So Tired Of Winning…

Drug companies are freezing prices.

Novartis’s chief executive, Vas Narasimhan, said during an earnings call with investors that the company had made the decision in June, amid escalating outrage over high drug prices. “We thought that was prudent, given the dynamic environment we’re currently in,” he said.

A spokesman for Novartis said the company notified the state of California, which has a new drug-price transparency law, of its decision in June, but the news was not widely known.

Who’d have thunk it?

If You Think Healthcare Is Expensive Now, Wait ‘Til It’s “Free”

Maryland “progressives” – but I repeat myself – are shocked, shocked I tell you, that their proposed single payer healthcare system is going to be ruinously expensive…

…well, no.  That’s too charitable.  If they (or any “progressive” with integrity) would admit to shock, or even concern, I’d be subtly impressed.

No.  Maryland progs just want taxpayers to not think about it too hard:

This morning, the largest newspaper in the state, the Baltimore Sun, reports that Maryland’s Department of Legislative Services calculated that the state would have to levy a 10 percent payroll tax against every business and charge a $2,800 fee for every man, woman, and child in the state to raise the needed $24 billion a year.Kevin Harris, a spokesman for Democratic gubernatorial candidate Ben Jealous says that it’s “premature” to talk about what kind of taxes or fees would be raised to pay for the plan. (When would be a good time, then?)

Don’t read the bill ’til you’ve passed it!

Of course, progressivism is, as always, the triumph of ideology (and vestigial idealism) over experience:

This is pretty much what happened in Vermont. Democrats made the bold promises to voters that they would never have to worry about paying for health care ever again, promised to provide details later, won office, formed their commissions and study groups . . . and then when they actually had to translate their idea into a detailed plan, found themselves stunned by the costs and the tax increases that would be necessary to pay for it all. Maryland’s state government currently spends about $44 billion per year, so they would have to increase the state’s spending by 54 percent to enact Jealous’s plan. Of course, some experts, such as those at the Maryland State Medical Society, think enacting the plan could cost even more.

Of course, single-payer is a key part of the endorsed DFL gubernatorial candidates plans in this election cycle.  Vermont and Maryland’s experiences will be carefully excised in any discussions here in Minnesota.

I’m From The Government And I’m Here To Help

Joe Doakes from Como Park emails:

We changed the formula for Oxycontin to prevent addicts using it.  So they switched to heroin.  Now they’re dying in droves, which means the problem is solving itself.  I’m having trouble seeing the problem.

Joe Doakes

Enh, not if it’s one of my relatives.

But it never fails amaze me that government never, ever figures out the whole “unintended consequenes” thing.

So Very Very Weird

First, the Trump administration slashed the Obamacare advertising budget by nearly 90 percent.

Obamacare advocates predicted disaster.

Then, the Trump administration cut the open enrolllment from three months down to six weeks – right around half.

Obamacare advocates predicted disaster.

The result? With less time, less money and less churn, Obamacare signed up…

… the same number of people as last year.

Why, it’s almost as if people will seek out freebies without the aid of bureaucrats, or pictures of Pajama Boy urging them to talk healthcare with their relatives over the holidays.

Crazy as that may sound.

Results

Joe Doakes from Como Park emails:

Canada has national health care, guaranteed free to all citizens.  Free that is, if you can get any.

Canada has so few MRI machines that patients go on a waiting list.  90% of patients get their scans within 9 months, the rest take longer.  If you only had six months to live, you wouldn’t find out in time to worry about it – you’d die waiting for a diagnosis.

But if you could get treatment, it would be free.  So that’s way better than our system in the US, right?  We should change to their system at once, right?

Joe Doakes

I’ve noticed – and I’ll put this in the form of a progressive blog comments – that “proponents of single payer healthcare conveniently omit the terrible outcomes that people get in the UK and Canada”.

