Medical Bills And Bankruptcy - Here We Go Again

Once again we get an advocacy study claiming that high medical expenses are driving people into bankruptcy [and Megan McArdle doesn't like it].

Back in 2005 Prof. Elizabeth Warren made a similar claim during the debate on the revised bankruptcy bill, which was refuted by Todd Zywicki.

The particularly alarming news from the new study is that not even people with health insurance can escape financial disaster:

More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.

"Unless you're Warren Buffett, your family is just one serious illness away from bankruptcy," Harvard's Dr. David Himmelstein, an advocate for a single-payer health insurance program for the United States, said in a statement.

Of course, this reverses the horse and cart - even if it is true that people who go bankrupt had serious medical problems first, it does not follow that everyone with a serious medical problem goes bankrupt.

In any case, among the many excellent points made by Prof. Zywicki was this:

Moreover, it is well-understood that debtors who are falling into bankruptcy pick and choose which debts they pay, paying down their mortgage or nondischargeable debts for instance, while not paying their unsecured debts, such as medical and credit card debt. So the fact that the medical debts were unpaid says little, because it may reflect strategic payment of debts prior to bankruptcy.

Just to emphasize the obvious - in many of these medical bankruptcies, it is not the high cost of health care that leads to bankruptcy; it is the loss of employment income due to disability.  Since this is an advocacy piece the authors obscure that point, but this does appear in the Q&A (my emphasis):

8- Would health reform eliminate the problem of medical bankruptcy?

Many debtors described a complex web of problems involving illness, work, and family. Separating medical from other causes of bankruptcy is difficult. Hence, we cannot presume that eliminating the medical antecedents of bankruptcy would have prevented all of the filings we classified as “medical bankruptcies.” The high rate of insurance among the medical bankrupts suggests that any health reform that fails to improve existing private coverage is unlikely to make a major impact on medical bankruptcy. Moreover, our data also highlight the need for improved disability coverage.

And one last caveat from the Zywicki rebuttal - alcoholism and drug addiction are considered to be a medical reason for bankruptcy, as are other things.  From Zywicki:

First, consider the self-identified filers. Among the self-identified factors that are listed as "medical" causes of bankruptcy in Exhibit 2 of the article are the following: illness or injury, birth/addition of new family member, death in family, alcohol or drug addiction, uncontrolled gambling. First, it is surely open to question whether uncontrolled gambling or a death in the family really should count as a "medical" problem. More generally, the category "illness or injury" is very broadly defined in the study, and there is no apparent limit on the time frame over which the illness or injury occurred, or the severity. So classifying all of these factors as medical problems that have "caused" bankruptcy certainly seems open to question.

I don't think National Health will prevent drunks from getting fired. 

TIMING IS EVERYTHING:  The authors of the current study make much of the fact that the proportion of what they define as medical bankruptcies rose dramatically from 42.6% in their 2001 study to 62% in 2007, from which they infer that health care costs are even more out of control than previously. 

However, nothing I see in the study to suggest that the authors made any attempt to control for the vagaries of the business cycle.  Let's imagine that there are two types of bankruptcies - "medical" bankruptcies, caused by unexpected illness, will be weakly correlated with the business cycle;  "normal" bankruptcies, caused by the failure of a small business or the loss of a job, will be highly correlated with the general business cycle.  

Back in 2001 the tech bubble had just burst, the S&P 500 fell for most of the year, and we experienced the 9/11 attacks - without looking it up I will bet that was not a great year for small businesses or jobholders.

Conversely, the S&P 500 rose in 2005, rose in 2006, and was still rising in the January to April 2007 period of the second study; let's bet that the business environment was favorable to small businesses and jobholders.

And a caveat - the 2005 bankruptcy reform did change the filing rules for everyone, which complicates the direct comparison of the two time periods.

That said, we would expect that medical bankruptcies ought to be a higher proportion of bankruptcies in 2007, not because medical bankruptcies have risen from their trend line but because "normal" business-cycle-related bankruptcies were down.

Oh, well - this advocacy study will no doubt be recycled endlessly as conventional wisdom.

Comments

[Danube of Thoudht]

But if we only had that coveted single-payer system, everyone could have all the health care they want, and it would all be free.

[clarice]

And Congress would never start mandating what treatment would and would not be covered--no ordered coverage of cosmetic plastic surgery and euthenasia of oldsters, for example. Congress would be above that sort of thing.

[Fresh Air]

Since all debt is fungible, and since most debtors filing for bankruptcy have many and varied debts, all you can really say is the debtor chose to borrow too much.

But wasn't it Megan McCardle who noticed 200 or something newspaper articles the day after another one of these "studies" was put out, each tailored to a specific state? More horse manure from Mediacrats who can't do math, and don't do independent reporting anymore.

Rush is right. It is the "State-Run Media." Idiots.

[Original MikeS]

I think I sense a subtle undertone of sarcasm. Seriously, wouldn't we all prefer to have committed public servants, like Nancy Pelosi, making decisions about our medical treatment rather than some greedy old doctors?

Surely, if we just give our public officials the authority to do so, they will be able to insure that nothing unpleasant ever happens to anyone. Yes we can!

