Why No One Will Even Try to Tame the US Healthcare Monster

Though it cannibalizes the rest of the economy.

The numbers, when it comes to healthcare costs in the US, are always stunning, and the report by the Department of Health and Human Services, published by Health Affairs, doesn’t disappoint. In 2015, healthcare spending surged 5.8% to $3.2 trillion: nearly $10,000 for every person in a population of 324 million. Healthcare spending rose from 17.4% of GDP in 2014 to 17.8% in 2015.

The report pointed out a number of reasons behind that surge in spending. But what it didn’t point out is the simple fact that without the surge in healthcare spending, GDP in 2015 would have essentially stalled. And without the secondary industries feeding off the healthcare boom, such as the construction boom of healthcare facilities, GDP would have looked even worse.

Among the components in the report contributing to this overall increase in spending:

  • Spending for hospital care up 5.6%
  • Spending for physician and clinical services up 6.3%
  • Spending for private health insurance up 7.2%
  • Spending for Medicaid up 9.7%
  • Retail prescription drug spending up 9.0%

The Federal Government was the largest spender, footing 29% of the total bill, largely due to the rising age of the population and thus the growing costs of Medicare, and due to rising subsidies for private insurance coverage.

The report had a special word about the pharmaceutical industry. Spending on specialty medications – to treat hepatitis C, cancer, autoimmune diseases, etc. – boomed, as did spending on other brand-name drugs. And 45 new drugs were approved in 2015, after 41 had been approved in 2014. New drugs create new money flows. That’s what Big Pharma wants. And then this:

Price growth for existing brand-name drugs remained strong in 2015…, reaching a double-digit rate for the fourth consecutive year.

Indeed, it’s not that Americans consume more healthcare; it’s that they’re paying higher prices for what they consume, in an industry protected by lobbying, patent laws, consolidation, and inscrutable pricing strategies, as PE firms are muscling into the endless money-maker to wring out those that pay for it, even as allegations of collusion and price-fixing are now rampant.

Healthcare spending is bleeding taxpayers, households, and companies alike, and thereby the rest of the US economy. In return for this enormous transfer of money, by far the most per-capita in the world, the US gets worse than mediocre results, with a life expectancy of 78.8 years, which puts the US in about 31st place, depending on who’s doing the counting.

It would be possible to do something about the price of healthcare in the US and bring this monster under control. The suggestions range from forcing competition on the sector to strict price negotiations by public entities, or even an iron-fisted single-payer system. But no real efforts will ever be made to bring these costs down. And here’s why….

No one in government, after looking at the numbers, and particularly not economists that are married to the concept of GDP growth, will ever dare go up against this ravenous monster – because every dime wrung out of taxpayers, households, and companies, and every dime borrowed from the future to pay for healthcare adds to GDP and GDP growth. Without it, there might not have been any visible GDP growth in 2015.

According to the report, healthcare spending rose by 5.8% or $175 billion in 2015. But GDP, adjusted for inflation, only rose by $304 billion in 2015, for a measly growth rate 1.88%. So:

  • If healthcare spending had remained flat in 2015, GDP would have grown a measly 0.79% on average for the year. On a quarterly basis, GDP would have declined at least in Q1 and Q4, and possibly also in Q3.
  • If efforts to crack down on these costs had pushed healthcare spending down 5% in 2015, to a still enormous $2.9 trillion, or $8,855 per person, the US economy would have been mired in a recession the ENTIRE YEAR!

No industry is more important to US GDP than healthcare – even though it cannibalizes the rest of the economy.

These figures don’t even include the secondary sectors that feed off the healthcare boom, such as construction of health care facilities which totaled $41 billion in 2015, according to the Census Bureau. Even in Houston, where commercial real estate is in a depression due to the implosion of the oil & gas boom, the healthcare segment was still doing well in 2015.

If consumers, companies, and governments didn’t have to spend so much money on healthcare, they could spend it on other things. Over the longer term, that would be more beneficial to the economy than feeding it to the healthcare monster. But given its lobbying power and its mega-footprint in the US economy, the industry has Washington wrapped around its little finger. And the occasional efforts to rein it in are effortlessly brushed off.

Private Equity firms don’t care. And they’re not required to care. They’re just in it for the money. Read… How PE Firms Are Flipping Drugs in Price-Gouging Scheme that Cannibalizes the Entire US Economy

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  155 comments for “Why No One Will Even Try to Tame the US Healthcare Monster

  1. gonzales27 says:

    I thought Obama care was supposed to fix this?

    • Gerald Stehura says:

      No…..Obama Care was passed to prevent any talking about Single Payer Health Care.
      The best healthcare is to take responsibility for our diets and exercise program. Reduce stress. Eat plenty of fruits and vegetables. Avoid dairy and meat and fast fried addictive(so called) foods. Take care of the only body you have.

      • Frederick says:

        Didnt you read the story about the 117 year old Italian woman who only ate 3 eggs a day Rarely any fruits or veggies Go figure right?

      • RepubAnon says:

        No, ObamaCare’s failure to include single payer was because the Blue Dog Democrats he needed to overcome the Republican filibuster blocked it from consideration.

        Remember, the President needs a majority of the House and (if a filibuster looms) 60 votes in the Senate to get legislation passed. President Bernie Sanders couldn’t have gotten single payer passed with the Congress as it existed in 2008-12, let alone today’s Congress.

        • DH says:

          Are you sure? Obama wasn’t even campaigning for single payer during the 2008 primaries and election. Clinton was.

      • Jerry Bear says:

        That is good advice for the individual but of little value for the probem we have. It would be like putting a band-aid on a melanoma.

      • Cousin Richard says:

        I tell people with cancer that all the time. Eat healthy, avoid medicine.

      • Edward E says:

        Vegetarian: Indian word for bad hunter. Superstar has now gone with the paleo-diet, don’t think that it was because of my smart mouth, but thank God anyway! I don’t really agree with her on the grains and corn quite as much. There’s nothing better than conebread with your venison and eggs, pretty sure the Indians thought so too. But I do agree that beans & legumes should be limited. Many beans are very toxic uncooked. Some will even kill rodents. Dairy is not part of this diet.

        Carry on folks! Love the banter at this place!

        • Denge Febre says:

          The Indians incorporated fats and yogurt , not to mention their bacteria in their diet, hence they were able to survive on a so called vegetarian diet. the data are clear. Vegetarian diets without appropriate fats and protein , are harmful to humans.

      • Terry says:

        The best healthcare is taking responsibility for your own health, including what food choices work best for you. There is no best choice for everyone.

      • Justa Lattie says:

        That’s ridiculous. The data are clear. Meat and diary are not problems, provided that it’s in moderation. Maybe 3 oz , 3 times a week, no hormones and no antibiotics in any of milk or meat. Fruits and vegetables are important also. our stomachs have evolved to be meat eaters. It’s the trans-fats from vegetable oils, processed foods , hormones and antibiotics, and processed sugars that are the culprits.

        • d says:

          “Maybe 3 oz , 3 times a week, no hormones and no antibiotics in any of milk or meat. ”

          In America you basically cant do that, or get Glysophate or other poison free products.

      • Chris says:

        What about pre-existing conditions and accidents? Eating healthy would not have prevented my ureter obstruction. Only surger could fix that.

    • Nick says:

      Is your point that you don’t understand how the US government works?

      • rich says:

        Here’s a good example of how the crony capitalistic US Government works, when it comes to expensive, worthless medical treatments. And Trump is rewarding him for his behavior:

        “Gen. Mattis joined Theranos’s board in July 2013, a couple of months after his retirement. As of Thursday night, Theranos’s website listed Gen. Mattis as a company director. Theranos referred questions about Gen. Mattis’s directorship to

        In 2012, Gen. Mattis, then leading the military’s Central Command, pressed for the U.S. Army to procure Theranos lab equipment and deploy it in the battlefield, according to senior military officials involved in Army medical research. His ties to the company stretch back to his days overseeing the military’s operations in the Middle East and central Asia.

        In 2012, Gen. Mattis, then leading the military’s Central Command, pressed for the U.S. Army to procure Theranos lab equipment and deploy it in the battlefield, according to senior military officials involved in Army medical research.”

        • nhz says:

          I’m hoping for huge damage claims against the board of Theranos; even better if they had significant personal investments in the company.

