The Way We Live Now: Planned Medical Obsolescence

On the one hand, some medical advances even skeptics might call miracles. On the other… Show Us on the Doll Where the Invisible Hand Touched You. Elisabeth Rosenthal at the NYTimes:

Catherine Hayley is saving up for an important purchase: an updated version of the tiny digital pump at her waist that delivers lifesaving insulin under her skin.

Such devices, which tailor insulin dosing more precisely to the body’s needs, have transformed the lives of people with Type 1 diabetes like Ms. Hayley. But as diabetics live longer, healthier lives and worries fade about dreaded complications like heart attacks, kidney failure, amputations and blindness, they have been replaced by another preoccupation: soaring treatment costs…

A new model, along with related treatment supplies, prices out at tens of thousands of dollars for this year and will cost her about $5,000, even with top-notch insurance. “It’s great,” Ms. Hayley said, “but it all adds up.”…

That captive audience of Type 1 diabetics has spawned lines of high-priced gadgets and disposable accouterments, borrowing business models from technology companies like Apple: Each pump and monitor requires the separate purchase of an array of items that are often brand and model specific.

A steady stream of new models and updates often offer dubious improvement: colored pumps; talking, bilingual meters; sensors reporting minute-by-minute sugar readouts. Ms. Hayley’s new pump will cost $7,350 (she will pay $2,500 under the terms of her insurance). But she will also need to pay her part for supplies, including $100 monitor probes that must be replaced every week, disposable tubing that she must change every three days and 10 or so test strips every day.

That does not even include insulin, which has been produced with genetic engineering and protected by patents, so that a medicine that cost a few dollars when Ms. Hayley was a child now often sells for more than $200 a vial, meaning some patients must pay more than $4,000 a year. Other refinements have benefited a minority of patients but raised prices for all. There are no generics in the United States.

Companies that produce the treatments say the higher costs reflect medical advances and the need to recoup money spent on research. But David Kliff, a financial analyst who is editor of Diabetic Investor, an independent newsletter on the industry, points out: “Diabetes is not just a disease state; it’s a huge business, too.”…

In Mr. Kliff’s defense, he’s not just a businessman, he’s also a client — per the heading at DI, he’s a Type I diabetic patient himself.

By all means, read the whole article. The author also included two separate comment streams — Can you relate an experience when pharmaceutical marketing influenced your treatment? and Have you delayed treatment or made life decisions based on the cost of your chronic condition? If the Democrats want to make some “How the ACA helped me” ads, they could start right there.

110 replies
  1. 1

    1) Ask me about my kid’s latest hearing aids. But only if you’re sitting down and have smelling salts at hand. Suffice it to say: You can’t put a price on a 5th operational sense…and yet, we did have to put it on a payment plan, because the required coverage in our state pays for a tin can and a string.

    2) We have a friend who lives in a developing country. Her view: “I can afford insulin here, and if it hasn’t been handled properly I faint…just like I did living with shitty insurance when I couldn’t get insulin.” Trying to persuade her that she can afford to come home now.

  2. 2
    Pogonip says:

    While we are on the topic of health, a few topics back someone mentioned advising Betty Cracker on insomnia. Would you please repeat that advice, as I missed it?

    Too Late for a Doctor Dept:: Archie, as in Jughead and, is supposed to be killed off in July. I guess he broke one too many of Mr. Lodge’s expensive vases.

  3. 3
    mclaren says:

    But front-pager Richard Mayhew keeps telling us how wonderful it is that more people are now insured under the ACA.

    Apparently Richard Mayhew isn’t telling us that more people insured under the ACA means more victims for the predatory greed-crazed American medical-industrial complex to rape out of tens of thousands of dollars per year for ripoffs like proprietary new planned-obsolescence insulin pumps and stratospherically priced insulin.

    America’s broken medical-industrial complex won’t get fixed until we start attacking the source of the problem — the underlying cost of American medical care, which continues to skyrocket under the ACA.

    Pathological liars like Richard Mayhew aren’t going to tell you that. But someone should.

  4. 4
    kindness says:

    There but for the grace of the FSM go I.

  5. 5

    @mclaren: Oh, bite me.

    Tomorrow I get another scan, paid for by the policy priced for my age and ZIP code rather than the Dx I already know I have.

    Tell us more about what the total cost of buying out the US health insurance companies would have been, in 2009 dollars, which is what would have had to happen to get single payer. Hint: Harry Truman nationalized the railroad under specific conditions, but he had to give them back. What was your better idea again, and how was it priced? Leave out how it was/is politically possible, just tell us the dollar figure.

  6. 6
    Cassidy says:

    @PhoenixRising: Nah, it’s completely cool for people to die of preventable diseases as long as the impure don’t get any money. Eggs and omelets you know.

  7. 7
    burnspbesq says:

    @PhoenixRising:

    Your response to mclaren was much more polite and measured than the one I had in mind; can I just sign on to yours?

    I assume you’re not holding your breath waiting for a response to your entirely reasonable question.

  8. 8
    Belafon says:

    @mclaren: You must have missed Mayhew’s article about counterfactuals. Why don’t you go read about it and tell us how what is listed above is different than it would have been without the ACA. And then tell us how you would get something passed that would cover all of these additional people.

  9. 9
    the Conster says:

    @mclaren:

    You must be a real hoot at parties.

  10. 10
    satby says:

    I’m in no mood for mclaren tonight. My nephew has type 1 diabetes and is on a pump. His mother, my sister, has MS, it’s progressing rapidly, and someone just stole some raffle ticket stubs and donation checks to the benefit her friends are putting on for her from her hospital bedside table as she slept, unconscious from painkillers. The envelope only was left there for an hour before the friend who was coming to pick it up arrived and realized it had been stolen. I feel so defeated by life today.

  11. 11
    ruemara says:

    Lord knows, I’ve put off a number of things due to costs. And I’m delaying my resignation so I can use some sick leave and my insurance, since my new job won’t have any.

    @satby: I hope that person suffers mightily for it. Sending good wishes to you and all your family.

  12. 12
    Villago Delenda Est says:

    It’s all about the churn.

    The Ferengi must be destroyed, or they will destroy us all. It’s inevitable.

  13. 13
    SiubhanDuinne says:

    @burnspbesq:

    mclaren hardly deserves “polite and measured” responses. But your own comment halted me in my tracks; I was about to erupt at him (her? — who can tell on the internet?) in a most unladylike way, and you put a stop to that for the moment.

    So thank you, I guess.

  14. 14
    SiubhanDuinne says:

    @satby:

    That completely sucks. I’m so sorry.

  15. 15
    Roxy says:

    Satby, I am so sorry about your situation. If I can contribute in anyway to the benefit, please let me know.

  16. 16
    satby says:

    @SiubhanDuinne: Thanks. I mean, who steals from an obvious cripple? My sister’s legs and hand have severe contractions, so her condition is evident to anyone.

  17. 17
    mclaren says:

    @PhoenixRising:

    My better response has been summarized by Brad DeLong here.

    Maintaining the pooling equilibrium as health care costs increase is going to be really hard. If it turns out to be impossible–well, then, the ACA system will lurch toward pay-or-play and then single-payer.

