Snark Easy, Mathematics Hard v2.0

You'd think someone doing a stock market blog would have some clue about, y'know, numbers, prices, costs, and such. Maybe some insight into how things relate.

You'd be wrong.
Case in point, Karl Denninger's post on Market Ticker (h/t WRSA): 

Market Ticker: A One Sentence Bill To Force The Health Care Issue

Here it is:
"Notwithstanding any other provision in state or federal law, a person who presents themselves while uninsured to any provider of a medical good or service shall not be charged a price greater than that which Medicare pays for the same drug, device, service or combination thereof."

That's it.
One sentence.

If you want to add a penalty clause with it I propose the following:
"Any bill rendered to a person in excess of said amounts shall (1) be deemed void, with all services and goods provided as a gift without charge or taxable consequence to said consumer but not deductible by said physician or facility from any income or occupational tax and (2) is immediately due to the customer in the exact amount presented as liquidated damages for the fraud so-attempted."
It ends the "Chargemaster" ripoff game.
It ends the $150,000 snake bite or the $80,000 scorpion sting.
It ends the $500,000 cancer treatment.
It ends all of that, immediately and instantly.

I remind you that Medicare is required to set pay rates by law at a level that in fact are profitable -- that is, above cost by a modest amount -- for everything it covers.  Further, those pay rates are audited regularly to prove that they in fact are above cost.
Does this solve every problem?  No, and in fact that would leave alone the existing monopolistic pricing systems that many medical providers, whether they be drug makers, device makers, service providers or otherwise have in place.  It would exactly nothing to get rid of the 10 paper pushers hired for every doctor or nurse, none of whom ever provide one second of care to an actual person through their entire time of employment.

But it would instantly end walking into an emergency room and getting hammered with a $50,000 bill for something that Medicare will pay $5,000 for.

  
It's hard to fisk this amount of sophistry properly without noting it's akin to spackling over the Grand Canyon using a shovel, but I wasn't doing anything better, so here goes.


TL;DR version:

Some will hail this as a simple solution.

The word you’re looking for is “simplistic”, not “simple”.

If we can agree that I may purchase your home and put you on the street by offering you 3 cents on the dollar of its value in cash, we have an accord.

It not, I’ll provide an anatomical diagram for where to shove that communist codswallop.

And If Denninger doesn’t get that, or never thought of it, he’s too simple to be burping his Good Idea Fairy B.S. on the ‘net.

Longer version:

Medicare reimburses healthcare at pennies on the dollar of actual costs.
And deadbeats, indigents, and illegals pay not one damned cent anyways.
(You out there, with IQs above room temperature, see if you can puzzle out why, therefore, your private insurance gets charged $42 for a single Tylenol. Or a $50,000 bill for something Medicare only pays $5000 for. I’ll wait.)

Then factor in EMTALA, in which the feds dictated that emergency medical providers shall treat every recklessly irresponsible shitbag without insurance, and every illegal alien baby momma about to burp out another brat to cash in on Uncle Sugar’s largess to US citizens.
And then, oopsie, "forgot" to fund that unfunded mandate, which basically bankrupted every small community hospital in existence (in case you were old enough to have wondered where they all went somewhere around thirty years ago), and forced everyone to Big Giant Expensive Healthcare Palace, where everything is more expensive.

So, tell me, how long would McDonald’s survive if the feds decreed that anyone who was hungry would receive all the Big Macs and fries they wanted, simply for walking into the establishment…?

Beuller? Beuller…? Ferris Beuller…??

You want to “solve” health care, it’s simple:
get government out of the whole business. Because everything they touch turns to shit.

Here’s your one sentence:
The Patient Protection and Affordable Care Act of 2010, all provisions thereof, and all associated legislation and administrative guidelines, are all hereby revoked in their entirety, and in perpetuity.

Pay for your fucking care your own goddamn self, and qwitcherbitchin.

When the bill’s coming out of your ass, you decide, with full responsibility for the decision, whether you want that CT scan or blood test or surgery, and if you die because you fucked up that guess, well, shit’s tough. No lawsuits, just personal fucking responsibility.

Too fucking hard, cupcake?
Contract with an insurance company to gamble on your health, and charge you appropriate premiums, and buy the coverage you want: just like you do in every single fucking facet of the rest of your life.

You want a Ferrari, you pay for it, and you pay Ferrari insurance rates, and Ferrari deductibles.

You can only afford a Chevy Caprice, or a Kia, you pay less, and you get less.
If you want the government to take pity on the poor, let anyone who doesn’t pay income taxes sign up for Medicare, or military Tri-Care.
 And force Congress on that too: put the Senate on Tri-Care, and the House on Medicare, effective immediately.

Or don’t do that.
Frankly, I don’t give a shit.
But whether I buy health insurance, and what it looks like, is my decision, and mine alone.
And who gets cared for is between hospitals, doctors, and patients.
None of that is any business whatsoever of anyone in the fucking government, at any level, except insofar as they offer insurance to cover some people.

(Ask around and see how many doctors don’t take Medicare patients, BTW. It’ll open your eyes, if your brain isn’t a shrivelled raisin. Ask yourself, if the reimbursement rates are so damned profitable, why they'd be doing that. Why is it, d'ya suppose, doctors and insurance companies have to hire shit-tons of clerks and coding specialists, to navigate the arcana of federal Medicare billing and reimbursement codes and regs, the very 10 paper-pushers that deliver no actual patient care Denninger damns so casually and thoughtlessly, if Medicare is so damned by-law profitable? {Most people, with a modicum of wit at this point in the discussion, would tenderly back their cleats out of their dicks, and STFU.} Hospitals, OTOH, don't have a choice: everyone 65 and over is on Medicare, and it's 75% of their patient-load.)

