FT219: “Obamacare will give us rationing and long wait times like America’s other national health care: the VA.” —Old Pithy

Posted by PITHOCRATES - April 25th, 2014

Fundamental truth

Our Veterans have been Wounded and Maimed and we thank them for their Service with the VA

Where do the rich and famous go when they go to a hospital?  They can afford the best.  So you will hear hospitals like Cleveland Clinic, Mayo Clinic, Johns Hopkins, Mount Sinai, etc.  The crème de la crème of the best health care system in the world.  But one name you won’t hear?  Any VA hospital.

Rich and famous people have something our veterans don’t.  Choice.  They can choose to go to the crème de la crème of the best health care system in the world.  While our veterans have no choice but to go to the dregs of the best health care system in the world.  Very often the worst place you can go in the United States for health care.

It’s sad, really.  For our veterans have given more than any other American.  They have put themselves in harm’s way.  Had people shoot at them.  Lob hand grenades at them.  Had mortar rounds and artillery rounds land near them.  And had improvised explosive devices (IED) detonate around them.  Our veterans have been wounded and maimed and faced the hell of combat.  And our thanks for their volunteering to do this for us?  The VA.

Our VA Hospitals are so bad because they know our Military will be good Soldiers and Wait

There aren’t a lot of VA hospitals around.  So some veterans have to travel to get to one.  And when they get there they have to wait.  As there are a lot of other veterans in the waiting room with them.  Because there aren’t a lot of VA hospitals around.  But that’s not the only waiting they’re going to do.

If they need surgery or treatment there will be even more waiting.  A lot more waiting.  Because there aren’t a lot of VA hospitals around.  Or a lot of VA health care providers.  Or a lot of VA diagnostic equipment.  Which means they have to ration out health care in our VA hospitals.  And when you ration health care you make people wait longer for treatment.  An alien concept for the rich and famous.  Who get what they want when they want it.  Because they have choice.

Our veterans, on the other hand, continue to be good soldiers, Marines, sailors and airmen.  And wait.  Just like the old military joke to ‘hurry up and wait’.  Where they will get up before dawn to wait on the tarmac for 4 hours to board an aircraft.  So we’ve trained our military personnel well in waiting.  Perhaps this why our VA hospitals are so bad.  Because they know our military will be good soldiers, Marines, sailors and airmen.  And wait.

VA Hospitals are run so poorly that Veterans are dying as they wait for this National Health Care

The sad thing is that some of our veterans are waiting so long that they are dying (see A fatal wait: Veterans languish and die on a VA hospital’s secret list by Scott Bronstein and Drew Griffin posted 4/24/2014 on CNN).  Because rationing leads to longer wait times.  And longer wait times lead to more deaths.  And this is why the VA hospitals (America’s national health care) are the dregs of the best health care system in the world.

The American left wants national health care.  They want VA hospitals for everyone.  Except them, of course.  For they will be going to the hospitals the rich and famous go to.  But it’s VA hospitals for the rest of us.  Where they will ration health care.  Increase wait times.  And provide some of the most inefficient health care service.  Another reason veterans have to wait so long is that the VA still uses paper records.  Like they did before the 1970s.

The left settled for Obamacare.  They wanted national health care but accepted Obamacare as a stepping stone to national health care.  For they think the government can run health care better than the private sector.  Even though they’ve been running the VA for decades without ever modernizing it.  The government runs the VA hospitals so inefficiently that veterans are dying as they wait for this rationed national health care.  But these same people who can’t bring the VA into the 20th century say they can improve the crème de la crème of the best health care system in the world.  But if they do the VA poorly they will do all national health care poorly.  Because the government just can’t do anything well.

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The NHS drops Life-Saving Drug as it would lead to more Rationing and longer Wait Times

Posted by PITHOCRATES - April 22nd, 2014

Week in Review

In 1954 almost 35% of all workers belonged to a union.  Since then that number has fallen to about 11.3%.  As the high cost of union contracts chased manufacturing out of the country.  Today the majority of workers belonging to a union work in the public sector.  Where they enter contract negotiations with the taxpayers to secure better pay and benefits than most taxpayers have.  Of course during these negotiations the taxpayers have no say.  As politicians and unions hammer out these contracts.  Unlike trade unions.  Where the people paying the workers actually have a say.