          But considering the people we are dealing with here, this is about as likely as a conviction of John Corzine for the MF Global theft ;-(

        • chris Hauser says:

          um, who knew?

          health is wealth, sez i.

        • Chicken says:

          ““Gen. Mattis joined Theranos’s board in July 2013, a couple of months after his retirement.”

          Thus, Mattis had no idea Theranos was actually a scam at least up until this point in time. In fact, he might’ve believed it was a game changer.

          So this guy has been around the block at least once.

        • Terry says:

          I’m just thrilled that no “progressives” supported Theranos. They could see thru that scam from the start. /s

    • Frieuline Schemexertrezandervan says:

      Take profit away from these M.B.A types , stop using healthcare as a source of profit for big business , pay doctors to manage patients and keep them out of hospital, rather than paying for quick fix patches and reform the TORT system.

  2. Greatful again says:

    It really is the elephant in the room. With 10,000 people retiring each day, Medicare is probably going to be the main thing that crushes the system first.
    Healthcare , and to some extent higher education, have been on a price increase rampage for a long time now.
    I’ve outsourced major medical costs by going to India. 90% less than US costs from a world class medical team. That was 6 years ago and at that time I wondered if it would catch on in the US? I don’t think it really has as I still hear huge fear from people when I mention it , despite how well it’s worked for me and many others.

    • David says:

      Please elaborate on what and how you outsourced.

      • Greatful again says:

        I guess you’re asking about my specifics? I had surgery that was quoted to me in the US at about $100K to $110K. Got it for $16k in India. Yes, there was shipping costs…me on an airplane …and some storage costs…me in a beach side resort for a couple of weeks. About $5K.
        Had my own hospital room suite with big screen satellite TV. Food was not so good. Service was fantastic.

        • nhz says:

          it can work, however if you get ‘complications’ it can get expensive very soon.

          In my country most of the medical tourism (for e.g. boob jobs, dental reconstructions, joint surgery and all kinds of treatments that are not always or fully covered by basic healthcare insurance, or for which there are long waiting lists) has stopped because if complications arise when you get home you might get in trouble with insurance and have to pay the follow-up cost out of pocket.

    • roddy6667 says:

      I retired in China as soon as I was able to collect Medicare. I figured I could fly back if I needed a big procedure. Turns out that I live within walking distance from first class hospital affiliated with a medical school. Many of their specialists have been educated in Europe, Japan, and America. The cost of health care is about the same as the deductible with Medicare, and I don’t need to pay airfare. Medicare also has co-pays. Medicine in China is less than 10% of American prices, and most drugs are OTC.
      There are quite a few places in the world with the same situation.
      America has the most expensive health care, with less than stellar results. Americans die sooner than the people in 25 countries. All that money spent just made the doctors, pharmaceuticals, and health insurance companies richer.

      • Dennis says:

        Just had surgery, $950 printed on paper, not stone. Medicare paid $382, I paid $97, hospital had a $463 “write-off”. I bet that last part is used to reduce taxes, etc. These prices are made-up, I don’t think they have much connection to reality. What a country!

  3. james wordsworth says:

    Uhm…. why not try single payer. It is a great solution for improved business efficiency.
    1. You get rid of an inefficient insurance bureaucracy
    2. Doctors get to doctor and not spend 1/2 their time arguing with insurance companies over what is and what is not covered.
    3. Everyone is covered, so medical bills will not bankrupt otherwise innocent people.
    4. Companies benefit from having a level playing field. All companies give their employees the same coverage. No forever renegotiating insurance coverage.
    5. Entrepreneurship benefits. Now individuals can start their own business and know that they still have health coverage.
    6. A central payer can negotiate better rates from bulk purchases. The balance of power gets switched away from big pharma.
    7. More efficient uses of equipment. Not every doctor’;s office needs an MRI/CAT/Xray machine that is unused for much of the day.
    8. SIMPLICITY. With a central payer system I do not worry about health costs. I know I pay elsewhere but the cost is worth it for the greatly enhanced peace of mind. It is not an issue I have to think about.

    There … a business oriented argument for single payer …. and then there are all the social benefits too. (Currently the US pays the most for health care and gets some of the worst outcomes – clearly NOT a great deal. It can do much better).

    • Arctic Melt says:

      Never going to happen until we elect politicians who actually care about ordinary, beaten down, working people.

    • d says:

      America is a Globalised Vampire Corporate owned Oligarchy.

      They are currently Allied with china not America.

      You want to stop them robbing everyday Americans for health care .

      POTUS Elect 45 was the last person to vote for.

      The process to stop the robbery has to start with term limits, as a direct attack on electoral funding systems in the US will fail. As you are asking non term limited Politicians, to get off their own gravy train.

      The Oligarchy still has America firmly locked into red V blue, either way it wins. As it owns them both.

      The sanders route is not the answer.

      3 senators per state with no more than 1 allowed per party, is another wedge in this, as the 2 senators a state locks in the red blue duopoly.

    • Tony O says:

      Be careful what you wish for. I lived in a country with single payer. One of worlds top cities. Healthcare was less than horrible. When my 14 month old daughter had an emergency I was shocked at the older equipment, mediocre facilities and lack of resources.

      If you want single payer you will get the drivers license office equivalent. Long waits, conflicting rules, not enough resources. Single payer is a liberal dream of utopia, but it is really shit on a shingle. Why do people from all over the world come to US for medical care?

      I know for a fact that many foreigners come to visit family or for vacation and suddenly need “medical attention” and end up at the local hospital for some procedure / treatment. Hospital can’t turn them away. Costs are usually in the tens of thousands. I date a nurse and almost every day there is some new non-citizen who showed up from Russia or somewhere that needs serious treatment. We pay, it drives up cost for the rest of us and uses resources that could be used to help others or veterans.

      Also, we have such innovative technology in medicine. But it costs money. With demand increasing due to aging population and new technology spending will increase.

      • economicminor says:

        When living in a society of other human beings the kind of health care that can be paid for is in direct connection with the incomes. When you live in a poorer country with lots of debt, the health care equipment will not be replaced. It doesn’t matter about appearances, they can be really deceiving.

        In the US there are many poorer communities are already that way. Medicaid does not pay the total costs. In the rest of the US there may be brand new equipment but the debt is causing price rises that are totally unsustainable. When something can not continue, it won’t.

        In much of the US we are on that peak where the costs have risen to unsustainable levels and something will give. You can only rob Paul so many times before he has nothing left to give.

  4. Gerald Stehura says:

    Look around…see all the fat people eating fried foods and sucking down sugar soda drinks. That is what is going to bankrupt the health care system. Stay out of the processed food sections of the food store and concentrate on the fruit and vegetables. Use our legs to walk a few miles every day. That is personal health care!

    • Frederick says:

      Walk a couple miles a day? Havent you seen the drivethrus at any fast food joint lately backed up Those people are too lazy to park and go in the place so they sit in line and burn gas instead I seriously wonder about people sometimes Quite often actually

      • Coaster Noster says:

        I have noticed that for years, and I’m angry about the four-door pickups, idling in line to get some Starbucks Coffee. Pickups with diesel engines are the worst. They never turn them off!! (even with the “no idle” law in California)…..
        ….driving a 4000-lb vehicle up to a window, to pick up a 000.4 lb burger, where has reason gone???!

        • MBBG says:

          Diesels use very little fuel at idle and it is more destructive to shut them down and turn them back on. You also seem to think that people own the truck simply to go pick up food at the drive through. If a person is going to own a single vehicle, that vehicle must accomplish all the needs of the owner. So maybe he’s hauled landscaping materials all week and is getting a burger on lunch break. Would it be more efficient for him to go home and get a smaller, more efficient car to go to the restaurant, or just use what he’s already driving?

    • Observer says:

      Cheap quality food is less expensive than high quality food. Poor people can’t afford to shop at Whole Wallet. They may also have to accept what they’re given at the food pantry. Walk a couple miles a day? When you work 2-3 jobs to make ends meet, that’s not going to happen. Not everyone has the luxury of making good personal healthcare choices.

      • DH says:

        I wonder if the bigger problem is simply over eating, rather than worrying about what to eat (as is alluded to by the 117 year old Italian women mentioned above.) Stress, whether it be financial, emotional, etc. easily leads to over eating.

