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Froma Harrop - Price-gouging in 'free-market' medicine

When folks pan the Affordable Care Act for being nearly 3,000 pages long, here's a sensible response: It could have been done in a page and a half if it simply declared that Medicare would cover everyone.
The concept of Medicare for All was pushed by a few lonely liberals. And it would have been, ironically, the most conservative approach to bringing down health care costs while maintaining quality.
Medicare bringing down health care costs? "Ha, ha, ha," says the program's foes, citing the spending projections for the government health plan serving older Americans.
Unfortunately, the critics confuse spending levels with costs. Total Medicare spending is bound to rise as more older Americans live longer.
Sure, you can curb that increase through a voucher system limiting how much taxpayers will subsidize each beneficiary. But that's not the same as curbing the cost of treating a heart attack or cancer. Without Medicare's cost controls, the size of the bill for each course of care would be larger. Which is exactly what the medical-industrial complex wants.
A Time magazine piece by Steven Brill is must-reading on this subject. For all the waste and perverse incentives in Medicare, the federal program remains an oasis of cost-control in a desert of price-gouging by medical institutions, many parading around as "nonprofits."
Brill writes of Sean Recchi, a 42-year-old Ohioan with lymphoma. Suffering chills, pains and sweats, he rushed off to the famed MD Anderson Cancer Center in Houston. Anderson wouldn't accept the Recchis' bare-bones insurance plan and required $83,900 upfront for an examination and initial doses of chemotherapy. (His mother-in-law wrote the checks.)
How did the bill get that high? Shameless overcharging. For example, the hospital charged Recchi $283 to have a simple chest X-ray for which Medicare would have paid $20.44. Recchi was billed more than $15,000 for blood and other lab tests. Medicare would have paid only a few hundred for the same thing.
"Why does simple lab work done during a few days in a hospital cost more than a car?" Brill asks rhetorically.
Recchi was charged $13,702 for a round of the cancer drug Rituxan. Researching how much hospitals pay for Rituxan, Brill estimated that Anderson had marked up the price 400 percent. And so on.
Janice S., age 64, felt chest pains and took herself to Stamford Hospital in Connecticut. While there, she was given three troponin tests to measure proteins in the blood. She was charged $199.50 for each troponin test. Had she been a year older and on Medicare, the hospital would have been paid only $13.94 for each test. The heart-attack false alarm ended up costing her $21,000.
Where does all this money end up? In the pockets of hospital administrators, doctors and makers of equipment and drugs on which the medical profession can multiply the markups.
Hospitals gripe that they lose money on Medicare patients, but that isn't true. As Jonathan Blum, deputy administrator of the Centers for Medicare and Medicaid Services, told Brill: "Central Florida is overflowing with Medicare patients, and all those hospitals are expanding and advertising for Medicare patients. So you can't tell me they're losing money."
Many Republicans and some Democrats want to cut Medicare spending by raising the eligibility age. That makes minus-zero sense. If anything, the age should be lowered.
This is not to say that Medicare doesn't waste money. Under current rules, for example, it must cover treatments that work, even when another, cheaper means of care does just as good a job.
But the economics of medicine in the private sector bears little resemblance to a real free market. Hospitals routinely put on a magic show designed to bilk ordinary Americans, especially — and tragically — the underinsured.
(A member of the Providence Journal editorial board, Froma Harrop writes a nationally syndicated column from that city. She has written for such diverse publications as The New York Times, Harper's Bazaar and Institutional Investor.)

Last Updated on Wednesday, 31 December 1969 07:00

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Pat Buchanan - Infantile conservatism