Medicare, foisted on the American public by the second-biggest communist ever to inhabit the White House, LBJ, was a tag-along Ponzi scheme like that perpetrated by the absolute biggest communist, FDR, when he passed Social Security.

In both plans, you, your kids, and your grandkids, are paying and will continue to pay for your parents, grandparents, and great-grandparents. In Medicare's case, by shifting the actual cost onto your private insurance. That's why grandma's appendectomy was only $5K: because your private insurance is picking up the balance. Well played, communists.

Apparently, financial genius Denninger can't figure this obvious truth out when it's smacking him in the face like a frozen mackerel.
He's probably also stumped as to why health insurance premiums have risen inexorably, as government piles more and more people and things into Medicare etc.: prescription drug programs, no children left behind, illegal aliens, the relatives of illegal aliens with 37 co-morbid chronic conditions, their kids with diseases normally only studied by med students in their tropical disease lectures, and so on. Paid for by Medicare at pennies on the dollar.

Gee, with more and more seniors, and less and less employed workers carrying private insurance, not to mention less full-time employees who even get insurance, why premiums keep going up is a real poser.

Back during WWII, US wages were frozen by law, and labor was tight, what with 1 man in 6 in uniform. So to allow companies to sweeten employment offers without causing economy- and war machine-wrecking inflation, they were allowed to offer benefits, like pensions and insurance, without them being counted (and taxed, thanks to the 16th Amendment) as wages.

LBJ et al finally got around to levying that tax in 1966, with Medicare, by jacking your premiums, so that your insurance would subsidize the costs of seniors' care.

For brevity, we'll skip over the MRIs, CTs, ultrasounds, and laparoscopic and arthroscopic surgeries that are commonplace for everyone now, but used to only be covered for NFL quarterbacks.

The problem isn't insurance. Insurance has been around since at least 1686, courtesy of Lloyd's of London (another boon to mankind courtesy of Dead White Males [tm]). An insurance company spreads risk, and charges you for the coverage. These charges are called premiums. The premiums are a wager on your part that something bad will happen, backed up at odds by the insurer(s) that it won't. They know they'll lose sometimes, and they have to absorb those losses and still make a profit, just like casinos. Because random acts, bad luck, poor actuarial forecasting and people skydiving and riding motorcycles. Call it the Shit Happens Factor.

So the premium calculates normal losses, plus the SHF, plus a reasonable profit to stay in business.

And because insurers have to be able to cut huge checks, and they have a monthly float of premium checks, they have to put their money where it'll grow. They also have to lay off their bets on other bookies insurers, so that one bad payout doesn't wipe out the company. So they do that, and invest a lot of their liquid assets in things like stocks, bonds, etc.

So far, so good, right?

Then government finger-fucks things.
They force insurers to do things they - and even the insured - may not want. Like ObamaCare forcing young healthy males to be covered for childbirth - an anatomically impossible occurrence, and akin to requiring flood insurance for desert dwellers in the Sahara, seatbelts on motorcycles, and diapers on dogs. It's what government does.

Which drives up insurance costs for the services you don't want. (Exactly like your cable TV bill and the channels you don't want, but still have to pay for.)

Then, more recently, government pooch-screws banks into making loans to people that can't afford houses, which plan predictably explodes. Banks fail, the stock market crashes, and insurance companies, just like your 401K, are suddenly out metric fucktons of money. So, gentle premium-paying reader, how, praytell, do you suppose they get that money back, to keep from cratering financially...?

Could it possibly be by...raising premiums??

If you got that on your own, award yourself the No Shit, Sherlock! Prize.
Unless you blog at Market Ticker.

And why would they do that?

Because if insurers fail, everyone loses all their insurance.
So, tell me again: Who was it that made banks give out loans to people who were horrible loan risks?
Who is it, in all of Denninger's hand-waving, that "audits" Medicare to make sure it reimburses providers at a "profitable" rate?
(Bonus points if you can see a problem with letting the fox guard the chicken coop. But hey, "by law", the NSA and CIA aren't allowed to spy on Americans either. So that must never happen either, because government is so respectful and trustworthy of its citizens' rights, and circumspect in their duties towards...sorry, I had to stop before soda cost me another keyboard.)
Who enforces the law on that in case there's a disagreement between Medicare and the payee(s)?
Who piled on all the silly shit that you don't need?
Who's been jamming more people into the shitty-paying government plan(s)?

I'll wait why you write the same answer in all five cases.

Who is it that's been trying to break insurers, while forcing them to jack up premiums, which causes companies and individuals to drop coverage, which forces more people into crappy government insurance plans?

Denninger seems to be stumped on all this. Kind of like Democrats in Congress were.
Color me shocked! Shocked, I say!

This is why simpleton solutions don't work.
If you don't know what the blistering f**k you're talking about, maybe stay in your own lane.

And instead of defaulting to some infantile mental picture of insurers, hospitals, and doctors raping privately insured patients and carting the proceeds to their private vaults,

maybe show the sense God gave a jackass, and put the blame where it belongs:

Firing the government, and laying off thousands of lawyers is always a good first instinct in any problem. And anybody, like Denninger, who reaches for government as part of any solution like a gunslinger going for a .45 Colt, should be run out of town on a rail, after a proper tar-and-feathering.