Blog

Misplaced Priorities and Misguided Decisions

Tuesday, April 28, 2009, 11:52 AM

Yesterday my assistant Tito missed an important late afternoon meeting because the train he was on from NYC was delayed by more than 3 hours. The train slowly crawled north on tracks that were in too poor condition to support a higher speed. This is a regular occurrence on this line. Perhaps a few tens of millions would be required to bring these tracks up to something other than third-world condition. That money does not exist at the moment, so they will be “repaired” all the way back to “almost functioning,” just like last time.

Meanwhile, the Treasury made this announcement today:

WASHINGTON (Reuters) - The U.S. Treasury Department will on Tuesday tap a $50 billion housing rescue fund to pay off mortgage investors and reduce monthly payments for millions of borrowers, said a senior administration official.

That, in a nutshell, displays our nation’s priorities. Another $50 billion to pay off mortgage investors, yet no money can be found to repair critical existing infrastructure.

This program is being sold as though it is “helping homeowners,” but, in fact, the program directly funnels money to the companies that made poor lending and investing decisions. No cash goes directly to homeowners, it only flows to mortgage investors. While it’s true that some homeowners will have reduced payments, it’s important to note that cash is only flowing to companies, not homeowners.

Day after day we are reminded that protecting mortgage investors is our nation’s highest priority. At least that’s where we are putting tens of billions, without any sign that there’s some sort of limit as to how far we’re willing to go, and no indication that perhaps mortgage investors deserve to lose their money.

After all, the types of mortgages being fixed here are not primary liens, but secondary liens, and the originators and purchasers of these types of loans should have known better:

"It will be a shared effort with lenders, investors, borrowers and the government to ease or extinguish second-lien mortgage payments," a senior administration official told Reuters.

During the height of the housing boom, some borrowers were able to buy a home with no downpayment by adding a second lien, and many of those loans are now failing as the economy and housing market struggle.

The especially grating part of this story is that these second lien mortgages were used to enable borrowers to buy houses with no money down; an action that was widely known at the time to be an especially foolish and risky business decision.

I want to contrast the eager and unlimited desire to bail out mortgage investors with a troubling story I recently heard.

This weekend at Lowesville, one small business owner recounted that their decades-old family business was facing extremely trying times. The people in their employ had been working there for years, and so this small business owner described a tale of burning through cash reserves to try and keep their staff employed during exceptionally lean times.

This is the type of company that needs and deserves help. Instead, they are now struggling with the latest outrage, a recent change to the COBRA laws that now require (force) small businesses owners “to ‘front’ the subsidy by paying the full premium and obtaining a reimbursement via a later payroll tax offset.

Did you follow that? As part of the 2009 stimulus bill, the US government decided to provide a COBRA “subsidy” by covering 65% of the cost of post-employment health care coverage to the newly laid off.  That's certainly admirable, I suppose.

But the government did not provide cash for this “subsidy,” opting instead to require businesses to come up with the actual cash to cover the cost.  These out-of-pocket business expenses are going to then get ‘reimbursed’ sometime later, via a payroll tax offset.

In other words, cash flows out of businesses for COBRA payments, never to return. All that potentially ‘comes back’ later on is a reduced requirement to send cash to the government in the future.

Now, imagine that you are a struggling business, where your survival or demise is a narrow margin of cash flow. What good is a future payroll tax offset if COBRA payments drag you under today?

This is happening even as you read this.

How can Washington be this tone-deaf?  Are they not aware of how many small businesses are struggling to survive and that cash flow issues are the #1 cause of business failure?  Perhaps this is what happens when lawmakers lack actual business experience in their background.

We can speculate as to why this approach was taken with small businesses when so many hundreds of billions are immediately available to protect the poor investment decisions of mortgage speculators and large banks, but I am unable to think of a good reason for this discrepancy.

It bears noting that small businesses are the lifeblood of our economy and that all recoveries are built upon the backs of small businesses, which are the first to return to health and hiring following a recession.

Instead of helping them and punishing the improvident, the exact opposite is happening and we are left to wonder why.

One could be forgiven for surmising that the government is finding what few pockets of solvency that remain (i.e. small business cash accounts) and using those to fund the recovery because the government itself is out of cash.

This seems like a terrific way to ruin a nation.

It would seem that our national priorities are still not in the right order.

Endorsed Financial Adviser Endorsed Financial Adviser

Looking for a financial adviser who sees the world through a similar lens as we do? Free consultation available.

Learn More »
Read Our New Book "Prosper!"Read Our New Book

Prosper! is a "how to" guide for living well no matter what the future brings.

Learn More »

 

Related content

53 Comments

kemosavvy's picture
kemosavvy
Status: Martenson Brigade Member (Offline)
Joined: Oct 13 2008
Posts: 254
Re: Misplaced Priorities and Misguided Decisions

businessweek just ran an excellent article on their economic insider page (james cooper).

business (big and small) is making the necessary adjustments to "correct" their surplus inventory through liquidations, writedowns, and fire sales. companies are taking the pain on their balance sheets right now, especially small business. to strap small business with anymore pain would be a fatal blow, such as the COBRA subsidy.

the govt (through ignorance or malice) is not allowing the pain to be felt where the open sore has occurred, in the banking and investment sector. i understand the need to prevent a collapse so i understand the knee jerk reactions but it's coming at the expense of the businesses that took on calcluated risks and are immediately making the ajdustments necessary to have a prosperous future. small biz is too busy trying to survive while big biz is making the appropiate legislation to take out the legs of the small guys. we'll be left with a landscape of nothing but massive players and no chance for our voice to be heard.

there is a centralization of power occurring on a magnitude that should have everyone a little frightened....

 

Mike Pilat's picture
Mike Pilat
Status: Platinum Member (Offline)
Joined: Sep 8 2008
Posts: 929
Re: Misplaced Priorities and Misguided Decisions

It is quite sad to see our rail infrastructure crumbling. By some estimates, the energy intensity (per pound per mile cost) of shipping goods on rail is a tenth of the intensity that it is for trucking (I'd appreciate any more data on this if anyone has it!). What a fabulous opportunity to reduce energy costs and increase the productive capacity of our nation. If the professional politicians that we have insist on running deeper deficits, let's make a true investment in an infrastructure system that at least offers the chance of paying dividends...Instead, I suppose Wall Street will now have the opportunity to remodel their offices and have more corporate cocktail parties while Joe Taxpayer is ground under their collective heels.

mcafeejs's picture
mcafeejs
Status: Bronze Member (Offline)
Joined: Sep 22 2008
Posts: 34
Re: Misplaced Priorities and Misguided Decisions

Chris, thank you for all of your efforts.  As we continue your mission of educating the public to reach a critical mass, the snowball that is our descending republic continues to gain mass and velocity in a downward direction.  Recognizing the phenomenal platform you have created, there is tremendous potential for action that is not being harnessed and time is a critical determining factor in the mass and velocity of that snowball.  As we "educate" the masses we are losing time for removing the political elite from office who aren't/can't/won't be changed.  Yes, I have given up hope on the sunk cost that is our current political establishment. 

Under your leadership, the CM community could organize petition signings, organize community building (in the form of relocation such as with the free state project), coordinate permaculture classes, layout/sanction a blueprint for a sustainable society construct for folks to commit to, endorse political leadership, and ultimately take specific concerted value-added action.  But this unity of effort can't, won't be achieved within your forum until that next step is taken which is you exerting your leadership.  So my question to you is, when (under what criteria) are you going to step out and try to break that snowball by facilitating your site visitors to take action beyond the self assessment you've provided?  The reason I ask is because your personal writings (save the crash course) are not focused on sustainable living but what some would call "the oligarchical fascism that was our republic."  I fail to see how your recommended actions in the self assessment while admirable and advisable have any direct influence on slowing down the snowball you vent upon.  The reality is what it is and when I read what you write above or the article from MISH below, I am at a loss for any tactical or strategic actions to improve the situation save this plea for you to TAKE A STAND in the political arena so that this community and likeminded others can form some measurable influence.  