Sell At A Loss: Make Up For It With Volume

Joe Doakes from Como Park emails:

Venezuela has national health care, guaranteed free to all citizens.  Free that is, if you can get any.  The hospitals have no medicine, no money, no beds available.

But if you could get treatment, it would be free.  So that’s way better than our system in the US, right?  We should change to their system at once, right?

Joe Doakes

Give ’em time.

What Could The Explanation Be?

A friend of this blog, who works in the healthcare industry, emails:

Per this study, stroke death rate began to increase from 2013. Mostly Hispanics and Black Americans. Article concludes that these people are just adopting an unhealthy lifestyle, though I think it is possible that unhealthy lifestyle was around for a longer period of time. Could implementation of Affordable Healthcare Act have played a role? Of course no mention of that in this CDC study.

The odds that suddenly black and Latino stroke rates coincindentally started spiking right after the ACA passed seems…self-indulgent.

Princess Pander

It’s almost a year until the convention, but Saint Paul DFL gubernatorial candidate Erin Murphy’s campaign is already doomed.

Rep. Erin Murphy, doomed gubernatorial candidate

Perhaps with that in mind, she’s swinging for the (Metrocrat) fences, calling for single payer helathcare:

Murphy criticizes capitalist models of health care, saying that a for-profit model of any part of the health care system is bad for Americans. She tells a story of her dying mother’s struggle to get her insurance company to cover the care she needed for cancer treatments near the end of her life.

“We must guarantee health care for people who are sick, focus on the health of Minnesotans, and control health care costs,” Murphy wrote. “We must make strategic and difficult choices with valuable resources, putting the health of Minnesotans ahead of health insurance profit making.”

Asked how this plan would be paid for, Murphy responded “with golden coins borne down from heaven by unicorns [1]”

[1] Fake but conceptually accurate.

 

Rationed

Joe Doakes from Como Park emails:

Which is the most efficient way to bring down prices: government dictate, or free market?

Warren Buffet seems to be saying government is a more efficient way to bring down prices, therefore America should embrace the single-payer model of health care used in Britain, Canada, Cuba, the Veteran’s Administration, etc.  He is mistaken.  He’s great at reading balance sheets, lousy at political economic theory.

I agree that government-run health care could theoretically control prices.  They’d simply pass a law: nobody can charge more than $1.00 for any medical procedure, device or drug.  There, see?  Prices contained.  Aspirin.  Heart transplant.  Everything’s a dollar.  In theory.

In practice, it won’t work.  People who provide medical services can’t afford to provide them at that price.  Either they stop providing medical services, or they go off-book somehow. Maybe all the doctors move to Mexico where they can charge fair prices.  Maybe all the medical device companies move to Poland where the government welcomes investment and doesn’t try to kill it.  Capital – including human capital – is mobile.

Hillary recognized this problem when she invented Hillarycare in 1992.  Her solution: draft all the doctors and treat them as members of the military.  You want to practice medicine in America?  Then you go where you’re told and do as you’re told.  In the past, you may have been a plastic surgeon making millions in Hollywood; today, you’re a gynecologist on the Pine Ridge Indian Reservation making the same pay as any other Captain in the Army.  Don’t like it?  Turn in your medical license. This is not an incentive for people to study 10 years to become a doctor.

It doesn’t work on the other end, either.  People who desire medical services have no incentive to forego care under a single-payer system.  Got a sniffle?  Run to the doctor, it’s free.  So the lines get longer and longer until patients die waiting for an appointment, which already has happened at the VA.  Or health care committees decide which patients are deserving of medical treatment and which should be denied treatment, which already has happened in Britain.  Or doctors decide which patients should be helped to die and thereby reduce caseloads, which some Dutch doctors already are doing.  The rich can afford to fly to wherever the doctors are, and to pay out of pocket for medical care.  The poor and middle class will be promised free medical care but won’t get it, facing endless waiting lists and rationed care.