    As we all know, since professor DeLong is advocating pretty much the same thing I’ve been advocating, he must be “off his meds,” “insane,” “an asshole,” and so on.

    Always nice to see the superwealthy one-percenter tax avoidance lawyer burnspbesq agreeing with the superwealthy one-percenter health insurance CEO Richard Mayhew.

    Tells you a lot about “birds of a feather,” doesn’t it?

  18. 18
    Fair Economist says:

    @mclaren:

    America’s broken medical-industrial complex won’t get fixed until we start attacking the source of the problem — the underlying cost of American medical care, which continues to skyrocket under the ACA.

    Fortunately we just recently passed something that’s brought medical cost increases to the lowest rate in more that 40 years. It’s called “Obamacare”.

  19. 19
    cthulhu says:

    Well, having worked quite a bit in drug development, this surprises me not at all (the stories I have…). This is an obvious consequence of the intersection of healthcare and capitalism. We end up with a drive for blockbusters or cheap tweaks that get dubious market protection and not a lot that doesn’t follow one of those two courses of development. Not to mention that much of the basic, pre-clinical, and early clinical research is subsidized by academia such that the risk exposure to the privatized side is minimized. Capitalism is really not a good way to run this particular railroad.

  20. 20
    mclaren says:

    @Belafon:

    You must have missed my response to Richard Mayhew’s ignorant and foolishly halfwitted article about counterfactuals.

    I’ll repeat here what I said there:

    Counterfactuals are a bad idea in any argment because they give your opponent the opportunity to drag out the wildest and most hysterical scenario possible and then argue for their crazy public policy because if we don’t implement it, doom! Disaster! Horror! Destruction!

    Case in point: Condi Rice gave us the counterfactual if we didn’t invade Iraq in 2003 — a mushroom cloud. At that point, everyone in America ran around like chickens with their heads cut off because ZOMG THERMONUCLEAR CLOUDS OF DEATH OVER WASHINGTON D.C.!!!!!!!!

    Case in point #2: Assholes like Richard Mayhew and the thugs commenting here drag out exactly the same bogus dishonest bullshit when we start discussing the ACA. We must stick with the ACA and eschew single-payer because ZOMG MY KID WILL DIE MY AUNT WILL GET THROWN ON THE STREET DEATH AND DESTRUCTION!!!!!

    Fuck counterfactuals. They’re a pack of lies and a really bad way to debate.

  21. 21
    satby says:

    @Roxy: thank you Roxy. I appreciate the kind thought. At 57, my sister probably has to go into assisted living, she is no longer safe on her own.

    The benefit her friends are putting on is http://www.greenforcolleen.com ( can’t copy/paste on my kindle). When I was working I would have just tried to help cover the loss, but now that I’m unemployed I have a hard time covering my own bills. This is not shaping up to be a great year.

  22. 22
    mai naem says:

    My dad was a diabetic and used the old Bayer Elite glucometer. When he got it, it was one of the nicest meters out there using less blood than the other ones out there and it was supposedly the most accurate one out there. My dad probably used the meter for around 3-4 yrs before he died in 2000. My mom started using my dad’s meter probably a couple of years after my dad died. My mom used the same meter until 2012 when the stopped making the strips. Walgreens and her doc kept on offering her other machines but she liked this one, it was working fine and most importantly the strips were cheap compared to the newer strips. The new strips are anywhere between $50-$100. The old strips were something like $30. I see people all the time with multiple glucometers, mostly because the manufacturers make money off the strips not the glucometer but there’s a cost to the meter – we all know that.

  23. 23
    Villago Delenda Est says:

    @mai naem:

    I see people all the time with multiple glucometers, mostly because the manufacturers make money off the strips not the glucometer but there’s a cost to the meter – we all know that.

    It’s just like inkjet printers. The money is not in the printer, it’s in the ink cartridges.

  24. 24
    Villago Delenda Est says:

    @mclaren: So, you’re giving us like a master’s course on winning friends and influencing people, right?

  25. 25
    efgoldman says:

    @mclaren: You know, I don’t spend 24/7 here, so you might at some time actually answered this question realistically and rationally, but I doubt it:
    Given the actual 100 people in the Senate at the time, and the actual 435 people in the House, how the fuck, exactly, were we going to get some version of single payer or a public option. How? Who was going to vote for it, given that the Dem supermajority in the Senate about which you like to bleat, barely passed what we got? How?
    BTW, I’m reasonably certain that every front-pager and most of the regulars here would support some version of single payer.

  26. 26
    Big R says:

    Okay, so, I’m not going to wade into the pool of name calling that is mclaren’s current target, but I will note that they are saying, on one hand, that the ACA is terrible policy even though they don’t have an explanation for how the politics of an admittedly better policy would have happened; meanwhile, they say on the other hand that a tool acknowledged to be proper for policy analysis in a backward-looking role, i.e., counterfactual analysis, is bad because it can be misused in politics in an improper forward-looking way.

    I’m confused. Are we more interested in examining the best policy possible, or are we concerned with political realities?

  27. 27
    Eric U. says:

    I know a guy that is perenially unemployed because he can’t afford a pump and managing his blood sugar manually is just too much for him. Any job he gets, he loses because he can’t manage his blood sugar manually. It’s a vicious cycle. I was only around him a couple of days, and I had to remind him to take insulin a batch of times.

  28. 28
    The Dangerman says:

    This is a pretty cool video on medical technology

    …but talk about extreme costs; not saying the technology isn’t worth it, just saying it has to get funded from someplace.

  29. 29
    SiubhanDuinne says:

    @mclaren:

    I strongly suspect you are not interested in persuading or changing anyone’s opinion — you’re really just here to churn up the waters — but in case you need a refresher in winning friends and influencing people, here’s a tip:

    Try to avoid calling a respected expert in the field of health care economics a “pathological liar,” “ignorant,” “foolishly halfwitted,” and “asshole.”

    If you have any reasoned arguments, they got lost in the fog of gratuitous ad hominems.

    EDIT: Or, having seen your latest spewvomit, fuck you very much.

  30. 30
    mclaren says:

    @Fair Economist:

    Fortunately we just recently passed something that’s brought medical cost increases to the lowest rate in more that 40 years. It’s called “Obamacare”.

    Thank you for telling that lie! It’s always wonderful when someone just up and regurgitates a pathological lie like that, because it makes everything so much easier for me.

    I can just point out that you’re lying through your teeth, and since is the best you can come up, the debate is over.

    The US is facing a major crisis in the cost of health care. Corrected for inflation, health expenditures in the public sector are nearly doubling each decade, and those in the private sector are increasing even more rapidly. According to virtually all economists, this financial burden, which is now consuming about 17 percent of our entire economic output (far more than in any other country), cannot be sustained much longer.

    Source: “How Doctors Could Rescue Health Care,” Dr. Arnold Relman, The New York Review of Books, 27 October 2011.

    Notice that this article was written after the passage of the ACA.

    The ACA contains no measures that restrict or control the underlying cost of U.S. health care. None. Zero. Zip. Diddly. Nada.

    Incidentally, the term “fair economist” is an oxymoron, like “jumbo shrimp” or “honest politician.”

  31. 31
    MomSense says:

    @satby:

    I’m so sorry. Sending you my support and some virtual hugs.