[Semanticleo]

Just as commercial Television sought to muddy the waters of competition with their 1950's war of words, calling Cable TV "Pay TV", so too the Commercial Medical Industry seeks to
wallop the drum "socialized medicine' and all the imagery that cojures.

Fact is, that self-same Industry has brought it on themselves. Naked Greed brought down the Financial Services Industry and the taxpayer got the bill.

Obama fired the first shot demanding they cut their costs and fees or else.......

I don't think they are really listening because they mistakenly assume, since they are financially sound, there's no danger of governmental intervention. They think they don't need a bailout.

But they had better start bailin'.

It's clobberin' time !!!!!!

[glasater]

Oregon's Health Care Plan began under Bush I--who opposed it as I remember. Clinton approved it in 1993. But from this wiki entry the operative phrase that stands out:

It was intended to make health care more available to the working poor, while rationing benefits.

Remember the word "rationing".

I'm pretty sure the plan is now broke.

[Danube of Thought]

A Canadian describes the true wonders of the single-payer system. LUN

[Gabriel Sutherland]

Mediacrats who can't do math

It's really much worse than this. Mediacrats may be poor at math, but they're mathematicians compared to the general public.

We really won't last if the liberal protestant educational method continues. We're just seeing the ends at this point. The means have been in place for decades.

[Danube of Thought]

Of course the care is rationed--it is one of the sternest and most immutable laws of economics (and of human behavior) that it must be.

The care you get from your doctor is not "rationed," provided that you are prepared to pay for it. If you want it paid for by your insurer, it gets rationed by that insurer, but if you don't like the coverage it gives you in return for the premiums you pay, you are free to bargain with another insurer.

Ask a Brit or a Canadian how he enjoys bargaining with the national health service.

[Danube of Thought]

June 2:

"Support for health care reform has slipped slightly as more voters think President Obama should work harder on his promise to cut the federal deficit in half in the next four years.

"Thirty-six percent (36%) of U.S. voters say cutting the deficit is the most important of the four priorities the president cited in a speech to Congress in February, according to a new Rasmussen Reports national telephone survey. That’s up from 32% in March.

"At the same time, 24% rate health care reform as the most important of Obama’s priorities, down from 29% in the earlier survey."

A very substantial majority of Americans say they are happy with their own health care. Just wait until millions of the wake up and discover that they are suddenly being taxed for the employer-provided benefits they've previously received tax-free. They will, of course, prefer to switch to the "competing" government plan, which is "free" and for which they are not taxed. And then they will discover the true wonders of health care provided on political terms.

Why does Obama think he's got to get this bill enacted by October of this year? Why are the Democrats so keen to minimize debate on the matter? Why do you think?

[Pofarmer]

I don't know about other states. But in MO, health care debts CANNOT force you into bankruptcy. It would also be interesting to know the costs of procedures that weren't even available 30 years ago, or, the number of tests and procedures done to-avoid litigation later on or-satisfy govt regulations. There is no free market working in health care. It's an extremely regulated industry. That it is a free market process is one of the biggest lies of all.

[Semanticleo]

The healthcare Industry has been populated 9for the most part) with Billing Experts rather than Healers who have patient care, not crass profit, as their chief objective.

After the promise of immediate wealth disappears, perhaps we will have Doctors and Administrators who have a Benevolent motive, rather than a mercenary, for entering into Medicine.

[Ignatz]

--After the promise of immediate wealth disappears, perhaps we will have Doctors and Administrators who have a Benevolent motive, rather than a mercenary, for entering into Medicine.--

Yes, I've been the grateful recipient of such benevolence from the IRS, the DMV, my drill sergeant and other assorted philanthropists not weighed down with that evil motive of having to please their client in order to be paid.
WAFI.

[Semanticleo]

"weighed down with that evil motive of having to please their client in order to be paid."

So you are satisfied with a 'reach-around' when yer healthcare professional buggers you?

[Danube of Thought]

"That it is a free market process is one of the biggest lies of all."

Absolutely--in fact, I don't know of anyone who contends that the existing system operates in a true free market, and few people would argue that it should. But the incidents of a free market that do exist within the current system are vital, and the principal one of those is consumer choice.

A great number of problems would be alleviated if consumers could shop among companies anywhere in the US, instead of being confined to their own states. A New Yorker, for example, cannot buy a policy that does not provide coverage of podiatry services, whether he wants such coverage or not. Is this because New Yorkers all demand podiatry coverage? No, it is because the podiatry lobby can persuade the legislature to mandate that coverage, and there is no one to argue against it.

And that is just the barest microcosm of what the nation will face should it ever sign itself on to a single-payer system. I am sure that a fully-informed electorate will never do so, and I'm sure the Democrats realize that. And that's why they want to act so fast, before the electorate becomes informed.

Remember when Obama absolutely needed to have the stimulus package passed by a particular Thursday afternoon? Remember how, once it was passed, he went off the Chicago for the weekend without having signed it into law? And how do you think the public views that urgently-needed stimulus package now?