This is another reason why national health care is the Holy Grail for the left.  They want to unionize all those health care workers.  Pay them more.  And deduct union dues from their pay to fund their political activities.  Leaving less money for patient health care.  But they’re okay with that.  But they’re not okay with a pharmaceutical company charging a lot of money for life-saving drugs.  Which, also, leaves less money for patient health care (see Breast cancer drug turned down for NHS use due to high cost by Sarah Boseley posted 4/22/2014 on the guardian).

A Herceptin-style drug that can offer some women with advanced breast cancer nearly six months of extra life has been turned down for use in the NHS because of its high cost.

In draft guidance now open to consultation, the National Institute for Health and Care Excellence (Nice) blames the manufacturers, Roche, who are asking for more than £90,000 per patient, which is far more than any comparable treatment…

“We apply as much flexibility as we can in approving new treatments, but the reality is that given its price and what it offers to patients, it will displace more health benefit which the NHS could achieve in other ways, than it will offer to patients with breast cancer.”

Paying health care providers more will not improve the quality of health care.  Unless health workers are doing a half-assed job now.  Which I don’t believe they are.  But Roche is helping people with death sentences live another six months or so.  That’s a pretty remarkable thing.  If the NHS can’t afford this wonder drug perhaps they should use their own.  Of course they can’t.  Why?  Because they don’t have one.  For they didn’t pour hundreds of millions of dollars in developing this drug and the all those drugs that failed.

Developing a miracle drug is costly.  Money the pharmaceuticals pay up front.  Because their employees don’t work for free.  Which is why these drugs cost so much.  That high price pays for all of the costs that went into this drug.  For all of the drugs that failed.  And provides a return for investors.  Who give these pharmaceutical companies hundreds of millions of dollars up front just in the hope they may develop a miracle drug.  Which is the only way we should invest in these miracle drugs.  Because these investors will only take a chance on a good thing.  Unlike government.  Which has a history of backing the wrong investment time after time.  And pouring good money after bad.

It’s a tough choice to make.  Take health care benefits away from other patients to pay for a miracle drug for those dying from cancer.  Or let people die 6 months or so sooner.  One thing for sure, though, unionizing our health care workers won’t give either of these patients more health care benefits.  It will only leave less money for everything else.  Leading to rationing.  And longer wait times.  Because less money will pay for fewer things.  Making those other things scarcer.  Forcing people to wait longer and pay more for treatment.

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The Left wants a Health Care System like Britain’s NHS despite the NHS having Crippling Deficits

Posted by PITHOCRATES - April 19th, 2014

Week in Review

Obamacare is not going well.  The say it is.  But it isn’t.  The White House can all of a sudden give us a number like 8 million enrollees when they said earlier they couldn’t tell until the insurance companies tell them.  And the other big question is this.  Are these enrollees?  Including all people who enrolled whether they paid or not?  Or are these only the people who paid?  Or are most of these people enrolling in Medicaid?  Those who won’t ever pay?  If that 8 million aren’t paying customers Obamacare is doomed.

So the financial foundation of Obamacare is likely very perilous.  Where the sick and poor are probably signing up more than the healthy with money.  And the delay of the employer mandate to sometime after the midterm election takes a bad financial foundation and makes it worse.  For they can’t keep delaying the funding parts until after elections.  Because someone has to pay for all of the subsidies.  As well as the high cost of the old and sick.  Which alone may bankrupt Obamacare (see Labour considers raising national insurance to fix £30bn NHS ‘black hole’ by Toby Helm posted 4/19/2014 on the guardian).

Radical plans to increase national insurance contributions to plug a looming £30bn a year “black hole” in NHS funding and pay the spiralling costs of care for the elderly are being examined by Labour’s policy review.

The Observer has learnt that the idea is among options being considered to ensure NHS and care costs can be met under a future Labour government, without it having to impose crippling cuts on other services in successive budgets.

Senior party figures have confirmed that a scheme advanced by the former Labour minister Frank Field – under which funds from increased NI would be paid into a sealed-off fund for health and care costs – is being examined, though no decisions have been taken.

Recent figures based on data from NHS England and the Nuffield Trust and produced by the Commons library suggest that NHS costs alone will go from £95bn a year now to more than £130bn a year by 2020.