        I used to worry about all of the nuances of what I was eating, and I used to micro manage my workouts. It always just led to ups and downs. At least for me, cutting my intake by a significant percentage, no matter what I’m eating, has led to a much more consistent and happy health. Some days I splurge and eat a lot of pizza, but other days I’ll go a whole day only eating some granola and an apple.

        Rather than making complicated workout schedules like I used to, I simply make sure I do at least 50 pushups straight every single day, which only takes a minute or two, and I’ll throw in short, 10 minute bar bell workouts a few times a week when possible. Granted, I tend to be a little impatient, so I walk fast/run almost everywhere, and I’m sure that also helps. lol

        I’ll turn 40 in a few months, and I’m 6’2″, and I’ve been in the lean 170-175lb range for years at this point. The best part is I just don’t stress about it anymore.

        • economicminor says:

          Spend some time studying the research on Omega 6 fatty acid and then understand that it shuts down and enzyme that controls people’s hunger sensations. So in affect the imbalances between Omega 6 and Omega 3 fatty acids in our diet cause us to be addicted to food. And especially the food that is high in Omega 6. Thus when people eat high doses of Omega 6, not counting the other down side from GMOs, just the Omega 6 down side, you realize that we are being played for the profits of the few who own the production.

          Add in a little subsidies for the stupid wasteful ethanol.. And the benefits that the Health Care/Drug Industry gets from treating us rather than helping us stay healthy and the picture becomes even clearer.

          We are being used for the Capitalistic gains of the few at the expense of the many in more ways than just ObamaCare etc,

        • IanCad says:

          May be wise to put a little weight on DH. Your scrawny frame wouldn’t survive a major trauma for very long.
          Heavy folk live longer than thin. Fit heavy folk live much longer.
          Thin is going the way of all fads.

      • PrototypeGirl1 says:

        There are ways of being healthy while not spending a bunch of money. I buy organic flax and sunflower seeds bulk from the health food store, and grind them up every morning for breakfast, I add cottage cheese for the sulfur protein and a little water and Himalayan salt. It tastes great and is an amazing nutrition boost. You can use Brer Rabbit molasses for energy. Nascent iodine for the glands, edible clay for the gut. Plenty of good clean water. I make my own liquid silver to combat any viruses I might come across. Thank goodness for that too just a couple of days ago I came in contact with a sick dentist, this guy had a terrible head and lung cold. I said oh do you know about silver and he said I’m a hard science kind of guy. Geeze I was so glad I had sprayed myself down with silver before leaving the house. Even so 30 hrs later I started feeling sick and dosed again with silver and I never got sick. I think people need to take a good look at their health professionals and realize they would be healthy if they knew how to be healthy.

        • JerryBear says:

          Be careful with silver! If you overdo it, it will deposit in your skin and turn you blue-gray like the Borg. It is quite impossible to get rid of if that happens though otherwise harmless.

        • Sound of the Suburbs says:

          Don’t go out and wrap yourself in cotton wool just in case.

          After being bored to death for years you may still come down with some hereditary condition or live so long you contract Alzheimers.

          Take a chance, break out the booze and start smoking.

          You may not live as long but your life will be a lot more fun.

    • Jerry Bear says:

      You apparent;y never learned arithmetic when you were in school. You are mistaking one small part for a vast whole. This is about the most absurdly irrelevant comment on here that I have seen.

    • HB Guy says:

      You’re right. I’d like to see cities like Los Angeles and others in Southern California made more pedestrian-friendly to encourage the trend.

    • Chicken says:

      Our government doesn’t seem to associate eating habits with health, otherwise why the emphasis on subsidizing some of the least healthy foods and allowing the consumption of the least healthy additives?

      I challenge anyone to analyze what that low-grade junk on grocer shelves actually is and which ones are subsidized.

      Then stop voting for more of the same bad decisions.

      • night-train says:

        As long as lobbyists exist in our crony capitalist system, subsidies for bad ideas will remain.

  5. Petunia says:

    I’m a registered republican and I have been advocating for national health insurance since I was in high school. Most Americans see the issue as a partisan issue or a free market issue but it is not. We all get sick.

    Since we all get sick, healthcare is not an insurable risk. Fire insurance works because not very many houses burn down. This is what makes a risk insurable, scarcity. We need to provide a basic level of healthcare that covers everybody and we all need to pay for it.

    I understand that this means subsidizing not just the healthcare providers but the educators as well. Doctors deserve to make a good income, but they don’t deserve to get rich, while impoverishing the rest of us.

    • DCR says:

      Catastrophic health care is an insurable risk. All other health care expenditures should be paid out of pocket.

      To prevent the costs of all health care expenses (including catastrophic insurance costs) from continuing to explode higher, all the monopolies/oligopolies, which lining politicians’ pockets have brought forth, need to be dismantled.

      • Petunia says:

        I’m sorry but catastrophic care is also not an insurable risk because of all the fraud in our system. It would be very easy for a cancer clinic to tell everybody that walked in door that they have some form of cancer and bill for the unnecessary surgeries and treatments. Please don’t respond that this never happens. Check our cancer figures against the rest of the world. Cancer is a profit center.

        • nhz says:

          Agree and I know this happens a lot (in a bit milder form). Basically almost everyone gets cancer, but many cancers will disappear without treatment, or are kept in check by the immune system until you die of old age. Genetic tests are designed and patented to drum up business, not for keeping the population healthy.

          What is needed is some hard cap on healthcare expenses. It’s ridiculous that people near the end of their life can get free treatments costing millions which at best prolong their life with a few months, while at the same time many people are not going to the doctor when they have disease symptoms because they have to pay a small fee (better wait till you get REALLY ill and have society pay for it …) and some very cheap treatments are blocked by a bunch of self-appointed experts because they are “too expensive”(e.g. antibiotic treatment for Lyme disease which could cost something like $10, but it’s better to wait till people get REALLY ill and cost society a fortune).

          Some countries have a cap system e.g. New Zealand and I think it is a great idea. If you want extremely expensive treatments that are judged almost useless by the medical community (also depending on age etc.) you can still get them, but you have to pay everything yourself.

          What is also needed is a system where many types of healthcare that are not medically necessary have to be paid fully out of pocket, instead of by society. I’m thinking about 99% of boob jobs, 95% of “reproductive technology”, dental reconstructions etc. etc. (even illegal migrants get all this for free in my country). If we don’t act there, in ten years there will be hundreds of extremely expensive genetic therapies that everyone feels entitled to and the whole system will go bankrupt.

          But no politician want to go there, they will wait until the system crashes completely. Just like with desperately needed reforms for the banking system, pension system, education etc.

        • Observer says:

          The problem with the US Healthcare system is way beyond the old “fraud, waste and abuse” meme or Doctors’ salaries; rather, the problem with the US health care system is the system itself. It is essentially ethically corrupt, which is what happens to certain basic public services (like health care, utilities, policing, and a military) when they are privatized in order to generate a profit. You had it right, Petunia, when you pointed out the for-profit insurance industry. Government provided single payer coverage would go a long way toward removing unnecessary profiteering and control by middle men such as insurance companies, thereby simplifying processes and reducing costs. Like is done in other countries, perhaps the combined bargaining power of a single payer system could be used to bring pharmaceutical profiteering back in line as well, so that the Martin Skrellis of the world will be forced to price their products fairly, rather than profiting by cornering the market on medications and then charging a sky’s the limit price to the sick who need them.

        • Ed says:

          And also the fact that nearly all of us are going to face something like catastrophic care at some point. The greatest expenditure is in the last year of life. So yes, a risk that is 100% certain isn’t and insurable risk. Nothing like auto insurance or homeowners insurance.

      • Jerry Bear says:

        That is a rather short-sited view point. It is not the catastrophic health care but the out of pocket expenses that are eating us alive. You say you want todismantle all the monopolies etc. Then what will replace them? Only a single payer health plan can give the average man the necessesary leverage to deal with the health care industry. We cannot have a functioning health care system in the long run if its main purpose is to maximise profits and provide investment opportunities for the rich.

    • robert sills says:

      exactly right.

      it’s pretty obvious that when the insurance companies are one of the prime beneficiaries of a system then something is wrong. you shouldn’t even need them and you wouldn’t under the single payer system.

  6. Paulo says:

    regarding two things:

    “The Federal Government was the largest spender, footing 29% of the total bill, largely due to the rising age of the population and thus the growing costs of Medicare, and due to rising subsidies for private insurance coverage.”