“Single-payer” is simply another way of saying “wage-and-price controls.”  They didn’t work when Diocletian tried them and never have worked since.  I confidently predict they won’t work now.

Joe Doakes

They did wonders for the US economy in the seventies.

You remember what a greaet time the seventies were, rigtht?

Howl

Joe Doakes from Como Park emails:

Republicans in Congress are doing their usual job of chickening out from taking effective action, preferring half-assed deck-chair-arranging and cost-can-kicking instead of risking the chance someone might call them names.  Fixing this mess requires understanding how we got into it. 

Before the Great Depression, doctors charged what the patient could afford, overcharging some to give free care to others.  Hospitals charged the patient directly.  In the Roaring 20’s, people could afford good medical care.

 During the Great Depression, people couldn’t afford doctors so they substituted nurses and midwives or went without care.  Private hospitals ran short of money.  FDR spent federal money on medical care as a stop-gap measure.  Hospitals associated with charities or religions provided reduced-fee medical care.

 When World War II loomed, FDR worried that federal contractors would gouge the government so the Office of Price Administration set wage and price controls.  When men rushed to enlist after Pearl Harbor, employers scrambled to fill positions on the now-booming assembly line but were unable to offer higher wages to entice employees.  Employers offered free health insurance to pad the offer and deducted the cost as a business expense.

 After the war, employers couldn’t drop insurance because it would be seen as a pay cut.  But as Baby Boomers aged and needed more expensive care and the economy slumped reducing profits, employers were forced to drop coverage.  The clamor for free health insurance turned to government, resulting in Obamacare. 

 The health insurance problem is just like rent control in New York – it was a temporary war-time something-for-nothing measure that was continued too long and now the addicts are screaming because they won’t get their special war-time subsidies.  They shouldn’t.  The war is over.

 The first step is to end the deduction for employer-paid health care so that more employers drop coverage, and prohibit units of government and unions from paying for health insurance, which will level the playing field as everybody becomes a health insurance consumer, same way everybody is a car insurance consumer.

 The second step is to let states decide what insurance policies are allowed to be sold.  Minnesota coverage will cost a bundle because the legislature will require every policy to cover everything.  That decision will cost us jobs as employees leave to get lower premiums elsewhere.  The laboratory of democracy eventually will find its balance.

 The third step is to means-test Social Security and Medicare.  Seniors who can afford to pay, must pay, or the system goes broke.

 The fourth step is to limit the use of welfare medical care.  People who buy health insurance have deductibles and caps so they don’t run to the doctor for every sniffle.  People who don’t buy insurance should have similar incentives to conserve resources.  Yes, this means some children will suffer and die.  If the entire system collapses, all the children will suffer and die.  We’re trying prevent that.

 The fifth step is to deregulate medicine.  Allow more drugs to be sold without prescription.  Allow non-doctors to prescribe medicine.  Allow medical providers flexibility in meeting standards.  The country doctor who had his office in the front room of his house could handle most of what came in the door, he didn’t need admitting privileges at a Level 1 trauma hospital.  That policy might also mean recruiting more health care professionals from other countries – we’d rather have them than have unskilled laborers climbing The Wall.

 The sixth step is to limit medical malpractice lawsuits to reduce malpractice insurance premiums so doctors can afford to charge patients less.  Doctors make diagnoses by using statistics to play the odds, there always will be mistakes, not every mistake is a lottery ticket.

 I know: Democrats will howl.  The media will howl.  College kids will howl.  Seniors will howl.  Everybody who wants Free Stuff will howl that they’re not getting enough Free Stuff, fast enough.  Doesn’t matter, clean up the mess anyway because (a) it’s the right thing to do and (b) if we don’t, the system will collapse and the howling will be even worse.  Time for Republicans to man up and do the right thing, for a change.

 No, I’m not holding my breath.

 Joe Doakes

Nor should you.  The cult of the government savior is ascendant.

