I have a good friend of mine –
nice fella, well meaning…and conservative.
Like many conservative-minded folks, he gets a lot of his news from
conservatively-oriented media. No crime
in that – it’s a free country.
Most of us take what we hear on TV and Talk Radio as the God-Honest
truth. We never stop to check the facts.
Or, more importantly, the completeness of the facts we are presented with..
We're all guilty of this. We've been trained to accept whatever we hear from an authoritative source as being the 'Whole Truth'.
The funny thing about facts is
that, if you pick and choose them carefully, they can tell whatever story you
want them to tell. Our favorite media celebrities use this to create sensationalist news stories to keep their ratings up. News, for the most part, is boring. Greed, corruption, blood and gore are what gets us to tune in.
So it cam as no surprise when, during a
recent conversation, my friend recanted some alarming facts about Obamacare that he heard on the radio.
“So you think that Obamacare is
going to be a bargain?” He blurted, “ I just heard that a plan for a family of
five will cost over $20,000 in 2015!”
He was right to be shocked - that's a ridiculous chunk of income right there. Plus, it doesn't include the costs of deductibles, copays, and non-covered services. Under Obamacare, we're going to be paying an extraordinary amount of money for our health care.
The $20,000 figure is not made up - it's actually a figure presented by the IRS.
But, as shocking of a figure as it is, it just doesn't accurately
reflect reality.
My buddy, like most of you, gets
his health insurance through his employer. Like co-pays, this has insulated him from what things actually cost in the world of healthcare. Like most of us, he was blissfully unaware of what health
insurance actually costs in this country. So I filled
him in.
My current health insurance bill
(for my wife and myself - a family of
two) runs me a healthy $28,000.00 a year.
Plus, my carrier raised my premiums 30-40% a year over the last few
years.
So if they raise me once more at this rate (before Obama plan to limit health insurance rate increases kicks in), I
would be paying (for two people-not five) at least $37,000 a year in 2015.
So if Obama wants to sell me
health insurance for $20,000 in 2015, all I can say is “Where do I sign up?”.
Because, unlike the current
system, Obamacare is something that the average American might actually be able
to afford.
And, like Paul Harvey used to
say, that’s the rest of the story.
Yes, I know that this isn't what
the Obamacare bashers on your favorite conservative talk show wanted you to hear.
Sorry about that.
Reality Bites.
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Remember the days of playground fights? When someone supposedly said something about someone else, sides are picked, and a rumble of sorts erupts with a lot of pushing and shoving. Nothing too serious – I’m talking about 3rd graders here, long before post-pubescent muscles increased the chance of anyone actually getting hurt.
I’ll admit that I was a bit of a chicken back then – elementary school politics never truly concerned me, at least not enough to risk bodily harm. However, not lending a helping hand was socially disastrous, as no one wanted to be labeled a chicken. So, I developed a simple strategy – when the fight broke out, pick on the little guy. This was the easiest way to save face and come out unscathed.
Today, I look back at that strategy, and I feel a bit embarrassed. Picking on the little guy - what a despicable and cowardly thing to do. Oh well, I was only 8 – what did I know.
What I didn’t realize back then was that this is a very sound and popular business strategy, especially if you are in the health insurance business.
I was pleased when President Obama was critical of Anthem Blue Cross when they recently posted record profits, handed out huge bonuses, and simultaneously raised rates for small and individual plan subscribers by as much as 39%. This new pricing will effect as many as 1 million of their subscribers. I wonder gow many of them will end up losing their health insurance because of this rate change.
It would be another matter entirely if Anthem Blue Cross had to raise rates in order to stay solvent, and did so across the board. This wasn’t the case. I am also sure that many Anthem Blue Cross individual policyholders will threaten to leave them because of this rate change. Which brings to mind one of my favorite Abbott and Costello routines:
Costello: "I'd rather marry a homely girl than a pretty girl anyway,"
Abbott: "Why?"
Costello: "Well, if you marry a pretty girl, she is liable to run away."
Abbott: “Isn't a homely girl liable to run away too?"
Costello: "Yeah, but who cares?"
Yes, I know, not very politically correct, but trust me, it was very funny in the days before Gloria Steinem.
The point is, Anthem Blue Cross doesn’t care if an individual subscriber leaves. Besides, even if they do leave, chances are they won’t be able to get affordable coverage elsewhere, especially if they have a pre-existing condition.
All that Anthem Blue Cross (or any other health insurance carrier for that matter) cares about is losing the large groups, of 50,000 or more subscribers. A loss like that would severely affect their bottom line. “So you want to take your overpriced individual plan elsewhere? Don’t let the door hit you where the good lord split you on the way out.”
But if you were the administrator of a large group, well, that’s a different story. They’ll wine you and dine you, and cut your rates to the bone to keep your business. We’ll just make up the difference by overcharging the little guy. There is no actuarial reason for doing this – you don’t have higher medical expenses if you work for yourself as opposed to working for GE. They charge the little guy a higher rate for a very simple reason – they can.