Some have suggested that they designed Obamacare to fail.  So they can get what they really want.  Single-payer.  Or national health care.  Like they have in Britain with their National Health Service (NHS).  Which is running an enormous deficit.  Based on the above numbers it currently is 31.6% (£30bn/£95bn).  Which is just unsustainable.  But this is what an aging population will do.  When you have more people leaving the workforce consuming health care benefits paid for by fewer people entering the workforce.  Which should be a huge warning for the United States.  Because they have an aging population, too.

At the current exchange rate that £30 billion comes to $50.37 billion.  Is this what the US can expect?  No.  Because they have five-times the population Britain has.  So their deficit will be approximately five-times as big.  Or $251.85 billion.  That’s a quarter of a trillion dollar shortfall PER YEAR.  At least.  And $2.52 trillion over a decade.  So unless the Americans can somehow make their people less sick so they won’t consume health care resources the deficit alone for Obamacare will be more than twice the original CBO projection for the total cost over 10 years.  Which means the Americans will have to do what the British must do.  Increase taxes.  Charge for some health care services in addition to these higher taxes.  Or impose crippling cuts to services.  Hello rationing.  And longer wait times.

This is the absolute worst time to impose a single-payer/national health care system.  Just as the baby boom generation fills our health care system in their retirement.  It might have worked if we had kept having babies the way we did before birth control and abortion slashed the birthrate.  But we didn’t.  And now we have a baby bust generation stuck footing the bill for a baby boom generation.  Fewer paying for more.  And the only way to make that work is with confiscatory tax rates.  Or death panels.  Because you have to raise revenue.  Or cut costs.  There is just no other option.  Or people can work longer, pay out of pocket for routine, expected expenses and buy real insurance to protect themselves from catastrophic, unexpected medical expenses.  Which is actually another option.  And probably the only one that will work.

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The Democrats think they can do National Health Care better than Britain despite the Obamacare Website Rollout Disaster

Posted by PITHOCRATES - March 30th, 2014

Week in Review

Those on the left settled for the Affordable Care Act.  It’s not what they wanted.  But they think it can, in time, give them what they want.  Single-payer health care.  Or a true national health care system.  Like they have in Britain.  Oh how the left would love to have a no nonsense National Health Service (NHS) in the United States.  A system totally funded by general taxation.  Because that would be better than Obamacare.  And far better than what Obamacare replaced.  Now those who think that are either lying to the American people.  Or are completely ignorant to what’s going on in the NHS.  For the highly esteemed NHS is on life support (see £10 each can save the NHS by Norman Warner and Jack O’Sullivan posted 3/30/2014 on the guardian).

A care and cash crisis is sending the NHS bust. In its present form, a shortfall of £30bn a year, or more, is expected by 2020. Paying off the nation’s deficit means five more years of further deep public expenditure cuts, whoever is in government. So, over-protecting an outdated, cosseted and unaffordable healthcare system inevitably means starving other vital public services, unless we choke off economic growth and worsen the cost of living with big tax increases. That might be worth contemplating if the NHS was offering brilliant care. But it isn’t.

Just look at the thousands of frail elderly people who get the care they need only by queuing in A&E and spending weeks in hospital – the most expensive and often the worst way to look after them. And let’s not forget that the NHS is sleepwalking through an obesity epidemic.

These are truths hidden from public view. Many politicians and clinicians are scared to tell people that our much-loved 65-year-old NHS no longer meets the country’s needs. Frankly, it is often poor value for money, and the greatest public spending challenge after the general election…

Our specialist hospital services should be concentrated in fewer, safer, better-equipped and more expert centres with 24/7 consultant cover and improved transport links…

A new integrated “National Health and Care Service” would pioneer a “co-producing” health partnership between state and citizen, with annual personal health MOTs agreeing responsibilities over the year for both services and the individual. At the heart of this relationship would be an NHS membership scheme, charging £10 a month (with some exemptions) collected through council tax for local preventative services to help people stay healthy.

This is one of several new funding streams urgently needed to renew impoverished parts of our care system but preserving a mainly tax-funded NHS that is largely free at the point of use. We have to escape the constraints of general taxation if we want a decent system…

Just 3.5% of the annual 500,000 deaths lead to payment of inheritance tax. We must expect the elderly, after their deaths, to contribute more. NHS free entitlements, such as continuing care, could be reduced or means-tested and hotel costs in hospital charged, as in France and Germany.