I know enough to take action for those things readily within my control and influence like this writing for instance, but these efforts aren't without frustrations.  I've put in a 12'X24' garden in my 24'X30' backyard, solar water heat is next, but I feel as though my participation in tea parties (for the right reasons) is falling on deaf ears as the MSM pollutes the message.  My numerous emails/phone calls to congressman concerning policy decisions do nothing but elicit an automated response if that.  My discourse with neighbors and family results in the "it'll come back, it'll get better, human ingenuity has always found more energy."   These frustrations would be less if I didn't feel as though I was the only one doing them and if I experienced more success.  I hope success can be achieved by pulling together the folks from your community with whom I generally identify and influence the snowball.  

I do hope exerting political influence is within your eventual vision because that is one of the ways meaningful change to sustainability will occur, if not then I will need to joust windmills elsewhere.

Warmest regards,

JJ

-----Break-----

With respect to another MISPLACED Priority and Misguided Decision

from Mish: globaleconomicanalysis...

//////////////////////...
Deal Recap

If the deal goes through as currently proposed....

* The Treasury (taxpayers) would be stuck with 50% of GM's equity (currently worth $625 million) in exchange for forgiving about $10 billion in federal loans.
* The UAW would get 39% of GM's equity (currently worth $488 million) in exchange for giving up $10 billion in health care benefits
* Corporate bondholders would get 10% equity (currently worth $125 million) in exchange for giving up $27 billion in bonds.

Under the above agreement there is still a missing $10 billion piece of the puzzle: "The government wants the union to accept company stock to finance half of G.M.’s $20 billion obligation for retiree health care as noted above."

What happens to the other $10 billion? Does it vanish into thin air? My guess is this would be dumped on taxpayers via the Pension Benefit Guarantee Corporation (PBGC)

Everybody loses but the credit default swap holders. Now who might that be? JPMorgan, Goldman Sachs, and/or Citigroup by any chance?
//////////////////////...

Dogs_In_A_Pile's picture
Dogs_In_A_Pile
Status: Martenson Brigade Member (Offline)
Joined: Jan 4 2009
Posts: 2606
Re: Misplaced Priorities and Misguided Decisions
mcafeejs wrote:

....I am at a loss for any tactical or strategic actions to improve the situation save this plea for you to TAKE A STAND in the political arena so that this community and likeminded others can form some measurable influence.  

....I do hope exerting political influence is within your eventual vision because that is one of the ways meaningful change to sustainability will occur, if not then I will need to joust windmills elsewhere.

 

 

 

Just my differing view here, but if the diversity of political opinion that was present at the recent Lowesville Seminar is any indication, the moment Chris took a political stance, half the people on the site would leave.

The fact that for three days, the Lowesville bunch was a true community and politics never came into play speaks volumes.  We can and will get this done despite the politicians, not because of them.

rocketgirl1's picture
rocketgirl1
Status: Silver Member (Offline)
Joined: Feb 11 2009
Posts: 230
Re: Misplaced Priorities and Misguided Decisions

Dear CM and CM viewers,

As someone who has taken out equity in my primary residence and built a small  and until recently, thriving, business, I just want to remind everyone that not everyone who has....

A. taken equity from their home

B. has an adjustable mortgage

C. at the end of all this mess may lose everything

should be considered someone who made "poor investing decisions", etc.  I personally know 12 (or if I ponder longer, maybe 20) people who created a small business (remember, part of our country's "life blood") from the equity in their primary residence and one family who planned and prepared for two years for their small business, took equity from their primary and just this winter pulled the plug on their plans for business. 

My business today has half the sales of last year, we blew through a huge amount of cash keeping it going this last winter and we continue to hope for a better tomorrow.  Like my dad used to say "hind sight sure as hell better be 20/20"  and for me it is but please keep us little guys in mind when you are bashing the home owners who took out equity because it's just not that simple.

Rocketgirl1

Cloudfire's picture
Cloudfire
Status: Diamond Member (Offline)
Joined: Sep 29 2008
Posts: 1813
Re: Misplaced Priorities and Misguided Decisions
kemosavvy wrote:

there is a centralization of power occurring on a magnitude that should have everyone a little frightened....

I couldn't agree more. . . . perhaps it would be in order to entertain a bit of speculation about where all this is going . . .

joemanc's picture
joemanc
Status: Martenson Brigade Member (Offline)
Joined: Aug 16 2008
Posts: 834
Re: Misplaced Priorities and Misguided Decisions
Quote:

It is quite sad to see our rail infrastructure crumbling.

I have the opportunity to take the train to work and I take full advantage of it. One night, I was coming back from NYC late at night, (trains run only once per hour after 9PM and the last one to leave NYC leaves at 1:30AM) and so I asked a conductor on my train about expanded service at night. He told me that because the railroad unions are so much smaller than the road building unions, that most of the public transit money goes towards roads and not the rails. We're stuck between a rock and a hard place. Sigh

mcafeejs's picture
mcafeejs
Status: Bronze Member (Offline)
Joined: Sep 22 2008
Posts: 34
Re: Misplaced Priorities and Misguided Decisions

Dogs, I am fortunate to get a response from you.  Thank you for sharing as I was unable to attend...that whole 9 to 5 thing.  I think we are in agreement and the miscommunication arises from the word "politic." I am refering to politic in the classical/literal sense of the word where specific policy (law, regulation, statutes, etc) are created/adjudicated.  Would your agree with these clarifying statements? 

95%+ of the people at Lowesville agreed on a preponderance of what Chris and others on this website have identified as problems that need to be solved and hoped to share in those mutual concerns because they want to change the current course of their lives and ultimately of our society.  These agreements can become the platform.  Decoupling the "problems/opportunities"  from the espoused solutions allows higher levels of agreement to be obtained within the community and these agreements allow a unity of effort that creates synergy amongst all our individual voices.  Levels of agreement and disagreement will vary greatly between perceived problems and hypothesized solutions, however, there is agreement and there is power (potential to do work) in that.

For example while Chris Kesser makes a great post about doing work to further "transtion" http://www.peakprosperity.com/forum/transition-town-training-may-30th-31st-oakland-ca/13011 I don't see his efforts being as successful as they could if Chris's team were to promote it.  Lost opportunity?

Some of the potential platform elements I have gleaned from the site are:  "the next twenty years will be drastically different from the previous twenty," "We need to live within our means," our current political system is broke because the government of the people is not for the people, the TARP bailout was wrong, and large institutions that are too big to fail are too big to exist.  There are many observations we agree upon.  There are going to be ACTIONS (including in the political arena) that we can agree upon as well.  Unity of effort allows us to accomplish more.  I think that these potential actions need to be sanctioned by Chris as leader of the site because the snowball is growing and the trend of his recent posts attest to this.  Now if the strategy is to just let it all collapse and pick up the pieces then I want to know that, but I feel the need for unity of effort to stem the tide or pick up the pieces.  Reading about all the stuff wrong with the world in Chris's and Davos's blog is great but I want a mechanism where I can change things and as Chris's recent posts point out, the arena where we need the most change is in our political establishment. 

I too agree that "traditional" politics of Red vs. Blue and a tremendous NEGATIVE.  It turns me off and is one of the reasons why I !  I am suggesting that a political platform be set even if it is to declare issues like abortion for instance, while important, a non-issue for this community.  I think we need to take a stand on specific policies because if we don't we significantly marginalize the potential that exists here. 

Any political stance the CM community takes must continue to transcend the main stream media political landscape, but positions ought to be taken and if so it is incumbent upon us as community members to ensure that we act accordingly.

Very Respectfully

Dogs_In_A_Pile's picture
Dogs_In_A_Pile
Status: Martenson Brigade Member (Offline)
Joined: Jan 4 2009
Posts: 2606
Re: Misplaced Priorities and Misguided Decisions

mcafee -

Your clarification of "politics" changed the framing of my thoughts on your first post.  Give me some time to digest your post a bit - my sense is we are on two slightly different paths to the same desired end state.

I'll be back to you on this one.........