[Bill in AZ]

There are already plenty of benevolent boneheads in medicine, just like there are in any field. The truly creative, the ones who would actually advance medicine, will move on to some other field that taps their talents and pays their worth. Is that what you want - the field of medicine staffed by benevolent boneheads? Where medical technology remains firmly rooted in 2009 for eternity? Well, that's what you will get with socialized medicine. Nothing new - ever.

[Semanticleo]

" the ones who would actually advance medicine"

Horseshit.

There is a culture within Medicine which benefits from the status quo.

A cure for cancer? Arthritis? Alzheimers?

They make money treating the symptoms, not the underlying disease. Remember 'planned obsolescence'? Manufacturers realized decades ago, you shouldn't make TOO GOOD a product. People won't buy new when the old works. Same with medicine. Too many Non-Profits make their bones on NOT finding a cure. It's counter-productive.....

[wuzzagrunt]

Could it possibly be that loss of income, due to serious medical problems, is significant factor in the bankruptcies? Health insurance won't pay your mortgage.

[Bill in AZ]

You prolly believe in the 200 MPG carburetors too, suppressed by big oil...

[Semanticleo]

"You prolly believe"

unresponsive.............

[Bill in AZ]

Sorry, forgot english isn't yer first language... I'll try again.

You probably believe in the 200 MPG carburetors too, suppressed by big oil...

[Semanticleo]

Well, Bill from AZ...do you have a counterpoint? Or are you out of gas?

[MeTooThen]

Hey, Troll

You know what?

Fuck you.

Really.

I don't care if this comment gets deleted or I get banned.

Fuck you.

How patients have you taken care of this week?

How many times have you had to tell someone they had Alzheimer's disease? or deal with the anguish of the surviving spouse? or brain cancer? or treat their debilitating stroke in the middle of the night? Or work on your birthday? Or Christmas? Or miss your friends and family because you were busy helping some stranger? or drunk? or rapist? or shit-hole like you?

You are a know-nothing, misanthropic, piece-of-shit, who cares nothing for anything except to continually vomit on yourself and wipe your own shit on your face and think you are clever or provocative.

You are not.

You are an ass, a fool, a loser.

Let be the first to tell you, if you think for one fucking moment that your doctor or anyone else in health care today takes care of others because they are "mercenaries" "interested in money" you are the most sadly mistaken and cretinous of individuals.

You want a cure?

Go fucking invent one yourself.

In the meantime, the many thousands of dedicated and caring doctors, nurses, and other health care professionals will take care of their patients whose illnesses defy cure, like MS, epilepsy, Alzheimer's, Parkinson's, myasthenia gravis, ALS, cancer, COPD, CHF, ESRD, etc.

You seem to think that the people here respond to you because you are provocative.

Again, you're not. You are an ass.

They do so because they are tired of having to bear witness to you soiling yourself over and over again.

Get the fuck over it.

And Fuck You.

Really.

[Semanticleo]

"And Fuck You.

Really.'

Do they have anger management as part of yer health coverage?

[Rick Ballard]

"Could it possibly be that loss of income, due to serious medical problems, is significant factor in the bankruptcies?"

wuzzagrunt,

From the sample size, the slant of the study, the inclusion of any medical bills in a BK helping to move the correlation needle to positive I'd say that a "significant factor" wrt to this study could be hat size, shoe size, eye color and/or astrological sign.

So, certainly, loss of income due to a medical condition preventing a person could be a "significant factor". It's a crap study from a school so far below average that it awarded a degree to Barack Hussein Obama. It's pure advocacy with a cheaper veneer of "science" than even the Lancet Iraqi deaths BS.

[Strawman Cometh]

"Seriously, wouldn't we all prefer to have committed public servants, like Nancy Pelosi, making decisions about our medical treatment rather than some greedy old doctors?"

No, but I'm totally down with insurance adjusters looking out for me!

[cindyk]

MeTooThen: Here, Here!

[Danube of Thought]

The odd thing to me is that with the British and Canadian experiences staring us in the face, there are still single-payer advocates in this country. It is readeily understandable that its proponents fear more than anything is a robust debate on the matter. They simply cannot survive such a thing.

[Semanticleo]

Here's yer Team....courtesy Kevin Drum

"Today House Republican leaders proposed a bold new plan to save $375 billion over the next five years. So what did they come up with?

Well, according to this document, $317 billion comes from every budget coward's favorite gimmick: an across-the-board spending cap that (a) they know perfectly well will never happen and (b) allows them to avoid mentioning any actual specific cuts. Another $45 billion comes from devoting returned TARP funds to deficit reduction — something that's going to happen over the next five years anyway. That leaves $13 billion in actual targeted cuts. For the arithmetic challenged among you, that's $2.6 billion per year out of a budget of about $3.5 trillion.

That's a reduction of 0.07%.

Every little bit helps, I guess, but for a bunch of fiscal watchdogs they seem curiously unable to find very much in the way of actual wasteful programs that they're willing to stand up and take some lumps for opposing. Instead it's just the usual smoke and mirrors. How tedious."

[Chris]

Me too,
That needed to be said.