I know that this is just business, but it doesn’t help the policyholder whose health insurance now costs more then his mortgage.
Fortunately, there are 2 simple solutions to this problem, one that has the government tell the carriers what they can’t do, and one that tells subscribers what they can do.
The first solution is having the federal government pass a law that all health insurance carriers must have the same rates for all subscribers across the board – no loopholes allowed. This involves ‘big government’, and I can see the tongues wagging about this on Fox News for months on end. Besides, I don’t think they would ever get this through Congress. So this is not the best solution.
The second solution is to allow individuals to form groups so that they can purchase their insurance in bulk like the other big groups. New Jersey has a small business group called NJBIA that does just this for auto insurance, and the rate differences are outstanding. The problem is, PAY CLOSE ATTENTION, there is a federal law that prohibits groups doing this for health insurance! I wonder who passed that law? I also wonder what corporations contributed heavily to their campaign funds? Want to take a guess?
As an adjunct to either plan, the federal government should allow people to purchase health insurance from any health insurance carrier they want. So, if I want to purchase a policy from Horizon Blue Cross in NJ or Anthem Blue Cross in California, I can choose the carrier that has the best rates and coverage. The problem now is, PAY CLOSE ATTENTION AGAIN, there is a federal law that prohibits you doing this for health insurance.
It seems to me that the second plan would be easy to pass Congress and implement, especially if there was a grass roots effort to make people aware of how unjust the existing laws are. Oh, to be sure, the Spin Doctors will be hard at work coming up with reasons why we shouldn’t allow these two laws to be changed, but please don’t believe a word they tell you. This plan promotes business and competition, and eliminates a de facto monopoly that many carriers now enjoy on our health insurance dollar. Monopolies are illegal, right?
When little guys gang up, they become a formidable foe. The health insurance carriers would learn that, sometimes when you pick on the little guy, it turns out that his name is Lee…first name Bruce. By making these simple changes, the government can make drastic inroads to making health insurance affordable for everyone.
After having time to digest the whole Fast Buck Freddie incident, I have one burning question left unanswered . Who was Freddie trying to scam?
Yeah, I know he was trying to scam me, but, who did he think I was? Did he actually think that I was capable of falling for his brand of Bull? Does he really think that there are people who lack the modicum of intelligence needed to see through his scam? Do such people actually exist outside of an institution?
I cannot, for the life of me, imagine that there are people alive on this planet who have the minimal skills needed to type an email or post an advertisement who are, nonetheless, stupid enough to fall for Freddie’s scheme. And yet, I know that, since he and his countrymen are actively pursuing these rip off schemes, that there MUST be some people out there who actually fall for this nonsense and lose their hard-earned money. Otherwise, obviously, Freddie would not be pursuing his little enterprise.
I had an acquaintance, Tony, in college. Tony envisioned himself as a young Hugh Heffner, living the Playboy lifestyle. No matter what the weather, Tony would walk around, inside and outside the dorm, wearing his blue bathrobe. Upon meeting a new young lady, Tony would immediately and unabashedly proposition her in the most graphic terms imaginable.
Tony got his face slapped a lot.
Tony also had a very active sex life.
As he explained it, it was strictly a numbers game. He knew that (by his count) one out of 80 young ladies was going to say yes, and that one yes was worth 79 face slaps.
Yes, Tony was a creep, but he was a happy creep.
I guess that Freddie is, in his own way, a lot like Tony. And Craig’s List (and the Internet) are his blue bathrobe.
STILL, I cannot, for the life of me, picture who Freddie’s target victim is. Until I remembered Mrs. Kerrigan.
Mrs. Kerrigan was my High Scholl Algebra teacher. She taught me how to figure out when certain trains would reach Chicago, as well as lots of other useless things. She also taught me Venn diagrams.
Since my High School days, I have never, ever, found the need to create a Venn diagram – until now.
So here, for the world to see, is my first real-world Venn Diagram:
Wow, I can actually envision who Freddie’s target victims are!
...same old story, same old act One step up and two steps back
Bruce Springsteen, "One Step Up"
Ah, the Boss – unofficial poet laureate of my generation.
Bruce certainly knows a lot about life’s ups and downs. This is in no doubt due to his experiences living in the great Garden State.
Witness, if you will, the latest debacle surrounding Medical Marijuana in New Jersey.
The prior governor, John Corzine, was certainly no Cracker Jack prize. His free-spending attitudes nearly bankrupted the state. But, giving proper respect where it’s due, Corzine did do at least one thing right: Shortly before leaving office, he made New Jersey the 14th State to approve the use of Medical Marijuana.
Now the new governor, Chris Christie, is doing a lot of good things to help the state get back on its’ feet financially.