 

purplequill's picture
purplequill
Status: Member (Offline)
Joined: Oct 7 2008
Posts: 3
How to Avoid Paying COBRA

There is a way to avoid having to pay COBRA: discontinue health insurance for your employees. It happened where I work; they gave us a $500 per month raise and said "go find your own." Even though it was a slap in the face, nobody quit to try to find more benefits. That was a few months ago, and honestly, it's probably what's kept them in business.

I wonder what the Feds will do at the prospect of businesses discontinuing health insurance? Will they try to make its provision mandatory (ala HillaryCare or the State of Mass.)? Or perhaps, will it be the final straw that galvanizes enough broad-based business/consumer support for a single payer system? Watch and wait.

mktqwn's picture
mktqwn
Status: Member (Offline)
Joined: Jan 8 2009
Posts: 22
Re: Misplaced Priorities and Misguided Decisions

Chris,

  Thank you for the incredible article.  Just when I had about given up hope that anyone at all cares about small business unless you have one, you listened!

  One of the several points you made at Lowesville was that all the protest, no matter the number of people at the protest, seem to be ignored by Washington DC so a grass roots effort is needed.  You, Becca, your family and your website are providing that.  It was evident at the seminar.  Education seems to be the key along with caring about our country.  You do an excellent job in providing the education in explaining issues that are clear and easy for all of us to understand.

  Small business owners work long hours, pour their hearts and money into their business.  As I've said for many years, we need people that have business experience or owned their own business and know how to operate within a budget to run our country.  I wish I could run our businesses like the government with endless money and no regard to overspending without a consequence.  Where's our Tarp, Talf, bailout?  We continue to be riddled with additional paperwork and laws that do not help produce a profit so we can expand and hire more people.

  Sorry, have a tendency to get started on my rant about all this!

  Thank you, your family and staff for everything.  Teresa

 

 

 

Rob Z's picture
Rob Z
Status: Bronze Member (Offline)
Joined: Nov 30 2008
Posts: 49
Re: Misplaced Priorities and Misguided Decisions

Once again, the information and articles I find here help me to personally understand the "issues" to be able to sift through the mountain of sound bites from the MSM and arive at my own conclusions, and take actions that are appropriate for me and my family. I continue to return to this site every day because I have come to expect high quality information that is clear, to the point and timely. The site passes my "Trust but verify" attitude and the information fiter in my brain. Keep it coming CM and Brigade members.

R.Z.

imagesbytjm's picture
imagesbytjm
Status: Member (Offline)
Joined: Feb 28 2009
Posts: 7
Re: Misplaced Priorities and Misguided Decisions

 

There is a way to avoid having to pay COBRA: discontinue health insurance for your employees. It happened where I work; they gave us a $500 per month raise and said "go find your own." Even though it was a slap in the face, nobody quit to try to find more benefits. That was a few months ago, and honestly, it's probably what's kept them in business.

I wonder what the Feds will do at the prospect of businesses discontinuing health insurance? 

Purplequill.

I think the Administration wants businesses to discontinue health insurance.  They want a national health care system like Canada, England etc. What do you think will happen when they roll out their national health care system? Employers will will drop health care coverage and tell employees to get the national coverage.  They say everyone will have the option of keeping their current insurance.  But the reality is the current insurance system will disappear. One of the biggest supporters of the national health care program is WalMart.  Wonder why?  

I've been covered by national health care for most of my life through the military.  Trust me, you won't like it.  Long waits for appointment or procedures. Limited choice of providers.  Restricted ability to see a physician (normally seen by a physician's assistant or nurse practictioner).  Restricted availability of certain drugs.  Just ask someone from Canada or England about their national health care systems.  You'll get an earful.  

 

 

jhelge's picture
jhelge
Status: Bronze Member (Offline)
Joined: Jan 7 2009
Posts: 43
Re: Misplaced Priorities and Misguided Decisions
imagesbytjm wrote:

I've been covered by national health care for most of my life through the military.  Trust me, you won't like it.  Long waits for appointment or procedures. Limited choice of providers.  Restricted ability to see a physician (normally seen by a physician's assistant or nurse practictioner).  Restricted availability of certain drugs.  Just ask someone from Canada or England about their national health care systems.  You'll get an earful.  

 

I have heard it is a mixed bag. Apparently you are not pleased with your insurance through the government (V.A.?) In a way it doesn't surprise me, considering how we treat veterans in this country.

My friend from Toronto says she's quite pleased with her state health care arrangements. She is also relatively healthy. She says there are waits; about 2 weeks for an average visit. Unless it's an emergency, in which case you go to the hospital, fill out a short form (note: not short here) and see a doctor. In terms of restricted physician access, that is a reality for many with decent insurance already, myself included.

The problems I see with the health care industry in America is our catering to entrenched business interests while simultaneously involving government more and more. The mixture of public and private moneys and interests forms some weird mutant organizations. The unfunded mandate CM talks about is just one facet of this dynamic. The very idea that insurance needs to exist with government subsidies of health care is ludicris. But then one must realize, the same people that run the insurance companies also run investment firms. It's how they make money between your payment and their eventual payouts. And we all know what a soft spot politicians have for investment firms. That their services are useless at best, a racket at a minimum and parasitic at worst is irrelevant to TPTB.

Dogs_In_A_Pile's picture
Dogs_In_A_Pile
Status: Martenson Brigade Member (Offline)
Joined: Jan 4 2009
Posts: 2606
Re: Misplaced Priorities and Misguided Decisions
imagesbytjm wrote:

Purplequill.

I've been covered by national health care for most of my life through the military.  Trust me, you won't like it.  Long waits for appointment or procedures. Limited choice of providers.  Restricted ability to see a physician (normally seen by a physician's assistant or nurse practictioner).  Restricted availability of certain drugs.  Just ask someone from Canada or England about their national health care systems.  You'll get an earful.  

Purple -

In the interest of providing a counter opinion - trust me, you will like it.  I have been retired from the Navy for 7 years and have zero complaints with my national retired Health Care.  I typically see my doctor within a day or two of a phone call out of the blue.  Referrals to specialists take no more than a week. to be seen.  Same with my family and they have a different primary care manager MD than I do.  I am under continuous care by a cardiologist - they call me for my 6 month check-ups.  My co-pays are minor and I have 6 military pharmacies within 15 miles to  get all of my and my family's meds for free.

One data point does not a valid sample make.

Neither does two - but the military Tricare model works better than 99% of the HMO and other medical insurance plans I checked out prior to retiriing.

imagesbytjm's picture
imagesbytjm
Status: Member (Offline)
Joined: Feb 28 2009
Posts: 7
Re: Misplaced Priorities and Misguided Decisions

 One data point does not a valid sample make.

 

 

Neither does two - but the military Tricare model works better than 99% of the HMO and other medical insurance plans I checked out prior to retiriing.

 

I am happy it works for you.  Maybe it's location dependent.  Last time I needed to be seen, I waited 36 days for an appointment.  My primary care provider determined I needed a minor surgery procedure.  That was six weeks ago.  I checked Monday and I am fourth on the list. Maybe another month.  Last Rx  I needed wasn't available from the military pharmacy.  I could go on, but I think you get the point.  If you're happy with your care, great.  But, if you're not, then what?  Can't change doctors, can't change clinics, can't change pharmacy.  You're stuck with it.  

 

Maybe someone from Canada could chime in here.  

 

Anyway, my main point was the fact that IMHO, the Administration doesn't want employers to provide health care.  They want to take it over. All of it. I think the CORBA payments issue is a subtle way to get employers to drop health insurance.  

purplequill's picture
purplequill
Status: Member (Offline)
Joined: Oct 7 2008
Posts: 3
Re: Misplaced Priorities and Misguided Decisions

Honestly, socialized managed care would have to be pretty darn horrific to be worse than what my family has now. When you live as close to the financial precipice as we do, it doesn't matter how "good" your insurance is if you can't pay the co-pays and deductibles for routine care and chronic conditions. I hate to say it, but socialized medicine would probably be better for routine care and minor chronic illness, because, for a lot of us, any care would be better than none at all.

I'd rather pay the same amount in taxes that I pay in insurance premiums, because health care that's simple, slow, basic, and free, is better than health care that's complicated and uncertain--with high deductibles, hidden costs and "gotcha" clauses--that I don't dare use.

