Standard Mischief

I’ve stolen the above title from tgirsch over at Lean Left. That and the statement that both Canada-style and USA-style health care has serious flaws are the only bits worth repeating. I was hoping that he’d also make one of his typical smarmy statements about the “free market”, but alas that was not the case. Truth is that both systems need a IV transfusion of a little free market to break out if their anemic slog.

tgirsch rightly spanks this WSJ article though. Although the author David Gratzer does come out strongly for the USA system, he does fail to note any shortcomings, and he drops the ball when it’s his turn to propose some solutions. Hmmm, maybe if you buy his book you’ll get those answers. (Yup, he’s writing in the WSJ to plug his new book) Hopefully, I’ll be picking up that ball and running with it.

I’m planning on a few posts over the next few days. I’ve had them kicking around in my head for a while, I suppose this quote it what spurred me to get started on them:

tgirsch Says:

[For the record, I don’t support adopting a strictly Canadian-style health care system. Instead, we should survey the top health care systems in the world and selectively pick the best aspects of them to build a world-class health care system for everyone, not just the well-to-do...

Sounds pretty good offhand, however he goes on:

...Unlike Canada, I’d also allow private practitioners to provide pay-out-of-pocket care to those who are willing and able to do so, noting that doing so does not exempt you from paying your share toward the larger system. Think of this like education, where putting your kids in private school, home schooling them, or simply not having any kids are all perfectly legal options, but they do not exempt you from chipping in to pay for the school system.]

Now despite the fact that he’s willing to travel the world to sample the very best ideas in health care, in the very next sentence he’s already got what he thinks is the perfect solution, one which would undoubtedly be the rose-colored glasses he’d view every other solution through. What bothers me most, however, is the knee-jerk assumption that more government regulation and control are what’s needed, not less.

Now I’m not going to claim that our national public school system is utterly broken, because it isn’t [1], but the reason why is because there really isn’t a national public school system. Oh sure there’s the federal boondoggle that is the school lunch program and the No Child Left Behind crap, but by and large the public schools are controlled locally, and funded with largely local funds to boot. This one fact that there’s a lot of control locally Is what I believe prevents public education to be the typical federal bloat-aucracy that I would expect it to be. His analogy breaks down here because I’m assuming his idea is that if you resided in Maryland and were vacationing in Tennessee and for some reason needed emergency care, his idea would be that the local health care system would not turn you away, or charge you cash prices because you were not funding the local emergency care network with your property taxes. That kinda thing does happen every day with our public school system. Every once in a while they catch a congress-critter trying to enroll his/her offspring in Montgomery County Maryland schools, instead of the District of Columbia’s public school system, even though the representative in question resides in the District (that’s because DC’s schools are horribly broken, compared to some of the local suburbs).

A better analogy might be our public retirement system, also called Social Security. Here, everyone pays in to the system according to their income, (except for a certain white religious minority), and everyone dips into the same retirement pool when they are eligible to receive payments. Except that if your income is still too high, you get taxed on those benefits at a higher rate. Except that we’ve let our congress-critters (Republicans and Democrats alike) steal the Social Security trust fund, transferring it by decree into the general fund, and leaving the Social Security Administration with a pocket full of IOUs not worth the paper that they are printed on. Except we’ve allowed ourselves to be saddled with a de facto citizens ID card, originally not intended for identification purposes at all, yet now has transformed itself into an essential ID number, without which one can not function today in society. Except that very same ID number has been used and abused as a way to violate the privacy of citizens by public and private parties for decades.

So now that I’ve trashed tgirsch’s proposed system (and by extension, Canadian style health care, HillaryCare, single-payer health care, socialized medicine, universal health care, and any other related name from the euphemism treadmill for the same socialist crap), where are my solutions? Well for that, you’ll have to wait until my next few blog posts. To preview, the problem with US style health care is that there’s little incentive to control costs. More on this later.

[1] I will interject here that I’m a strong advocate of vouchers, and abolishing public schools altogether, letting the private schools compete with each other and cater to the educational wishes of their customers.

Yep, is seems to be true, Jacqueline Mackie Paisley Passey seems to have cut way back on the blogging. Seems that the dreaded “Real Life” syndrome (in this case a new job) has intruded on to the scene.

Although the quantity and quality of posts seemed to be declining, I suppose the comment discussion is what really kept me there. Still, I’d probably would have kept her blog in the “guilty pleasures” category regardless.