Many are talking about him being a front runner for being the Republican presidential candidate in the next election. However, he is doing one thing very wrong here – he is doing whatever he can to sabotage legal Medical Marijuana in the state.
OK, I get it – Medical Marijuana wasn’t his idea – it was dumped upon him by his predecessor as a parting shot. But, Mr. Governor, that’s not any reason to try to sabotage a good idea.
At first, Governor Christie did whatever he could to drag the state’s collective feet on Medical Marijuana. He claimed that a production system had to be established. A distribution systems had to be in place. The entire matter required a great deal of study and evaluation. But, to anyone with half a brain, it was easy to see that this was just stalling tactics on the Governor’s part.
Hey, General Eisenhower didn’t ‘study’ and ‘evaluate’ this much before invading Europe in 1944. Besides, if he ever bothered to tour any college dormitory in the state, he would have seen that many production and distribution systems are already in place….
Finally, after a year of delay, the Governor is now talking about ‘compromises’ in order to get Medical Marijuana off the ground in NJ. Chief among these ‘compromises’ is his declaration that Medical Marijuana can only be prescribed as a ‘last resort’ medication when all other medications have failed. In other words, if you are lying on your death bed, suffering through the final stages of terminal cancer, maxed out on morphine, Christie will give you a reluctant green light to light up.
Give me a fricken break.
Another compromise will limit the potency of Medical Marijuana. Yet another great idea. Patients who are dealing with extreme health issues will be forced into inhaling greater quantities of smoke in order to receive the needed dose. After all, conventional wisdom in the 1940’s was that smoking was good for you – none of this new-fangled anti-smoking rhetoric from Trenton, thank goodness.
Maybe they should pass a law taking that pesky surgeon general’s warning of the side of the cigarette pack – that stupid warning makes it so much harder for teenagers to look cool these days.
No other prescription drug is limited by such provisos, including popular pain killers like Morphine, Codeine, Hydrocodone, Oxycodone, Methadone, Fentanyl and Meperidine.
These drugs are all opiates, closely related to heroin. And they all carry the terrible potential side effects of addiction, overdose and death. (Of all the potential bad side effects of modern pharmaceuticals, death, for me, is one of the biggies). But the good Governor obviously doesn’t have a problem with these popular medications, even though they carry with them the very real risks? No siree – pop ‘em if you got ‘em – it’s OK with Governor Christie!
After reading about the latest developments with Medical Marijuana in NJ, I had to stop and check a calendar, and yup, it turns out that it actually IS the year 2010. So why are we still treating Medical Marijuana like the good people of Salem Massachusetts treated their single womenfolk back in the 1600’s? The governor doesn’t appear to be stupid or naive – so why the witch hunt on Medical Marijuana?
Perhaps the governor is concerned that, if Medical Marijuana was given the acceptance that it deserves, millions of dollars of the NJ economy would flow out of the state and across the river into Philadelphia. Philadelphia is, after all, the home of the Tastycake factory.
Come to think of it, the Governor is a known Twinkie aficionado – perhaps he is fearful of a shortage of his favorite sweet snack?
Applying Ockham’s Razor, it’s most likely some other influence that is affecting his decision making regarding Medical Marijuana – but what, pray tell, can it be?
Let’s take a moment to ponder this query – and whilst we ponder, here is an interesting, totally unrelated, factoid.
Did you know that 10 out of the top 12 pharmaceutical companies in the world have ties to New Jersey? Here’s a list:
1 - Johnson & Johnson - 5 NJ Locations including US and World Headquarters
2 - Pfizer - 7 NJ Locations
3 – Roche - 2 NJ Locations
4 – GlaxoSmithKline - 2 NJ Locations
5 - Novartis - 3 NJ Locations including US Headquarters
6 - Sanofi-Aventis - 2 NJ locations, including their US Headquarters
7 - AstraZeneca - No NJ connections (Boo! Hiss!)
8 - Abbott Laboratories – 2 NJ Locations
9 - Merck & Co. - 4 NJ Locations including Global Headquarters
10 - Bayer HealthCare - 2 NJ locations
11 – Eli Lilly – No NJ locations
12 - Bristol-Myers 2 NJ locations including Corporate HQ
Those ten top compsnies with ties to NJ had combined revenues in 2009 of around 389 billion dollars.
That’s not a typo – that’s Billion with a ‘B’
Isn’t that interesting?
OK, enough pondering – let’s get back to our main topic.
Rats. Ponder as I may, I still can’t figure out why so many of our elected leaders are so against Medical Marijuana.
I guess we’ll never know why our politicians are so freaked out by an ugly little weed that has proven medical benefits with very few harmful side effects. Mind you, I am not talking about making it available to everyone - or decriminalizing it - that's someone else's bailiwick - I refer only to it's medicinal use. Also, Medical Marijuana is not some illicit substance that outlaw bikers are cooking up in an abandoned trailer out in the woods – it’s a silly little plant that anyone could grow in their backyard. And that, my friends, is the problem.