I didn't used to think this way... then I got married and had a baby.

Dogs_In_A_Pile's picture
Dogs_In_A_Pile
Status: Martenson Brigade Member (Offline)
Joined: Jan 4 2009
Posts: 2606
Re: Misplaced Priorities and Misguided Decisions
imagesbytjm wrote:

I am happy it works for you.  Maybe it's location dependent.  

It may be - we are in the Tidewater area of Virginia - and going back to '98 when I was still Active, we've had the same PCM and very good treatment when needed.

Hope it works out for you.

SagerXX's picture
SagerXX
Status: Diamond Member (Offline)
Joined: Feb 11 2009
Posts: 2236
Re: Misplaced Priorities and Misguided Decisions

As a small biz owner (along w/Mrs. S) I can attest that we are battening down every hatch we have (and creating additional hatches simply so we can then batten *them* down) and we're still likely going to have to close 1 of our 2 locations to reduce overhead.  The second location was part of our growth plan but right now survival's the name of the game.  

We just gave ourselves pay cuts so as to reduce the outflows from the biz.  And we're reducing every expense we have in our personal lives to accommodate that.  There's just about no fat left.  (Hmmm...I guess there's always a liiiittle more fat but...*dang*)

My only encounter with nationalized healthcare was as an exchange student in NZ.  Had a nastily-infected ingrown big toenail.  My host family took this Yank to the doc, who cut that puppy in half, pulled the bad half out, scraped and cut the necrotic flesh out (sorry if you're eating dinner at home, folks [wry grin]) and then zapped the root of the toenail on that side.  Dished me a scrip for some antibiotics, charged me zilch and sent me on my way.  

No wait for the appointment.  He was really nice.  The toe got better.  OH, the antibiotics did cost me about NZ$6.  FWIW.

Viva -- Sager

Gord.Barker's picture
Gord.Barker
Status: Member (Offline)
Joined: Mar 2 2009
Posts: 13
Re: Misplaced Priorities and Misguided Decisions

"Maybe someone from Canada could chime in here.  "

I'm from Alberta (Canada West).  From what I can tell, the general opinion of Canadian Health Care from the US point of view is so wrong as to serve as a new definition of wrongness.

I can walk into a clinic (I have 6 in a 10 minute drive from home, more from the office) and see an actual GP with about a 2 hour wait.  If I call my doctor I can see her by appointment in as little as 2 days (the maximum I have been put off is 4 days but that was a scheduling thing between me and her).

I might expect to wait a month (or even several) to see a specialist (like a neurosurgeon).  I can get X-rays done in about 10 minutes and that includes the drive there.

Now its not all milk and honey for sure.  Triage at emergency wards is bizarre to say the least but (personally) I think people go there for mostly non-emergency reasons and so wait around too much.

Health Care is not a business, its a cost; and a cost that is predictable based on the population demographics.  Large number smooth out the variations.

Watching from the sidelines in morbid fascination

Gordb

joe2baba's picture
joe2baba
Status: Martenson Brigade Member (Offline)
Joined: Jun 17 2008
Posts: 807
Re: Misplaced Priorities and Misguided Decisions

 "

 

"Instead of helping them and punishing the improvident, the exact opposite is happening and we are left to wonder why."

well some of wonder why chris some of us hang out at the ct thread and get the answers. its really pretty simple

for someone who does a great deal of research i would have thought by now the dots would all be numbered. well i am left to wonder why?

Vanityfox451's picture
Vanityfox451
Status: Diamond Member (Offline)
Joined: Dec 28 2008
Posts: 1636
Re: Sicko - Micheal Moore

Sager,

In comparison to New Zealand and as a citizen of the UK, I have no qualms with the system in place being there for me when, for one reason or other I'd be out of work and sick. By paying into the state system while working, I can happily forget about the worry of being uninsured against sickness. No system is entirely faultless and many holes can be found no matter what can be done. The advancements in drug therapy and a doubling population has far exceeded the ideals set into the beginings of the National Health Service that were put into place back in 1948, but it is there to support you in most every circumstance for about $35 (American) per week.

Micheal Moore has his followers and detractors with his movie-making style, but the compelling issue from the film 'Sicko' that approximations to the sum of 50 million Americans eek out their existence without proper medical cover sends a level of fear in me that the idea of living in the States in this financial crisis would be perilous if at this time I found my medical expenses far exceeded what I could afford to pay.

This is but a matter of my own opinion that a state system should be created, stopping the monopolization of drug industries, even though their argument has always been that high profits advance study. I can see the issue on this thread quite readily, yet the system still in place has no better place to go long-term, unless others can chime in with their opinion...

Much that I find in this film is compelling from my standpoint :-

Sicko - Micheal Moore

http://video.google.co.uk/videoplay?docid=5186750007944385887&ei=uYz3SeDNE4S62wLmi6CiBw&q=sicko+full+movie

Best,

Paul

ckessel's picture
ckessel
Status: Martenson Brigade Member (Offline)
Joined: Nov 12 2008
Posts: 479
Re: Misplaced Priorities and Misguided Decisions
mcafeejs wrote:

I fail to see how your recommended actions in the self assessment while admirable and advisable have any direct influence on slowing down the snowball you vent upon.  The reality is what it is and when I read what you write above or the article from MISH below, I am at a loss for any tactical or strategic actions to improve the situation save this plea for you to TAKE A STAND in the political arena so that this community and likeminded others can form some measurable influence.  

mcafeejs,

Having attended the Lowesville Seminar and gaining some insight into the values and ethics of the Martenson family I can say that IMHO the self assessment is not intended to provide "recommended" actions for you to take but rather to ask you what actions you might recommend that you take for yourself and for your family and your community. Chris is really extending a plea to you and the rest of us to DO SOMETHING. He (and his family) are working flat out to provide us with leadership in the form of data (Chris' job) and by example of how we can all make a difference with community involvement. Remember.....he is the guy who quit his Fortune 300 job to devote his time to be our "faithful information scout".

Like they say on the airlines safety data, "put on your own oxygen mask first and then help others".  Rather than asking "Chris to do it" we need to be saying .... "OK..Got it. Now what am I going to do to. This means to do the Self Assmt and solve your immediate scene in a way that works best for you and then get on board any of the myriad of other activities you outlined and get busy.

And I think delving into politics and or religion would be a fatal diversion given the current state of affairs. But that is only my opinion.

Coop

timG's picture
timG
Status: Member (Offline)
Joined: Apr 22 2009
Posts: 15
Re: Misplaced Priorities and Misguided Decisions

Here in England, the National Health Service does get many critisisms but I know quite a few people who would have certainly died an early death without it. Treatments for cancer and other serious diseases are very expensive, and most of the people I know who went through this could not have afforded the treatment, even if they sold all of their assets. At least they will now still be able to raise their families with some quality of life.

Private medical insurance here has so many caveats that you are very limited in what treatments are fully covered. The most serious cases are usually refered back to the NHS. Only the very wealthy can afford the best of care.Standards of care also vary: sometimes they are better, sometimes worse.

I know your side of the argument and appreciate it, but, when disaster strikes a 'free at the point of delivery' system (you get help regardless of financial concerns) is of great comfort. Without this, what is a nation state for? If your country is willing to let you suffer and die without any mercy, then why the hell pay any taxes to it?

I don't think that was the earful that you were expecting. By the way, I do not work for, or have any other financial interest (apart from being a potential patient) in the NHS.

r's picture
r
Status: Gold Member (Offline)
Joined: Oct 2 2008
Posts: 262
Re: Misplaced Priorities and Misguided Decisions

According to Aristotle, "Politics is a practical science [...] concerned with the noble action or happiness of the citizens."  Therefore, once you concern yourself with the well being of fellow citizens you are engaging in politics.  It can't be avoided.  A local movement dedicated to serving communities first, which is being advocated here (correct?), is a political movement in as much as it must engage the local community power structure.  From the inside out that would be:  the home association (I have one), the PTA, school principal, teachers, the local police, the mayor, the county commissioner, and so on.

