Mittwoch, Februar 23, 2011

Menetekel and Reality Intruding...

First of all, sorry for the long absence: reality has been intruding for some time now. Way too much to juggle for the time being.

However, this reminded me of what is going on in the background.

Simply put, the core principle driving ObamaCare - and how the Democrats are hating having it called that now - is the reorganization of the entire medical profession: the destruction, as it were, of the American Doctor.

Even if it were to be repealed tomorrow - and de-funding is a good first step - it has already started a negative trend, one that is deliberate and, even worse, aimed at doctors based on a faulty understanding of why medical costs are so high.

In the liberal mind set, costs are so high because medical doctors charge so much, earning enormous amounts of money based on their monopoly position as primary health care givers. The vast majority are private and you can't effectively put limits on what they can earn.

So what you do is force the doctors out of their private practices and into collectives of one form or another:

Six years ago, doctors owned more than two-thirds of U.S. medical practices, according to the Medical Group Management Association. By next year, nearly two-thirds will be salaried employees of larger institutions.

This is astonishing: there are fewer and fewer traditional medical doctors out there with their private practices. For the Democrats: goal achieved.

Why is this important?

Because once medical doctors lose their autarky, their independence, they became just one more salaried profession.

Under the faulty Democrat (sorry, I repeat myself) understanding of why medical costs are so high, they have forced medical doctors out of independence into collectivized institutions of one kind or another, which will then be controlled by ObamaCare.

Why is this a faulty understanding?

For two reasons, the second one the more important one.

First, medical doctors in private practice may appear to be earning quite a bit of money, but in reality they are also employers and have to carry their own malpractice insurance as part of being in business. Once that is deducted - plus rent for their offices and bills for their equipment, as well as salaries - things look slightly different for medical doctors' actual real take-home after costs and taxes. They continue to earn well, but it's nothing near what they took in overall.

The real reason why this line of thought is faulty is that the real problem is medical liability and malpractice insurance costs: these are what is driving up health care costs, not merely via the cost of the insurance, but also pushing medical doctors to run tests just in case someone takes them to court.

That is the real problem: this kind of insurance plus the cost of doing due diligence testing (because the cost of not doing the testing is, if you are sued (or even threatened with a lawsuit), is catastrophic and can financially destroy any medical doctor out there.

Now, collectivization of medical doctors may bring some efficiencies, but unless the real cause of increasing medical care costs is addressed, any health care reform is not worth the paper it is written on.

To repeat: ObamaCare is damaging, not merely because it is based on faulty thinking, but because it is already doing damage to the US health care system.

Who benefits?

First and foremost, the insurers who, if they play the game right, can charge more for the insurance they supply. There is no other explanation for the strong support for ObamaCare amongst the insurance companies.

Second, the trial lawyers. Without tort reform, but with collectivization of medical doctors, the pockets of the collective entities of medical doctors becomes automatically deeper and hence more lucrative to sue. What is the worth of bringing a $200mn wrongful injury/malpractice suit against a single doctor, who can never pay that, when they can collectively take 300 doctors to court?

Further, if ObamaCare reaches its logical conclusion, when there are no private medical doctors around any more. The entity of last resort in an injury/malpractice lawsuit is the owner of the company: if ObamaCare sets up the situation, then the payer of last resort will be the US taxpayer, who will then end up feeding the lawyers and accountants (and professional witnesses) through the practically unending deep pockets.

In other words, it is the usual Democrat politics, Liberal thoughts and intentions galore. Misplaced, as usual, and downright destructive if left alone.

Read the writing on the wall: מנא ,מנא, תקל, ופרסין

Daniel 5:25–28: And this is the writing that was inscribed: mina, mina, shekel, half-mina. This is the interpretation of the matter: mina, God has numbered the days of your kingdom and brought it to an end; shekel, you have been weighed on the scales and found wanting; half-mina, your kingdom is divided and given to the Medes and Persians.

The Democrats have numbered the days of the United States and plan to bring it to an end; you will be weighed on the scales and found wanting; your goods will be divided and given away.

That is the writing on the wall: this way lies madness, lies an utterly unsustainable doctrine that must end in thievery and disenfranchisement, all to be sacrificed on the alter of "social justice" and "fairness".

As I've said, reality intrudes on my side of the computer screen and I have been remiss. Suffice to say that things will ease up slightly and you can expect more. Very little of it will be nice and complimentary of recent events.

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