Big Pharm doesn’t want the competition. In fact, none of the formulations that they produce can compete with Medical Marijuana when it comes to the ratio of benefits/harmful side effects. In addition, no one needs Big Pharm to produce Medical Marijuana – almost anyone could produce their own backyard. Big Pharm hates competition. They spend billions on lobbyists and spin doctors to help ensure that no one rains on their 400 billion dollar cash parade. In the meanwhile, millions of Americans are suffering needlessly because they are being denied medicinal use of this ugly little weed – and it’s just not fair. In fact, from my standpoint, it’s downright criminal.
So what are we going to do?
Well, regular readers of my blog should know that I have already published the solution last Spring. If anyone had the foresight to follow my lead, the debate over Medical Marijuana would already be moot point. In case you missed it, here’s a link to my brilliant idea:
Barring this solution, I would ask a special favor of all our lawmakers who continue to roadblock Medical Marijuana– something we all should demand them to do before they consider any further legislation against Medical Marijuana. It wouldn’t take them very much time, but I’ll warn them up front, it may be a very difficult for them to do.
In fact, it may be the most difficult thing that they will ever have to do.
First, I would ask them to visit a few people in their constituency. People wasting away in cancer hospices. Other people who are in the midst of battling cancer, and who are devastated by the horrible side effects of chemotherapy. Other courageous souls who are trying to live with Multiple sclerosis. Or with the insidious creeping blindness of Glaucoma. Or living with chronic pain. Or who are dealing with a host of other debilitating diseases and conditions. People whose suffering might just be eased, if only by a little bit, by a silly, ugly little green plant.
Then, after visiting these people – people who they’ve sworn a sacred oath to represent – after seeing and experiencing the hell that is their daily lives – I would ask them to go back to their homes, walk into their bathrooms, and take a long good hard look at themselves in the bathroom mirror.
That’s all I would ask of them.
I bet they can’t do it.
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Because of your obsession with organized crime, most Americans are infinitely familiar with the world of organized crime – even those who live in North Dakota.
Over the years, ‘Mafia’ movies are perennial favorites with the American moviegoer. Such classic films like the Godfather trilogy, Goodfellas, Once Upon a Time in America, Casino, and my all time favorite, My Blue Heaven have given us a an immersion into the life of American Mafioso.
Not to be outdone, the small screen has contributed to our national obsession with such classic series such as ‘The Sopranos’ and ‘Boardwalk Empire’. The History, Discovery, and Biography channels also contribute their fair share of Mafia inspired reality stories.
Fortunately for me, being raised in Northern New Jersey, I was never subjected to the real thing . RIP, Tony Pro.
Most of us are familiar with the modus operendi of the American mob. Gambling, Robbery, extortion, and prostitution were all major revenue streams for the 20th century mobster. However prevalent these activities were, however, the classic mob fundraiser has always been The ‘Protection’ racket.
The way ‘protection’ works is simple - If you don’t want your small business to suffer from broken windows or worse, you would pay your local mafia soldier a weekly stipend to ‘protect’ your business interests. An ‘unprotected’ business also suffered because legitimate customers were fearful to patronize the establishment, as they might be subject to some form of retribution themselves for doing so.
Thankfully, law enforcement has worked tirelessly over the past century to help eradicate this type of “strong arm’ behavior.
Today, the world of ‘Protection’ schemes is mostly limited to the silver screen…and your doctors’s office.
Yes, health insurance companies utilize many of the same threats that mustached Pete’s used to employ in their protection schemes. Sure, they don’t send a few goons to an office and have them crack a few heads (that could potentially result in some unwanted and expensive neurosurgical claims to process – and they certainly don’t want that) but they do employ many of he same fear tactics in order to get providers to join their networks (and accept lower fees).
Thirty years ago, when manages care plans were first being marketed, physicians were urged to join the networks in spite of the lowered compensation that they offered. “Soon everyone will have this type of insurance” they were told. “If you don’t join our plan, ou soon won’t have any patients”. Many physicians fell for this line, and soon afterwards the hold outs started following them as they grew fearful of being left out.
Like the Mafia itself, these physicians soon discovered that, once joined, these networks were almost impossible to get out of. Leaving a plan would mean losing a significant chunk of their patient base all at once as these patients would switch to an in network office in order to avoid the high out of pocket expense of “out-of-network” benefits. Like a small businessman beholden to a Godfather, these in network offices were forced at accept an ever-growing list of demands and compromises from these carriers lest they get dropped from a plan.
This scenario was especially true of primary care physicians. Sub-specialists could normally survive leaving a network (or never joining one in the first place) especially if they were the “only show in town”.