Cleo,
Is retarded not covered by your insurance plan? Pre-existing condition? What else could explain your bitterness toward people who do the helping/healing?

[Melinda Romanoff]

Leopold-

Your shallowness is betraying itself in your arguments.

You, quite obviously, have never faced, alone, the miasma that Federal rules have imposed on the medical field. Leaving aside for the moment the "tax" imposed by the malpractice racket (nor student loans), between MediCare and MedicAid, a city based hospital will spend upwards of a third of their founds just to stay in compliance with those two behemoths. They demand that for every patient that they agree to cover, a certain percentage of those patients be covered for free, and they must fit a demographic model, otherwise no one is free, and the physician or clinic must cover the cost out of pocket.

You have exposed yourself fully in this folly.

We have offered you the chance to learn in this space, and potentially grow and become a human being, fully sentient, argumentative, but respected, by respect the arguments of others.

I will follow the unstated counsel of my wiser associates from henceforth. I will do the worst thing to you.

I will ignore you.

Good bye.

[DrJ]

Too many Non-Profits make their bones on NOT finding a cure. It's counter-productive.....

Well thank God for those eeevilll Pharmaceutical, Medical device and technology companies that profit from finding those product compounds and devices and tools. With non-profits, like the government, we'd have none of that.

[Fresh Air]

What MeToo said.

What I've been doing--since I don't understand what, if any, trollblocker plug-ins are available for Safari--is simply scan down to the end of each post. As soon as I see the "S" followed by an "e" I skip to the next one. It's not hard to do if you train yourself, but it would be easier if TM would just junk this Typepad garbage and get a blogging package that puts the name first.

[Semanticleo]

"I will ignore you."

A cruce salus

[Semanticleo]

Troolblocker is my friend.

Fresh Air; will you give the step-by-step instructions to yer peers. I would appreciate it.

[Semanticleo]

Or if Fresh is clueless,,,,anyone will do.

[Fresh Air]

Melinda--

I've seen some internal numbers on several major hospitals here in Chicago. The indigent care that is provided by inner-city hospitals is massive. Even more affluent operations are still substantially burdened by Medicare/Medicaid populations and their attendant low reimbursement rates. Unknown to some of the fools out there is that "charity care" is both available and widely offered to the indigent. It is not advertised for obvious reasons, but those truly in need are never denied urgent care due to inability to pay. See also, Stafford Act, The.

[royf]

KKKLeo everything you say is a lie and you are a liar.

[Boatbuilder]

"Manufacturers realized decades ago that you shouldn't make TOO GOOD a product."

Yeah, that really worked out great for GM and Chrysler. What were those Honda and Toyota people thinking?

[Semanticleo]

KKKLeo everything you say is a lie and you are a liar.

Dont yoo think jd is a gud teecher?

[royf]

I think you are a worthless lying piece of scum. I've thought it since I found out you were lying about having a son who was a Marine. I was on the thread when you lied about it, having been a Marine I told you that he would be with the best and would be safe. He would be trained and be a part of a team.

But that was all a lie wasn't it KKKleo. You are scum my dear nothing more.

[peter]

I just read the posts. If it seems to be idiotic in the first sentence, I scroll down, and usually I see cleo's name, and I keep scrolling.

[Fresh Air]

From Megan McCardle, today: What Warren et. al. neglect to mention is that bankruptcies fell between 2001 and 2007. In fact, they were cut in half. Going by the numbers Warren et. al. provide, medical bankruptcies actually fell by almost 220,000 between 2001 and 2007, a fact that they not only fail to mention, but deliberately obscure.

The whole study is B.S.

[Semanticleo]

"having been a Marine"

with a not-so-smart MOS, I take it...

[PaulL]

Very good, MeToo.

Fresh Air, I do the same thing with the loser on this site.

I forgot momentarily and read several words of his--made me feel a little sick.

[royf]

As a matter of fact KKleo I was assigned to the first class in my MOS. Which was repairing a computer controlled combat aircraft control system called MTDS for Marine Tactial Data System. That was in 1965 so no I wasn't a grunt, I was in the Air Wing of the Marine Corp.

But why does it matter are you a bigot as well as a liar?

[Rick Ballard]

Personal BK filings increased by 266,859 (31.3%) in '08. I can't find the actual "study" but it would be interesting to see what kind of babble the "researchers" could come up with to explain the bounce if if illness is such a big contributing factor. Likewise, what kind of lies did they use to justify the drop after BK restrictions were tightened. AFAIK, the restrictions didn't apply to medical debt at all.

C'mon Harvard, we know you're as 3rd rate as the NYT but you still need to put some effort into the agitprop.

[JM Hanes]

DrJ:

"With non-profits, like the government, we'd have none of that."

Oh ye of little faith! I'm sure we'll be producing just as many miracle cures as the Brits, the Canadians and the Cubans.

DoT:

"Why does Obama think he's got to get this bill enacted by October of this year?"