Regularly now, The Washington Post, as always concerned with fairness and balance, runs a blog called "Right Turn: Jennifer Rubin's Take From a Conservative Perspective."
The blog tells us what the Post regards as conservatism.
On Monday, Rubin declared that America's "greatest national security threat is Iran." Do conservatives really believe this?
How is America, with thousands of strategic and tactical nuclear weapons, scores of warships in the Med, Persian Gulf, Arabian Sea and Indian Ocean, bombers and nuclear subs and land-based missiles able to strike and incinerate Iran within half an hour, threatened by Iran?
Iran has no missile that can reach us, no air force or navy that would survive the first days of war, no nuclear weapons, no bomb-grade uranium from which to build one. All of her nuclear facilities are under constant United Nations surveillance and inspection.
And if this Iran is the "greatest national security threat" faced by the world's last superpower, why do Iran's nearest neighbors — Turkey, Iraq, Azerbaijan, Afghanistan, Pakistan — seem so unafraid of her?
Citing The Associated Press and Times of Israel, Rubin warns us that "Iran has picked 16 new locations for nuclear plants." How many nuclear plants does Iran have now? One, Bushehr. Begun by the Germans under the shah, Bushehr was taken over by the Russians in 1995, but not completed for 16 years, until 2011. In their dreams, the Iranians, their economy sinking under U.S. and U.N. sanctions, are going to throw up 16 nuclear plants.
Twice Rubin describes our situation today as "scary."
Remarkable. Our uncles and fathers turned the Empire of the Sun and Third Reich into cinders in four years, and this generation is all wee-weed up over Mahmoud Ahmadinejad.
"For all intents and purposes, (Bibi) Netanyahu is now the West's protector," says Rubin. How so? Because Obama and Chuck Hagel seem to lack the testosterone "to execute a military strike on Iran."
Yet, according to the Christian Science Monitor, Bibi first warned in 1992 that Iran was on course to get the bomb — in three to five years! And still no bomb.
And Bibi has since been prime minister twice. Why has our Lord Protector not manned up and dealt with Iran himself?
Answer: He wants us to do it — and us to take the consequences.
"With regard to Afghanistan, the president is pulling up stakes prematurely," says Rubin.
As we are now in the 12th year of war in Afghanistan, and about to leave thousands of troops behind when we depart in 2014, what is she talking about?
"In Iraq, the absence of U.S. forces on the ground has ushered in a new round of sectarian violence and opened the door for Iran's growing violence."
Where to begin. Shia Iran has influence in Iraq because we invaded Iraq, dethroned Sunni Saddam, disbanded his Sunni-led army that had defeated Iran in an eight-year war and presided over the rise to power of the Iraqi Shia majority that now tilts to Iran.
Today's Iraq is a direct consequence of our war, our invasion, our occupation. That's our crowd in Baghdad, cozying up to Iran.
And the cost of that war to strip Iraq of weapons it did not have? Four thousand five hundred American dead, 35,000 wounded, $1 trillion and 100,000 Iraqi dead. Half a million widows and orphans. A centuries-old Christian community ravaged. And, yes, an Iraq tilting to Iran and descending into sectarian, civil and ethnic war. A disaster of epochal proportions.
But that disaster was not the doing of Barack Obama, but of people of the same semi-hysterical mindset as Ms. Rubin. She writes that for the rest of Obama's term, we "are going to have to rely on France, Israel, our superb (albeit underfunded) military and plain old luck to prevent national security catastrophes."
Is she serious?
Is French Prime Minister Francois Hollande really one of the four pillars of U.S national security now? Is Israel our security blanket, or is it maybe the other way around? And if America spends as much on defense as all other nations combined, and is sheltered behind the world's largest oceans, why should we Americans be as frightened as Rubin appears to be?
Undeniably we face challenges. A debt-deficit crisis that could sink our economy. Al-Qaida in the Maghreb, Africa, Arabia, Iraq and Syria. North Korea's nukes. A clash between China and Japan that drags us in. An unstable Pakistan's nuclear arsenal.
But does Iran, a Shia island in a Sunni sea, a Persian-dominated land where half the population is non-Persian, a country whose major exports, once we get past fossil fuels, are pistachio nuts, carpets and caviar, really pose the greatest national security threat to the world's greatest nation?
We outlasted the evil empire of Lenin and Stalin that held captive a billion people for 45 years of Cold War, and we are frightened by a rickety theocracy ruled by an old ayatollah?
Rubin's blog may be the Post's idea of conservatism. Ronald Reagan wouldn't recognize it.
(Syndicated columnist Pat Buchanan has been a senior advisor to three presidents, twice a candidate for the Republican presidential nomination and the presidential nominee of the Reform Party in 2000. He won the New Hampshire Republican Primary in 1996.)