    From an outsider looking in, this tax and spend giveaway seems to exist by lurking behind the US meme of ‘everything socialist is bad’, while funneling hard earned but skimmed taxpayer dollars into the shareholder pockets and executives of protected/insider corporations. Plus, when everything is exceptional because ‘we are an exceptional society’ (US), where does critical analysis of the healthcare system grab a foothold?

    I simply cannot imagine a population putting up with the situation that if one gets sick and needs care, you might lose your house and financial standing? There are so many alternatives. Will Trump have the jam to ramrod through a positive change that is not designed by and for the insurance and medical care corporations? I doubt it because he was born rich and has always been rich. I don’t think he has the ability to empathise through his well-fed and entitled narcissistic personality.

    My best friend in high school came from a wealthy family. Through no fault of his own, he believed that it was so commonplace to have wealth in all aspects of living, that poor people were simply stupid or lazy.

    The other issue I always take exception to is citing life expectancy at level 31 as a reflection of a poor healthcare system. Can you blame the system on a population that is sedentary, over-fed, and addicted to sugary corn syrup beverages and instant food/cooking products? It may be that under another system the population would die even younger!! :-)

    Except for the vagaries of bad luck in contracting disease, illness, and accidental injury, a person’s general health is a personal responsibilty. One can choose to live better for improved outcomes. Hey, I just had a fry-up of bacon and eggs. Having said that I did so after an intense exercise bike ride of 30 minutes at 5:00am, the bacon was low sodium (tastes better than the high salt variety, anyway), the bread was my own homemade full of oats and grains, and the eggs were from our own free-rangers. Plus, I am going to be outside working all day in the cold. Lunch will be soup and supper will be homemade spaghetti with our own tomatos, etc. If I put on heart risk weight I’ll have to lose the fry-ups or cut down. It isn’t the health systems fault for lifestyle disease.

    • Flying Monkey says:

      Better the natural fats than carbohydrates. I do better controlling my weight eating more fats and a lot fewer carbohydrates. You body better regulates the hunger feeling with fats than it will with carbs. Carbs swing your blood sugar too and the insulin response swings it low. That saturated fats are a heart risk is all bunk.

      Everybody I know who went Vegan and eats most carbs has gained weight and wonders why. They do not understand the metabolism and its effects on blood sugar.

      We were all brain washed with the low fat mind set.

      • nhz says:

        That’s true but there are also many individual differences. People should not blindly do what the government, some industry group or the supermarket offers them but use common sense and listen to their body. Most dietary advise should be ignored, especially when coming from the government or big business, because most of that advice has been totally wrong for the last 50 years or so.

        BTW understanding metabolism is complicated; I’m a biochemist and there are many things I cannot predict based on scientific knowledge. There are all kinds of biochemical and psychological feedback mechanisms and especially important stuff like sugar levels aren’t simple ;-)

        BTW, I’m 99% vegetarian (not Vegan), eat most cards and have very low weight / BMI.

      • Keith says:

        I am mostly Vegan and eat primarily starches (carbs). I eat some fat but on the low side. I am 6’1″ and weigh in at 205 lbs. I am 55 year old grandpa and look like a strong safety. Tough being brain washed.

        • Frederick says:

          Im 6ft 2 and 180lbs and 62 year old grandpa and I eat just about everything in moderation I also walk 3 miles a day and avoid sugar and fast foods like the plague

    • jb says:

      bravo !!!! why have not we heard a word about prevention !

      to quote an old proverb is : ” an ounce of prevention is
      worth a pound of cure ” .

      I would start by eliminating certain unhealthy food items from
      food stamp purchases. Is health being taught in schools ?

      is gym still a requirement ? it was a requirement when i attended school.

      ALSO>>> look on food labels : there is no percentage
      of recommended daily amount of daily sugar !

      • nhz says:

        Agree that this would be far more effective than spending billions on prescription drugs and surgery, but never going to happen of course because in the current system it’s impossible to make loads of money with ‘prevention’.

        I think China long ago had a system where the doctors were paid to keep their patients healthy, instead of making money mostly when they get ill (or when they are judged ‘ill’ by some diagnostic test). Apparently it didn’t work in the end, but I don’t know the details.

        I see this closeup all the time e.g. better (and cheaper) diagnostic tests that could help in treating early and prevent much more expensive and harmfull stuff down the road are blocked, while billions are spend on useless and sometimes even very dangerous vaccines (e.g. HPV vaccination). Almost nobody in the medical community wants preventive medicine, you will be stealing from their pockets! And the major medical journals try to ban such research from the pages too, they know where the money comes from.

        I doubt gym is a requirement for adults; in school it’s a different story because the body is still developing. Research shows that one hour of low-level exercise like walking is often better for general health than half an hour of intense workout; if you want bigger muscles, more endurance etc. it’s another story and you have to work for it ;-)

        • Dan Romig says:

          One of the first impressions I got when traveling in European cities was that people walked, and most of those in middle to late ages looked to be fit; which is generally speaking, not what I see Minneapolis/St. Paul. A brisk twenty minute walk each day is one of the best things a person can do to maintain health and well being.

        • economicminor says:

          Another impression is that there aren’t fast food chains on every corner with super sized HFCS drinks.

        • nhz says:

          @ Dan:
          regarding city design and health: yes, much of Europe is better especially the older cities that are less suitable for massive use of cars. My country is known for biking (there are a few others) and this is a cheap and healthy way to cover small distances e.g. between home and work. I haven’t driven a car for 15 years, I can do almost everything by walking or cycling plus sometimes public transport (which has become terrible unfortunately).

          You can see in the statistics that biking helps to keep weight and some other problems down. Of course, biking and walking is not really an option when cities are designed in such away that there are no local shops, if homes are always far from the workplace etc. While the Netherlands is leaner than most of Europe, we basically have the same problems with junk food (often from US retail chains …), softdrinks (similar story …), insufficient exercise especially for the young, overeating etc.

      • Frederick says:

        Your jealousy is showing bubba My wife is 38 by the way

      • d says:

        GMO plus Agricultural chemicals = Health problem.

        These things are not on American food labels.

        Hence America = Health Problems, Simple

      • Chicken says:

        Our government subsidizes the production of corn, certainly not the most healthy of food stuffs, and gives no subsidies to fruit growers (AFAIK), certainly that’s not a health policy positive unless perhaps you’re voting your book.

      • economicminor says:

        You can’t prevent unless you entirely modify the industrial food complex’s entire matrix. It is what we eat that is making us ill. From the fats in our food to the chemicals and hormones. If we went to locally produced aquaponics instead of industrial farms we could be much healthier but then all that investment in producing corn and wheat would no longer produce those huge profits.

        Do we want health of profits for the few?

    • Jerry Bear says:

      It is the system’s fault for the very heavy promotion of these grossly unhealthy foods in advertising starting from early childhood. Furthermore, if everybody followed healthy life styles, the industry would just jack up prices to retain their profits. Also keep in mind you are going to end up dying of something however healthy a life style you pursue and you will experience the physical disabilities of old age if you live long enough.

      • Michael Fiorillo says:

        While diet influences health, and we can argue over what foodstuffs should or shouldn’t be subsidized by the government, none of that refutes Petunia’s point, which is that we all get sick and that strips the gears of the actuarial tables.

        I also have to laugh at all the virtue-signalling about diet and healthy living, and talk about personal responsibility, since my healthy-living and epitome-of-responsibility wife, who never once put a cigarette to her lips, died of lung cancer.

        We all get sick, even vegan yogis, and most of us require immense amounts of care in the final months/years of life. The political system should seek to ameliorate those costs on individuals and society, rather than create incentives to drain the masses dry.

    • josap says:

      It’s great to have healthy foods, gather the eggs and bake the bread. You know exactly what you are eating.

      However the majority work an 8 hr shift with an hour for lunch, a one to two hour commute in traffic each day. Many sit at a desk all day. When you get home to your house on the postage sized lot it’s time to get dinner on the table as fast as possible as the kids are hungry. So something goes in the nuke while you start a load of laundry and try to get the kids settled down.

  7. DCR says:

    GDP would not necessarily have gone down versus its reported level in 2015 (or any other year) had health care spending been lower. For that to have been the case, you would have to assume that those benefiting from higher health care profits have a higher propensity to consume and/or invest than health care consumers, and I doubt this is the case.