Think Campaigner-in-Chief! Obama can't get anything done without a compliant Dem majority behind him in Congress. If disenchantment sets in, or they start losing elections, his moment in the sun will pass. He needs to get the bill done this fall, so that he can play it to advantage as the 2010 elections ramp up. He'll hit the road -- and the media -- for Democratic candidates, singing hosannas and counting all the ways the New Improved Healthcare is already making the lives of voters Americans (and their children!) soooo much better in every way. The gratitude of re-elected Democrats might even survive into election season 2012.

[JM Hanes]

As I recall, the whole healthcare costs=bankruptcy canard was pretty thoroughly debunked back when Obama started making that claim in the primaries.

[sbw]

Why is it that those who wring their hands over medical bills producing bankruptcy never stop at offering catastrophic health care?

[Melinda Romanoff]

FA-

The numbers are there for those who wish care to support their local institutions, and avoid them for what they can not do reliably (my case). So I support them for what they do, and do well. My crisis is past, but the damage has been done. This is not "bad luck", it's life.

Some people learn this early, others, later, but we all learn it.

Chicago's private hospitals have a particularly big load from Cook County's "help".

One party rule and all that

[clarice]

sbw, I'm in a foul mood. Please quit asking why stupid people do not behave intelligently.

[Melinda Romanoff]

I will mock later, because someone has been to ignorant to realize they have been mocked from the word "go" just by the use of a name.

JMH-

Remember, the "stimulus" bill has a balloon payment system embedded in it. It is designed to provide maximum cash flow at the second half of 2010, just when "those in need' need it. It's a laundry lesson provided by the wizards from Chicago.

Not that I would have any familiarity with that sort of system, or anything.

Just sayin'

[Rick Ballard]

JMH,

Where does the duck sleep when it loses its bed?

It doesn't really matter whether the "study" is whole cloth, a tissue of lies, poorly designed and completely unbelievable but, as with the ridiculous Lancet study, put "Harvard professor" in the first graf and the agitprop soars like an eagle - even if it had all its tail feathers shot off a few months ago.

You know it's garbage and I know its garbage but the thick witted Muddle has to decide how it feels about the garbage. They may not buy it at all. They didn't buy the SCHIP Slacker Family Saga.

[Melinda Romanoff]

Exactly, Rick.

Well put.

[Stephanie]

http://alaskareport.com/audio/palin.mp3

The best speech of the day...

“And mark my words, this is going to be next, I fear, bail out next debt-ridden states. Then government gets to get in there and control the people.”

You go girl!!!

[Stephanie]

Just dayum...

Best speech of the day...

http://alaskareport.com/audio/palin.mp3

Previous post disappeared...

[Stephanie]

And reappeared...

[JM Hanes]

That's Typepad's favorite little game, Stephanie. If you wait to if a comment will show up a little later, it never does. If you repost, it shows up almost right away -- singin' nana, nana, na na.

[Rick Ballard]

Stephanie,

I think it's time to sacrifice a prog to Typhuspad. Perhaps Mr. Uk could work up a raffle for a once in a lifetime trip to see Kilauea.

[Stephanie]

"As the financial crisis eases, an energy shortage lies ahead," Goldman analysts Jeffrey Currie in London and David Greely in New York wrote in a research report e-mailed today. The bank set a 12-month price target of $90 a barrel, up from $70, and introduced a forecast of $95 for the end of 2010.

Someone (name starts with an S) must be getting heavily involved in the oil markets again. Ain't no way the "financial crisis eases" causing an oil shortage... we are swimming in oil right now and the "financial crisis" isn't going to ease anytime soon. And not with the massive buildup of $$ in the mattresses and the job openings gapping job losses by upwards of 400%. Can we officially rename it Government Sachs now????

And the commenters aren't buying it either and it's the LA Times... not known for their conservative commenters.

[clarice]

Seems like just yesterday G-S pegged oil prices to rise to $150 a barrel. That one really worked out.

[Stephanie]

I lovingly nominate semen stain. ;)

/that's how I always read the name anyways... a waste of DNA...

[larry]

AFLAC! I think the correlation between serious medical problems and BK is not the med bills, but the ill/injured party's inability to work. Many live hand-to-mouth and interrupting their cash flow starts the ball rolling. I say AFLAC because they sell payroll deduction DISABILITY insurance that provides a percentage of regular income for a given time. Other insurers do the same and many professionals carry high dollar individual policies.

[Melinda Romanoff]

GS is having fun pumping its own position,

Tyler's been a busy boy.

Read the LUN, and then read the Chrysler testimony at the home link.

This is what the intertubes was designed for...

Night all.

[RichatUF]

Steph-

It's an excuse for the Obama Administration to either sell off the SPR (and re-fill it with low quality Venezuelan oil) or to use the SPR as a price control mechanism. And $70/bbl seems to be the inflection point where the bite of oil costs propagates into the economy. So much for the Obama "tax cut" and those oft mentioned "green shoots". Wonder how Obama's popularity will hold up with $3/gal gas and a 20% increase in power bills, before he even gets to his cap-and-trade program or all his other "green" initiatives.