Last Updated on Wednesday, 31 December 1969 07:00

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Michelle Malkin - Obama out to destroy thousands of good paying jobs

Here's the latest example of head-splitting cognitive dissonance in Washington: President Obama used his State of the Union address to crusade for a revitalized U.S. manufacturing sector. But while he pays lip service to supporting businesses that build their products on American soil, Obama and his left-wing operatives are hell-bent on driving a key sector of the U.S. manufacturing industry six feet under: the American firearms and ammunition industry.
The White House is pushing new government spending to "spur economic growth," protect manufacturing plants and "create good-paying jobs" to help America's middle class. Yet across the country, with aggressive lobbying by the White House itself, Democrats are working to destroy tens of thousands of good-paying jobs and the firms that created them. Assault rhetoric has lasting real-world consequences.
In New York, Democratic Gov. Andrew Cuomo imposed radical, ineffectual gun-grabbing measures that are backfiring in more ways than one. Nearly half a dozen gun companies have now announced that they will no longer sell their products to police in the Empire State. In protest of Cuomo's gun-control regime banning citizens from owning semi-automatic rifles or shotguns because of cosmetic features deemed "military-style," Washington-based Olympic Arms "will no longer be doing business with the State of New York or any governmental entity or employee of such governmental entity within the State of New York."
According to USA Today, other companies including "LaRue Tactical, York Arms, Templar Custom and EFI, as well as sporting-goods retailer Cheaper Than Dirt" have also joined the sales boycott of New York.
Worse news for New York citizens: At least one local manufacturer, the storied Remington Arms Company founded in Ilion, N.Y., in 1816, is in dire financial danger as a result of Cuomo's draconian regulations. The company's innovations in weaponry and ammunition have been used in sporting, self-defense, law enforcement and warfare for two centuries.
Now, as a result of hysteria-induced government pandering, nearly 40 percent of Remington's weapons can no longer be sold to citizens legally. Its small-town plant employs more than 1,300 people in a town of 8,000 and generates revenue of an estimated $400 million from sales in the U.S. and 55 other countries. As an Ilion local official noted, "Remington is not only a major employer, but it's a historic employer. It's been part of our very fiber for 200 years."
And so it is with the rest of the industry. Despite tough economic times, firearms and ammunition companies have created nearly 27,000 well-paying jobs over the past two years alone, according to the National Shooting Sports Foundation. Businesses in the United States that manufacture, distribute and sell firearms, ammunition and hunting equipment employ nearly 100,000 people in the U.S. and generate an additional 110,000-plus jobs in supplier and ancillary industries.
"These are good jobs, paying an average of $46,858 in wages and benefits," the NSSF reports. In addition, "the firearms and ammunition industry was responsible for as much as $31.84 billion in total economic activity in the country ... (and) the industry and its employees pay over $2.07 billion in taxes including property, income and sales based levies."
In my adopted home state of Colorado, where unemployment hovers near 8 percent, nearly a dozen businesses are being forced to consider leaving their home state because of extremist gun-control proposals. Vice President Joe Biden himself leaned on Democratic lawmakers to support an arbitrary 15-round limit on ammunition magazines. So, what have Sheriff Joe and his gun-grabbing pals wrought? Denver-based ammo magazine manufacturer Magpul served notice that it will take its 400 full-time employees and subcontractors somewhere else. Magpul generates some $85 million in spending in the state.
As the Denver Post reported, the privately held company makes an array of consumer products in addition to sales to the military, law enforcement and gun owners. And because Magpul has made a conscientious effort to support other Colorado companies, the ripple effect could reach far beyond the gun industry — including several cutting-edge innovators in the plastics-injection-molding business. One of Magpul's most important contractors, Denver-based Alfred Manufacturing Co., employs 150 residents. It, too, will "relocate part or all of our operations out of state" if Democrat Gov. John Hickenlooper enacts the stringent gun-control regime pushed by Biden and company. The company has already put expansion plans on hold.
Smart lawmakers from Texas, Michigan, Oklahoma, Arizona and South Carolina are now courting Remington away from New York and Magpul away from Colorado. For now, these states can offer business-friendly, Second Amendment-defending climates that support a demonized industry. But how much longer will it be until Obama and the pro-jobs hypocrites on Capitol Hill find new, more nefarious ways to obstruct this innovation-driving, wealth-producing sector of the American economy? Make no mistake: Gun-control demagoguery is a lethal weapon.
(Syndicated columnist Michelle Malkin is the daughter of Filipino Immigrants. She was born in Philadelphia, raised in southern New Jersey and now lives with her husband and daughter in Colorado. Her weekly column is carried by more than 100 newspapers.)