I worked extensively with one such sub-specialist who never joined any insurance networks. He was constantly barraged by different insurance plans, all cajoling him to join their networks. When he refused, they would always act incredulous at his audacity. As time went by, these same companies would make his business more and more challenging as they would underpay or even out rightly deny claims for out of network benefits. It soon became a full time job to collect on these out of network claims. We would have to make numerous phone calls and write threatening letters to the carrier. At one point Horizon Blue Cross decreed that they would no longer accept letters of phone inquiries regarding claims from out of network physicians. If the patient was deceased or incapacitated (as was often the case with his office) there was nothing that you could do with the carrier to collect on a claim. Often we would enlist the aid of the state medical society and the Department of Insurance to intercede on our behalf. Often we would be forced to hire a well known law firm to handle our collections from these carriers. It would often take years to collect on a simple claim.
While they didn’t employ goons carrying baseball bats or ice picks, these were nonetheless strong arm tactics used by these companies to threaten the doctor and to get him to ‘play ball’.
I think I know why you can’t buy Blue Cross insurance from an out of state plan – doing so would violate the RICO Act.
If an Italian-American businessman tried to use these same tactics with his customers, he would end up on trial racketeering charges. Yet, we allow our health insurance companies to use these fear and intimidation tactics without any retribution.
Tony Soprano types used to claim that they were in the ‘waste management’ business. Today, it wouldn’t surprise me if they say that they are in ‘health insurance’.
I’m just shy of my 10,000th read of this blog. Actually, since I didn’t start using a counter until several months after I started writing the blog, I’m probably well over my 10,000th hit already. However, I’ll stay my celebration until the counter makes it official today or tomorrow.
At this mini-milestone, I am getting reflective as to why I bother to write this. Yes, I’m both passionate and concerned about the current state of health care, but can I really make a difference? Well, maybe, but there are no concrete guarantees that all of this will ever amount to much. So, why do I do it?
I have come to the realization that, like the scorpion on the frog’s back swimming across the stream; it’s just in my nature.
I recall a time 25 years ago when I purchased my first townhouse. It was new construction, and like many things built in the 80’s boom years, it wasn’t built to the highest standards. This was the day of the Yugo, remember.
The townhouse looked real nice from a distance, but it was plagued by a host of quality issues due to poor construction. The first time I turned on my shower, for example, nothing came out – at least out of my shower head. The shower water did pour into my next door neighbor’s living room, however. Not the most ideal way to meet your neighbor, trust me on that. Luckily for me, Sal was a good sport about it – Sal was a tough Italiano who worked on Staten Island in the waste management business. I remember being both upset about my malfunctioning shower and relieved that I wasn’t bathing with the fishes, if you catch my meaning….
Anyhow, the shower incident was just a harbinger of things to come. Everyday, it seemed, my neighbors and I added to our punch list of everything that the builder needed to fix under our homeowner’s warranty. In the meanwhile, the builder dragged their collective feet as they tried to stall us until the warranty expired. It soon turned into a game of wills and wits, with the homeowners pitted against the big corporate builder.
As winter approached, my fellow homeowners all started to voice the same complaint – the units were next to impossible to keep warm. Cold drafts pervaded the units, especially on the second floor. The builder, of course, denied any wrong doing.
One evening, as I sat shivering in my bedroom, I noticed that the drafts seem to emanate from the floor adjacent to the outside wall. In a moment of inspiration, I developed a theory of why we were getting the nasty, unstoppable drafts. The townhouses were designed so that the second stories were actually larger then the ground floors – they cantilevered out about 3 feet on either side. This overhang must not be insulated – Eureka!
The next day, I excitedly called the builder’s office to clue them as to the root cause of the draft problem. Instead of thanking me, they just dismissed my revelation – the units were all properly insulated they assured me. There was no way that the second story overhangs weren’t insulated. When I protested, they explained that I was crazy to think that the builder wouldn’t insulate such a critical area of the townhouse. Besides, the underside of the overhang was already sheathed in aluminum siding, and it would be very expensive and labor intensive to remove that siding just to prove me wrong, so the case was closed – period.
So, my neighbors and I continued to freeze throughout that cold, cold winter, until one night, as I shivered, I had another brilliant revelation – if the builder wouldn’t inspect the overhang space from the outside, I would do it from the inside. Like a man possessed, I grabbed my electric drill, attached a hole saw, and tore back the carpeting in my master bedroom. After cutting a neat 2 inch hole round hole in the floorboards, I shone a flashlight down into the abyss. Shocked but satisfied, I saw nothing in that large open space – except for the underside of the aluminum siding. As I suspected, the entire area was totally uninsulated.
The next morning, I stormed into the builder’s office and tore them a new one. I demanded that the site manager accompany me back to my house and see for himself how my overhang was uninsulated. After sheepishly admitting to their oversight, they got a work crew to come out, remove the siding, and insulate the overhang.