  32. 32
    satby says:

    @ruemara: Thanks ruemara@MomSense: and MomSense

  33. 33
    Mnemosyne says:

    @satby:

    Are you in a large enough area that you could get some publicity about the theft? If there’s a TV station and/or local newspaper, they might be willing to do a story about it.

    Plus, hey, WTF is up with that hospital? Are they letting people just wander into patient rooms and steal whatever they want? That’s another possible angle for a story if the sad one isn’t juicy enough.

  34. 34
    Mnemosyne says:

    @mclaren:

    Still waiting for you to answer the question rather than dodging it:

    What was your better idea again, and how was it priced? Leave out how it was/is politically possible, just tell us the dollar figure.

    Show us your math, not more links that don’t actually say what you claim. Prove that you’re not just parroting articles you don’t really understand.

  35. 35
    mclaren says:

    @Fair Economist:

    Oh, and since it occurs to me that not everyone on this thread is likely to be numerate, let’s be clear about what’s being claimed and what’s actually going on with the ACA and medical costs.

    Claim: The ACA has lowered medical costs.

    FACT: After the passage of the ACA — which coincided with the biggest economic downturn since the Great Depression, no causal relation obviously but they both did happen at around the same time — the rate of increase of medical costs dropped.

    The rate of increase reduced. That’s not the same as “lower medical costs.” The cost of medical care in America is rising, just more slowly than before.

    Moreover, economists who have studied the recent slowdown in medical costs say that it’s not due to the ACA — it’s due to the gigantic recession that has crushed middle-class Americans.

    Rep. Chris Van Hollen claims the Affordable Care Act “has resulted in significantly reducing the per capita cost of health care.” To be clear, the per capita cost of health care is rising. Van Hollen’s office says he meant that the ACA has significantly reduced the growth in health care costs. That’s different.

    Per capita health care costs have been rising at just under 3 percent a year over the last four years, but that’s less than half the average annual growth in the preceding eight years. Economists say the recession is the biggest reason for the dip — though many also credit the ACA for a bit of the decline.

    Source: “ACA impact on per capita cost of health care,” factcheck.org

    I just want to make it pellucidly clear that the propagandist who calls hi/rself “fair economist” is not just lying through his teeth, he’s telling you stupid lies which are easily and obviously debunked.

    The ACA is a band aid on a severed arm spurting arterial blood.

    Barack Obama kicked the can down the road on the health care crisis in America, as he did on so many critical policy crises like America’s addiction to endless unwinnable foreign wars and the massive militarization of police state America and the takeover of the American economy by rapacious remora-eyed bankers who now commit any financial crime they can dream of without ever facing any jail time for their crimes.

  36. 36
    Eric U. says:

    I’d just like to take this opportunity to mention how great Cleek’s pie filter is. I wish I undestood grease monkey well enough to port it to some other sites

  37. 37
    scav says:

    mclaren is into nothing other than the internal rush of provoking a response. Cheap and easy drug addiction. Mere actual peoples actual lives and actual health can go hang so long as she gets her sweet pure moral high. .e.g. detect obvious, we’ve seen this before.

  38. 38
    something fabulous says:

    @ruemara: I haven’t been around much of late– looks like I missed an update! New job!?! Huge congratters!!

  39. 39
    satby says:

    @Mnemosyne: I hate to think it, but I have a feeling it was the roommate. Opportunity and overheard the conversation when the envelope got put in the drawer because my sister was very zoned. 3 checks, so probably won’t really do the thief any good.

    It’s just so discouraging that people would take advantage of a very sick person that way.

  40. 40
    SiubhanDuinne says:

    @Mnemosyne:

    In the last few years, I’ve had more experience with hospitals than I’d have preferred. Security seems to be non-existent. Even in the cases where I was told in advance that I’d need a “password” to visit the patient, in point of fact I was never stopped, never challenged. If you know the room number, you can go anywhere. This was the case at three different hospitals.

    And don’t get me started on how my dying father‘s explicit requests and preferences were violated by a supposed “friend” who apparently thought he was too special to be bound by patient orders and just lied his way in. It’s been nearly 20 years, and I’m still steaming. My dad didn’t need that upset on his deathbed.

  41. 41
    JaneE says:

    @mclaren: If you want to throw a tantrum because your favored solution wasn’t the law we got, do it on your own blog. If you have a proposal to make, say it instead of name-calling. If you actually have a point to make, which seems pretty doubtful. Or maybe you have missed all the proposals that have been made to reduce costs that were voted down in congress. Latest casualty – the cuts to Medicare advantage are being reversed. The cost reduction in the PPACA didn’t last a year. So what cost controls do you think you will get?

  42. 42
    satby says:

    @SiubhanDuinne: I actually used to work at this hospital. It was a losing battle for most hospitals to try to control visitors, and patient families seldom appreciated the effort; instead devising all sorts of ways to get around the system. So I understand they can’t control everyone. I also know leaving anything in a virtually public place is asking for it. But it was just for an hour, the other people were on their way.
    Famous last words…

  43. 43
    different-church-lady says:

    If Steve Jobs had been diabetic, insulin pumps would be about $400, they’d be made out of brushed metal, fit in your pocket, a bunch of other companies would be making look-alike pumps for $150 that didn’t work, and everyone would still be complaining the iPump cost too much.

  44. 44
    different-church-lady says:

    @mclaren: It’s amazing: I was scrolling up the page backwards and I could tell it was one of your offerings before I even climbed halfway back through it all to your name.

  45. 45
    eemom says:

    @scav:

    mclaren is into nothing other than the internal rush of provoking a response. Cheap and easy drug addiction. Mere actual peoples actual lives and actual health can go hang so long as she gets her sweet pure moral high. .e.g. detect obvious, we’ve seen this before.

    fwiw, she’s a he who spends the rest of his time jerking off to fantasies of “tapping the ass” of Megan McArdle. Not gonna waste my time linking, but it’s out there.

    Go figure, eh?

  46. 46
    Ruckus says:

    @Eric U.:
    Cleek deserves a medal or something.
    I only have a very few names in my filter but my blood pressure and I’ll bet everyone else’s eyes really likes that I don’t feel like I have to respond-rant to those few assholes.

  47. 47
    a hip hop artist from Idaho (fka Bella Q) says:

    @satby: Can we contribute? I know how lucky I am that my MS, which wasn’t symptomatic or diagnosed until the last few years, is so less limiting than most.

  48. 48
    Joel says:

    Speaking as a boochemist, generating recombinant insulin is one of the most overlooked advances of our time. Much more complicated than it seems.

  49. 49
    mclaren says:

    @Mnemosyne:

    Still waiting for you to stop lying. That’ll be a long wait.

    Lie #1: I parrot articles I don’t understand.

    FACT: I cited Brad DeLong’s article showing that the current situation is unsustainable because (and I will quote deLong once again for the second time in the same thread):

    Maintaining the pooling equilibrium as health care costs increase is going to be really hard. If it turns out to be impossible–well, then, the ACA system will lurch toward pay-or-play and then single-payer.