The part that ticks me off most is that she never blogged about her Health Savings Account (HSA) with a medical High Deductible Health Insurance plan that she had since post-college and probably right up to her new employment opportunity, if not held currently (I understand that her employers are libertarian leaning). She did, however, have quite a few posts about paying cash for excellent care in third world countries.

‘Tis a shame because I could use the ammo against those who want some kind of state run health care, or who confuse the Health Savings Accounts with the use-it-or-lose-it Medical Savings Accounts everyone is more familiar with.

Thankfully, in a post that had gone wildly off-topic, tgirsch doesn’t want to mandate that you participate, only that you are forced into supporting some sort of public health care boondoggle.

We’re veering off-topic now, but I wouldn’t support a Canadian-style Universal Health Care system where all services must be obtained from government providers. I would instead prefer a system where everyone is welcome to use (and, through taxation, help pay for) those providers and services, but could elect to go to a private practice at their own expense. Doing so would not exempt you from helping to pay for the government-run system, any more than sending your kid to private school (or not having kids at all) exempts you from helping to pay for the school system.

Yup, he want a system analogous to our *cough cough* World Famous Public School System. He might as well compare it to Social Security, where everyone (except one white religious minority) is forced to pay into a system that has had its operating surplus funneled right into the nation’s general fund while only having a pocket full of IOUs to show for it.

Oh and for the threat to privacy angle that appears after you have been taxed to the level that forces you into the public health care system?

Regarding personal records, you do what we do now with IRS records and the like: you prosecute the holy hell out of anybody who abuses access to that information. In any case, as Ted implies, your personal medical records are probably already in far more nefarious hands than those of the government.

I’m sorry, but please remind me who is now in jail for when the FBI overstepped their authority in using the perpetual patriot act? How ’bout the AT&T internet peering? When they pass laws like that mandating privacy, they frequently “forget” to add any penalties for breaking the laws, or if they do they ignore them. This is in stark contrast to the usual helmet or seatbelt laws chock full of fines and points.

Left on another blog, about a year ago by myself, after being ripped to shreds about my inexact, but apparently good enough grasp of the Canadian health care system:

…I can only guess that those who would support any kind of government controlled healthcare either think that medical privacy no longer matters, or that the moment we get socialized medicine in the USA, the horns will blow in the heavens; the United States will instantly turn into one of those enlightened European countries, except that it’s really freaking big, and has slightly less cool architecture; oh, and all the “fundies” will melt away like the Wicked Witch of the West.

Am I missing a third option? Please, do tell.

The response to that, oddly enough, was crickets chirping.

Yea, I’ll have to blog about this a bit more.

In what quite possibly may end up being my mantra, I’ll ask again. If Free Trade is good, isn’t it good for everyone, or is it only good when it directly benefits Corporations, LLC, and other types of corporate personhood thingys?

A few days ago, on May 8, the US Senate voted to add a “poison pill” amendment to a bill that would allow importation of drugs sold in other countries.

On a 49-40 vote, the Senate required the federal government to certify the safety and effectiveness of drugs before they can be imported, a requirement that health officials have said they cannot meet.

That’s a link to a story pulled off the AP. Unfortunately, they fail to explain further why the federal government can’t or won’t certify overseas drugs. The AP also fails because they don’t cite the name or bill number of the legislation.

My best guess is that it was S. 251, which - just for the record - comes in at a short 6,045 words.

If this is the proper bill, however, it does not have the text of the poison pill amendment. It’s been four days, Thomas.loc.gov is lagging.

The cited concerns, “safety” and “counterfeit” are pure FUD. I’m having a hard time understanding how the exact same drugs, frequently from the very same manufacturing facility, are somehow tainted just because the were packaged differently and then sold overseas. Are not the drugs available in “Australia, Canada, Israel, Japan, New Zealand, Switzerland, South Africa, Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxemburg, Netherlands, Portugal, Spain, Sweden, the United Kingdom, Iceland, Liechtenstein, and Norway” safe and effecitve? Or is someone making the case that the rest of the world is getting scree swept up from the floor of the manufacturing facilities? Also, seeing as we already have a problem with counterfeit drugs in this county, cheaper prices perhaps would remove some of the incentive to counterfeit drugs because that would be less profit to be made. It seems that simple countermeasures such as verifiable lot numbers should be able to take care of the problem. Pfizer is also implementing color-shifting logos as an additional countermeasure.

No, this amendment is just about allowing big pharma to be able to sell drugs at one price in one market and another price in a different market. It uses the resources of our government to protect the current business model.