They assured me that this was just an isolated incident.
The insulation refit solved the heating issue in my master bedroom, but then I noticed that the guest bedroom had a similar problem. I asked the builder to please schedule a crew to come out and refit that overhang as well.
“No way” they told me. The master bedroom problem was an isolated incident – there was no way that they were going to tear apart my other overhang just to satisfya draft that surely must exist solely in my imagination. After failing to win that argument with them, I stormed back to my townhouse, got out my hole saw, and repeated my little craniotomy in my guest bedroom floor. No surprise to me – that overhang also had not been insulated either. Another work crew was dispatched to tear apart the overhang in the back of my house.
As the winter progressed, I bragged to my neighbors how my little hole saw brought down the evil empire of Kaplan and Sons. Of course, through chattering teeth, they explained that they had the same cold drafts, and the same cold shoulder given to them by the builder – my unit was an isolated incident, they were told – all the other townhouses in my development were properly insulated.
The revolution started with my neighbor Sal. He asked if I could come over with my hole saw and drill through his floors? Happily, I obliged (Sal, besides being a nice guy, was not the sort of man you refused unless you actually wanted an ice pick in your ear).
Of course, the results were the same in Sal’s townhouse.
Soon, I became the Johnny Appleseed of Belcourt. Have hole saw, will travel. I flitted from unit to unit, drilling holes in many of my neighbor’s floors. I actually never found a single overhang that was insulated. And I drilled enough holes to wear out my hole saw and my drill.
Several months later, my wife and I chanced to walk by a work crew refitting yet another overhang with insulation. After they removed the aluminum fascia, they gazed up at yet another neat 2 inch hole in the floor above their heads. On workman griped – “Yep, the asshole with the hole saw is at it again”. I bit my tongue as I walked past them, but my chest filled with pride.
I was that asshole, and I was damn proud of it.
So may be that’s my motivation for writing this blog. Someday, somehow, I dream of overhearing some CEO of a pharmaceutical company or insurance company referring to me as “that asshole with the blog”.
I know that the chances of this actually happening are between slim and none, but an asshole can dream, can’t he?
***** Found this Interesting, Entertaining or Informative? Please read the complete blog at: *****
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Who are you? Do you agree with me, disagree with me, or have another perspective to share?
PLEASE put your 2 cents in by leaving a comment or email me at HealthcareBlog@SystematixOnline.com
Our great nation is at a
crossroads. The Supreme Court, the pinnacle
of our legal system, is deciding the fate of Gay Marriage for the country. This is a momentous point in our Nation’s
history. Will our most elite jurists be
able to preserve the sanctity of marriage?
Like many Americans, I am all
for preserving the sanctity of marriage.
If Gay Marriage will somehow hurt that sanctity, then I guess I am
against it.
Of course, the opposite is true
as well. Quite frankly, I am yet to be
convinced how matching genitalia has any effect on the sanctity of
marriage. I know lots of gay
couples. If they were to get married, I
can’t conceive how it would have any effect on the sanctity of my own
marriage. I’d just be happy. Call it Schadenfreude.
However, we need to protect the
sanctity of marriage at all costs.
Therefore, I propose that we, as a nation, take immediate action against
two known threats to the marriage contract.
To wit, I propose that we pass a law saying that, if you are divorced,
you cannot hold public office. In fact,
let’s just make divorce a felony. Any person who destroys the sanctity of
marriage by getting a divorce shouldn't be allowed to vote.
In addition, let’s attack that
other great threat to the sanctity of marriage – infidelity. Infidelity is such an affront to the sanctity
of marriage that I think it should be a capital offense. If you are caught cheating on your spouse, you
should be put to death. In fact, the
Bible talks about this quite a bit, so there should be little resistance to
this law from the religious right, who like to quote from the Bible when
discussing how gay marriage is an affront against God.
Truth be told, the Bible has
LOTS to say about infidelity and divorce.
I was going to quote from the Bible here to prove my point, but there
were just too many citations to fit. So, if you are so inclined, please visit this
link to see how the Bible is really, really against infidelity and divorce:
Kind of makes homosexuality look
like an also-ran in the eyes of God, n’est pas?
If this law were to pass (and I
hope it does so we can truly protect the sanctity of marriage), I have a great
idea for a growth business – being a stone salesman in Washington! Baseball season is upon us, I’m getting the ‘ol
pitching arm limbered up, and I just can’t wait to throw a few fastballs (er…fastrocks?)
at the sinners who cheat on and divorce their spouses.
The sad thing about the Gay
Marriage debate is that it is taking the Supreme Court’s attention away from
the other great issue they are discussing – one that truly has an effect on the
daily lives (and wallets) of most Americans.
In fact, I’d bet that most of us are unaware that this is even on the
Court’s Docket.
I am referring to the ‘Pay to
Delay’ scandal.