    What deLong is saying here, very simply, is that lowering the rate of increase of medical costs only gets you so far. It staves off the inevitably collapse of the system. At some point in the foreseeable future, the underlying medical costs will get so high that no one can afford to pay them — not insurance pools, not exchanges, no one. The money is just not there. A typical MRI in America costs betwseen $1090 and $3500, while the exact same MRI using the exact same machine in France costs $250.

    If the ACA reduces the rate of increase of that American MRI, it only buys you a few years before even the insurance-pool-distributed costs becomes so high no one can pay it. No one. Not your employer, not the insurance company, not a pool of insured people gathered together into a gigantic exchange market, nobody.

    So now that we’ve disposed of your first lie, let’s move on to your second lie.

    Show us your math, not more links that don’t actually say what you claim. Prove that you’re not just parroting articles you don’t really understand.

    Notice the double standard here: I have to show everyone my math…but the proponents of the ACA never have to show us their math of how they expect people to continue paying insurance premiums if the rate of inflation of medical costs continues to rise as it has for the past 40 years.

    So since proponents of the ACA like Mnemosyne and Richard Mayhew won’t show us their math but demand that I show them my math, let’s do that. It will kill two birds with one stone.

    Here’s the math:

    This chart gives us the baseline inflation rate for U.S. medical care from 2001 to 2011. That’s a long enough period, and the line is close enough to linear, that we can make a decent stab at estimating the year-over-year inflation rate of U.S. medical care during that period. That turns out to be
    1.5^(1/11) = 3.75% inflation per year. Note that the rate of inflation in medical care after 2009 moderated, but economists tell us that’s largely due to the Great Recession. So we can’t count on that continue. The underlying inflation rate in medical care is 3.75%.

    Now let’s run that rate out using the rule of 72. 72/3.75 = 19.2, so in just about 19 years, the real cost of U.S. medical care, adjusted for inflation, will double. That means that in 19 years, your medical insurance premium will double.

    Now let’s run that another 19 years. In 38 years, the cost of your health insurance premium will quadruple even after accounting for inflation.

    You’re telling me that’s sustainable?

    Let’s a take a look at the percent of U.S. GDP that will get gobbled up by medical costs in another 19.2 years: at present health care accounts for 17.6% of U.S. GDP, so a doubling of medical costs in real terms (after accounting for inflation) means that 19.2 years down the road, healthcare costs will account for 35.2% of U.S. GDP.

    Let’s push that out 38.4 years. At that point we get another doubling in real terms, after inflation, so health care costs will account for 70.4% of U.S. GDP.

    I have news for you, folks — social security already accounts for 5% of GDP, and it’s projected to go up slightly to 6.5% when the baby boomers retire en masse by 2035. Also, America pisses around around 1 trillion dollars per year on national security, which includes the Pentagon budget + items not include in the military budget but which actually are costs, like military retirement, the NRO surveillance satellite program, the CIA with its drone programs and global assassination teams, the DOE which is really a stalking horse for exotic weaponry like particle beam weapons and laser death rays for Navy ships, and of course the Department of Homeland Security, whose budget has skyrocketed at a compounded rate of above 11% since it was formed and whose headquarter is now larger than the Pentagon. So America spends well over 7% of GDP on national security, broadly defined.

    The Congressional Budget Office estimates a total outlay of 3.4% of GDP to pay interest on T-bills and other debt instruments by 2020.

    Put those numbers together. You get 75.4% on healthcare, 7% on national security, and 6.5% on social security. 3.4% of GDP for interest on T-bills and other debt instruments. What’s the total?

    75.4% + 7% + 6.5% + 3.4% = 92.3% of GDP.

    Do you think that’s workable?

    Do you really America can make do with only 7.7% left over for spending on everything else, from basic scientific research to highway funding to programs like SNAP and WIC?

    Really?

    Okay. So it’s obvious from the numbers that the ACA is not a sustainable solution to America’s healthcare crisis.

    So what’s the solution?

    The solution, as I’ve enumerated before, is single-payer nationalized health care. It’s going to arrive at some point, since the ACA is unstainable and will eventually break down. So we might as well get nationalized single-payer health care sooner rather than later.

    The way we do that is for the president of the united states to announce a national emergency and nationalize every professional in the healthcare industry. Doctors, nurses, orderlies, you name it.

    They get put into a five-year program where their salaries are strictly controlled. National wage-price caps on medical care, like the ones Nixon imposed nationwide in 1971. Same wage-price caps on medical devicemakers and all hospitals are nationalized and turned into non-profit organizations. Million-dollar-a-year hospital directors are all fired and replaced with civil servants making a modest salary. All the big pharma companies are dissolved and nationalized. All drugs are now developed by public employees and sold to the public at cost. Health insurance is abolished by executive order.

    Naturally, this sets off a firestorm of frenzy among the greed-crazy remoras of the medical-industrial complex. No problem: the president declares people who oppose this public health reform “enemy comabatants” and uses the NDAA to arrest and confine them “for the duration of the emergency.”

    Members of congress who try to impeach the impeach the president for reducing health care costs likewise get arrested and confined under the provisions of the NDAA.

    Now the kooks and cranks and crackpots infesting this forum will scream “But that’s illegal! It’s violates the law as passed by congress! The president can’t do that!”

    The response to that foolish claim?

    Barack Obama has already violated the constitution and flouted the law as passed by congress. Obama ordered the assassination of U.S. citizens (four so far), so clearly a Democratic president has no problem violating the constitution. And as far as ignoring and flouting laws passed by congress, Obama recently ordered the IRS to delay by a year one of the aspects of the employer mandate. This was a law passed by congress, and Obama totally ignored it.

    No one objected.

    Not.

    One.

    Person.

    So let’s hear Mnemosyne explain why it’s so horrible, horrible, horrible and unthinkable and illegal and terrible and monstrous and insane for the president of the United States to ignore the constitution and violate laws passed by congress under one circumstance (lowering health care costs and saving tens of thousands of American lives every year) while the very same president ignoring the constitution and flouting laws passed by congress is just peachy-keen ‘n dandy ‘n wonderful under another circumstance (murdering U.S. citizens and ordering the IRS not to implement part of the ACA legislations).

    We’re waiting, Mnemosyne.

    Explain it to us

    We’re all ears.

  50. 50
    Fair Economist says:

    @mclaren:

    I can just point out that you’re lying through your teeth, and since is the best you can come up, the debate is over.

    The US is facing a major crisis in the cost of health care. Corrected for inflation, health expenditures in the public sector are nearly doubling each decade, and those in the private sector are increasing even more rapidly. According to virtually all economists, this financial burden, which is now consuming about 17 percent of our entire economic output (far more than in any other country), cannot be sustained much longer.

    Source: “How Doctors Could Rescue Health Care,” Dr. Arnold Relman, The New York Review of Books, 27 October 2011.

    Written before the effects of Obamacare had kicked in. Actually the increase in health care that year was pretty low, but most people were ignoring it at the time.

    Name a four-year period in the last 40 years with a lower increase that 2009-2013. I’ll be waiting! Hint: your best chance is probably 2010-2014 but you’ll have to wait a while for the data.

  51. 51
    jl says:

    The linked article uses the word ‘cost’ repeatedly, but no one except the private for-profit firms making them really know what the true costs are. The article should have used the word ‘price’ or ‘charge’ instead.