It's true that I have to fix my own financial situation first.  With the information I found here and other places I am trusting that things won't get better and probably get worse so I am following through on difficult decisions I otherwise could not make.  But after that, when at the next stage of engaging my community, I find that the more people already know about these issues the easier it is for me to talk to people about getting started and organizing.  So when I bring up ideas on how to get the word out and generate awareness I am also asking for help with my community.

BTW as a student of history I find that governments generally have operated with a deliberate and obstinate incompetancy.  These times don't seem to be any different.

HarryFlashman's picture
HarryFlashman
Status: Bronze Member (Offline)
Joined: Aug 1 2008
Posts: 54
Re: Misplaced Priorities and Misguided Decisions

For the gentleman who was saying you would get an earful from the Brits and Canadians,all I can say is"Mate, you re totally wrong!".

Nobody ever said that The NHS was perfect,but it works and it works well.Do You not find it a national disgrace that the richest and most advanced state that the world has ever known cant look after its citizens health needs? If you dont, you should.Watch Sicko,Ive never been so proud to be British and so glad I dont live in the States.

jonesb.mta's picture
jonesb.mta
Status: Silver Member (Offline)
Joined: Jun 11 2008
Posts: 126
Re: Misplaced Priorities and Misguided Decisions

I've worked for the federal government for the past 3 years and believe me, you don't want the federal government as your health care provider. Government has caused the problems we're having now because our politicians are for sale to the highest bidder. Do you really think they'll do any better on health care? I've heard the old saw about politicians for fifty years, "He may be a crook but he's our crook". Well, that gives us mostly a bunch of crooks running the country and the majority of the voters in this country are getting exactly what they deserve.

sensei's picture
sensei
Status: Bronze Member (Offline)
Joined: Aug 30 2008
Posts: 26
Re: Misplaced Priorities and Misguided Decisions

I almost can't believe what I am reading here.  Chris does a brilliant job of outlining what a foolish and dangerous idea it is to hand over too much control to a central power like the federal government and the general consensus after reading that is to discuss what a great idea it would be to hand over TOTAL control of our healthcare system to the federal government?  Are you serious?!!!! 

Our government is in WAY over it's head.  The last thing we want is for a crucial system like healthcare to collapse along with the government when it finally reaches its inevitable gruesome demise.  The best thing we could have to weather that storm is a system of private clinics and non-profit community hospitals like we have now.  Businesses in private ownership will still be there.  I am a dentist by profession and when the time comes I will probably be pulling teeth and draining infections in exchange for chickens.  Nobody is going to keep going to work at the government clinics when there is no money left to pay them.

And it's pretty hard to compare Canada to the US.  Canada is 1/10 the population of the US and each province regulates its own healthcare.  The people are close enough to the government that they actually have a chance of having their voice heard.  An equivalent system in the US would be for each state / major metro area to have its own system.  I could actually be convinced to go along with something like that. But nobody is proposing that.  I am absolutely certain that a federal system is a BAD idea.

hightor's picture
hightor
Status: Bronze Member (Offline)
Joined: Aug 12 2008
Posts: 26
Re: Misplaced Priorities and Misguided Decisions

                 "...... the moment Chris took a political stance, half the people on the site would leave."

Since my first visit to this site and the Crash Course, I have been struck by the lack of politics displayed by CM and his co-writers. Besides the clarity of the insights found here, the lack of any political tone to the information is a large part of the value of these messages. It's easy and even tempting to inject politics into all of this, but it would immediately taint the universal value of what's being expressed here. Politics is of course very present in many of the causes of the problems discussed here, but politics are not necessarily important to the solutions.

There have occasionally been comment threads that have sunk into political back-and-forths, and they quickly become useless and unreadable. I can't say enough for Chris' skill at keeping his message as apolitical as possible. 

Jamie A

captain1202's picture
captain1202
Status: Member (Offline)
Joined: Nov 4 2008
Posts: 1
Re: Misplaced Priorities and Misguided Decisions

Regardless of how we choose to participate to effect a change, particularly distressing to me is the recent branding of veterans, Ron Paul supporters, gun owners, etc. (CM enthusiasts?) as potential terrorists!!!!!!!!!

Just where are we heading?  I am very concerned for the direction this country is taking. The politicians and bureaucrats are out of control and anyone with a brain is now going to be called a potential terrorist.  There isn't one elected official who seems to have a basic understanding of the problems and is willing to step up to the plate.  Except, or course, for Ron Paul (and he's probably a terrorist).

I'm not saying you should subscribe to Ron Paul's positions only to point out that someone who does speak out is branded as a nut.

It ain't lookin' good folks!

Vanityfox451's picture
Vanityfox451
Status: Diamond Member (Offline)
Joined: Dec 28 2008
Posts: 1636
Re: Misplaced Priorities and Misguided Decisions

Captain,

history is branded in the moment with your post now relegated to history. What I'm trying to offer you is the guarantee that change is coming. Some will not be for the good of politicians and, some will not be for the good of us. Time is going to change what we think is the outcome of today, with more variables than even the greatest minds can conjure.

Ron Paul has awoken many, with his voice and reasoning loud and clear. It is fear from the rank and file that set your mind to assume others see him as a terrorist.

As I'm trying to communicate to you, don't believe that the future is already lost to the stupidity of this government. There are, already, greater movements surfacing and, July 4th is going to be a pleasure to watch what unfolds from it.

People are waking up. Look about you, in this forum, and see how many have a first post?

Welcome to CM.com...

Best,

Paul

Mike Pilat's picture
Mike Pilat
Status: Platinum Member (Offline)
Joined: Sep 8 2008
Posts: 929
Re: Misplaced Priorities and Misguided Decisions

I'm late to catch this topic, but I'm also familiar with the military's socialized health system. It is excellent and I I have personally received top notch care from various providers. But I can't see it as a workable model on a larger scale. As it is now, any of the payments required for Tricare are basically nominal and I'm sure they can't cover the entire costs of the program (i.e. it's subsidized). It seems easy to run socialized medicine when you've got the American taxpayer fueling it for a more select group of individiduals (military and their families) but without this support, I don't see Tricare as a profitable (or even sustainable) business model. Am I missing something?

Mike

VeganDB12's picture
VeganDB12
Status: Platinum Member (Offline)
Joined: Jul 18 2008
Posts: 740
Re: Misplaced Priorities and Misguided Decisions

Mike

I have heard that VA care is quite good from the local vets that I know.  I work in health care and truly feel that the idea of profitable healthcare is a fallacy.  There is always someone footing the bill,  it is a game of cost shifting, a shell game.  The new technologies and medicines and other doo dads are just too expensive, especially when the manufactuers need to make a profit and recoup research and development costs in a free market system.  This is just my opinion of course.  What I have seen is that costs get transferred to the taxpayer as hospitals have become more and more reliant on medicare and medicaid entitlements.  This is no judgment again safety net insurance programs, they are a lifesaver in this system. This cost shifting became particularly onerous (in my own experience, an N of one) as managed health care came on the scene.  Hospitals became more and more dependent on patients with state and federal health insurance.  I was told this many times during my work in healthcare and I believe it to be true but cannot give you hard data to back it up.  During the 90's some of the fanciest hospitals in my area became big medicaid providers whereas in the 80's they wouldn't need to do that. 

How the dollars are spent is a whole other issue.  Too many unnecessary people in middle and upper management IMHO. Too much money going to the politicians and the BIG corporations. Maybe we docs make a little too much too but it would help if we got free education like they do in Europe.

I really believe healthcare is a cost and an entitlement. Best we can hope for with that is that we contain costs in a reasonable way, but the free market system has had its downside in that it primarily feeds the large medical corporations at the expense of everyone.  It is way out of balance.

It was great meeting you and everyone else at Lowesville BTW

Regards

Denise

Dogs_In_A_Pile's picture
Dogs_In_A_Pile
Status: Martenson Brigade Member (Offline)
Joined: Jan 4 2009
Posts: 2606
Re: Misplaced Priorities and Misguided Decisions
Mike Pilat wrote:

It seems easy to run socialized medicine when you've got the American taxpayer fueling it for a more select group of individiduals (military and their families) but without this support, I don't see Tricare as a profitable (or even sustainable) business model. Am I missing something?

