How Wall Street Destroyed Health Care By PAUL CRAIG ROBERTS
At my annual check-up, my doctor handed me a sheet explaining the reasons for office fee increases for Medicare Patients. It is worth reporting at length.
Medicare fixes the prices for Medicare patients’ health care. All office charges for Medicare, including office visit charges, have been set by the Federal government since 1984. In real terms (adjusted for inflation), these fixed prices are less today than they were three decades ago.
During the last four years, there have been large decreases in Medicare reimbursements for laboratory services provided in-house by private physicians. Payments for in-office blood work, for example, have been cut 35 to 47 per cent. Yet, a physician’s overhead continues to increase as a result of uncontrollable costs, such as property taxes, building insurance, electricity, maintenance, malpractice and workers compensation insurance.
As one result, my doctor had to close both the x-ray unit and the state and federally licensed medical laboratory on his premises. Now patients are inconvenienced by having to go to other locations for services that formerly were provided by the doctor at lower cost. A one day medical check-up is now a multiple day event and more expensive.
While Medicare payments to doctors have been cut, regulations have been increasing: “Almost every outside diagnostic procedure (CT, MRI scan, sonogram) ordered by this office now has to be pre-approved by some outside agency. Many medications are now requiring pre-approval or step therapy. Each requires filling out 1-2 pages of forms and/or two or more phone calls. This requires personnel time and therefore more cost. Consultant referrals are requiring more paperwork and time to schedule.”
This is of course partially accurate and very close to the root
cause.
Wall-Street Revenue Stream (where they get their wealth): 1) Consumers-who-Purchase, 2) Consumers-who-Invest, and 3) Consumers-who-Abdicate (vote, lobby, buy corporatist products, keep assets in banks and on wall street, pay taxes, and do not support localism).
In a free-society: 1) Consumers-who-Purchase and 2) Consumers-who-Invest.
That's it -- That's Liberty -- That's Individualism.
We must destroy #3 in the above Wall-Street (et all Corporatist, Fed Banker, Politician, or Lobbyist) Revenue Stream.
Counter-Economics (begets) Consumer-Minarchism (begets) Consumer-Individualism (anarchy).
*&^ Constitution --- Constitutional Rationality
Wall Street owns both the
Wall Street owns both the insurance companies and the larger health clinics and hospitals. And now, they have been in charge of writing the health care bill currently stalled in Congress. It is only a mmatter of time before this system entirely collapes as well and people will have to "Care" for themselves and then we will have real Health Care. Sigh.....
There is no Left or Right -- there is only freedom or tyranny. Everything else is an illusion, an obfuscation to keep you confused and silent as the world burns around you." - Philip Brennan
"Invest only in things that you can stand in front of and pr
uh
"Wall Street is romanticized by libertarians and “free market economists.” They believe, entirely on the basis of their ideology, that Wall Street finances venture capitalists who bring economic progress and higher living standards. Wall Street does no such thing, especially since financial deregulation turned Wall Street into a speculative hedge fund."
WTF is this even doing on the front page of this pro-liberty site? Paul Craig Roberts is a total statist douche that has NO idea wtf Libertarians even stand for nor how the *deregulation* excuse for the current crisis is so much horsesh*t that purple lucky charms horseshoes are flying out of Roberts eyes.
That guy is totally devoid of understanding of what brought the current healthcare system into being nor how to fix it. Just more bs partisan hack, blame it on the republicans stupidity that is PART of the problem with this political system.
While Dr. Roberts is a more
While Dr. Roberts is a more moderate free marketer than perhaps the Austrian economists(he is a supply sider), I think you missed his explicit statement that "There is no free market present."
Ventura 2012
If you have ever heard him interviewed on Alex Jones' show you
will know he is not a "total statist douche" at all. I found this article very interesting and I don't think he meant real "Libertarians" and real "free market economists" but those who give it lip service. He even put "free market economists" in quotes. He knows a lot and I think made some very good points.
Debbie
"I found this article very
"I found this article very interesting and I don't think he meant real "Libertarians" and real "free market economists" but those who give it lip service."
And yet he goes and blames deregulation for the financial turmoil....typical douche move. He has no idea wtf he's even talking about apparently. Just because he was on Alex Jones doesn't mean he's somehow pro-liberty or pro-free markets. Webster Tarpley, who is diametrically opposed to Austrian economics, libertarians or any notions of a free society, was on Alex Jones show as well.
Don't fall into the same trap the Che/Chavez lovers do. Just because some person is against *the evil corporations* does NOT mean they are lovers of liberty.