    It is nice to have a wide product variety available and tailored to small groups of patients. But basic micro econ 101 (and 102 and on up) says that more product differentiation provides more opportunity for profit maximizing, and income transferring price discrimination, a form of private for-profit rent seeking.

    Some countries have realized this, even free market paradises worshiped by GOPers and reactionaries, like Switzerland. So, the Swiss have a rigorous program of death panels, er… I mean comparative effectiveness analysis, and a cut off level for public reimbursement for devices drugs and procedures. Besides controlling costs in a direct way, this program also encourages product standadrization and interchangeability, and discourages the problem of dominant firms preventing entrance by potential competitors. It also discourages profiteering by dominant firms through reducing the effectiveness of direct manufacturer marketing to patients and doctors.

    Also, the Swiss have a program of federal open book audits for insurers and providers who raise prices higher than allowable ranges. The system of audits provides transparent information about where higher charges are coming from, which indirectly discourages rent seeking.

    However, even with this, Swiss has one of the highest medical expenditures in terms of per capita and proportion of GDP. It is difficult to prevent private for-profit rent seeking in any health care system dominated and controlled by private for-profit firms.

    But, anyway, it ain’t all ‘costs’ that the linked article is talking about.

  52. 52
    different-church-lady says:

    @mclaren: Because, ya know, nothing at all is going to change in 40 years. Yeah, I can completely see your point.

  53. 53
    Fair Economist says:

    @scav:

    mclaren is into nothing other than the internal rush of provoking a response. Cheap and easy drug addiction. Mere actual peoples actual lives and actual health can go hang so long as she gets her sweet pure moral high. .e.g. detect obvious, we’ve seen this before.

    I suspect mclaren is a for-pay troll and not a for-fun troll. Balloon Juicers are a pretty thick-skinned lot; it’s a poor location to troll for reactions. The abrupt jump onto bogus or irrelevant ACA issues right after it became an obvious success makes me extra suspicious.

  54. 54
    Firebert says:

    why it’s so horrible, horrible, horrible and unthinkable and illegal and terrible and monstrous and insane for the president of the United States to ignore the constitution…

    When you get to high school, take a class on government and civics. For now, ask your mommy or daddy to explain it.

  55. 55
    Mnemosyne says:

    @mclaren:

    This chart gives us the baseline inflation rate for U.S. medical care from 2001 to 2011. That’s a long enough period …

    Oh, sweetie. Really, a cherry-picked 10-year period that includes 2 years of PPACA is a “long enough period”?

    If anyone actually thought you understood statistics, or even simple math, you’ve certainly disabused them of that notion.

  56. 56
    StringOnAStick says:

    I haven’t installed Cleek’s greasemonkey script, but I am also reasonably at visually filtering for our resident assholes. McLaren is easy because even if you don’t read his name, there is enough nastiness contained within the first sentence to make you name-check. After that, he’s obvious because his rants get longer as the thread does. Just scroll on by and read the normal humans who are capable of commenting without obvious sociopathy; no problem.

  57. 57
    Violet says:

    @mclaren:

    the superwealthy one-percenter health insurance CEO Richard Mayhew.

    Is this a true statement? Is Richard Mayhew a superwealthy one-percenter CEO of a health insurance company? In his introductory post he said the following:

    I’m a bureaucrat at a health insurance company which most of you have never and will never hear about. My job is to be a subject matter expert on a fairly arcane set of knowledge

    CEOs are SME bureaucrats? Has Richard Mayhew specifically said he’s the CEO of a health insurance company? I must have missed it if he did.

    As for this claim:

    Assholes like Richard Mayhew and the thugs commenting here drag out exactly the same bogus dishonest bullshit when we start discussing the ACA. We must stick with the ACA and eschew single-payer because ZOMG MY KID WILL DIE MY AUNT WILL GET THROWN ON THE STREET DEATH AND DESTRUCTION!!!!!

    In the same introductory post, Richard Mayhew said:

    I would not choose the US model or the modifications to the model that are being made by Obamacare. I would have chosen a far more comprehensive single payer system that is not a kludge of multiple previous kludges.

    It sounds like he would have preferred single payer.

  58. 58
    mclaren says:

    @Fair Economist:

    Name a four-year period in the last 40 years with a lower increase that 2009-2013. I’ll be waiting! Hint: your best chance is probably 2010-2014 but you’ll have to wait a while for the data.

    Name a four-year period in the last 40 years with a bigger drop in GDP than from 2008-2010. I’ll be waiting! Hint: your best chance is probably 1929-1932.

    Once again, you’ve failed to disentangle the effects of the most catastrophic economic collapse since the Great Depression from the U.S. healthcare system.

    Economists say the recession is the biggest reason for the dip — though many also credit the ACA for a bit of the decline.

    Source: “ACA impact on per capita cost of health care,” factcheck.org

    …the current rate of inflation in health costs—between 4 and 6 percent
    per year—obviously cannot be sustained.

    Why is this the case? First, the present trajectory of federal health expenditures predicts continued rapid growth of Medicare expenses and the exhaustion of the Medicare Part A fund—which partly covers hospital costs—within a decade or so. Second, most economists agree that the states will not be able to pay the rising costs of Medicaid in future years, when millions of beneficiaries will be added to the rolls. And looking at the private sector, there is increasing evidence that the inflation in the cost of health insurance cannot be supported by employers and employees much longer. In sum, the whole health system, if not radically transformed, seems headed toward bankruptcy.

    Source: “Health Care: The Disquieting Truth,” Arnold Relman, The New York Review of Books, September 30, 2010

  59. 59
    TooManyDans says:

    Wow, mclaren, that was bad.

    If medical costs double, there is no reason to expect the percentage of medical costs to GDP will just double. Presumably, GDP will also increase. Or, in 76.8 years, medical costs will be 105.6% of GDP!

    Also, I don’t understand how you can show us a chart of the inflation in medical costs, clearly compared against the overall inflation from CPI which obviously hasn’t been normalized out (because it is not flat), and then claim that the medical inflation rate is real, not nominal.

  60. 60
    SatanicPanic says:

    @satby: that sucks. That really really sucks.

  61. 61
    mclaren says:

    @Mnemosyne:

    Oh, sweetie. Really, a cherry-picked 10-year period that includes 2 years of PPACA is a “long enough period”?

    If anyone actually thought you understood statistics, or even simple math, you’ve certainly disabused them of that notion.

    The usual fallacious argument of calling any data segment “cherry-picked.” Once again, you haven’t showed us your math. Once again, you demand everyone submit vast amounts of data to you and do all the math…but once anyone does, you dismiss it as “cherry picked.”

    It’s always useful to turn this kind of catch-22 scam around on the perpetrator, and demand from Mnemosyne: show us your data. Show us your math. And now: prove it’s not cherry-picked according to the arbitrary and undisclosed whims of anyone else who cares to comment without providing either the math or the dataset on which to base that kind of unsubtantiated claim.

    We’re waiting, Mnemosyne.

    Where’s your data?

    Where’s your math?

    Nowhere. You have nothing but vacuous claims and empty insults, whereas I’ve taken my discussion from actual charts and graphs collated by the government, from the CBO, from large datasets collected by the federal government.