Firmly entrenched as the most evil corporation in America, and leveraging on their enormous buying power, Wal-Mart plans to sell almost 300 generic drugs at the price point of $4 per prescription for up to a 30-day supply. That price will apply even when the patient’s co-pay is larger than that, and it will also apply to people without insurance.

The Wa-Po is reporting that the pricing plan starts first in Tampa, Florida, and will move to most of the rest of the country by 2007.

Unfortunately, the Wa-Po fails in it’s news-bringing mission because they don’t link to the formulary, which was undoubtedly included in the press kit. However, I’m pleased to tell you that they have included a flash video of the Wal-mart spokesperson in their news article. There’s even a unrelated commercial spot that you have to watch first. Update: It might be here without the ad. (either it’s taking forever to load, or it’s not playing nice with my OS)

Without a formulary, it’s impossible to see if Wal-mart is doing the real deal, or just blowing hot air. It’s also difficult to get you doctor to prescribe medications on the list if the list is a big mystery. Still, this could be a major coup in the “walmart=evil” PR battlefront.

I’ve always said that the problem with the way we do medicine in this country is that it does absolutely nothing to encourage providers to compete on prices. Just think about it, if your copay is $15 for prescriptions you are not likely to price shop around for the best deal, you just get it filled where it’s most convenient. When I called around to get the price on off-label Plan-B using generic birth control pills, one clerk was confused, and actually asked to be sure I wanted the cash price, and not my co-pay. Obviously no one price shops for prescriptions. Let’s hope this changes that .

BTW, I mostly like Wal-Mart, but I’m unhappy with them when they use their corporate personhood to get themselves kickbacks on their tax rates, or they get local zoning boards to abuse Eminent Domain laws in order to locate their stores instead of paying a fair market price.

Update: I found the formulary on www.walmartfacts.com, at the bottom, as a PDF. At first glance, it seems pretty complete, but then again, I am not a doctor. I see several strengths of the same drugs, so it?s probably best if you print the list and discuss your options with your health care provider. I could see an advantage to getting a thirty day supply and using a pill splitter to save money. Not every pill can be split, so ask or check a PDR first. Some of the prescription drugs, like Ranitdine, or Ibuprofen are available OTC at a lower strength, and might be cheaper that way. There?s also no type of birth control pill. Although they list several strengths of say Doxycycline Hyclate, they don?t really state how many pills or capsules one gets for a 30 day supply. Doxycycline is commonly given twice a day, so you would need 60 pills for a 30 day supply, except that antibiotics are rarely prescribed for more that say 14 days, so I?m unclear to what you would get for your $4.

Update 2: It looks like Target is already matching prices, but of course only right now in the Tampa area near the first discounting Wal-Marts. Wow, this free market stuff really works.

Update 3: @5:15pm I fixed the link to www.walmartfacts.com, also a closer reading of the press release netted the phrase “$4 per prescription for up to a 30-day supply” While they do have a formulary listed, they don?t clearly indicate the quantity available at the $4 price level.

A few weeks ago, I started making a conscious effort to keep Tartrazine out of my diet.

Tartrazine is also called FD&C yellow dye #5. Although it’s certified as safe, this ingredient is probably the coal tar dye that people most commonly have allergic reactions to. Also, some people seem to link this junk to hyperactivity in kids. I don’t think it has that effect on me, but it does seem to do something. No double-blind studies on my part, but I can tell. Coca-Corosive does not sing the same song to my neurons.

I probably haven’t totally eliminated it from my diet, but I think it’s having some kind of effect. For instance, I’ve heard that there’s large amounts of tartrazine in chicken feed, the purpose of which is so egg yokes have that nice yellow color. I haven’t cut out eggs, but I also haven’t felt the need to spontaneously research exactly how much tartrazine ends up insides your average egg, as a massive google quest, at three AM in the morning. That’s something that might have happened a few weeks ago.

Anyway, what’s it like to cut out one’s favorite liquid smack? What’s it feel like to deny yourself the breakfast of champions? No real cravings of course, but, well, you like feeling smart, right? Withdraw is like this: you know you’ve got some kind of thoughts going on up there in your head, but there’s a thick layer of sludge keeping any coherent thoughts from sticking together without a huge amount of effort. That sludgy feeling does subside after a few days, but plain caffeine doesn’t do the same thing for me in the morning.

Obligatory Wikipedia Link: Tartrazine

Related Tags: Tartrazine, FD&C yellow dye #5, FD&C yellow 5, Yellow dye #5