He doesnt understand Austrian
He doesnt understand Austrian business cycle theory(most people dont) because he is from a marginally free market school of economic thought(supply siders) that does not ascribe to it. He is still a good ally, maybe someday someone will explain it to him.
Ventura 2012
i've been saying the same
the site moderators are neo-libertarian at best. many, many progovernment articles like one recently saying we want a powerful FDIC. They shame Dr. Paul's message with their lack of understanding of it.
I didn't go to the link but the amount of the article on this site is enough to show what the problem is... WHO IS CUTTING MEDICARE payments and requiring more work of doctors?????????? Try the Federal Government. Welcome to government medicine. The rationing is already here where you refuse to see it my friends.
Double digit inflation in the
Double digit inflation in the price of health care is not sustainable.
It's the price of the product being insured stupid? Hint: The price of the the product being insured is inflated into the stratosphere. The current price of the product being insured is the problem. It's the price stupid.
True
As a resident physician nearly done with my training, I can tell you that MD's salaries continue to be cut at drastic rates. Most of my colleagues and I are coming up with back-up plans to get out of medicine "just in case" the trend continues to the point that it is more profitable to go into business, research, or pharmaceuticals.
Let me explain part of the problem with the structure of healthcare. Your doctor has pretty much no incentive to be a better doctor and treat you nicely. In fact, he has every incentive to do the opposite. Unlike most other professions in which better lawyers, retailers, restaurants, etc. get paid more for a good job and get customers by building a quality name, we do not. Also, we are never concerned that we'll run out of patients. In fact, we always have lines and waitlists. The only way we increase our wages is through Relative Value Units (RVU's) which is what medicare (and thus the insurance industry) uses to pay us. We generate these RVUs based on how we fill out our forms and the number of things we do, not the quality of the service we provide.
Example - If you come to me and I ask you about your head, neck, chest, lungs, and abdomen I might get $40 for the visit, but if I ask (AND DOCUMENT THAT I ASKED) about those aforementioned body parts and also say your legs and skin, I might get $55. Furthermore, if I can see 20 patients in a day instead of 15 then I can make more money with the knowledge that I won't lose net patients because patients come armed with "FREE MONEY" through a third party payer...it's not their money so they're ready to come often. Sure they'll be made that I rushed them out and barely examined them, but I have no incentive to spend time with a patient or be nice other than my own personal sense of pride...which many people lose quickly in this beast.
In medicine, things are backwards because of the payment structure. Some of the best MD's make the least money and some of the worst make the most money. As a physician, again, we don't get paid for quality, but quantity.
I think about it like hotels. Nearly everyone can stay at a hotel. If you're poor, you can stay at the red roof inn or a motel or something for $20-40/night, if you're wealthy you can stay at the Ritz in NYC for $1000 a night. Both provide a bed and a hot shower. The Ritz can earn more because they have a better reputation and provide a more luxurious stay. The pillows are softer, the counters are granite, the floors marble. However, in medicine there is no incentive for the red roof inn of doctors to try and be more like the Ritz doctors to make more money. In medicine the Red Roof Inn gets $100/night and the Ritz gets $100 too, so eventually the Ritz of medicine starts cutting out the luxuries and the friendly service because it can't afford to operate for $100. Pretty soon, the Ritz of MD's decides to remove the marble, the granite, and the nice pillows to cut cost. The Ritz of MD's figures they also can only let you stay for 14 hours instead of 24. Also, you can only shower for 10 minutes now. You get the point. In the end, every physician/hospital/doctor's office lowers their levels of service and quality to stay in the black and the patient's suffer. Ever wonder why so many MD's, nurses, secretaries, etc. can be such jerks whereas a waitress will kiss your ass and thank you for allowing her to bring you your food? Waitress is working for her money and her boss wants her to be nice so you'll come back. In medicine - doesn't even factor into the equation.
Btw, an average day for me is 14 hours when in the hospital, I make less than $9 per hour, I talk to patients approximately 10 minutes of my day, I sit at a computer and fill out forms for the vast majority of my day...
thanks for sharing your insights.
.
It's unfortunate he doesn't see
the problems arise from government collusion, favoritism and legislation that hurts the small,independent and alternative health providers.
Good, but...
Libertarians and free market advocates, to my knowledge, don't defend the current system. They were/are against the government intervention that has led to the special interest system that's now in place.
I think his criticism is more
I think his criticism is more accurately applied to the Republican sheep that think we have capitalism.
Ventura 2012
exactly
Paul Craig Roberts has no idea wtf he's even talking about. He's just busy pointing fingers without even reading what Libertarians have to say.