    Charts like this from the CBO.

    Charts like this.

    Show us your math and your charts and your datasets, Mnemosyne.

  62. 62
    mclaren says:

    @Violet:

    Richard Mayhew seems to have four or five hours per day to spew out at least two posts daily on the ACA. Richard Mayhew has also persistently refused to disclose how much money he makes per year, despite repeated requests to do so.

    People employed in large corporations in white-collar jobs with tons of free time on their hands, who adamantly refuse to tell anyone how much money they make, are usually people at an elite level. CEOs. VPs. Corporate board members.

  63. 63
    Omnes Omnibus says:

    @Belafon: No, mclaren shat all over that one too.

  64. 64
    different-church-lady says:

    @mclaren: Here’s some math: you = troll.

    I hope that’s simple enough for you.

  65. 65
    SatanicPanic says:

    @the Conster:

    You must be a real hoot at parties.

    some of the crowd I used to hang with were pretty psycho. A couple of them went to a party, pooped in some tupperware and then left it in the freezer, just cause they were assholes like that. I don’t know why I suddenly remembered that. Oh wait, I do, McLaren reminds me of those dudes.

  66. 66
    Omnes Omnibus says:

    @satby: Some people are assholes.

    AL @ top: Any chance of a donation thread or some such?

  67. 67
    Violet says:

    @mclaren: So you don’t know he’s a CEO. You’re only guessing.

    You claim Richard Mayhew works at a large corporation. How do you know that? He said he works at a company most of us have never and will never hear about. That doesn’t sound like a large health insurance corporation because most of us have heard of the big ones.

    How do you know how long Richard takes to write his posts? Has he reported how much time he spends on writing?

    As for not reporting how much money he makes, have any of the front pagers on Balloon-Juice said how much money they make? I haven’t seen that. Are they all CEOs? Many people keep their salaries private. Most of them aren’t CEOs. Have you reported your salary to us? Are you a CEO one-percenter?

  68. 68
    scav says:

    @Fair Economist: It’s not exactly either-or, is it? There are levels of counting coup. What’s clearly lacking in either case is a fundamental giving a shit about whatever topic is being verbiaged to death with random pseudo-logic. Bog standard BS. I can’t really see the market logic for paying for usual mclaren obsessions though (this exact one being an exception) — unless they’re just throwing around bitcoins for baseline thread-deflection. Might be, fools and their money, not to say Mozilla protests.

  69. 69
    mclaren says:

    In their frantic effort to defend the indefensible economic rapine of the middle class by greedy corrupt medical devicemakers and doctors and hospitals, the various bully worshipers on this forum have tried to gloss over the sheer magnitude of the greed and price-gouging going on America’s healthcare industry.

    Take a look at the article “The Medical Cartel: Why are M.D. Salaries So High?”

    Along the way, you’ll discover that American general practictioners make an average of $230,000 (some higher, some lower), while the average for France is $60,000 and the average for the general practitioner in Germany is $80,000.

    You’ll also discover that there are today fewer medical schools than there were in 1965. Helps explain those high doctor’s salaries, doesn’t it?

    Then peruse the article “The Fix Is In: The hidden public-private cartel that sets health care prices,” slate magazine online.

    Then take a look at the San Jose State economics department webpage “The Social Costs of the Medical Cartels.”

    Think about what you’re defending here, people, when you hurl venom-laced spittle and insults at me.

    You are defending doctors and hospitals and medical devicemakers who are killing tens of thousands of people every year to feed their greed.

    This is on the level of Omnes Omnibus laughing and joking about rape in the U.S. military. You people are rushing forward to defend corrupt mass murderers who are killing sick people to make a buck.

    Unbelievable.

    Just…un-fucking-believable.

  70. 70
    Omnes Omnibus says:

    @mclaren:

    This is on the level of Omnes Omnibus laughing and joking about rape in the U.S. military.

    Cite?

  71. 71
    Mnemosyne says:

    @mclaren:

    Why? I’m not the one making crazy claims about how medical spending is going to be 125% of our GDP.

  72. 72
    different-church-lady says:

    This is great people: we’ve gotten it to go from “They’re ripping us off” to “Doctors kill people!”

    A bit more rope and I’m pretty sure we can get it to babies thrown on to bayonets and executing people with starving dogs level stuff.

  73. 73
    Mnemosyne says:

    @mclaren:

    Could we get some links more recent than 5 years ago? KTHXBAI.

  74. 74
    Mnemosyne says:

    @different-church-lady:

    Careful what you wish for. Once you get mclaren to that point, s/he starts accusing you of masturbating to concentration camp footage. It’s even creepier than it sounds.

  75. 75
    SiubhanDuinne says:

    @mclaren:

    Richard Mayhew has also persistently refused to disclose how much money he makes per year, despite repeated requests to do so.

    Now why in the ever-loving blue-eyed world should Richard Mayhew tell you, or me, or John Cole, or Mitch McConnell, how much money he makes?

    If you are the one who has made those “repeated requests” (don’t for a minute think I missed your passive-voice two-step there), I wonder whether you have similarly asked for financial disclosure statements from, oh, say, Tom Levenson? I mean, who knows what an MIT professor might be pulling in, right? Or Kay? The Democratic Party of Ohio has a lot to answer for, amirite? Then there’s DougJ. Everyone knows you can’t trust an accomplished troll who’s also a professional mathematician to be straight with you about his annual income. SPT? Are we including as declarable income the folded C-notes tucked surreptitiously into her garter belt?

    Do you realize how ridiculous you sound? ^This^ ridiculous.

  76. 76
    mclaren says:

    Another article worth reading all the way through: “Experts warn of medical industry cartels’ power,” San Francisco Chronicle, 21 February 2010.

    The planned spike in health insurance rates by Anthem Blue Cross in California is just the tip of a Titanic-size iceberg of exorbitant price increases, secret pricing and consolidation not only by insurers – but by the hospitals, doctors and medical devicemakers that send the bills to the insurers.

    Insurers, who strike deals with providers, pass the bills on to patients, businesses and governments. The nation is fast being bankrupted by a medical money machine that costs $2.5 trillion a year and takes more than $1 of every $6 that Americans earn.

    “It’s an insider’s game in health care,” said Jeffrey Lerner, president and chief executive of the ECRI Institute, a nonprofit that researches medical practices.

    Anthem, a subsidiary of WellPoint Inc., has come under state and federal scrutiny for its plan to raise rates by as much as 39 percent for many of its 700,000 California members who buy individual coverage. The company blames the increases on healthy individual policyholders who have dropped out of the market, creating a pool of sicker people.

    The company said it will delay the rate hikes until May 1 to allow a state review. Hearings are planned in Sacramento and Washington, and Health and Human Services Secretary Kathleen Sebelius issued a report Thursday that found double-digit premium hikes in California and a half-dozen other states.

    While the Anthem case has raised a political storm, the underlying surge in costs gets far less scrutiny. But each sector of the health industry points fingers at the other for driving up prices, and all are raking in money.

    Insurers blame hospitals and doctors, doctors blame insurers, and hospitals blame doctors and medical devicemakers in what academics call an inscrutable medical-industrial complex that rivals anything the defense industry ever invented. All these groups are combining into what many experts describe as cartels.