Mike

Hey Mike - (sufficiently recovered from the scotch tasting I presume?)

Tricare could be a good starting model.  One of the biggest issues would be expanding the number participating providers who would accept the lower payments.  Here in Va Beach almost every provider accepts Tricare, no doubt because of the large number of military and retirees.  They take the lower payments and press on knowing they have a huge pool of patients who will always be there.  I had an MRI a few months ago - received a bill for ~$1900, Tricare paid ~$400 (accepted by the provider) and my copay was $14.44.  I think you could make it work - especially if it came down to providing the service at a lower cost, or not having patients recieve the care and the provider not getting any payment.

Another key issue is that the cost of services would have to come way down - as you note, the American taxpayer covers the costs of healthcare for the country's military members and their families (a fair exchange in my opinion, I'm sure many would disagree, but I'm not going there).  Opening up the service to a national level would require a better defined model of taxpayer-employer-member support to work.  And I would entirely exclude elective procedures such as vanity plastic surgery, medically necessary plastic surgery of course would be fine, but if you want new boobs for the upcoming cruise or high school reunion, pay for them yourself.  Tricare in its current form and function couldn't support the entire nation, but could certainly be used as a starting point to implement a workable system.

The biggest challenge is that Tricare doesn't have enough moving parts to satisfy the meddling knuckleheads in DC.

Cloudfire's picture
Cloudfire
Status: Diamond Member (Offline)
Joined: Sep 29 2008
Posts: 1813
A Mind is a Dangerous Weapon of Mass Instruction
captain1202 wrote:

  Anyone with a brain is now going to be called a potential terrorist.  

I am reminded of the [possibly apocryphal] assertion that "Pollock jokes" originated from the Nazis' wholesale murder of the Polish intelligentsia, who loudly decried Hitler's fascist government.  The "joke" was that the slaughter was so significant that the collective I.Q. of the Polish people was lowered.

 

Cloudfire's picture
Cloudfire
Status: Diamond Member (Offline)
Joined: Sep 29 2008
Posts: 1813
Re: Misplaced Priorities and Misguided Decisions
Mike Pilat wrote:

 As it is now, any of the payments required for Tricare are basically nominal and I'm sure they can't cover the entire costs of the program (i.e. it's subsidized). It seems easy to run socialized medicine when you've got the American taxpayer fueling it for a more select group of individiduals (military and their families) but without this support, I don't see Tricare as a profitable (or even sustainable) business model.

An excellent, and discerning point, Mike.  The two situations are indeed different, both in their sheer size, and the ability to access "outside" funds. 

RNcarl's picture
RNcarl
Status: Gold Member (Offline)
Joined: May 13 2008
Posts: 382
Re: Misplaced Priorities and Misguided Decisions
imagesbytjm wrote:

 

There is a way to avoid having to pay COBRA: discontinue health insurance for your employees. It happened where I work; they gave us a $500 per month raise and said "go find your own." Even though it was a slap in the face, nobody quit to try to find more benefits. That was a few months ago, and honestly, it's probably what's kept them in business.

I wonder what the Feds will do at the prospect of businesses discontinuing health insurance? 

Purplequill.

I think the Administration wants businesses to discontinue health insurance.  They want a national health care system like Canada, England etc. What do you think will happen when they roll out their national health care system? Employers will will drop health care coverage and tell employees to get the national coverage.  They say everyone will have the option of keeping their current insurance.  But the reality is the current insurance system will disappear. One of the biggest supporters of the national health care program is WalMart.  Wonder why?  

I've been covered by national health care for most of my life through the military.  Trust me, you won't like it.  Long waits for appointment or procedures. Limited choice of providers.  Restricted ability to see a physician (normally seen by a physician's assistant or nurse practictioner).  Restricted availability of certain drugs.  Just ask someone from Canada or England about their national health care systems.  You'll get an earful.  

 

 

 

Well,

I have one of the "best" private insurances (except for congress) in my state. I pay extra for supposed "access". I see PA's and NP's and not the MD's. I can get prescriptions as long as they are on the "approved list". Surgeries I can't comment on because thankfully I haven't needed any.

The issue is, our entire healthcare system is broken. Kinda like the trains (to get back on track).

In all things, and I mean ALL things, to find who is in charge, "follow the dollar." It will lead you to the real decision makers.

On a side note, ever wonder when we stopped being "citizens" and became "consumers"?

 

FWIW - C.

Cloudfire's picture
Cloudfire
Status: Diamond Member (Offline)
Joined: Sep 29 2008
Posts: 1813
What's in a Name?
RNcarl wrote:

On a side note, ever wonder when we stopped being "citizens" and became "consumers"?

About the same time we started having "clients" instead of "patients", as I recall . . . . .

Bhanja's picture
Bhanja
Status: Member (Offline)
Joined: Apr 2 2009
Posts: 2
Re: Misplaced Priorities and Misguided Decisions

Isn't obvious the people telling Obama what to do are the banksters. This government is working for the interest of wallstreet. Obama is just another puppet like Bush.

Erik T.'s picture
Erik T.
Status: Diamond Member (Offline)
Joined: Aug 5 2008
Posts: 1234
Re: Misplaced Priorities and Misguided Decisions

Chris et al,

I hate to say this, but only a few hours before Tito was unfortunately delayed, I checked out of my hotel in SIngapore, walked across the street to the spotlessly clean, shiny and new MRT station, and took the subway right to the airline terminal. Everything worked flawlessly and was on time.

As I passed through Immigrations, the officer made an abrupt hand gesture and said "Please!". Having become accustomed to the gruff, brash demeanor of U.S. Immigrations and Customs officials, I assumed that I had violated some pedantic rule, and stepped back, trying to appease him. He looked up, baffled, and again gestured and said "Please!". I showed a confused look to convey that I didn't understand what I did wrong. He reached over and physically moved the candy dish closer to me, and again said "Please!", which I finally interpreted correctly to mean "Please [help yourself to a piece of candy because we want you to feel welcome while I process your paperwork!]". I accepted the gesture of kindness and he gave me back my passport, visibly confused by my first reaction.

Next I flew (face mask and all) on Singapore Airlines to Hong Kong, where customs and immigrations officials were similarly polite. Directly from the baggage claim hall I boarded the "Airport Express" train to downtown Hong Kong. I'm not sure whether this was a "mag lift" train or not, but it was remarkably quiet, smooth, and fast. Digital displays kept me apprised of the progress of the journey, and 24 minutes later I disembarked at Central Station, Hong Kong Island.

From there I made an easy connection to Hong Kong's state of the art MRT system, and rode the subway to a station only steps away from my hotel. Total cost of the journey from airport to hotel, about U.S. $11. Everything was modern, shiny and new, and in flawless working condition. All public transit payments were made with state of the art cash cards, eliminating the need for currency.

Oddly enough, the whole experience was extremely emotional and quite sad. I kept recalling my first trips to Europe in the early '80s, when I was dumbfounded by store clerks working up sales receipts by hand, perhaps with the aid of a calculator. What? No electronic cash register? How  antequated it all seemed. In those days, you couldn't help but be proud of being American. We were the world's top dogs, and it was obvious. The rest of the world was trying to keep up, but failing. We were the undisputed technological leaders, and everyone knew it. In those days, Americans had to remember not to boast too much about how advanced things were in our society, because it was considered rude to flaunt our obvious technological superiority.

Here in Asia, I am dumbfounded every day by how far behind we are. You can pay for just about everything with your cellphone or a high-tech electronic cash card here. There is little reason to even carry bank notes. The public transit systems work flawlessly, and the trains come every 2 to 3 minutes, even into the wee hours of the morning. Contrast with New York or San Francisco, where the train or bus comes when it comes, if it comes, if you're lucky.

Everything here is shiny and new. Most elevators are finished in polished stainless steel, which is brought out to a full mirror finish. I haven't seen that in the USA since the early 80's. Most of the bright-finished stainless steel in the USA has been "roughed up" intentionally by maintenance crews, because scratched-up stainless steel isn't as susceptible to vandalism as the brightly polished stuff.