    It is lobbying and campaign contributions, which results in legislation creating health care monopolies/oligopolies, that shifts more of the economic pie into the health care companies pockets.

  8. Arctic Melt says:

    Hay…your talking about the exceptional country that elected Bush twice after lying us into two wars and Donald Trump – the gift of stress. I have never been more depressed in all my 74 years of life. I am going through my time of grief so I can reach my state of acceptance – like accepting the death of a loved one.

    • Chicken says:

      You’ve been witnessing the bloodbath for several decades now and just have become alarmed? Good one.

    • John Brownstone says:

      Yo! I too am working at this first time fear about the direct effects our new government and our politically deaf population will have on me and the wife unit. I am your age. My wife and I worked, lived a nice life, and shouldn’t have to worry now about food and shelter. Oh well, give me a month or two, a ride in my friend’s big boat, and quicker Trump-mute clicker and I’ll get back to worry about bathroom tile colors…

  9. Flying Monkey says:

    Hey, without health care the economy would be really sick…. ;)

    • Tom Kauser says:

      4 trillion 500 billion dollars are on the fed balance sheet and obamacare has somehow failed us!

    • d says:


      Think of all the debt American’s would have paid down, or other things those funds would have been spent on.

      The average American does not know the Meaning of the word save, or how to say it.

      In America BIg Pharma gets to big a slice of the cake. Simple.

  10. nhz says:

    Very similar story to Netherlands, although we have a pretty different type of government etc. The sick-care monster is global :-( The main drivers for cost increases in my country are prescription drugs (especially the new and extremely expensive stuff) and general care for the elderly (which wasn’t included in the healthcare budget previously).

    Our cost is slightly, I think about 7000 euro ($7500 now, but nearly $10.000 not too long ago …) for every person. A big difference is that here – probably like in most of Europe – most of the expenses are covered by taxes and the mandatory healthcare insurance is 1500-2000 euros per year pp.

    Of course it’s ridiculous that prescription drug prices are increasing every year, even with double digits. It would be perfectly normal if prices were DEcreasing every year, for newer drugs even with double digit declines because of rapid technological development. Clearly Big Pharma has cornered the market with help from politics.

    Obviously it’s not just about keeping GDP rising, it’s about profits. Just read about how the 0.1%, including most high level politicians, are raking in the money thanks to collusion with Big Pharma. Even if GDP growth wasn’t threatened it would continue.

    • Petunia says:

      The govt paid home health care industry in Florida was a big ripoff. I would see the elderly with their aides in the supermarket, hairdressers, and even at the doctors, and the ones that looked like they needed the help were a very small minority.

      • Petunia says:

        This industry is a big employer of low wage immigrants.

        • Observer says:

          Insurance does not pay for the aides you see. Those are private aides paid for out of pocket. Unless the individual resides at an Assistant Living Facility or Skilled Nursing Facility, in which case the aide works for the facility and is accompanying them for safety. Those who do not appear to need assistance may need it in other ways, for example, if they have alzheimer’s or dementia.

      • nhz says:

        also very similar to my country …

      • PrototypeGirl1 says:

        I have lost cleaning jobs because the health care industry now provides housekeeping. No way I can compete with free labor.

        • Observer says:

          Those are home health aides, and insurance does not cover them. They are paid for out of pocket and the cost is prohibitive – on average about $15-20 per hour in the US. They do not do usually do deep house cleaning, but may do light cleaning. They also prepare light meals, do grocery shopping, assist with dressing or bathing, assist with transportation to and from doctor appointments, hair appointments, pharmacies, or the grocery store, assist with transferring into and out of vehicles or transferring into/out of bed or a chair, and remind clients when to take medications.

      • DCR says:

        If people had to pay those expenses out of their own pockets most of this would miraculously vanish.

        • economicminor says:

          The miracles of magical thinking..

          And the US instantly turns into a 3rd world country. Not only would 20+% of our GDP vanish but the leverage on all those hospitals and surgery centers and drug and health care corporations would collapse into a pile of defaulted debts.

          And it still wouldn’t solve the problem of our tainted food supply that is making people ill. Or our captured and corrupted major media that can’t ever get around to faulting its owners for their involvement.

          No wishful thinking nor asinine draconian law changes as in privatizing Medicare and block granting Medicaid will fix our problems. What ever the fix it will have to be well thought out and slowly implemented as to not totally destroy the US economy.

  11. NotSoSure says:

    Healthcare is probably one industry that won’t get sent to Mexico? Although the high prices do indeed push the customers to Mexico :)

    But since it’s not outsourced, it automatically will be part of Making America Great Again.

    • James Murray says:

      Healthcare is being outsourced to Mexico, especially dental and plastic surgery. I live in Mexico and recently broke 2 front teeth and got a 2 tooth bridge. Extraction of the broken teeth and bridge was $390 total. 4 trips to the dentist. According to Google, US prices would be $500-1200 per tooth.

      This is “Snowbird season” where I live and I was noticing all the US plated cars at the dentists office. People put off their dental work until they come down for the winter. They save enough to help pay for the trip.

      • Greatful again says:

        I go for dental care as its only an hour drive for me. Very good and inexpensive. I’ve also heard that retirees can get long term resident visas for Mexico and then be allowed to buy their national medical insurance at about $400 USD/year. The people I’ve spoken with that have it say it’s quite good.

      • Chicken says:

        “They save enough to help pay for the trip.”

        Pretty sad commentary. I’m sure Hilary’s priority was to fix that too.

    • Chicken says:

      Who’s been sending industry to Mexico, US Government negotiated trade treaties on behalf of whom?

      When I travel overseas it’s often customary to present my hosts with some small gift pf some sort. I expense these under the category of “Presentation Materials” and I figure the US taxpayer pays the bill.

    • d says:

      Not Outsourced.


      Check who owns those clinics/Hospitals in Thailand Mexico Etc Serving American’s.

  12. Grumpy Old Timer says:

    If one wants to know why health INSURANCE will never be solved, read the above comments. There are too many strong emotions on all sides to form any real consensus and this is an emotional issue that impacts everyone.
    Perhaps the empire will collapse naturally before this issue does the job.

  13. roddy6667 says:

    Nobody needs health insurance. Everybody needs health care. Insurers just stand between you and health care and take a cut of the action.
    Americans are so brainwashed. They believe that the insurance racket is the only way to deliver health care.r

    • Me says:

      You are absolutely correct.

      The only people who provide health care to you are the nurse and doctor standing in front of you……

      EVERYTHING else is an expense. Today, most MD offices have more people in the back rooms doing Insurance Billing than doing health care in the front.

      I personally don’t spend more than 12 minutes with any patient, but the staff time in pulling their Insurance coverage/benefits and filing claims and the follow up paper work can be up to 1 hour PER PATIENT. Think of the staff we have to hire to do NOTHING but push paper so we can be under-paid, or some time REFUSED payment from your friendly Insurance Company who sells you B.S. propaganda a bout “how much they care”. They consider Doctors and Nurses to be expenses and YOU are called a “subscriber”.

      They don’t give a damn about you and they are not in the “health” business anyway.

      There is an old phrase, still valid today: “Doctors don’t practice Medicine, they practice Medicare”.

  14. Mel says:

    theautomaticearth just popped up this:

    It’s a long read, but it’s lively, and it’s Steve Keen and Michael Hudson talking about what this “GDP” thing, so improved by Healthcare, actually is.

  15. Tom Kauser says:

    Trump is impressing this casual observer by his cabinet choices.
    Putting billionaires and ex girlfriend’s in the cabinet is stroke of genius?
    Give them all something to do and none will bother him and avoid each other?
    Divider in chief.
    A billionaire cabinet secretary beats a 6 figure lobbyist when talking to an esteem colleague about getting something of utmost importance?

  16. economicminor says:

    What is unsustainable will fail

    This is parasitic and is killing the host (along with the financialization parasite and the military industrial complex parasite and how consolidation/monopolization is doing the same things).

    The entire economic system is already unstable

    Add into this the rising interest rates.

    Then add the push towards privatization which will also try and move money from the impoverished to the elite.

    And … and… and!

    And the only question I have is what will be the trigger to cause the implosion?