    Many industry insiders are afraid to speak on the record for fear of antagonizing the medical groups they rely on for their survival. Contracting practices are draped in secrecy. Prices are almost impossible to obtain because of “confidentiality agreements” among hospitals, physician groups, insurers and devicemakers who do not want their markups exposed to competition or public scrutiny.

    Christina Bernstein, a medical-device engineer and independent sales representative based in San Francisco, sells disposable surgical tools made mostly out of plastic that she estimates are manufactured for about $40 each. These are marked up and sold to hospitals for as much as $350, she said, for a single use in a surgery on a patient.

    “But if you were to get a detailed bill of what the hospital was charging the insurance company for the insured patient, those things get marked up to something like $1,200,” Bernstein said. “It’s ridiculous. There’s no open competition.”

    Notice the weird moral inversion here: I’m called a “sociopth” because I object to killing sick people due to greed…but the corrupt system that lets sick people die because they can’t afford obscenely costly copayments or insanely overpriced drugs or wildly inflated prices on lifesaving surgery gets nary a word of criticism from the balloon juice commentariat.

    It’s a fascinating spectacle to watch the reaction to someone (like myself) who advocates substantive change in America’s greedy corrupt cartel-ridden healthcare system. The amount of envenomed verbal abuse spat at me is akin to watching the middle eastern tyrannies like Saudi Arabia and Jordan and Oman hurl insults and imprecations at the “sick evil murderers” of Israel while praising Palestinian suicide bombers as “martyrs” and “innocent victims” of the “monstrous mad-dog Israeli death machine.”

  77. 77
    different-church-lady says:

    @Mnemosyne: Well, it’s like Eleanor Roosevelt said: masturbating to concentration camp footage is only an insult to those who are in doubt about whether they masturbate to concentration camp footage.

  78. 78
    SatanicPanic says:

    @SiubhanDuinne: I like the idea that Mclaren thinks that if someone is (allegedly) fucking around in the office it’s proof they’re the CEO

  79. 79
    mclaren says:

    @SiubhanDuinne:

    Now why in the ever-loving blue-eyed world should Richard Mayhew tell you, or me, or John Cole, or Mitch McConnell, how much money he makes?

    Richard Mayhew should tell us exactly and precisely how much money he makes because Richard Mayhew bombards us with at least two posts per day, every day, about the alleged intricacies of America’s health care economy.

    We’d all like to make god damn sure that Richard Mayhew is not another Tom Friedman…bombarding us with posts about the supposed wonderfulness and alleged glories of globalized capitalism — while he sits back sipping iced martinis idelivered by an army of servants in his wife’s 20,000-square foot mansion living off her two billion dollar trust fund inheritance.

    History has taught us that we should be extremely wary of people who claim to purvey unbiased information on complicated subjects. These people often have an axe to grind. They are often serving their own interests.

  80. 80
    Violet says:

    @mclaren:

    the corrupt system that lets sick people die because they can’t afford obscenely costly copayments or insanely overpriced drugs or wildly inflated prices on lifesaving surgery gets nary a word of criticism from the balloon juice commentariat.

    Nary a word of criticism of our medical system here? Your reading comprehension skills are somewhat lacking.

  81. 81
    Omnes Omnibus says:

    @different-church-lady: I have, on occasion, been drunk. I sincerely doubt that I have done such a thing, but my recollection is not completely clear.

  82. 82
    different-church-lady says:

    @mclaren:

    Richard Mayhew should tell us exactly and precisely how much money he makes because Richard Mayhew bombards us with at least two posts per day, every day, about the alleged intricacies of America’s health care economy.

    And what’s your excuse?

  83. 83
    Mnemosyne says:

    @mclaren:

    Well, that’s a little better — at least now your articles are only 4 years out of date. Anything more recent? Maybe from 2013? Bueller?

  84. 84
    mclaren says:

    @Mnemosyne:

    Once you get mclaren to that point, s/he starts accusing you of masturbating to concentration camp footage. It’s even creepier than it sounds.

    Only if you try to defend the president of the united states murdering U.S. citizens without a trial or charges.

    And yes, that kind of extrajudicial murder is wayyyyyy creepier than it sounds.

  85. 85
    Mnemosyne says:

    @mclaren:

    Yes, poor innocent al-Awlaki, who ended up living in an al-Qaeda camp totally by accident, you guys! It was all a wacky misunderstanding!

    Also, giving someone instructions on how to build a bomb and when to detonate it is free speech because shut up, that’s why.

  86. 86
    jl says:

    Maybe Mayhew is a fatcat CEO or maybe not. He might make millions, or billions, or gazillions.

    But on the other hand, somehow he travels in orbits that cross Cole’s so…. lower mortal income levels are a distinct possibility

    I will politely request of John G. Cole that we see a pic of Mayhew naked with a verified vault-copy certified IRS form with adjusted gross income dangling from his clenched teeth.

    Mayhew has briefly mentioned his working method. He usually works on posts for indeterminate periods of time, sometimes more than one, and posts them when he thinks it is a good time, or thinks one fits well with the news.

    And that seems to be true of most of them, except brief ones that summarize something big breaking in the press.

    When a post is written is not usually the same time that it is posted, though it may well be the same for some front posters (Hi Cole, how’s the new care doin’?)

  87. 87
    different-church-lady says:

    All we need to do is throw a little Snowden on this thread and the core will go critical.

  88. 88
    Omnes Omnibus says:

    @Mnemosyne: The substance of the argument doesn’t matter. There really are good legal arguments on both sides. The problem is the tendency to go immdeiately from a disagreement over a complicated legal issue to suggestions like mclaren made.

  89. 89
    SiubhanDuinne says:

    @mclaren:

    We’d all

    Here’s where you lost me.

  90. 90
    Steeplejack says:

    @Pogonip:

    The advice was to go camping for a few days, with the idea that it would reset one’s biological clock.

  91. 91
    different-church-lady says:

    @mclaren:

    We’d all like to make god damn sure that Richard Mayhew is not another Tom Friedman…bombarding us with posts about the supposed wonderfulness and alleged glories of globalized capitalism — while he sits back sipping iced martinis idelivered by an army of servants in his wife’s 20,000-square foot mansion living off her two billion dollar trust fund inheritance.

    Because if he were that, the way he’d be choosing to spend his time is writing intricate stuff about obscure insurance minutia in a nearly entirely obscure corner of the interwebs, you betcha!

  92. 92
    Violet says:

    @mclaren:

    Richard Mayhew should tell us exactly and precisely how much money he makes because Richard Mayhew bombards us with at least two posts per day, every day, about the alleged intricacies of America’s health care economy.

    I fail to understand the connection. How does knowing Richard Mayhew’s salary affect anything related to his posts?

    We’d all like to make god damn sure that Richard Mayhew is not another Tom Friedman

    We would all like to make sure of this? All of us? Did someone forget to ask me if I wanted to make sure that Richard Mayhew is not another Tom Friedman? I wasn’t asked if I wanted to make sure of it. When did the asking happen?

  93. 93
    different-church-lady says:

    @Violet: No, wait, I think there might be some common ground here after all — universally I believe we all have a responsibility in seeing that there is never again another Tom Freidman anywhere in the world.