My Obamacare Debate With Nearly Every Democrat

SCENE:  Mitch BERG is cutting brush with a sawzall.   Avery LIBRELLE walks through the alley and catches BERG unawares.

LIBRELLE:  Hey, Merg!

BERG:  Er, hey, Avery.  I’m kinda busy…

LIBRELLE:  The GOP’s Obamacare repeal will throw people off their insurance policies.

BERG:  Nah, that’s what the subsidy and tax cuts and medicaid are for

LIBRELLE:   You won’t lower bills!

BERG:  Well, that’s what the free market is for.

LIBRELLE:   But you’ll throw people off their insurance.

BERG:  Nah, that’s what the subsidy and tax cuts and medicaid are for

LIBRELLE:   You won’t lower bills!

BERG:  Well, that’s what the free market is for.

LIBRELLE:   But you’ll throw people off their insurance.

BERG:  Nah, that’s what the subsidy and tax cuts and medicaid are for

LIBRELLE:   You won’t lower bills!

BERG:  Well, that’s what the free market is for.

LIBRELLE:   But you’ll throw people off their insurance.

BERG:  Nah, that’s what the subsidy and tax cuts and medicaid are for

LIBRELLE:   You won’t lower bills!

BERG:  Well, that’s what the free market is for.

LIBRELLE:   But you’ll throw people off their insurance.

BERG:   You realize you’ve  just repeated the same recursive series of denials three times?

LIBRELLE:  Misogynist!

BERG:   Er, are you a…er…

And SCENE

That Which Can’t Be Sustained, Won’t Be

Joe Doakes from Como Park emails:

Every year for the last 40 years, the United States has run short of money in the budget.  To fill the shortfall, the General Fund borrowed from the Social Security fund, but that still wasn’t enough.  To make ends meet, we borrowed even more.  The total accumulated debt is now $20,000,000,000,000.  That’s twenty trillion, with a T.

 That number does not include the cost of promises the government will be obligated to pay in the future such as Social Security and Medicare, the 20 trillion number is only the total of the promissory notes signed to fund government operations in the past.  Covering the cost of all government promises is closer to 100 trillion, give or take, depending on who you talk to.

 We’re not paying down the debt.  We’re making the minimum monthly payments on existing debt while running up ever more debt, month after month, with no end in sight.

 I don’t care whose fault it is.

 No, I really don’t care whose fault it is.  Finger-pointing and blaming is useless blather, at this point.

 I want to know what we’re going to do about it.

 The reason it comes up is because Republicans in Congress are talking about reforming Obama-care to make it affordable enough that the government can continue to offer the program, but Democrats are screaming the reforms will make the program unaffordable for individual citizens.  Both have fair points.  Both fail to address my point.

 Can government programs run in the red forever?  Can public debt be accumulated forever?  Is there literally no limit to how much debt we can run up?

If so, why?  That’s not true for private individuals or corporations.  If it’s true for government, there must be a reason why it’s true.  What’s the reason?

 Joe Doakes

Let’s ask Paul Krugman.

Symptom Of A Completely Screwed Nation

Wednesday night on national public radio, I listened to Illinois senator Dick “Turban” Durbin respond to President Trump State of the Union address.

Asked about the Democrat response to republican healthcare initiatives – in this case, the proposal to allow people to buy insurance across state lines – his response was:

“Come on. You think people are going to go to a hospital or a doctor in another state?”

And sure enough, you can see Democrats repeating this on social media today.

Do they not see the difference between “health insurance” and “healthcare”?

Faster!

The progressive chattering classes are all in a tizzy because many of Donald Trump’s cabinet nominees are long-time opponents of the departments they’ve been chosen to lead:

  • Rick Perry at Energy – who has advocated disbanding the entire department and reducing a cabinet seat
  • Ben Carson at HUD, who has criticized federal housing
  • Betsy DeVos at Education – a major proponent of school choice and degrading the government monopoly on education
  • Scott Pruitt at the EPA, an agency against whom he’s spent years litigating
  • Andy Puzder at Labor, who would oppose most “progressive” labor regulations
  • Tom Price at HHS, who advocates rolling back Obamacare.