[narciso]

Well Edward Morse, formerly of Lehman Bros, seems to called it right, the first time.
Goldman seem to have gotten it,spectacularly
wrong. at least in the short run.Iunderstand
that this mass debauching of the currency, what in a different context, would be called
'nongenuine destabilization' big WiseGuy fan, years ago. Demand still seems to be slow although the Chinese and the Russians seem to planning ahead, while we are seemingly performing the Tonya Harding to our own industrial infrastructure.

[Cloak the raven, Nevermore.]

Heh, MTT, Leo was depicting his doctor, the poor soul.

[Fresh Air]

Melinda--

What does Durden do? Does he run a fund, or is he just an Internet gadfly? He i busy--and thorough, too.

[clarice]

I love virginia postrel--from instapundit:
VIRGINIA POSTREL: First, fix Medicare: “Think about this for a moment. Medicare is a huge, single-payer, government-run program. It ought to provide the perfect environment for experimentation. If more-efficient government management can slash health-care costs by addressing all these problems, why not start with Medicare? Let’s see what ‘better management’ looks like applied to Medicare before we roll it out to the rest of the country

[Stephanie]

...politics may have been at play in the Muhammad case as well as in other cases involving Black Muslim converts. Several weeks ago, STRATFOR heard from sources that the FBI and other law enforcement organizations had been ordered to “back off” of counterterrorism investigations into the activities of Black Muslim converts. At this point, it is unclear to us if that guidance was given by the White House or the Department of Justice, or if it was promulgated by the agencies themselves, anticipating the wishes of President Barack Obama and Attorney General Eric Holder.

We're in the very best of hands...

LUN

[Blue Ox]

Just as commercial Television sought to muddy the waters of competition with their 1950's war of words, calling Cable TV "Pay TV"

And here I've been mailing in a check with my cable bill every month like a chump.

[Danube of Thought]

Remember when it was considered bad form to politicize the justice department?

[Frau Jedöns]

"politicize the justice department?"
President GWB was criticized for removing six federal attorneys who did *not* move fast enough in prosecuting voting fraud and now AG Holder thinks the fed. govt. can order the state of GA to stop cleaning up its voting procedures. I wonder how Wise Sonia would "feel" about that?

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[glasater]

I've always wondered how much lawsuits add to health care costs.

OB/GYN docs pay enormous insurance premiums and those premiums have kept one such doctor and his family quite poor.

[glasater]

Here's one article on Soros and Energy.

[Ann]

‘Any world order that elevates one nation over another will fail..” President Hussein 2009

What a depressing day for a nation that gives blood and treasure around the world for good and asks for "no repayment" not even a "thanks".

There are so many things wrong with Hussein's speech today that have made me livid. That statement keeps me up because he believes our country is bad. He has told our allies that you can not trust us anymore. Justice is not blind anymore, it depends on who controls the power in our country not the people who died for it.

And then there is this: "And finally, just as America can never tolerate violence by extremists, we must never alter our principles. 9/11 was an enormous trauma to our country. The fear and anger that it provoked was understandable, but in some cases, it led us to act contrary to our ideals. We are taking concrete actions to change course. I have unequivocally prohibited the use of torture by the United States, and I have ordered the prison at Guantanamo Bay closed by early next year.

Yes, he just told the world that our military sucks, kills, tortures, occupies, and is BAD and he alone will solve the United States of America's shame in the world.

9/11 did not happen...it was just a nightmare.

[Stephanie]

The government is also pursuing a separate revamping of financial-sector rules that could change industry compensation practices more broadly. For instance, the Federal Reserve is considering rules that would curb banks' ability to pay employees in a way that would threaten the "safety and soundness" of the bank.

First they came for the bankers....

There are stirring in banking that the government is going to unionize the rank and file employees in all TARP receiving firms - one way to increase the numbers of people dependent on the democrats for their livelihoods and ensuring more dem voters. They are already demanding that the banks eliminate their independent contractors...

LUN

[narciso]

And he did in Cairo, possibly one of the most corrupt, violent, torture crazed lands.
I've read Silva, Al Aswani, Sussman, it does rankle deeply. The 'right to wear the hijab' who is he kidding, in Marseilles, maybe but in Cairo.

[Elliott]

Though I imagine myself a trenchant analyst of leftist rationalizing, I am at a loss in reconciling these two statements from Obama's speech:

We were born out of revolution against an empire.

And:

Palestinians must abandon violence. Resistance through violence and killing is wrong and does not succeed. For centuries, black people in America suffered the lash of the whip as slaves and the humiliation of segregation. But it was not violence that won full and equal rights. It was a peaceful and determined insistence upon the ideals at the center of America’s founding.

This same story can be told by people from South Africa to South Asia; from Eastern Europe to Indonesia. It’s a story with a simple truth: that violence is a dead end. It is a sign of neither courage nor power to shoot rockets at sleeping children, or to blow up old women on a bus. That is not how moral authority is claimed; that is how it is surrendered.

Apologies if this has already been mentioned and I missed it.

[narciso]

In South Africa, it was Unkhonto Du Sizwe, the Spear of the Nation, founded by Mandela but later presided over by Mbeki and even with a hand by Zuma,along with the sanctions regime that really brought the edifice down. The economic crisis,triggered by Soros, when he was playing the Baht and the Renimbi, had a lot to do with the Indonesian crisis, that toppled Suharto,
and the expansion of AQ in the whole of South East Asia. Eastern Europe is an exception, to that sad trend, with the possible exception of the former Yugoslavia.