I have to confess that this trip is really affecting me emotionally. 25 years ago, when I traveled internationally I knew I was from the best nation on earth, and I felt damned proud of that fact. I read this blog post from Chris just after arriving back at my hotel at 1am, after a flawless late-night journey on a very comfortable, very modern, very quiet and very reliable MTR train.

What the hell happened to America? I liked it better when we were the top dogs...

Erik :-(

 

joe2baba's picture
joe2baba
Status: Martenson Brigade Member (Offline)
Joined: Jun 17 2008
Posts: 807
Re: Misplaced Priorities and Misguided Decisions

 how many have left because there is no political solution?

joe2baba's picture
joe2baba
Status: Martenson Brigade Member (Offline)
Joined: Jun 17 2008
Posts: 807
Re: Misplaced Priorities and Misguided Decisions

 how many have left because there is no political solution?

Cloudfire's picture
Cloudfire
Status: Diamond Member (Offline)
Joined: Sep 29 2008
Posts: 1813
Re: Misplaced Priorities and Misguided Decisions
ErikTownsend wrote:

Chris et al,

I hate to say this, but only a few hours before Tito was unfortunately delayed, I checked out of my hotel in SIngapore, walked across the street to the spotlessly clean, shiny and new MRT station, and took the subway right to the airline terminal. Everything worked flawlessly and was on time.

As I passed through Immigrations, the officer made an abrupt hand gesture and said "Please!". Having become accustomed to the gruff, brash demeanor of U.S. Immigrations and Customs officials, I assumed that I had violated some pedantic rule, and stepped back, trying to appease him. He looked up, baffled, and again gestured and said "Please!". I showed a confused look to convey that I didn't understand what I did wrong. He reached over and physically moved the candy dish closer to me, and again said "Please!", which I finally interpreted correctly to mean "Please [help yourself to a piece of candy because we want you to feel welcome while I process your paperwork!]". I accepted the gesture of kindness and he gave me back my passport, visibly confused by my first reaction.

Next I flew (face mask and all) on Singapore Airlines to Hong Kong, where customs and immigrations officials were similarly polite. Directly from the baggage claim hall I boarded the "Airport Express" train to downtown Hong Kong. I'm not sure whether this was a "mag lift" train or not, but it was remarkably quiet, smooth, and fast. Digital displays kept me apprised of the progress of the journey, and 24 minutes later I disembarked at Central Station, Hong Kong Island.

From there I made an easy connection to Hong Kong's state of the art MRT system, and rode the subway to a station only steps away from my hotel. Total cost of the journey from airport to hotel, about U.S. $11. Everything was modern, shiny and new, and in flawless working condition. All public transit payments were made with state of the art cash cards, eliminating the need for currency.

Oddly enough, the whole experience was extremely emotional and quite sad. I kept recalling my first trips to Europe in the early '80s, when I was dumbfounded by store clerks working up sales receipts by hand, perhaps with the aid of a calculator. What? No electronic cash register? How  antequated it all seemed. In those days, you couldn't help but be proud of being American. We were the world's top dogs, and it was obvious. The rest of the world was trying to keep up, but failing. We were the undisputed technological leaders, and everyone knew it. In those days, Americans had to remember not to boast too much about how advanced things were in our society, because it was considered rude to flaunt our obvious technological superiority.

Here in Asia, I am dumbfounded every day by how far behind we are. You can pay for just about everything with your cellphone or a high-tech electronic cash card here. There is little reason to even carry bank notes. The public transit systems work flawlessly, and the trains come every 2 to 3 minutes, even into the wee hours of the morning. Contrast with New York or San Francisco, where the train or bus comes when it comes, if it comes, if you're lucky.

Everything here is shiny and new. Most elevators are finished in polished stainless steel, which is brought out to a full mirror finish. I haven't seen that in the USA since the early 80's. Most of the bright-finished stainless steel in the USA has been "roughed up" intentionally by maintenance crews, because scratched-up stainless steel isn't as susceptible to vandalism as the brightly polished stuff.

I have to confess that this trip is really affecting me emotionally. 25 years ago, when I traveled internationally I knew I was from the best nation on earth, and I felt damned proud of that fact. I read this blog post from Chris just after arriving back at my hotel at 1am, after a flawless late-night journey on a very comfortable, very modern, very quiet and very reliable MTR train.

What the hell happened to America? I liked it better when we were the top dogs...

Hi, Erik;

This is a great example of the everyday anecdotes that you zero in on as barometers of where we are and where we're going.  I pay attention to this stuff myself, as it is unfiltered by the media, and I look forward to more of this kind of post from you.

SamLinder's picture
SamLinder
Status: Diamond Member (Offline)
Joined: Jul 10 2008
Posts: 1499
Re: Misplaced Priorities and Misguided Decisions

As regards the health care system in the U.S., my wife and I have been Kaiser Permanente members for a number of years. I am pleased to report that the level of care is excellent. I have a primary MD who I see whenever I want (usually within days based on their schedule). If I need immediate care, and my MD is unavailable, I'm seen by another MD that same day.

I had a significant surgery, before I turned 65, that went flawlessly and the follow-up care was excellent. My co-pay was insignificant and Kaiser covered the rest (approx. $20,000+)

Mind you, our monthly premium was pretty stiff while my wife and I were both under 65. However, now that we're enrolled in Medicare, the taxpayer is picking up most of the tab. We don't even have co-pays anymore for doctors visits.

All this to say that the Kaiser system seems to work very well from what I've experienced. If this could be expanded nationwide, I see it as a much better option than National Health Care.

As for who picks up the tab, I think the taxpayer should do so as is done in other civilized countries around the world. It is unforgivable that any segment of our population should lack basic health care in this country.

If the health care premiums paid by the average worker were a payroll tax instead of a payment directly to Kaiser, it would go a long way towards covering those who are unable to pay for their health care.

mktqwn's picture
mktqwn
Status: Member (Offline)
Joined: Jan 8 2009
Posts: 22
Re: Misplaced Priorities and Misguided Decisions

If the health care premiums paid by the average worker were a payroll tax instead of a payment directly to Kaiser, it would go a long way towards covering those who are unable to pay for their health care.

 

I'm new to posting and couldn't figure out how to put the above quote by Sam in the nice little gray box??  Sorry.......

Anyway, being owner of two family businesses, I don't agree payroll taxes are the answer.  We have offered health insurance in both companies for years, with one company employing all part timers, and the employee does not want to pay the 50% of the premium's we do not pay.  We offer health insurance as a benefit and most young people will not participate feeling it cost too much and things just won't happen to them.  Other employees know they will get treatment for any condition whether they have health insurance or not, be it going to the emergency room for a cold, they will get treatment or surgery needed or participate in Medicaid   Had one employee who didn't have insurance and "after" an emergency room visit wanted to participate thinking the visit would be covered.

I think we need to educate our citizens so they participate, ask questions about their care and make sure they are getting the best value for their money.  We are the customers here. 

If it is a payroll tax, this is yet another burden to small business to handle, even if it's just paperwork.  Unless you are a business owner, you can't imagine the time we spend on paperwork for employees and the government.  We have to pay and do forms for state unemployment, federal unemployment, payroll taxes, W-2's, retirement plans, employee garnishments, employee child support and there's so much more.

I am just very passionate about saving small businesses and with the current environment I have no idea why anyone would open one.  Teresa

 

 

 

 

 

SamLinder's picture
SamLinder
Status: Diamond Member (Offline)
Joined: Jul 10 2008
Posts: 1499
Re: Misplaced Priorities and Misguided Decisions
teresa wrote:

If the health care premiums paid by the average worker were a payroll tax instead of a payment directly to Kaiser, it would go a long way towards covering those who are unable to pay for their health care.

I'm new to posting and couldn't figure out how to put the above quote by Sam in the nice little gray box??  Sorry.......

Just place your cursor somewhere in the middle of the sentence or paragraph you want to "quote" and click on the " icon.