The chattering classes are all aflutter.  Perhaps because most of these departments are nothing but make-work programs for worthless Ivy Leaguer poli sci grads like, well, themselves.

Or perhaps because the American people might just support it:

And that leads us to the really burning question: Will anyone miss those departments if they go away?

We could try to answer that question by diving into the bitterly partisan political and economic debate over the size of government that’s been dividing people in this country since the days of Jefferson and Hamilton. Or we could wisely dump that academic argument and realize that the answer lies in how well the Trump team manages to make sure the changes get noticed by normal voters in a positive way. In politics, perception truly is reality.

And Trump, for all his faults, gets that better than most other Republicans.  For worse or, when it comes to slashing the size and power of the Federal Government ,much much better.

The Strib: Lowering Their Own Bar?

The Strib “reported”, after a fashion, about attitudes about Obamacare after an election where it was primarily responsible for ejecting the DFL from power in the Minnesota Senate.

DFLMinistryofTruthLARGE

And it’s either a masterpiece of selective fact, or some fairly incurious reporting:

Anxiety is greatest among Minnesotans with preexisting medical conditions. Before the ACA, insurance companies could simply deny them coverage.

Which is technically true.

After which, in Minnesota at least, they would get insurance from one of the state-subsizied high risk plans.

Before MNSure, 92% of Minnesotans were insured, via the private market, a public plan, or some combination.   It was the highest share in the nation.   Of the 8% who didn’t have insurance, the vast majority were people who didn’t want insurance – mostly young, mostly healthy.  There were exceptions – but they were few, rare, and mostly the product of poor information and a pre-Obama media who were actively pitching the “47 million uninsured Americans…” narrative.

Today, the state says half as many Minnesotans are uninsured – but networks have shrunk (in vast swathes of Minnesota, only one plan is available), premiums have skyrocketed for individual members (like me!),  people could not keep their doctor (The Lightworker’s promises notwithstanding…)

So why is the Strib story – a “Team Report” by Jeremy Olson, Christopher Snowbeck and Glenn Howatt, no less – either so slanted or uninformed?

To borrow a Glenn Reynolds phrase – if you treat them as DFL operatives with bylines, it all makes sense.

Starting Off With A Bang

As the nation – or at least the nation’s chattering classes – continue to rend their garments over Democracy giving them the leader they deserved, and with about 66 days until Donald Trump takes office, let’s take a break from the Peltschmertz and start talking policy.

Donald Trump proposed a healthcare plan.  It’s on his website.

And…it’s good.  Really good.  To paraphrase Joe Biden, it’s a big freaking deal, if he follows through on it:

  1. Repeal Obamacare. “Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to,” the plan says.
  2. Repeal the McCarran-Ferguson Act, and allow the sale of insurance across state lines. “By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up,” it says.
  3. Allow tax payers to fully deduct health insurance premium payments in their tax returns, as businesses can. The plan asks: “Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions?”
  4. Review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it.
  5. Allow all individuals to use Health Savings Accounts (HSAs), and make those contributions tax-free and allow them to accumulate year after year. Make them part of an individual’s estate, able to be passed on to heirs without fear of any death penalty.
  6. Require price transparency from all healthcare providers, including clinics and hospitals.
  7. Block-grant Medicaid to the states. Incentivize the states to seek out and eliminate fraud, waste and abuse to preserve government resources.
  8. Remove barriers to entry into free markets for drug providers that offer safe, generic options. “Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service,” the plan says.

Speaking as a newly self-employed person for whom 3 and 5 alone would be financial lifesavers, I’ll say right now that if passing this plan is the only thing he accomplishes domestically in his first term, it’ll be a successful term indeed.