Britain has an aging population.  Fewer people are entering the workforce to pay the taxes that fund the NHS.  While more people are leaving the workforce and consuming NHS resources.  So less money is going into the NHS while the NHS is spending more and more money on patients.  Leading to a deficit that they can’t pay for without killing the economy.  Or taking money away from other government services.

If the NHS was providing quality health care they could probably justify taking money away from other areas.  But it’s not.  The one argument for passing Obamacare was that it would reduce the burden on emergency rooms.  But it’s not doing that in Britain.  The wait times are so long to see a doctor or get a procedure that people are going to the emergency room (A/E in Britain) and waiting for hours instead of waiting for months.  Further increasing costs and wait times.  And frustrating patients.

So what is the solution to a failing national health care system?  Close hospitals and make people travel further for treatment.  And charge them £10 ($16.64) monthly in addition to some of the highest tax rates they already pay to fund the NHS.  So, to summarize, to make national health care work in Britain they need to close hospitals, make people travel further for care, charge them more money and make them wait longer for treatment.  Which is basically the argument against the Affordable Care Act.  It would lead to rationing.  And longer wait times.  Worse, the quality of care will decline.  As it has in Britain.  As it will in the United States.  For we also have an aging population.  And we have about five-times the people they have in Britain.  Which will make our problems five-times worse than theirs.

What’s happening in the NHS is no secret.  Any proponent of national health care no doubt looks at Britain and their NHS.  So they must be familiar with how it’s failing.  Yet they press on for a similar system in the United States.  Why?  If it won’t improve our health care system why do they want national health care?  This is the question we should be asking the Democrats.  Why?  Of course they will say Britain just isn’t doing national health care right.  After all, they’ve only been doing it for 66 years.  So what do they know about national health care?  While we, the liberal Democrats will say, will get national health care right from the get-go.  Because we are just so much smarter than everyone else in the world.

Of course the British could, and should, fire back with, “Yeah?  How did that Obamacare website rollout go?  You’d think that someone who is so smart that they could do national health care right from the get-go could actually build a sodding website that works.”

But, of course, they didn’t.  And the website was the easiest part of Obamacare.  A one and done thing.  And if they couldn’t do that right do we really want these people anywhere near our health care?  No.  Especially when the British are struggling with national health care after trying it for 66 years.  For national health care is apparently more difficult to do than building a sodding website that works.

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Some in Canada consider a Parallel Private Health Care System to reduce Wait Times

Posted by PITHOCRATES - March 29th, 2014

Week in Review

People don’t want Obamacare.  And they are getting angry.  Making the Democrats very nervous.  Especially those up for election this fall.  Which is why there is yet another delay in implementing the Affordable Care Act.  To make voters less angry this fall.

This law was never popular.  The American people never wanted it.  The only reason why we have it is because the Democrats pushed it through when they had control of the House, Senate and White House.  And bought off a few recalcitrant Democrat senators (the Louisiana Purchase, Cornhusker Kickback, Gator Aid, etc.) to garner the 60 votes necessary to force this unpopular law onto the American people.  So the Democrats could put us on a path towards single-payer.  Which President Obama is on the record preferring.  Single-payer.  But accepted the Affordable Care Act as a means to that end.  So we can one day have a health care system like they have in Canada.  Because things are so much better in Canada (see Waiting times cost B.C. patients $155.5 million last year: Fraser Institute study by Bethany Lindsay posted 3/25/2014 on The Vancouver Sun).

Waiting for medically necessary surgeries cost British Columbian patients about $155.5 million in lost time last year, a Fraser Institute economist claims in a new study.

It estimates that the total cost to Canadian patients of waiting for treatment after seeing a specialist was $1.1 billion in 2013, up from $982 million in 2012. Quebec had the highest cost at $267.7 million.

Author Nadeem Esmail said the report explores a consequence of waiting for care that Canadians don’t often consider…

Esmail said that in order to address the problem of long waiting times, he’d like to see Canada allow more private sector participation in the provision of health care, including the development of a parallel private system…

Overall, British Columbians waited a median 10.4 weeks for treatment after their first appointment with a specialist last year, compared to 9.6 weeks across Canada, according to the study.

Imagine that.  The Republicans were right.  A single-payer health care system leads to rationing of health care resources.  And sick people waiting for their turn for fewer, rationed health care resources leads to, of course, longer wait times.  This is what the Democrats want to force on the American people.  Even when some in Canada are suggesting a parallel private health care system to reduce wait times down from 10 weeks or so.  Which is why the Democrats had to be as devious as possible to pass Obamacare into law.  With shady backroom deals like the Louisiana Purchase, Cornhusker Kickback and Gator Aid.  And then lying through their teeth about being able to keep the health insurance and doctors you liked and wanted to keep.  A lie so bold it earned President Obama the Lie of the Year from PolitiFact.

