they vet Republican candidates.  But they didn’t.  Because they were already in love with him.

Should the president do that, he – and the country – would face virtually no bad outcomes. The worst-case scenario for Obama? In January 2013, he walks away from the White House having been transformative in two ways: as the first black president, yes, but also as a man who governed in a manner unmatched by any modern leader. He will have reconciled the nation, continued the economic recovery, gained a measure of control over the fiscal problems that threaten our future, and forged critical solutions to our international challenges. He will, at last, be the figure globally he has sought to be, and will almost certainly leave a better regarded president than he is today. History will look upon him kindly – and so will the public.

No.  They won’t.  President Obama wasn’t succumbing to pressure from his liberal base.  He wanted to remake America into a quasi-socialist state like those social democracies in Europe.  The American people don’t.  Hence the 2010 midterm election results. 

More Obamacare Waivers to Companies that can’t Afford Obamacare

Obama lied during the 2008 presidential campaign.  He said he was a centrist.  He said he didn’t want to nationalize health care.  Well, after winning he said elections have consequences.  There would be no reaching across the aisle.  It would be his way.  Because the Republicans lost.  And what did he want more than anything else?  A Big Government takeover of health care. 

And he lied again.  He said they would provide health care to more people and bring total costs down.  Well, Obamacare forced private insurers to provide more benefits.  So, of course, they raised their premiums.  Some dropped children-only policies because Obamacare basically made those pure unfunded welfare.  And McDonald’s asked for, and got, waivers for their min-med plans.  As did others.  Why?  Because Obamacare increased the cost of those plans so much that they would have dropped health insurance for their employees without the waivers. 

Obamacare is forcing higher costs on others, too.  To date the government has issued another 111 waivers (see Approved Applications for Waiver of the Annual Limits Requirements of the PHS Act Section 2711 as of November 1, 2010 from the U.S. Department of Health & Human Services website).  And because the unions didn’t get the public option to offload their health care burdens, a lot of them want out of Obamacare.  They can’t afford it.  And if they can’t, you know others without big legal staffs who have no idea what’s coming can’t afford it either.

Medicare:  Broke and Inefficient

Besides out of control costs what can we expect with government managed health care?  Well, I guess we can look at government managed health care we have now.  Medicare.  And what’s it like working in that government run system (see Doctors brace for possible big Medicare pay cuts by Ricardo Alonso-Zaldivar, Associated Press, posted 11/13/2010 on Yahoo! News)?

“My frustration level is at a nine or 10 right now,” said Wagner, who practices in San Antonio. “I am exceptionally exhausted with these annual and biannual threats to cut my reimbursement by drastic amounts. As a business person, I can’t budget at all because I have no idea how much money is going to come in. Medicine is a business. Private practice is a business.”

Yeah, well, she’s probably just another greedy doctor.

Last summer, when Congress missed the deadline for an extension, Wagner had to tap her line of credit to pay the salaries of her nurses and office staff. Medicare is only a fraction of her practice, but the cancer surgeon said private insurance companies also held up payments waiting to see what would happen. “I didn’t get a check in the mail for almost a month,” she said.

Well, maybe not.

Social Security:  Broke and Inefficient

How about Social Security?  Sure, that’s been flirting with bankruptcy for like forever.  But it works, doesn’t it?  On the benefit side?  Providing a swift and life-saving safety net for those most at risk?  Yeah, pull the other (see Social Security judges facing more violent threats by Sam Hananel, Associated Press, posted 11/14/2010).

Judges who hear Social Security disability cases are facing a growing number of violent threats from claimants angry over being denied benefits or frustrated at lengthy delays in processing claims.

And how long are they waiting?

Nearly 2 million people are waiting to find out if they qualify for benefits, with many having to wait more than two years to see their first payment.

Wow.  Even renewing your driver’s license is less painful than that.

Obamacare:  Soon to Become Broke and Inefficient

And this is what President Obama wants to give us.  He wants to take over health care and make it like Medicare and Social Security.  Chronically on the verge of bankruptcy.  And grossly inefficient. 

The social democracies of Europe are imploding under their own weights.  People are rioting.  Cities are burning.  And while they desperately try to reverse direction, Obama is dragging a reluctant America in the other direction while whistling a happy tune.  And unless history is a product of our liberal public school system, there’s no way in hell it will look kindly on the man that so greatly damaged America.

It’s not the partisanship causing the trouble in Washington.  It’s an ideology.  Liberalism.  Which is broke and inefficient.  It’s time to get rid of it.  And a good place to start would be to repeal Obamacare.  If he did that, perhaps history would look kindly on him.

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