[sylvia]

I agree that the problem of bankruptcies and medical bills is more complex than the article on the study suggests. However Tom, does it not seem odd that there are medical bills, at all, as part of the problem, especially with people with health insurance? If you have health insurance, you are not supposed to have problem medical bills. At least not in a perfect world. That right there should be a clue not to discount this study.

It seems to me that you may have a point that the problem is loss of employment because of disability. But what typically happens when you lose your job? You lose your health insurance, and just when you need it most, if you have a disablity. Then if you have a precondition, like a disability, you can't get any other health insurance. So no matter which way you look at it, it is still a health insurance problem.

Tying health insurance to work is crazy. We need to have an alternative. And you all need to be honest about it or the Democrats will keep winning. Now don't look to England because I read the London Times a lot and see that they are complaining about their system all the time. However, I hear that France Germany and Italy are doing much better.

I know in England you are forced to stay within the system and if you want to pay for any other treatment they punish you by cutting your benefits. I don't believe it is the same in France and you can supplement your treatment if you can pay for it. And that seems to work much better because then there is at least some private competition. I think Obama is right in that we need to have two systems and a stepped approach and use some experimenting so we can slowly adjust to a society where many people will be self-employed.

[Pofarmer]

I don't believe it is the same in France and you can supplement your treatment if you can pay for it.

And this solves the imaginary bankruptcy problem somehow?

I'm with sbw, the solutions is low cost catastrophic coverage, but, that doesn't answer the right question, which is, how can politicians get more power and control.

[sylvia]

Here's an fyi from Wiki. See Germany has a two tiered system and I heard it's performing very well, much better than England. However that may be in part to German efficiency, but still we can try to do some of the same here:

-------------

Germany has the world's oldest universal health care system...has gradually expanded to cover virtually the entire population.

[70] Currently 85% of the population is covered by a basic 'Statutory Health Insurance' plan, which provides the standard level of coverage.

The remainder opt for private health insurance, which frequently offers additional benefits. According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004.[60]

The government partially reimburses the costs for low-wage earners, whose premia are capped at a predetermined value. Higher wage workers pay a premium based on their salary. They may also opt for private insurance, which is generally more expensive, but whose price may vary based on the individual's health status.[71]

[sylvia]

"And this solves the imaginary bankruptcy problem somehow?"

It won't solve the whole problem, but it will alleviate the crushing medical bills when someone has a disability. It might help some of the problem.

"I'm with sbw, the solutions is low cost catastrophic coverage, but, that doesn't answer the right question, which is, how can politicians get more power and control."

Yes I agree low cost catastrophic is a good place to start. I think the trick to avoid total government control is to offer a public/private mix, like in Germany, and let people choose

[MeTooThen]

If you have health insurance, you are not supposed to have problem medical bills. At least not in a perfect world.

(A bit long but not a rant.)

The purpose of health insurance is to offset the cost of your health care as some people will remain healthy, others not, and the science of actuary does the rest.

This, I believe, is one of the fundamental problems with this country's view toward health care: that it should be "cost-free", in other words, either the government pays for it, or you do up front vis a vis your premium.

The cost of your premium and "co-pay" (which often is a token, not always, but often) does not allow for your provider to fully absorb the cost of doing business.

In our practice, our cost of "ordering a test" is sky-rocketing. Imagine that, it costs our practice money to order a test on behalf of one of our patients.

My staff spends hours each day, on the phone, fax, computer, with insurance companies, the state, and other adjusters just to see to it that the MRI I feel is needed is done.

Add to that, the number of tests that are ordered by all practices, and some that are done by doctors practicing "defensive medicine" and the cost of just test-ordering becomes humongous.

Ordering tests is becoming a cost center.

Think about that.

Now, add to that all of the staggering costs in OSHA, HIPPA, and other federal mandates, and what you're left with is a low margin, high-risk, and very difficult and complex business.

Notice I have said nothing about the difficulty or complexity of actual medical practice.

For those that think their chiropractors or homeopaths or accupuncturists can do a better job than your allopathic physician of treating what ails you, and by this I mean more than your unhappiness and neurosis, please, by all means, enjoy.

Ascending cholangitis?

Once lethal, now, piece of cake.

Acute myocardial infarction, once near universally debilitating or lethal, now, not so much.

Oh, and by the way, in practice you must be compassionate, smart, never wrong, always available, even if your patients are rude, non-compliant, hostile, litigious, malingering, and have no interest in being healthy or recovering.

Good luck with that.

The solution to this enormous and complex dynamical system, if their is a solution, is to reframe expectations and understandings of what health care means and what it can and cannot do. That, and what responsibility the patient has in his or her care.

Without this, the system will collapse. It may have already passed the bifurcation point. What's next is the Obama Iteration, and if you are unhappy now, just wait.

Misery lies ahead.

Out here.