Will this anger boil over this November at the 2014 midterm elections?  Will voters remember how the Democrats lied and made backroom deals to change a health care system we liked and wanted to keep?  Apparently President Obama thinks so.  Which is why he violated the law once again and extended the enrollment period for Obamacare.  Without having Congress rewrite the law.  To make this latest change in the Affordable Care Act (and the 30 or so that preceded it) legal.  But then again, when the media keeps giving the president a pass on his law-breaking activities what incentive does the administration have to act lawful?  It’s kind of like Vladimir Putin taking Crimea.  The way Putin sees it no one is going to do anything when he breaks the law so what incentive does he have to abide by international law?  If anything he’s probably puzzled why President Obama is saying anything at all.  For what’s a little law-breaking between two law breakers?

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Canadian Hospitals suffer from Overcrowding in British Columbia

Posted by PITHOCRATES - March 22nd, 2014

Week in Review

The left likes to say we’re idiots here in the United States.  Because every other advanced economy has national health care.  Of course, every other advanced economy doesn’t have the best health care system in the world.  No.  That honor goes to the United States.  And perhaps NOT having national health care is the reason why we have the best health care system in the world.  For those national health care systems have their problems.  Even the system north of the border the American left yearns to have.  The Canadian single-payer system (see New B.C. seniors advocate to focus on needs of growing elderly population by ROB SHAW posted 3/19/2014 on The Vancouver Sun).

Isobel Mackenzie, a longtime Victoria seniors care administrator, was named Wednesday as the province’s first seniors advocate, more than 16 months after the office was first announced…

There are more than 700,000 seniors in B.C. and that’s expected to double to 1.4 million over the next 20 years…

Mackenzie said she’s not sure if her office will get involved in how hospital overcrowding is affecting seniors care, and sidestepped a reporter’s question at her press conference Wednesday about the case of an elderly man who had spent eight hours waiting in a hospital emergency room…

“Obviously, health care is a priority and home care – giving support to people so they can stay at their home and healthy,” she said.

Logan said the government tried an “experiment” of providing funding to United Way but they’ve been “overloaded with requests.”

All of the advanced economies share something in common.  They all have an aging population.  Thanks to birth control and abortion people in the advanced economies stopped having babies after the Sixties like they used to have.  Which is why the seniors are now the largest growing sector of the population.  We have fewer people entering the workforce to pay the taxes that support a greater number of people leaving the workforce.  And thanks to modern medicine, these people are living long into retirement.  Which is why Canadian hospitals in British Columbia are overcrowded.  Which lead to longer wait times and the rationing of care.  Things common with national health care.  And these things are only going to get worse as their aging populations age further.

This is the future of Obamacare.  For the Affordable Care Act is already proving unaffordable to those who have to pay.  And people are losing the health insurance and the doctors they liked and wanted to keep.  A lot of doctors are opting out of Obamacare.  Leaving fewer in the system to treat a larger number of patients.  Which will, of course, lead to longer wait times and the rationing of care.  Just like in Canada.  And in every other advanced economy with a national health care system.  Which is why the United States is the only advanced economy without a national health care system.  Because Americans don’t want longer wait times and the rationing of care.  And they don’t want the Affordable Care Act.

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Ontario Health Care has Long Wait Times and Rationing despite it being 973% More Costly than Obamacare

Posted by PITHOCRATES - December 21st, 2013

Week in Review

To pass the Affordable Care Act (aka Obamacare) into law the Democrats submitted numbers to the CBO that crunched the cost to less than $1 trillion over 10 years.  No more than the cost of the wars in Iraq and Afghanistan.  So it would be a wash.  As if they never decried the spending for those wars as wasteful.  Or simply unaffordable.  But now that spending was not wasteful or unaffordable.  If it paid for Obamacare.

Of course that original cost of $1 trillion over 10 years was very suspect.  In time that number was revised up.  For it was impossible to provide health insurance to everyone without spending a lot more.  As we can see if we look to our neighbors to the north.  Canada (see Ontario not receiving expected health transfer funds by The Canadian Press posted 12/17/2013 on CBC News).