Some of these – especially “Repealing Obamacare” – are going to be difficult.  I personally authorize air strikes.

Eurasia Has Always Been At War With Eastasia

The Minnesota DFL is sending out mailers…:

14570281_10154072325051194_5375400904606317268_n

…blaming the GOP – not one of whose elected representatives voted for Obamacare – for Obamacare.

Two observations:

  1. So there’s your admission; the Democrats are officially admitting Obamacare and its children are worthless political turds
  2. Who would the Democrat be trying to reach with this piece?  The stupid, the incurious, the entitled, sufferers from Urban Liberal Privilege, the stupid…yes, I said it twice, but there would seem to be that many.

Pass it around.

About Those Death Panels

As we’ve noted in this space in the past – while no health insurance provider has a room with the words “Death Panel” on an embossed brass plate on the door, the notion of allocation of services, including life-saving ones, to make sure scarce supplies of life-extending medicine and treatment go to the people who’ll gain the most usable lifespan, has been around for a long time.  It’s an integral part of the HMO business model.

In other words, if they’ve got one liver available, and one person on the transplant list is a 32 year old marathon-running woman who’s never smoked, and one is a 62 year old diabetic smoker, you can guess who’s going to get the liver, and who’s going on “palliative care” right?

And while that decision may not be made by people whose job title says “Death Panelist”, if you’re the 62 year old diabetic, it’s all tomayto tomahto, right?

Anyway – to those who thought calling the above the equivalent of a “death panel’ was overreach, I present this:

About one-year ago, Gov. Jerry Brown signed the state’s assisted-suicide bill into law. It fully went into effect this June, with the opening of the first clinic. While there is no data on the number of California assisted-suicides, Oregon recorded over 130 last year as part of their legalized physician-assisted death program.

Now, one young mother says her insurance company denied her coverage for chemotherapy treatment after originally agreeing to provide the fiscal support for it, but indicated it would be willing to pay for assisted suicide instead.

No, it’s not just one woman:

Packer attends meetings with others suffering from terminal illnesses. She indicates that the tone of those meetings have changed since the California assisted-suicide law was enacted.

“As soon as this law was passed – and you see it everywhere, when these laws are passed – patients fighting for a longer life end up getting denied treatment, because this will always be the cheapest option.”

Packer attends a support group for terminally ill patients. She said legally sanctioned suicide has changed the tone of the meetings, which used to be “positive and encouraging.” With patients under new societal pressure to kill themselves, she said meetings “became negative, and it started consuming people. And then they said, ‘You know what? I wish I could just end it.’”

There’s a website for patients concerned that insurance companies under price pressure  are trying to strongarm them into killing themeselves.

Yep.  It’s come to this.

So – you can’t keep your doctor, or the plan you like, your prices are going to rise, and if your life is inconveniently expensive for your insurer, it will try to kill you.

Thanks, Obama.

You Can Keep Your Doctor, Provided Your Doctor Is A Unicorn

Obamacare’s state exchanges are melting down – some faster than others, none faster at the moment than Tennessee:

Seventy-three out of Tennessee’s 95 counties will have only one insurer on the exchange, meaning no meaningful competition whatsoever. In regions where BlueCross BlueShield is pulling out, there will be two remaining major carriers, Cigna and Humana. The only large metro area with more options will be Chattanooga.

Then there are the premiums. State regulators have already approved the highest annual rise in the nation, a weighted average of nearly 56%, according to data at ACASignups.net. The rate increases authorized in late August include an average of 62% for BlueCross BlueShield, 46% for Cigna and 44% for Humana. The latter two companies could ask to revise their rates upward depending on how many former BlueCross consumers they pick up.

The idea that Obamacare is a conspiracy designed to fail, to leave only “single payer” government healthcare as a viable option, is looking less and less like a conspiracy theory.

Blind Squirrel

Governor Dayton admits Obama care is a flaming goat rodeo.