    • Jerry Bear says:

      Karl Marx predicted this a long time ago in “Das Kapital”. The book itself is rather heavy reading but their are good interpretations and summaries that will help you to understand his main ideas without too much effort. In it, he makes some quit grim prognostications about the final days of capitalism and they are all pretty much happening right now. Call this the “Curse of Karl Marx” effect. If we don’t find some way of deafeating it, we shall indeed plunge over the precipice he describes.

  17. Chicken says:

    ” without the surge in healthcare spending, GDP in 2015 would have essentially stalled. And without the secondary industries feeding off the healthcare boom, such as the construction boom of healthcare facilities, GDP would have looked even worse.”

    Nice job, a big thumbs-up for the policy of change and the administrations globalization and economic agenda which fully supported the free trade policies where Chinese state corporations are rewarded for operating at a loss and committing human rights violations.

    Chinese Burritos forever….

    • economicminor says:

      That spending might have gone into retail and kept it afloat. There is a war going on for consumer spending and right now health care is winning. Wonder when those who own the retail and energy sectors will advance their counter attack.. It has to affect even the travel industry.

      Only so much blood from those ole turnips you know.

  18. economicminor says:

    The diet in the US is based on profits not heath. Corn and corn syrup are extremely high in Omega 6 fatty acid. Omega 6 fatty acid is very inflammatory and shuts off the part of the brain that tells you that you are full. On top of that the when it is GMO most of the beneficial neutralists are removed so that the plant doesn’t die when inundated with Round UP.

    People with money can purchase food that is more healthy as it costs a lot more..

    That is one of the issues with the population explosion. To produce enough food for this explosion the producers have had to resort to high volume, low nutrition foods thru the use of GMOs.

    Then on the other side is the Industrial Drug/Health Care complex that wants to keep you alive thru chemicals to counteract the poor quality foods the Industrial Foods Complex provides..

    And this is Capitalism at its best.. All to accumulate capital.. Profits..
    And round and round we go.

    • Jerry Bear says:

      Ummm, I should mention in passing that there are no fatty acids of any kind whatsoever in corn syrup and one of the essential fatty acids we need to survive is omega 6. The real problem is the ratio between omega 3 and omega 6 (both essential) is unbalanced in our modern diet.

      • economicminor says:

        Jerry, you are correct in that HFCS is not a fatty acid but your body treats it similarly. It also, along with corn oil, cause the body to not understand the normal hunger signals. So your body continues to feel hungry and wants more nutrition. People are addicted to food and the wrong kinds of food so they then need drugs. What a insidious game that is being played.

        This is like the tobacco industry saying that there was no harm in smoking. The producers of corn and all the GMO products are the same shills. Profits over your health is their business. And with regulatory capture, the American public is being taken for a long ride to hell.

        • economicminor says:

          Then allow the Private Equity players to purchase the drugs and run the prices up for profits for them.

          Defang the IRS, change a few accounting rules and the rich get not only richer but the poor get sicker and even poorer.

          Does anyone wonder why the American public is fed up?

      • Me says:

        Are you sure you don’t mean Omega 9?

        • JerryBear says:

          Your body can make Omega 9 without any trouble. But mammals cannot synthesize Omega 3 or Omega 6 and some are essential.

    • Me says:

      4 Great books about this are:

      THE END OF FOOD, by Paul Roberts
      THE BETRAYAL OF HEALTH, by Joseph D. Beasley, MD.
      WHEAT BELLY, by William Davis, MD
      GRAIN BRAIN, by David Perlmutter, MD.

    • Lee says:

      IMO many of the FAT people in the western countries are FAT simply because they are lazy.

      Lazy because they don’t educate themselves about food and health.

      Lazy because they take a car instead of walking or riding a bike.

      Lazy because they buy crap food instead of cooking at home.

      What really gets me is that many say that poor people can not afford to buy healthy food. Grow it instead.

      How many times have you seen a run down house with a bunch of ‘poor’ people sitting around a weed filled yard?

      Why not turn some of that yard into a garden and grow simple things like spuds, peas, spinach, beans, and other vegetables?

      The cost is minimal and the return is huge!!!

      Our garden is not huge, but we get several thousand dollars worth of fruit and vegetables out of it every year.

      • economicminor says:

        What you seem to want to ignore is that 1/ high levels of Omega 6 cause food addiction and 2/ in many poor urban centers there are no other options.

        Yes there is a segment of our population that probably could break this addiction but 3/ the education and media systems in the US are also broken so people are not informed. The same people who own and control the media control the food/drug and health care conglomerates.

        The food/health care/drug companies in this country act like big tobacco did before the big law suits and eventual laws. The public is not being told the truth about food and there are people making billion$ because of it. Most of the University food research is also funded by same people. For the most part, you have to go outside this country to get any valid research on Omega fatty acids or GMOs.

  19. Bonnie Smith-Yackel says:

    Please don’t call it “health care.” We all know it’s “insurance care.” The corporate world has its priorities, and corporations, not people, top the list.

  20. Sound of the Suburbs says:

    For US labour to compete in a free trade world, US healthcare costs must be dealt with.

    Milton Freidman thought all free and subsidised services should be removed and paid for in the private sector.

    He didn’t think how these costs would have to be covered by wages.

    He didn’t think how these costs would need to be the same in West and East in a free trade world.

    The minimum wage is set by the cost of living and must be the same in West and East for free trade.

    No one else thought either and a rent seeking real estate sector, healthcare sector and education sector have been busy in the US not thinking, raising the cost of living and pricing US labour out of international labour markets.

    Until the populist revolt occurred this was all hidden by national businesses using cheap overseas labour for manufacturing and services, where possible, while the rentiers priced domestic labour out of international markets.

    The forgotten domestic worker is now shining a light on the conflict of interests between business sectors that was obvious in the days of the Classical Economists and lead them to distinguish between “earned” income and “unearned” income.

    The Classical Economists did think about these things and thought the cost of living must be kept low with free or subsidised housing,
    education and healthcare funded through taxes on “unearned” income.
    “Earned” income shouldn’t be taxed as this raises the cost of doing business, real productive business that earns real wealth.

    Imaginary wealth can be produced by inflating the value of a nations housing stock until the bubble bursts and all the imaginary wealth disappears (e.g. US 2008, Japan 1989, Ireland, Spain, etc …..).

    • Sound of the Suburbs says:

      The Corn Laws and Laissez-Faire, the requirements of free trade, a historical lesson:

      “The Anti-Corn Law League was a successful political movement in Great Britain aimed at the abolition of the unpopular Corn Laws, which protected landowners’ interests by levying taxes on imported wheat, thus raising the price of bread at a time when factory-owners were trying to cut wages to be internationally competitive.”

      The landowners wanted to maintain their profit, charging a high price for corn, but this posed a barrier to international free trade in making UK wage labour uncompetitive raising the cost of living for workers.

      The anti-corn law league had to fight the vested interests of the landowners to get the UK in a position where it could engage in free trade. They had to get the cost of living down to a point where they could pay their workers internationally competitive wages.

      Opposing national interests, productive industry and landowner rentiers.

      If you want free trade it’s all about the cost of living.

      • Kent says:

        So, in the end, they lowered the standard of living of the workers to be competitive with cheap foreign labor? Genius!

  21. Me says:

    I’m in the “health care business” and IT is all messed up.

    I am an Optometrist (I know, we are not “real doctors” and we aren’t ….don’t ever go to any Optometrist for anything medical…only glasses and contacts…..)

    There are 16 codes for billing Medicare for the different levels of “eye exams”, yet in all practicality, it is all the same. The fee reimbursements vary from around $58 to $250, for the “same” basic procedure, and if you are clever, you simply code up, following the BS guidelines, and you can make a fortune with billing Medicare. I know. I do. AND, it is all “legal”.

    The America public wants it this way. They want “affordable” health care, which means to most of them, to bill our neighbors or somebody else. QUALITY Health Care is not “affordable”. It could be, but with the extensive technology today, it will not be “affordable”.

    If the public was willing to pay each month, from birth to death, about as much as they pay for their useless and nonsensical “smart” phones, the system would work. AND, we need an advisory, over-sight board, which contains NO practicing Doctors or Insurance executive or Politicians (unless totally retired), to set the rules so it would be impossible for people like me to bill medicare $258 for an actual $58 procedure.

    • Kent says:

      No, the American public doesn’t want it this way. And quality healthcare is affordable. Just not in the United States. The American public just doesn’t have a political mechanism for understanding the options available and making an appropriate selection.