Anyway, being owner of two family businesses, I don't agree payroll taxes are the answer.  We have offered health insurance in both companies for years, with one company employing all part timers, and the employee does not want to pay the 50% of the premium's we do not pay.  We offer health insurance as a benefit and most young people will not participate feeling it cost too much and things just won't happen to them.  Other employees know they will get treatment for any condition whether they have health insurance or not, be it going to the emergency room for a cold, they will get treatment or surgery needed or participate in Medicaid   Had one employee who didn't have insurance and "after" an emergency room visit wanted to participate thinking the visit would be covered.

I think we need to educate our citizens so they participate, ask questions about their care and make sure they are getting the best value for their money.  We are the customers here. 

If it is a payroll tax, this is yet another burden to small business to handle, even if it's just paperwork.  Unless you are a business owner, you can't imagine the time we spend on paperwork for employees and the government.  We have to pay and do forms for state unemployment, federal unemployment, payroll taxes, W-2's, retirement plans, employee garnishments, employee child support and there's so much more.

I am just very passionate about saving small businesses and with the current environment I have no idea why anyone would open one.  Teresa

Teresa,

My mistake. I didn't mean payroll tax, I meant if the premium I paid was instead paid as a direct deduction out of my paycheck. This way, the employer wouldn't be affected at all. In fact, I would personally remove the employers responsibility for health care completely. That would improve the lot of the small business owner and maybe the employer could raise employees salaries at the same time!

mktqwn's picture
mktqwn
Status: Member (Offline)
Joined: Jan 8 2009
Posts: 22
Re: Misplaced Priorities and Misguided Decisions

Sam,

  With any type of payroll deduction the employer is responsible for its payment and then the weekly, monthly, quarterly and annual reports for that deduction.  For example, with payroll taxes the "minimum" paperwork burden for the employer is the payment we make for withholding it, quarterly and annual reports for the tax along with the W-2 to the employee.  If the employee has a garnishment the sheriffs department serves the employer with paperwork, it is the employer's responsibility to determine the percentage that can be held each week based on the employees net pay, keep track of this total amount and then the employer must mail it to the court system before the court date.  Then comes child support and the list goes on...............

  My point being, the employer continues to be burdened with the employee's responsibilities because it's the easiest thing to do for the government and the employee.  Why couldn't the employee make the payment for health insurance to the government each month (this is just an example since I want to keep health insurance private with no government intervention)?  Why is it yet another burden for the employer to track and be responsible for? 

  My passion gets the best of me these days, Teresa

 

 

Cloudfire's picture
Cloudfire
Status: Diamond Member (Offline)
Joined: Sep 29 2008
Posts: 1813
Re: Misplaced Priorities and Misguided Decisions
teresa wrote:

  My point being, the employer continues to be burdened with the employee's responsibilities because it's the easiest thing to do for the government and the employee.  Why couldn't the employee make the payment for health insurance to the government each month (this is just an example since I want to keep health insurance private with no government intervention)?  Why is it yet another burden for the employer to track and be responsible for? 

  My passion gets the best of me these days

Forgive me for jumping into the middle of this, but guess is that, by making the employer responsible, the government is effectively cutting off the possibility of simultaneous employment and nonpayment.  It's might be a way of making sure no one can opt out.

Vanityfox451's picture
Vanityfox451
Status: Diamond Member (Offline)
Joined: Dec 28 2008
Posts: 1636
Re: Misplaced Priorities and Misguided Decisions

Kaiser Permanente

http://en.wikipedia.org/wiki/Kaiser_Permanente

National Health Service

http://en.wikipedia.org/wiki/National_Health_Service

Personally, I don't think you could slide a piece of paper between the two, other than :-

Mandatory arbitration

In order to contain costs, Kaiser requires agreement by planholders to submit patient malpractice claims to arbitration rather than litigating through the court system. This has triggered some discussion and dissent. Some cases proceed to court and one argument is over whether the requirement to go through dispute resolution is enforceable[citation needed].

Kaiser established an Office of Independent Administrators (OIA) in 1999 to oversee the arbitration process. The degree to which this is independent has been questioned.

Wilfredo Engalla is a notable case. In 1991, Engalla died of lung cancer nearly five months after submitting a written demand for arbitration. The California Supreme Court found that Kaiser had a financial incentive to wait until after Engalla died; his spouse could recover $500,000 from Kaiser if the case was arbitrated while he was alive, but only $250,000 after he died. The Foundation for Taxpayer & Consumer Rights contends that Kaiser continues to oppose HMO arbitration reform.

Patients and consumer interest groups sporadically attempt to bring lawsuits against Kaiser Permanente. Recent lawsuits include Gary Rushford's attempt to use proof of a physician lie to overturn an Arbitration decision.

Homeless patient treatment

Kaiser has settled three cases for alleged patient dumping since 2002. During that same period, the Office of the Inspector General settled 102 cases against US Hospitals which resulted in a monetary payment to the agency.[51][52][53]

On November 16, 2006, Los Angeles city officials filed civil and criminal legal action against Kaiser Permanente for "patient dumping"--the delivery of homeless hospitalized patients to other agencies or organizations in order to avoid expensive medical care[citation needed]as reported by National Public Radio's All Things Considered.

The legal filings are intended to punish hospitals for releasing homeless hospital patients (often via taxis) on the sidewalk near relief shelters instead of accepting responsibility for releasing hospital patients into the care of a relative, or of a recognized agency.

The city's decision to charge Kaiser Permanente reportedly was influenced by security camera footage, allegedly showing a 63-year-old patient, dressed in hospital gown and slippers, wandering toward a mission on Skid Row, as outlined in a 20-page complaint. City officials say that as many as 10 other area hospitals are under investigation for possible future action for this practice.

 Kidney transplant program

In 2004 Northern California Kaiser Permanente initiated an in-house program for kidney transplantation. Prior to opening the transplant center, Northern California Kaiser patients would generally receive transplants at medical centers associated with the University of California (UC San Francisco and UC Davis). Upon opening the transplant center, Kaiser required that members who are transplant candidates in Northern California obtain services through their transplant center.

On May 3, 2006, the Los Angeles Times published an investigative report which accused the transplant program of mismanagement which resulted in delays for patients awaiting kidneys. According to the report, Northern California Kaiser performed 56 transplants in 2005 and twice that many patients died waiting for a kidney. At other California transplant centers, more than twice as many people received kidneys than died during the same period.

On May 13, 2006, after less than two years of operation, Northern California Kaiser announced that it would discontinue the kidney transplant program. As before, Northern California Kaiser now pays for pre-transplant care and transplants at outside hospitals, as do all other Kaiser Permanente regions. This change affected approximately 2,000 patients.

Two patients have filed personal injury lawsuits against Kaiser and the widow of a patient who died has filed a wrongful death claim. According to the lawyer representing the three plaintiffs, more lawsuits are planned.


 See also

  • Sicko, a movie about, among others, Kaiser Permanente. (which you can also find in post#22 above...
  • ..............................................................................................................

The NHS took to checking by phone when patients who were due an operation when they were taking holidays. Using this information, it wasn't unknown for the 'patient' to be booked for the operation during their holiday period so that the operation would be logged as cancelled yet still maintaining favourable statistics.

'Meet And Greet' nurses have been used in the past for waiting emergency patients in what appeared as 'finding out the severity of the case'. The reality was that the patients were then logged as 'seen' to show favourably low waiting times.

To counter the short supply of hospital beds, wheels were removed from trolley beds and placed into corridors and called wards to statistically lower waiting times...

Nothing like percentages are there...

My thoughts are that 50 million uninsured Americans should be seen as a national disgrace. If calculating the one-sixth of Americans against the English population of some 60 million, there would be both an estimated 10 million without medical support and a public outcry!!!

Call me bias...

Best,

Paul

Davos's picture
Davos
Status: Diamond Member (Offline)
Joined: Sep 17 2008
Posts: 3620
Re: Misplaced Priorities and Misguided Decisions

Teresa wrote:

"My passion gets the best of me these days, Teresa"

 Super. Makes me wonder how things would be if we called them for what they really are and left political correctness off. 

Comment viewing options

Select your preferred way to display the comments and click "Save settings" to activate your changes.
Login or Register to post comments