What’s ‘Pay-to-Delay’ you might
ask? Simply put, this is where Big Pharmaceutical
companies are paying millions of dollars to manufacturers of generic
medications NOT to make their off-patent drugs. This is an interesting case, because both
sides (Big Pharm and the Generic manufacturers) are all for it. The generic manufacturers are being paid
millions every year for literally doing nothing, and Big Pharm can continue to sell
their drugs for top dollar. In a
marketplace where a ‘name brand’ pill might cost $900 for a three month supply, it would be almost
impossible to compete with the generic equivalent that costs $10 for the same
number of doses.
When you consider the millions of
Americans who use prescription pills, the economics of ‘Pay to Delay’ make
perfect sense for both parties. In fact, the only people getting screwed here
are – you guessed it – the American consumer.
‘Pay to Delay’ has been going on
for many years. In fact, Big Pharm has
successfully had it upheld in lower courts for many years. Finally, due in no small part to the efforts
of the FTC, the issue is finally where it needs to be – in front of the US
Supreme Court. Hopefully, they will be
able to see this practice for what it really is – illegal collusion – and put
an end to this practice once and for all.
Unfortunately, we’ll all have to continue paying untold
millions of extra dollars evrey month for
off-patent name brand meds until after they decide whether two people with
matching genitalia can call themselves ‘married’.
*****
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You have to love Columbus.
And by Columbus, I’m not talking about Genoa’s favorite son – the guy
who got credit for ‘discovering’ a land that was already inhabited by millions
of indigenous people. I’m talking about
the Columbus Market – one of the largest flea markets on the East Coast.
I went there this weekend with my family – it’s a fun way to
spend a Sunny Sunday morning. If they
don’t have what you want at one of their indoor or outdoor vendors, chances are
you don’t need it.
Columbus Market’s most infamous offerings has to be counterfeited merchandise.
Whether you’re looking for that fake Louis Vuitton bag, that faux-Rolex
watch, or that fake designer Polo shirt, Columbus has one of the widest selections this side of Macao. Knock
off goods are so prevalent there that the market is often featured in National
News stories about crack downs on illicit merchandise. These crack downs are very effective – after each
major effort by law enforcement, Columbus Vendors start keeping all of their
trademark-infringing goods under their tables instead of on top of them. The bargain-hunting buyer then has to ask for
them instead of just browsing the table-top selection. Alas, in spite of Law Enforcement efforts,
the wheels of commerce continue to turn.
I had to laugh this morning while watching BBC America
news. It seems that Interpol, the famous
international police force has started a
new crackdown on the latest product that is appearing on the black market –
prescription drugs. According to the
report, as much as 10% of all prescription drugs worldwide are fakes – and that’s
a problem. Very often, these drugs do
not work in the same way as the name-brand formulations that they are
aping. According to the report,
hundreds of thousands of deaths worldwide can be traced to counterfeited
prescription drugs. However, I am not
100% convinced that this is really all that worrisome. After all, statistically speaking, I think
that this is in line with the number of deaths world-wide that are annually
attributed to bonafide prescriptives. Plus, I’m
sure that some people might actually be better off taking the fake stuff. We all have heard of the placebo effect, so
these phony pills are probably helping some people. In addition, these fake formulations probably
don’t have all the nasty, life-threatening side effects that the real McCoys
have. That totally bogus drug won’t cause cerebral hemorrhaging,
suicidal thoughts, or kidney cancer like the real stuff does. So, when you look at it from a ‘bang-for the
buck’ perspective, these fake pharmas
start to look like a real bargain.
From another perspective, consider the folks who have no
choice but to purchase the fake stuff. I
am sure that the people forking over $50 for a very convincing Louis Vuitton satchel
at Columbus would never be inclined to lay out $895 for the real thing. The same logic can be applied to the fake
pharmaceuticals. So what’s the
harm? Besides, some of these fakes are
of extremely good quality – maybe not as good as the genuine article, but
certainly good enough. And the savvy
consumer will always come out on top. If
that purse falls apart after a few weeks wear, you can bet that they’ll never
buy from that vendor again. Since many
of these vendors have been selling at Columbus for many, many years, I am
convinced that the quality of a lot of these fakes is actually quite good.
You also have to consider what type of fake drugs are being
sold. I am fairly sure that no one is peddling phony
cancer meds. Much more likely, the fakes
being sold are falling into the recreational category. This means one of two classes – ‘feel good’
meds like prescription pain killers or boner pills. In either event, the sought effect is readily
apparent to the end user, and if the drugs don’t work as expected, the person
selling the fakes won’t be in business for very long.
So with little relative harm to the end user. Why the big
push to stop the sale of these knock-off pills.