      America is a Republic, not a democracy.

      • NotSoSure says:

        I think the correct saying is “America is a business not a country.”

        • Edward E says:

          Just look at how a couple thousand former and current servicemen arrived to support and shelter Native Americans. Thanks to the US Army Corps of Engineers, for halting the Dakota Access Pipeline. Real life in a country is better than the movies when the cavalry shows up to help the Native Americans.

          Army will not grant easement for Dakota Access Pipeline crossing | Article | The United States Army


          Now what if something causes them to go to Washington DC like the Bonus Expeditionary did? Déjà vu…

      • nhz says:

        It’s not just the US, most of Europe is much of the same; only the way all those medical bills are paid is different.In Europe most healthcare expenses are directly paid by the government, with the money coming from general taxes; healthcare insurance and personal expenses cover just a fraction of the total cost.

    • Felix_47 says:

      I have seen podiatrists do this too. They code up by giving some sort of salve to the patients whose nails they cut paid by Medicare….then it becomes some sort of medical visit. With 100 patients in a nursing home getting their nails done twice per month that can add up to some real money. If the government has determined that health care is a right to be subsidized by the public there is no other option than putting the doctors on salary…..just like firemen. 911 is a right subsidized by the government. Why should medical care change financially at the ER doors? Let the doctors decide what care is appropriate……..they went to med school. And if they feel the money is not worth it let them go do something else. If no Americans want to practice medicine because the pay is too low we can import doctors from Africa or India or other third world disaster areas….like we don’t now?? Entire med schools in the third world are set up to generate third world doctors for the US. If there is no incentive for more treatment then there won’t be any excess treatment. You always get what you measure or pay for.

      • Me says:

        You are correct. None of my children will go to any form of Medical School. They see the cr@p I put up with. We will import our docs from India and Pakistan, like England does, since no self-respecting “American” will want to work in a “third world” profession.

        And, when it goes to Single Payor, then these lucky Pakistani docs will never have to be worried about being sued, etc. since that will be removed as well. You’ll be going to the Post Office for your medical care.

        How does that feel?

      • Kent says:

        Why pay by the procedure. Why not by the hour?

    • Petunia says:


      I’m using a pair of $6 readers from Big Lots because I can’t afford the new glasses I need. At about $200 a pair, I need reading glasses, regular glasses, and sun glasses. That’s $600 if I’m lucky, for the cheap stuff, another ripoff. And the liberals are still wondering why the working class is PO.

      • nhz says:

        Until a few years ago most people in my country were entitled to free glasses every two years. So every two years they hurried to the store to get the most expensive (up to EUR 500,-) and latest model, after all they are entitled to it. This is an invitation for widespread fraud, insurance companies and optometrists were even advertising how you could get the most out of this rule. By “buying” free glasses that you didn’t need for the whole family you could even get a EUR 300,- tax deduction (and probably sell the glasses to someone else).

        Hearing aids, similar story. Result: a device that costs maybe $50 in China is billed to the customer for EUR 3000,- (all covered by healthcare insurance). Nobody cares about the cost when someone else pays the bill, many even boast about their new and very expensive medical devices.

        Recently there have been some changes to make sure there are limits on how expensive the ‘totally free’ stuff can be, if they want the most expensive devices they need to pay part of the bill out of pocket. But here too the shops that sell glasses and hearing aids have invented dirty tricks to keep things totally free for most customers :-(

      • d says:

        GET you Prescription and have them made in Thailand The Philippines or heaven forbid even Australia where they would still cost a lot less than $200 US delivered.

        also get some “Progressive ” lenses they are a lot better than Bifocals then you would only need 1 pair instead of 2.

        • josap says:

          When I got new glasses this year, Progressives were 2.5 times the cost of bifocals. Glasses and exam are not covered under my insurance. Sunglasses were out of my price range completely.

        • d says:

          Where are you, and where are they being made, progressives should not be even 2 X the cost of STD, as there is only 1 frame.

          With out going back and checking. I think progressive is around 25 – 30 % over cost of STD. (STD for me includes anti glare and anti scratch) which is still way cheaper and less Hassle than 2 pairs.

          Progressives are good for me to drive with, as it got to the stage where with my driving glasses I could no longer read the gauges properly, which is dangerous.

  22. night-train says:

    I understand that Cuban doctors are well trained in basic medicine. I expect many Americans will start going to Cuba for basic health care services. Get affordable health care and a vacation. Many do that now in other countries. Why not Cuba?

    • Observer says:

      If I can pay with my Paul Ryan Health Voucher, I’m there!

    • nhz says:

      It’s affordable, but many procedures that are common in the US are probably not available in Cuba because they are deemed medically useless or not worth the risk. Cuba is especially good at preventive medicine, and rightly so.

      • Me says:

        Correct. Heart stents, transplants, by-pass surgery, kidney transplants , etc and other procedures for old, non-working, non-tax paying people are useless. Why should a society pay for someone around 70 who produces nothing and most likely be dead in a few years anyway.

        The Peoples Republics are aware of this smart, cost saving health care. Best to put the money into numerous kids who can at least work the sugar cane fields and tobacco farms and produce products to sell to Europe, than keeping some half-dead geezer alive at $100,000 a year.

        We would be smart to adopt the Single Payor, Free Health Care system of Cuba.

      • JerryBear says:

        The medicine available to the average Cuban is a far cry from the deluxe version you saw served up in Michael Moore’s video. That hospital is reserved for those who have hard currency to spend, mostly foreigners and the elite.

        Triage is common and necessary in the 3rd World. I saw a video of a doctor treating a rabies patient at home, basically making him comfortable until the end. In India, hospital beds are reserved for those who have a chance to survive.

  23. B Fast says:

    Wolf, you are right that the medical care system is, well, uber-expensive. This, of course is a problem. What is worse is that when looking at simple statistics, it isn’t the best care. The dreaded Canadian system produces better infant mortality rates, cancer recovery rates and longevity rates than the American system does. Its cost? About equal to what the US pays for its single payer senior care.

    Oh, and other systems are more cost effective and quality effective than the Canadian system.

    The American military, however, is every bit as large a black hole of economic destruction as health care is. If the US simply budgeted to spend twice the amount that the second nation (China) spends on military, it would nearly wipe out the deficit. After all that, the uber-funded American system is held at bay by a few sand-dwellers with machetes.

    In my opinion, rather than protecting America, the US military is crushing her with bills. This, by the way is the same problem that North Korea has.

    Fix these two money vacuums, and the US economy will be able to weather its $20,000,000,000,000.00 debt quite handily.

    • nhz says:

      Infant mortality rates and cancer recovery rates are very much a product of statistics and not objective facts that can be easily compared between countries.

      Longevity rates have very little to do with medical care and far more with ‘lifestyle’, diet, personal genetics (which vary statistically between countries) etc. Even better cancer recovery rates could be mostly the result of other factors than medical care (e.g. due to better diet and other lifestyle choices for the average citizen).

      My country has a small defense budget. Health care is by far the biggest government budget, and this doesn’t mean that we have much better health care than the US.

      IMHO the MIC and the Sick-care mob have much in common :-(

    • Me says:

      If we de-funded the Military Complex, and the Health Complex, there would be massive unemployment.

      This was deduced in the book: “Report From Iron Mountain”, where the Fed’s got a think tank to determine what would happen to a “Free” Industrial Democratic Capitalist Economy without war. What would we do with production, workers, excess capacity? War consumes all this. War is Good.

      Their conclusion was that we would have to waste money on something else….and that something else was…..Health Care.

  24. JayTe says:

    Dear All, The lies about healthcare are so large so monstrous that it boggles the mind. First let me start by pointing out that most people’s concept of healthcare is flawed. For the overwhelming majority of the population, healthcare is assumed to be the market related to you taking tar derived petrochemicals or undergoing surgical procedures for diseases or accidents. This concept has come about because of constant programming of the population that this is what healthcare has always been and it is further reinforced by medical schools (all paid for by the pharmaceutical companies) in the training of doctors. But that concept is flawed because first of all there are only two sources of diseases that have been known by every person who has actually looked honestly into the topic: nutritional deficiencies and toxic exposures (excluding accidents). This implies that most if not all of these diseases can be reversed by addressing these issues. I’m not going to make a judgement as to what form of medicine is superior but what I will say is that if we actually had real competition across all the different forms of medicine and oblige makers of health remedies to assume liability from the products that they sell by getting liability insurance rather than being protected by regulatory agencies from the damage that they cause to health, prices would drop and the quality of healthcare would improve drastically from the disaster that exists in conventional medicine by what is shown here (http://pharmadeathclock.com/).