The federal Conservatives have betrayed Canada’s most populous province by breaking their promise over health-care funding, Ontario Health Minister Deb Matthews charged Tuesday.

The Harper Tories promised all provinces a six per cent increase in health transfers, but they’re only giving Ontario 3.4 per cent in 2014-15, she said…

The $300 million that Ottawa is shortchanging Ontario is more than the province’s increase in home care and other services for seniors this year, she said.

“It’s less money to reduce wait times, it’s less money to hire nurses, it’s less time to provide Ontario families and particularly Ontario seniors with the care that they need,” Matthews said…

Flaherty was unavailable for comment Tuesday, but a spokeswoman said health transfers are rising…

“In fact, in 2014-15 Ontario will receive over $12 billion in health transfers, almost a 60 per cent increase from under the previous federal Liberal government.”

The province’s share of federal health dollars will increase from $11.9 billion this year to $12.3 billion next year.

Ontario allocates about $49 billion a year on health care, the highest area of spending in its $127.6-billion budget…

Ontario, which is facing a nearly $12-billion deficit, is the only province that will see fewer federal dollars next year, with total transfer payments shrinking by $641 million to $19.1 billion.

Canada’s single-payer system (actually one system per province subsidized by the federal government) has long been an object of affection to those on the American left.  Who kept pointing to it.  Saying, “See?  That’s what we should be doing.”  Rational people said doing so would increase wait time and cause rationing.  “Uh-uh,” they said.  “Providing more health care to more people will NOT lead to increased wait times or rationing.”  Proving their ignorance of the most basic arithmetic.  So let’s use some arithmetic to show why they are so wrong.

First of all despite the utopia of Canada’s single-payer system they apparently have long wait times and rationing.  Or else they wouldn’t say that the reduction in health transfers would hurt their ability to reduce those very things.  Ontario has a population of 13,472,400.  Which means they’re spending $3,637.07 per person ($49 million/13,472,400) on health care.  Or about $3,418.84 per person in US dollars.  The US population is about 313,914,040.  So if we spend what Ontario is spending that comes to about $1.07 trillion per year.  About $10.7 trillion over 10 years.  Or about 973% more than the Democrats said it would cost.

Obviously the government is not going to have this kind of money available.  So there will be longer wait times.  And rationing.  Which is why people won’t be able to keep their health insurance, doctors and medicine they liked and wanted to keep.  And why President Obama and his fellow Democrats lied to pass the bill.  Because things are going to get that bad.  They’re just hoping by the time people realize just how bad it will get Obamacare will be so entrenched that it will be impossible to repeal.  Because if it’s not the people will demand we repeal it and replace it with something better.  Like what we had before the Affordable Care Act.

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Longer Wait Times, Rationing and Higher Mortality Rates are the Inevitable Outcome of National Health Care

Posted by PITHOCRATES - November 23rd, 2013

Week in Review

The American left wants national health care. Just like the British have.  In their National Health Service (NHS).  But when critics say national health care will lead to longer wait times and health care rationing the left says balderdash.  Despite what’s happening in the NHS (see Hospital discharges: figures highlight impact of delays by Adam Brimelow posted 11/22/2013 on BBC News Health).

Last month the number of days “lost” by patients who needed the beds was the highest for more than three years.

Senior doctors working in accident and emergency departments say it is a major cause for concern…

“The delays are a key cause of overcrowding in emergency departments, which is associated with higher mortality,” he said…

A spokesman for the Local Government Association said councils had worked hard to protect social care services from the full impact of cuts, but added: “Unless local government finance is put on a sustainable footing, social care will remain substantially underfunded and services will suffer as a result.”

A shortage of hospital beds led to longer wait times in moving patients out of emergency departments and into a hospital bed.  Leading to higher mortality rates.  Which means longer wait times and rationing have caused more people to die.  This isn’t balderdash.  This is the inevitable outcome of national health care.  And the inevitable outcome of Obamacare.

As the Affordable Care Act rollout continues to crash and burn the Obama administration will soon be saying we tried fixing our health care problems the private health insurance route and failed.  Proving that the problem is the health insurance companies.  And the only way to fix this problem is with a single-payer system.  Or a true national health care system.  Like the NHS.  It’s coming.  Because it’s been the plan all along.