Last Updated on Friday, 22 February 2013 23:45

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Bob Meade - Drip, drip, drip

When did sovereignty become a bad thing? Or undesirable? Or not to be protected? Each of us is sovereign, and our nation and others are sovereign. Sovereign translates to "independent", which is essential to a free people. If our government decides to, essentially, let our national sovereignty lapse, can our individual sovereignty/freedom be far behind?
Who decided to ignore our established boundaries? Who decided not to enforce duly enacted laws? Who decided to start penalizing those who follow the rules and begin rewarding those who don't? Who decided it was okay to court those who violate our immigration rules? It seems like we can fill the page with those questions, but perhaps the most important one is, why have we, the people, allowed it to happen?
It seems like we, the people, are being led like sheep. Instead of following the Constitution, or duly enacted laws, or past precedents of the courts, we nod our heads in acceptance of some commentator's or some politician's feel good suggestions. Who needs a law when what we want to do feels like it's right? Is political correctness the answer to everything?
The essence of management is to prevent things from happening that you don't want to happen. Using our sovereignty example, are you willing to give up your sovereignty, your freedom? Do you think our nation should have open borders and allow any and all people to come in? If you do, should they receive all the benefits of native born citizens? If you answered no to any of those questions, you are thinking like a manager. Now the question becomes, how do you prevent those undesired things from happening?
And what of other things that you don't want to happen. For example, do you want the federal government to continue to assume the powers the Constitution left to the states? Do you believe the government has the right to absolve people, in advance, of their personal responsibility? Do you believe the executive branch has the authority to tell grocery stores they must label extensive dietary information on things like salads or other prepared foods? Even if the deli makes you a sandwich? Do you believe that without enacting a duly passed law, the government should have the ability to put a grocer in jail and/or impose a fine for failing to properly label that salad or sandwich? Do you believe it is not the duty of the government to dictate what food you can eat and drink, that such decisions are yours to make?
These things chip away at our freedoms. We become observers as our sovereignty, our independence gives way to federal dictates. We watch as the Constitution is ignored or bypassed. Our leaders substitute political correctness, feel good decisions, in place of the rigor required to affect change as put forth in the constitutional process. Ad hoc government! And we, the people, ignore the shredding of the documents that placed the power of government in we, the people.
We have not seen our liberties snatched from us in one giant grab. What we have seen, and are undergoing, is more akin to what has been called, Chinese water torture. That is when drops of water are continually dripped on a person's forehead, with the frequency of the drip being varied, sometimes slower, sometimes faster. Such is the case with our liberties, our freedoms, our sovereignty. A continuing drip that gradually takes away what for centuries has been determined to be our unalienable right to life, liberty, and the pursuit of happiness.
The government dictates what children must be fed in their school cafeterias. No matter that substantial amounts of that food is emptied into the trash because the students don't like it and refuse to eat it. And, the government has gone so far as to take away from students the lunches prepared for them by their mothers, because the government decided they didn't have the proper nutritional value. Even soda! The government (NYC Mayor Bloomberg) decided that merchants could not sell carbonated beverages that were more than 16 ounces. How far into our lives, our decisions, will we allow the government to tread?
And we have the government imposing its "humanism" into religious individuals and institutions, not by the passage of a Constitutional Amendment or a duly enacted law, but by allowing cabinet departments to write regulations that are a finger in the eye of the First Amendment. Instead of our unalienable rights being protected by the Bill of Rights, we see the government ignoring the Constitution and our individual sovereignty, and disrespecting the separation of powers and the rigors of the legislative process.
Stop the drip, drip, drip, before it's too late.
(Bob Meade is a resident of Laconia.)