[Pofarmer]

I dunno sylvia. From Tarp, to the bailout, to countless other programs, this administration has been about what it can ram through, not, "what the people choose", although that sounds nice and all.

[narciso]

We tried catastrophic insurance in 1988, the premiums on the elderly, Rostenkowski was nearly overturned in his car. This crew shows no understanding of that basic fact, and Sebelius is not the equal of Stafford Cripps or Beveridge, the men behind the NHS.

Like I pointed out earlier, if ThinkProgress
and the Huffington Post, two outposts of the sinisphere, are guiding the intellectual
conversation, such as it is, we're in deep trouble.

[jimmyk]

I have unequivocally prohibited the use of torture by the United States

Gosh, and here I thought it had already been prohibited.

What a jerk, to suggest that torture was legal before and "I" prohibited it. What a way to smear the country's name, all for self-aggrandizement.

He could have said something like "Our country's reputation for liberty and human rights is so important that we have ended practices that even come close to some people's concept of torture. We do not want to be even near that line." But it's all about him.

[Captain Hate]

This is all the fault of the founding fathers; if they would've included free health care and gay marriage in the Bill of Rights, Bammers wouldn't have to apologize to the rest of the world, although he'd probably find something else to whine about.

[Sue]

You lose your health insurance, and just when you need it most, if you have a disablity.

Which is why they invented SSI.

I'll tell you a short story about the government. They are idiots. I called Medicare to tell them we were taking no fees for settling an automobile accident and the insurance company was tendering the limits. Medicare would be entitled to all of the settlement proceeds, less any amount we retained for our services. I told them upfront we were not taking any fees or reimbursement expenses, just tell me where to send the check. The government employee read me a list of what I needed to send them, including a detailed statement of our fees. I repeated, we are tendering the entire limits of the insurance proceeds to Medicare. No deductions, just a check for the entire amount. Where do they want me to send it? She had to transfer me to a supervisor, who transferred me to her supervisor, who transferred me to her supervisor. Each one of them read me a laundry list of what I needed to send them, including a detailed statement of our fees. I finally said give me the freaking address and I'll send you a detailed list. I sent them a statement with zeros along with the settlement check. I kid you not, about a month later they sent me a letter repeating what the idiots on the phone had already said. They cannot think outside the box. The government won't let them.

They cashed the check, btw.

[Sue]

http://www.gallup.com/poll/120761/Cheney-Pelosi-Poor-Ratings-Common.aspx>Go Cheney, go Cheney

According to a May 29-31 Gallup Poll, 37% of Americans have a favorable view of Cheney and 34% have a favorable view of Pelosi.

[Pagar]

I can not imagine the Democrats allowing any private medical insurance or private practice by medical doctors. These are huge private industries which they can shut down in their efforts to turn America into a totally communistic regime. They are not going to pass up this opportunity.

[Neo]

The unemployment number looks worse than the Recovery Plan (or without it)

[Bill in AZ]

Speaking of polls, Chairman Zero's approval index hit Zero. Expect fields of Green Shoots to erupt all over the State Run Media in the next few days.

Someone will have to tell Soros to stop dicking with oil prices for a few weeks until the administration can get this approval stuff back under control. Artificial high gas prices are not going to help.

[Porchlight]

Rasmussen convergence, finally. I'm honestly surprised it happened, as it was looking like he was going to skate for quite awhile.

Now we'll see where it goes from here. Yes, green shoots will erupt, but GOP milquetoasts may also become a little braver.

[Stephanie]

On the bankruptcy note... it is entirely possible to have perfectly wonderful health insurance and still get hefty medical bills... case in point.. my daughter was born with a cleft palate and Pierre Robin Syndrome. The health insurance company had a list of doctors to choose from for treatment. Problem is, the number one doctor in the area was not on the list. We elected to go with him and pay the difference for out of network services. It's not like you want to trust your child's appearance and speech issues to the second best... anyways, the cost difference was almost $30K. I was unable to work for the first 2 years of her life until she was no longer on heart monitors and breathing monitors... couldn't find a caregiver who would take on THAT responsibility. Peanut butter and jelly sammiches were de riguer at that point for dinner.

When you are dealing with issues like this, you go for the best and figure out how to pay for it later. The doctor was wonderful and worked with us to arrange a payment schedule for the 5 surgeries. The Craniofacial Center at the hospital that we used for speech therapy, occupational therapy etc, was in service and thus covered, after the deductible and copays...

So, yes you can make choices with excellent health insurance and still have a hell of a bill come due...

[Rick Ballard]

Hey! No stomping on green shoots allowed!

The drop in employment was lower than anticipated. Sure, the increase in the number of unemployed people by 787K in May seems a little discouraging but you have to put it in context. It's better than the 851K losses in February (we just won't talk about the 500K January number or the 694K March number or the 563K April number). Nor will we speak of the reduction in index of aggregate weekly hours. 'Cause, ya know, that would count for like an additional 300-400K jobs lost.

And whatever you do, keep your mouth shut about the drop in retail sales. That 4% reduction is totally meaningless in the Age of Ogabe.

[narciso]

It's a tick under the 1982 record for the equivalent period, and on par with 1975