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Hinchingbrooke Hospital breaks free from the NHS Bureaucracy and Improves Health Care

Posted by PITHOCRATES - October 13th, 2013

Week in Review

Britain has government-run national health care.  The National Health Service (NHS) provides free health care to all Britons.  And the medical tourists who travel to the country for free health care.  Straining the NHS budget.  At a time when Britain’s aging population is stretching their limited resources thin.  Leading to longer wait times.  Longer travel times as they close local hospitals to consolidate their resources in fewer locations.  And rationing.

Even with their longer wait times, travel times and rationing of services they are still running a deficit in the NHS.  To address these chronic cost overruns they are trying to find £20 billion ($30.54 billion) in efficiency savings over three years.  But there is a beacon of hope for the NHS.  At Hinchingbrooke Hospital (see Set doctors and nurses free to use their common sense – as Hinchingbrooke Hospital does by Charles Moore posted on The Telegraph).

Last month, I visited Hinchingbrooke Hospital, near Huntingdon, the only NHS Trust in the country operated by a private partner…

I spent half a day at Hinchingbrooke, talking to doctors, nurses, administrators and patients, and seeing several wards…

One can visit a large organisation without being aware of big problems. Indeed, one of the great difficulties of the NHS is that internal communications are so bad that people can work well in one area without being aware of utter disaster a few yards away. In the case of Hinchingbrooke, under previous management, maternity was very good while the colorectal unit was shameful. So what follows is not definitive; but I feel I learnt something.

Uniquely in the NHS, Hinchingbrooke’s executive board is dominated by clinical practitioners (doctors and nurses, to you and me). The chief executive is an obstetrician. Only three of the 14 board members have non-clinical backgrounds.

In the only trust that has a private partner doctors and nurses determine how best to treat patients.  Instead of the faceless bureaucracy in the rest of the NHS.  Or what the proponents of Obamacare hope to force onto the American people.

One of the key working methods, borrowed from Toyota, is “Stop the Line”. Anyone in the hospital can stop the line if he or she believes that there might be a “serious untoward incident” or danger to a patient…

A similar, lesser action is a “swarm”. If you are urgently worried about something, you can summon all the relevant people together immediately. Unlike “whistle-blowing”, which is inevitably retrospective and often involves grievance and disloyalty, these ways of acting are instant and preventative. You are encouraged to use them. Someone stops the line in Hinchingbrooke most days.

Nurses work differently from most parts of the NHS. They all wear uniform, even if in managerial roles, and they are encouraged to take part in management without abandoning clinical work…

But what struck me about Hinchingbrooke was not that it was brilliantly original – simply that it was free to act according to common sense. Involve staff in decisions. Make sure that doctors and nurses can run things. Learn from commercial examples of how to improve services. Let the right hand know what the left is doing. Encourage innovation. Don’t “benchmark to the middle”, but to the top. And little things: get A&E nurses to wear identifiable name-badges; get rid of hospital car-park fines. Most of this is simple, but, in the leviathan of the NHS, it is not easy. And at present there are about 2,300 NHS hospitals in the United Kingdom, and only one Hinchingbrooke…

This is far behind the public. As you understand better if you spend a morning in Hinchingbrooke Hospital, the public want health care free at the point of use, but have no ideological prejudice about who delivers it, or how. They rightly judge by results – are they, their spouses, parents, children, well or ill? Are the staff medically competent, efficient and kind? They are not sentimental about the most shocking producer interest ever to have gained power in this country.

The one hospital where things are greatly improving is the one hospital that is moving away from bureaucratic national health care and towards private health care.  Like it once was in the United States.  While President Obama and the Democrats want to move the American health care systems towards the bureaucratic national health care of the NHS.  Where there are longer wait times.  And service rationing.  Well, everywhere in the NHS but Hinchingbrooke Hospital.

Do President Obama and the Democrats care that they will destroy the American health care system?  No.  Because it’s not about health care.  It’s about creating the “most shocking producer interest ever to have gained power in this country.”  Yes, it’s about the power.  Social Security and Medicare made the elderly dependent on government.  Giving the government power over the elderly.  If they can’t raise taxes they just threaten to cut Social Security and Medicare benefits.  National health care, though, makes everyone dependent on government.  Giving the government power over everyone.