Last Updated on Thursday, 21 February 2013 21:15

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Jim Hightower - Do more than the minimum on minimum wage

"In the wealthiest nation on earth," President Obama declared in his State of the Union speech, "no one who works full-time should have to live in poverty."
Right! Way to go! Not only does his call to raise America's minimum wage put some real pop in populism, but it could finally start putting some ethics back in our country's much-celebrated (but rarely honored) "work ethic." Kudos to Obama for putting good economics and good morals together — and for putting this long overdue increase on the front burner.
But then came the number: $9 an hour. Excuse me, Mr. President, but if you're going to bother making the fight, why start out with a number so low that many minimum-wage employees would still "have to live in poverty"?
About 60 percent of America's lowest-paid workers are women, including single moms struggling awfully hard to make ends meet. Yet, at your $9 an hour level, a single woman with two children, would, in fact, be paid a poverty wage. And, since you would slowly phase-in the increase, she wouldn't even be paid that until nearly two years from now.
Yes, nine bucks is a buck-seventy-five better than the current low wage of high misery, but it doesn't even elevate the buying power of our nation's wage floor back to where it was in 1968. Nor, by the way, does it match the $9.50-level you pledged to push in 2008 when you were running for president.
This is not merely about extending a badly needed helping hand to people struggling to work their way out of poverty, but it's also about enabling them to give a bottom-up jolt of new energy to our economy, which it desperately needs.
Ironically, while super-rich corporations are hoarding trillions of dollars in offshore accounts, refusing to invest in our nation, minimum-wage workers will invest every extra dollar they get in America — spending it right where they live on clothing, food, transportation, health care and other needs.
A 2011 Federal Reserve study found that a $1 hike in the minimum wage produces an additional $2,800 a year in spending by each of those households — so this is no time to shortchange these workers.
Yes, I know that congressional Republicans' idea of governing is, first, to snap a sharp "No," and only then ask what the proposal is. So, at the direction of corporate lobbyists, they were bleating a loud negative to any wage hike — and when Obama proposed $9, GOP House leader John Boehner jumped on it like a gator on a poodle.
Incredibly, he claimed that raising the wages of our country's most poorly paid workers would hurt — guess who? — America's most poorly paid workers! This disingenuous pitting of poor people against themselves is derived from a corporate manufactured political myth that hiking the minimum pay squeezes small-business owners to the breaking point, "forcing" them to fire employees or even go bankrupt. "When you raise the price of employment," Boehner grumped, "guess what happens: You get less of it."
Well, guess again, John. That "job killer" fable has been debunked again and again by real world experience. Over decades, the pay floor has constantly been elevated by Congress, states and cities, and the great preponderance of studies show that it causes little to zero negative impacts on job numbers, but very positive results for employee morale, productivity and turnover. It also tends to generate a nice income boost for — guess who — small businesses, as wage earners spend their increase in pay in the local economy.
Obviously, the major impact of the raise is to lift incomes of about 18 million hardworking people being paid at or near the minimum. This allows them to save enough to make a down payment on a used car or to enroll in a couple of community college classes. Plus, it gives at least a token nod to the essential need of bridging America's dangerously widening chasm of economic inequality.
The real shame in the Republican leader's attack is not its flagrant dishonesty, but the raw disdain that it flings at low-wage workers. The hidebound "no's" in our society — including Boehner, Mitt Romney, the Koch brothers and Wall Street billionaires — see working people in terms of their price tags, not in their value. This dehumanized contempt for the working class not only stains these corporate elitists, but it also holds back America's phenomenal economic potential — and this contempt of America's workaday majority is social dynamite.
While those power elites say "no," the American people overwhelmingly say "yes." A poll last June found that seven out of 10 of us — including a majority of Republican women (but not men) — favor raising the minimum wage above $10 an hour. So, Mr. President, this is not a time for meek proposals. Think big, and take it to the people.
(Jim Hightower has been called American's most popular populist. The radio commentator and former Texas Commissioner of Agriculture is author of seven books, including "There's Nothing In the Middle of Road but Yellow Stripes and Dead Armadillos" and his new work, "Swim Against the Current: Even Dead Fish Can Go With The Flow".)

Last Updated on Thursday, 21 February 2013 21:12

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