  25. Dave W - CPA says:

    Wolf: If the new administration is able to reduce healthcare costs [and reduce GDP in that sector], wouldn’t that put more money in peoples’ pockets that they would spend or save and thus increase GDP in other sectors?

    • Wolf Richter says:

      Overall, over time, that would be a great thing for the economy. But it won’t be instant.

      And since a good part of healthcare spending is borrowed (government, corp, and plenty of individuals), not all the money saved might flow back into the economy. It might just not increase their debts, also a good thing. And cracking down on price fixing, patent abuses, lack of competition, etc. at a minimum, would be great. But some sectors in the economy, including commercial real estate and much of the healthcare sector, including hospital bonds and their investors (!), would take a big hit.

      So yes, I think it’s time we did something about it, but given the amount of money involved, I don’t think anyone in Washington will have any appetite to get it done.

  26. Dr Truth says:

    A couple facts to add to the discussion:

    1) One root problem is that we have far too few physicians; supply and demand. In the 1960s and 70s, physicians were concerned “a doctor glut’ might develop. As a result, US med schools held their class sizes constant, graduating 16k new MDs per year, from 1980 to 2006. This while America’s population grew by 50%. Fully half of residencies are currently filled by graduates of foreign medical schools. These are residencies, BTW, which cost the taxpayer an average of $650K per resident, paid out of your Medicare premiums. Again, supply and demand. Want to know why healthcare costs are out of control; there’s one of the root answer.

    We have changed the situation slightly, since 2006, and American med schools graduated 18.5K new MDs in 2105, up from 16k in 2005 through 1980. These figures can be verified by Googling “number of med school graduates’.

    2) Medicare pays MORE, not less, than the private insurers, for most procedures and medical devices. Yes, this is contrary to the oft-repeated lie where a physician exclaims he will go broke if he has to see Medicare patients. Medicare is finally getting around to changing this. In 2016, CMS (the govt agency that runs Medicare) is requiring labs that do tests for doctor’s offices (e.g. analyze patient blood samples) to report the fees that private insurers pay for these tests, so that Medicare can lower their rates to that of the private insurers. Again, you can Google this for proof. This would be funny if it weren’t so sad, but Medicare is actually phasing their decrease in fees over 5 years, because the labs complained they would otherwise go out of business. This is for the exact same tests. Because I am required to put an email on this post, I cannot reveal anything about what fees private insurers pay me for clinical services. That is considered price fixing. But I strongly suspect you will find, if you do some research, that private insurers typically pay around 1/3rd less.

    • economicminor says:

      Add to that the problems with the returning vets.. The entire psychology field was decimated after Reagan closed all the mental health facilities and now when we have all these damaged vets needing treatment, there are none to hire.

  27. John Hunt, MD says:

    The definition of GDP is evidently flawed. Or at least our reliance upon it as a summation of economic health is flawed. Digging holes and filling them back in decreases unemployment and increases GDP, but is pointless and wastes valuable human lives accomplishing nothing.

    The problem with our medical system has always been too much health insurance. Too much third party payment. Too much moral hazard. Insufficient individual responsibility. Prices rise when third parties pay. He solution is to get government out of the way, stop subisidizing health insurance. Stop letting government serve as big pharma’s tool to eliminate its competition. Stop the government from treating adult moral agents like children. We are adults. Get out of our way.

    • economicminor says:

      I certainly agree with you that the current definition of GDP is flawed. It is more likely just plainly fraudulent.

      On the revitalization of our medical system by privatizing the system isn’t a good idea. To many have been marginalized and left behind by financialization which includes globalization and selling off their employment to the lowest bidder by Vulture Crony Capitalists funded by TBTF institutions and the FED. Getting government out of health care and leaving each person having to find their own way is elitist. The only fair way to eliminate the third party payments is to reduce insurance companies to secondary insurance only. The way to real in big pharma is to regulate its profits and stop private equity from buying drug lines and raising the prices astronomically for pure selfish interests.

      Under your proposal I see people dying in the streets and the US looking more like a disadvantaged 3rd world country if those with the ability refuse to help those who have been left behind for the last 30+ years. If those in government follow you down the road you envision the USA will cease to be great or good and our experiment will have ended in failure. Privatizing the US will end our empire quickly and would most likely end in violence and catastrophe.

      • John Hunt MD says:

        Putting people back in charge of their own health care is the opposite of elitist. Your notion of having government bear the responsibility is indeed the elitist path. Plus it requires expanded compulsion (force–the opposite of peace). Furthermore government elitism is blatantly destructive as has been proven in most socialist experimentation to date. Letting people decide for themselves is the goal. The rightness or wrongness of their decision should be determined by them, not the elite that currently tries to narcissistically manipulate everything.

        I agree that cronyism is essential to stop. But you cannot have cronyism without government. And the more government you have, the more inviting it is to the cronies. You won’t stop crony parasites by giving more power to government. You have to take the power away from government. Freedom is a remarkable thing. It is the cornerstone of human dignity and honest wealth creation and the proven path to poverty elimination. Taking something as important as health care and relegating it to the hands of government and the sociopaths that control it, is surely not a rational path. It is a path to war and to poverty and to crony empowerment, built upon lies that it will make things equal.

        Ends never justify means. That is an important lesson progressives rarely learn.

        Instead find ways that are moral and voluntary to improve health for all. Find the political force in the system and eviscerate it. Find the idiotic subsidies of bad behavior that enwealthen cronies and eliminate them. Find the malincentives created by government and abolish them.

        And then let freedom ring.

        • economicminor says:

          Except that the elite Crony Capitalistic system has made peons and economic slaves out of the majority of the US population. And your answer is to allow those elite Crony Capitalist to continue to own the drugs supply and health care supply systems and force the majority of the rest to now fend for themselves. And purchase from your system of greed and corruption in order to stay alive. So now those who have can not only keep it but to continue to use their superior positions to play god with other people’s lives. And make these less fortunate scramble to live.

          We have gone to far down this road of Crony Capitalistic accumulation to now say that those who have little or nothing should remain that way. It isn’t about self determination any longer because the education system is totally broken for the poor. It isn’t about personal ethics or personal responsibility for the disadvantaged alone because the people you want to throw under the bus are still citizens and as such deserve the full protection by the government. We the People! Are still equal under the Constitution no matter what you wish.

          People will not go your way without protest. Down your road will be violence and chaos. How is that going to make your or your children’s lives better?

          You must live in a gated community in a wealthy area where you can remove yourself from the majority of humanity to even think the way you do. Life is already very tough for most Americans and making it worse is not going to make this country Great Again!

        • economicminor says:

          Dr., The utopian world of the Libertarians doesn’t exist, can no longer exist. It might have been a possibility a hundred years ago but since then the world has changed a lot. The population of the world is taxing the ability of this planet to provide even a moderate standard of living for everyone.

          Because of the nature of humans to want to survive and prosper civilization made rules to control the urges to take advantage of each other. Some people though have been lucky. They have had the right set of skills at the right time and place to succeed beyond everyone else. And these people in order to protect the advantages they obtained over others used some of their money to pay others who also had obtained special positions and privileges to change the rules that applied only to themselves.. They have also used their positions to propagandize and try and convince people who weren’t on their level of advantage that the wealth would trickle down if we only kept our heads down and followed the rules they made.

          Thus the eventual rise of the uber rich and what many of us call the elite. They are just people who thru years of networking and self interest have taken over the leadership positions in this country. Yet they are still human and as such have the same problems as others in being selfish and greedy and want to protect and expand their positions.

          Where we are today is that after decades of being lied to and propagandized, we know that that Trickle Down is a lie and so is the FED and so is all this BS about Pulling ourselves up by our boot straps.

          So all your talk about people taking care of themselves and privatizing all the public services is no longer being accepted by the majority. Some do not even know that they understand that lies are lies. They do understand that the current direction of privatization and taking away what we earned as a country is just the continuation of the Power Grabbing by a few that are really no different than those Royal Aholes our forefathers revolted against in the 1770’s.

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