Until the day they can no longer maintain that power.  And that day has come in Britain.  Their aging population is breaking the system.  Which is in essence a Ponzi scheme.  The masses in the workforce pay in via taxes.  And the few sick consume health care services at the top of the pyramid.  While a bloated bureaucracy makes sure to take very good care of itself.  But the aging population is shrinking the workforce paying the taxes.  And swelling the number of sick consuming the health care services.  Inverting the pyramid of the Ponzi scheme.  As it will in America thanks to Obamacare.  Because the United States has an aging population, too.

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Obamacare and the Laws of Supply and Demand

Posted by PITHOCRATES - September 30th, 2013

Economics 101

A Scarce Thing has a Higher Price because Everyone that Wants One can’t Have One

Economics is the study of the use of scarce resources.  Scarce resources that have alternative uses.  For example, we can use corn for human food.  Animal feed.  We can make bourbon from it.  And we can even use it for fuel to power our cars.  So there are alternative uses for corn.

And corn is scarce.  There is not an unlimited supply of it.  During the drought the United States suffered in 2012 farmers brought in a greatly reduced corn harvest.  Which caused corn prices to rise.  Per the laws of supply and demand.  If demand remains relatively constant while the supply falls the price of corn rises.  Why?

Scarce things always have a higher price.  A painting by Vincent van Gogh has a very high price because each painting is a one of a kind.  And only one person can own it.  So those who want to own it bid against each other.  And the person who places the greatest value on the painting will get the painting.  Because they will pay more for it than anyone else.  Whereas no one would pay for a cartoon in a newspaper.  Because they are not scarce.  As they appear in every newspaper.  Newspapers we throw away or put in the recycling tub every week.  Something that would never happen with a Vincent van Gogh painting.

Price Controls fail because People won’t Change their Purchasing Habits when Buying Scarce Resources

Government spending exploded during the late Sixties and early Seventies.  Paid for with printed money.  A lot of it.  Igniting inflation.  Causing a great outflow of gold from the country.  And with inflation spiking prices soared.  Rising prices reduced the purchasing power of American paychecks.  Add in an oil shock and the people were reeling.  Demanding relief from the government.

With the price of gasoline going through the stratosphere President Nixon stepped in to fix that problem.  Or so he thought.  First he decoupled the dollar from gold.  So they could print more dollars.  Causing even more inflation.  And even higher prices.  Then to solve the high prices Nixon implemented price controls.  Setting a maximum price for gasoline.  Among other things.  Sounds nice.  Wouldn’t you like to see gas prices held down to a maximum price so it consumed less of your paycheck?  But there is only one problem when you do this.    People won’t change their purchasing habits when it comes to buying scarce resources.

Why is this a problem?  Because the oil shock caused a reduction in supply.  With the same amount of gas purchasing with a reduced supply the supply will run out.  Which is what happened.  Gas stations ran out of gas.  Which they addressed with gas rationing.  Which led to long gas lines at gas stations.  With people pushing their cars to the pump as they ran out of gas in line.

Obamacare will Fail because no matter how Good the Intentions you cannot Change the Laws of Supply and Demand

Obamacare is increasing the demand for health care.  By providing health care for millions who didn’t have health insurance before.  So demand is increasing while supply remains the same.  There is only one problem with this.  With more people consuming the supply of health care resources those health care resources will run out.  Leading to rationing.  And longer wait-times for health care resources.  Just like gasoline in the Seventies.

One of the stated goals of Obamacare was to lower health care costs.  But what happens when you increase demand while supply remains relatively constant?  Prices rise.  Because more people are bidding up the price of those scarce resources.  Obamacare may try to limit what doctors and hospitals can charge like they do in Medicare, but everything feeding into the health care industry will feel that demand.  And raise their prices.  Which will trickle down to the doctors and hospitals.  And if they can’t pass on those higher prices to whoever pays their bills they will have to cut costs.  Which means fewer doctors, fewer nurses, fewer technicians and fewer tests and procedures.  Which means rationing.  And longer wait-times for scarce health care resources.

President Obama may say he’s going to provide health care to more people while cutting health care costs but the laws of supply and demand say otherwise.  In fact the laws of supply and demand say Obamacare will do the exact opposite.  So whatever rosy picture they paint no one will be linking arms and singing Kumbaya.  Unless they like paying higher taxes, waiting longer and traveling farther to see a doctor.  Which is what is happening in the United Kingdom.  And in Canada.  Which is why Obamacare will fail. Because no matter how good the intentions you cannot change the laws of supply and demand.

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