Well, it turns out, Interpol’s crackdown id being funded in part by a
coalition of more than two dozen of the world's largest
pharmaceutical companies, who have pledged
piddling 1.5 million Euros a year over the next three years to fund Interpol's
newly created Pharmaceutical Crime Program. When you compare this to the several billions
in sales lost annually to the fake drug sales that the Pharmaceutical companies
are claiming, this is a great no-brainer
investment for Big Pharm.
Of course, there is a much easier solution – just make the damn drugs
affordable in the first place.
Any vendor at Columbus will tell you, there is no way that you’re going
to sell a knock-off purse for $50 when the real one retails for $85. It’s really a matter of Economics 101.
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To me, there is nothing worse than a lame excuse. When you’ve been caught red-handed, have some
dignity, man up, and admit that you screwed up.
When the whole world knows you’ve made a mess of things, it’s better to
own your mistakes rather than to continue to try to justify your misdeeds. I think that, like most people, I came to
this realization dome time prior to my fifth birthday. Unfortunately, some people have never learned
this lesson
I think that the world heard the lamest excuse ever at the
Nuremberg trials after the Second World War.
Nazi War Criminals, when identified as the perpetrators of genocide, and
of being the most despicable people on the face of the earth, often quoted the
mantra that “we were just following orders”.
Hanging was too good for these sub-human scum.
The second lamest excuse is only slightly better. It’s basically just the civilian version of
the ‘just following orders’ excuse. Time
and time again, we here of people who royally screwed the pooch explain that they were “just doing our job”.
This often escalates into even greater lameness when someone
self appoints themselves to a job, fouls it up, and then tries to explain away
their sub-par performance.
A prime example of this were the Windshield Swipers of
Manhattan. Those of you who lived around
Manhattan may recall the windshield swipers
– homeless people who would spring on your car as soon as it was stopped at a
light and then proceed – without invitation – to wipe your windshield with a
dirty rag. I can’t recall at time when
my windshield was ever left cleaner after being the unwilling recipient of
their ‘cleaning’ services. Even though I
never asked them to clean my windshield – and even though they always did a
horrible job – they would also get belligerent or even violent if you didn’t
pay them for their ‘service’
Thank goodness that Mayor
Rudy Giuliani put an end to these
leeches when he took office in the
mid-eighties. Manhattan is now a much
nicer place to visit by car.
Of course, they windshield
swipers didn’t go away without a fight – they claimed that they were (you
guessed it) “ just doing their job “ .
While not readily apparent
to most of us, we have a version of ‘Windshield Swipers’ in our healthcare
system – and they are infinitely more intrusive, costly, and devastating to our
economy and well being than a squeegee carrying Manhattanite could
ever be. In fact, their uninvited
‘squeegeeing is ruining our healthcare system.
I am referring, of course,
to our health insurance carriers.
Let’s put things in
perspective. Our health insurance
carriers have injected themselves into our lives like a sterno bum at the exit of
the Lincoln Tunnel. They exact a 25-30%
premium from us for their uninvited services, extorting hundreds of dollars
every month from most Americans. They
greatly increase administrative overhead.
They cause runaway inflation in the cost of medicine. They make medical decisions regarding our
health and treatment.
They frustrate providers and
patients alike. They have interjected themselves soundly into our
healthcare system, much to it’s detriment.
And how do they justify
these dirty deeds? They say that they
are ‘just doing their jobs’. They are
helping ‘control the cost of medicine’. I
don’t know about you, but I’ve got a real problem with this.
First things first – who
gave them the job of ‘controlling the cost of medicine’? I certainly don’t recall doing this. Nor do I recall an Executive order, or Act of
Congress, or great public mandate demanding that they (or anyone else) help us
‘control the cost of medicine’. They
seem to have come up with this ‘job’ all by themselves.
Secondly, even if it is
their job to help us ‘control the cost
of medicine’ (and that’s a VERY BIG
‘IF”. They are doing a terrible job of it.
In the past 20-30 years, as health insurance became an ever-larger part
of the healthcare biosystem, we have watched helplessly as the cost of
healthcare has spiraled hopelessly upwards,
In other words, like that
guy outside of Port Authority smearing my windshield, they suck at their self
appointed job. Instead of improving
things, they make matters worse – in fact, much worse. It would be bad enough
if we hired them to ‘help control the cost of medicine’, but we didn't So, how do you fire someone you didn't hire? In fact, this whole scheme sounds
like something George Costanza dreamed up.
Fortunately, Manhattan
happens to hold the answer to this dilemma.
One of their most famous residents has made a second career of
this. So, it seems to me that all we
need to do is to get The Donald himself to start calling out the major players
in health insurance and let them know, in no uncertain terms, “You’re Fired!”
Now, that would be an
episode of ‘The Apprentice’ worthy of my DVR.
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I have a good friend of mine –
nice fella, well meaning…and conservative.
Like many conservative-minded folks, he gets a lot of his news from
conservatively-oriented media. No crime
in that – it’s a free country. 