On its surface, the story is about one of the most left of center governors in America throwing Obamacare under the bus. And that’s all interesting, don’t get me wrong.

But the governor – and depressed it’s been covering for him for six years – is counting on you,or at least the mainstream Minnesota medias audience,forgetting a few things. He overrode the legislatures decision to get out of the Obama care exchanges. Then, he presided over one of the two or three most botched attempts to build an exchange. MNSure’s gestation was protracted, obscenely costly, and a technical nightmare. And for all that, the products that delivers – with soaring prices, ballooning deductibles and lower availability and choice – are worse.

The media coverage of the governors admission that the Minnesota state exchange, and Obamacare itself, has worked out very badly, tends to portray the governor as a kindly but well meeting fellowadmitting that his ministration’s signature product has had some teething problems.

It’s much, much worse than that.

Before Obamacare and MNSure, Minnesota had the best level of health insurance in the United States; between public and private plans, 92% of the states population was covered..

Proponents of the state/federal plans claim that number is up to 96%, today.  And that maybe true – but more and more people are hanging onto that insurance – policies much bigger than they need, with higher premiums, and deductibles that in many cases will bankrupt families  (What, you could pay her $12,000 a year deductible, along with 20% coinsurance?)

And people wonder why the media obsesses about things Donald Trump said on the TV 11 years ago…

This Is DFL Government

You, the DFL voter, wanted a government-managed healthcare market?  You got it!

And we’re all paying for it!

Health insurers are hiking premiums and limiting enrollment in Minnesota’s individual market next year, with regulators saying the emergency measures were needed to avert a market collapse.

The moves are a clear sign that the market for some 250,000 people who buy coverage for themselves is dysfunctional and needs reform, said Commerce Commissioner Mike Rothman during a Friday news conference.

While rate increases of more than 50 percent aren’t fair to consumers, Rothman said, things could have been worse. He described a period this summer when all health insurers in the state seemed prepared to abandon that segment of the market.

Elections have consequences; as former New York mayor Ed Koch put it, “the voters have spoken, and now they must accept the consequences”.

It’d be nice if those consequences didn’t botch up everyone else’s life.

You Were Warned: MNA Edition

A friend of the blog writes in re a piece on the ongoing Allina nurses strike:

[Saint Paul City Councilman] Chris Tolbert said, “If a nurse in the health care industry can’t get quality health care from a health care company, we’re all in trouble.”

Well, that is what we Republicans said when the ACA was first signed into law.

History has such an ineluctable symmetry, sometimes….

Rationing

Joe Doakes from Como Park emails:

Doctors are like walleyes: everybody wants one but there aren’t enough to go around, so we must ration them.

 Walleyes are rationed by license.  Medical care traditionally has been rationed by price.  But when the government pays, there is no price, so now Britain is rationing by morality.

 It should be obvious that obese people have more medical needs than fit people, and smokers more medical needs than non-smokers.  The new rationing cannot be medically based on need; instead, it must be morally based on reward.  The unspoken rational is that fat people and smokers are lazy and  stupid so they don’t deserve medical care.

 Before you start nodding, consider that when Hillary is elected, she might change it to “Conservatives are stupid and don’t deserve medical care.”

 If we shift to a political basis for deciding who lives and who dies . . . .

 Joe Doakes

Power is always a temptation.

“You Can Keep Your Doctor” Update

Next year, if all proceeds as expected,  one out of six Americans will have exactly one option in their Obamacare exchange:

According to an analysis done for The Upshot by the McKinsey Center for U.S. Health System Reform, 17 percent of Americans eligible for an Affordable Care Act plan may have only one insurer to choose next year. The analysis shows that there are five entire states currently set to have one insurer, although our map also includes two more states because the plans for more carriers are not final. By comparison, only 2 percent of eligible customers last year had only one choice.

The conspiracy theory that Obamacare was intentionally designed to wreck the system to make single-payer inevitable looks less and less far-fetched every day.