  94. 94
    mclaren says:

    @Violet:

    Nary a word of criticism of our medical system here? Your reading comprehension skills are somewhat lacking.

    Great. Show me all the people accusing doctors of being “sociopaths” who let sick people die because the sick people can’t afford the sky-high inflated prices they’re charging.

    Was there one person who made that charge about doctors, instead of about me?

    One single post that expressed outrage about that, other than my posts?

    Somehow I’m the only person on the thread who gets accused of being a sociopath. The hospital administrators who take home in excess of a million dollars per year while defending atrocities like the chargemaster list — no one on this thread has uttered a peep to vilify or attack or even mildly criticize those hospital administrators with their chargemaster system.

    I’m not hearing much (if any) criticism of the AMA for reducing the number of medical schools in America in 2014 to lower than the number of medical schools we had in 1965, in order to inflate the salaries of U.S. MDs.

    I’m not hearing much (if any) criticism of medical devicemakers for obscenely jacking up the prices on their equipment — and that, by the way, was the entire point of the original post on this thread.

    I’m not hearing much (if any) criticism of hospitals that charge $1200 for $40 disposable plastic surgical instruments.

    I’m not hearing much (if any) criticism of big pharma cartels that bribe doctors to prescribe their insanely overpriced drugs.

    No, the attacks and insults and vituperation and sneers and verbal assaults I’m seeing are all aimed at the person who is pointing out these gross abuses and corruptions and legalized briberies.

    One of us has deficient reading comprehension skills, Violet, that’s for sure.

    Oh, and by the way — let me know when Richard Mayhew gets around to posting an article about the intricacies of America’s health care system that’s titled

    Drug Giant Accused Of Bribing Doctors To Prescribe

    LOS ANGELES — California has joined a whistleblower lawsuit that claims Bristol-Myers Squibb Co. bribed doctors to prescribe its drugs, costing insurers perhaps millions of dollars in the largest alleged health care fraud case ever handled by the state, Insurance Commissioner Dave Jones announced Friday.

    The suit claims company salespeople plied physicians with speaking fees, expensive meals, gifts and trips to induce or reward them for prescribing large amounts of its drugs, which were billed to private insurers.

    For example, the company invited doctors to attend Los Angeles Lakers games at Staples Center and spent thousands of dollars on luxury suites, the suit claimed.

    “Golf outings, basketball camps, samba lessons, you name it,” Jones said at a news conference.

    The lawsuit said the aim was to boost prescription levels for legally approved and so-called “off-label” uses of drugs ranging from the antipsychotic Abilify to the blood thinner Plavix.

    The company is accused of setting up a speakers bureau that doled out thinly veiled kickbacks in the form of cash payments to influential or high-prescribing doctors for speaking about its products.

    One doctor received a $2,500 honorarium even though he never actually spoke, Jones said.

    Source: op. cit.

    Somehow, Richard Mayhew is a “highly respected expert” on healthcare costs…yet he never manages to mention little things like giant pharmaceutical companies bribing doctors to prescribe wildly overpriced medication as a factor in health care costs.

    Mysterious, isn’t it?

  95. 95
    mclaren says:

    @Violet:

    I fail to understand the connection. How does knowing Richard Mayhew’s salary affect anything related to his posts?

    You asked a simple question. So here’s the simple answer:

    ‘It is difficult to get a man to understand something, when his salary depends on his not understanding it.’ — Upton Sinclair

  96. 96
    Omnes Omnibus says:

    @mclaren: Fine, in order for us to be sure you aren’t a sekrit Koch undercover agent, could you please post every detail about your life? I am deeply concerned about you being a sekrit Koch undercover agent.

  97. 97
    Omnes Omnibus says:

    @Omnes Omnibus: “And I ain’t even got a garage, you can call home and ask my wife.”

  98. 98
    different-church-lady says:

    @mclaren:

    No, the attacks and insults and vituperation and sneers and verbal assaults I’m seeing are all aimed at the person who is pointing out these gross abuses and corruptions and legalized briberies.

    Good god, being you must be an incredible burden. I just don’t know how you bear it.

  99. 99
    Violet says:

    @mclaren: You’ve moved the goalposts. Your original statement, which I quoted previously, was:

    the corrupt system that lets sick people die because they can’t afford obscenely costly copayments or insanely overpriced drugs or wildly inflated prices on lifesaving surgery gets nary a word of criticism from the balloon juice commentariat.

    In the above you are saying the system gets “nary a word of criticism”.I said that was not true and it had been widely criticized. You don’t address that comment and respond by saying people here aren’t calling doctors sociopaths:

    Great. Show me all the people accusing doctors of being “sociopaths” who let sick people die because the sick people can’t afford the sky-high inflated prices they’re charging.

    That’s not the same thing. The medical system has been widely criticized here. That was your original comment, which I pointed out was false. There are good and bad doctors. Some won’t see anyone if they can’t pay. Some volunteer their time and effort at free clinics and donate medical supplies. There are bad people in all professions. Doctors are no different.

    I’m not hearing much (if any) criticism of the AMA for reducing the number of medical schools in America in 2014 to lower than the number of medical schools we had in 1965, in order to inflate the salaries of U.S. MDs.

    I’m not hearing much (if any) criticism of medical devicemakers for obscenely jacking up the prices on their equipment — and that, by the way, was the entire point of the original post on this thread.

    I’m not hearing much (if any) criticism of hospitals that charge $1200 for $40 disposable plastic surgical instruments.

    I’m not hearing much (if any) criticism of big pharma cartels that bribe doctors to prescribe their insanely overpriced drugs.

    Again, your reading comprehension skills are lacking. All of these issues have been discussed here and cited as problems with our medical system that need to be addressed. The AMA was the topic of discussion in a recent thread and the medical school issue was part of it. All the rest have been discussed here at various times and things like the exorbitant prices hospitals charge for cheap items plus the opaqueness of hospital bills have been discussed extensively.

  100. 100
    Violet says:

    @mclaren: That doesn’t answer the question. If Richard Mayhew tells you his salary, how will that affect anything related to his posts?

  101. 101
    Violet says:

    @different-church-lady: I know, right. The victim is strong in this one:

    Was there one person who made that charge about doctors, instead of about me?

    One single post that expressed outrage about that, other than my posts?

    Somehow I’m the only person on the thread who gets accused of being a sociopath.

    No, the attacks and insults and vituperation and sneers and verbal assaults I’m seeing are all aimed at the person who is pointing out these gross abuses and corruptions and legalized briberies.

    Such a burden. How does he or she manage?

  102. 102
    Chris T. says:

    His salary is One Meeeell-yunn Dollars. [touch pinky finger to lip]

    Per minute.

  103. 103
    Omnes Omnibus says:

    @Chris T.: Is that a 900 number?

  104. 104
    eemom says:

    @Omnes Omnibus:

    “Then he started saying something ’bout the way I was dressed…”

    /Clash/Soft Cell ain’t all there is to musical appreciation

  105. 105
    Central Planning says:

    @mclaren:

    So what’s the solution?

    How about get everyone back to work and grow the economy?

  106. 106
    NorthLeft12 says:

    Sorry that I am not jumping on the mclaren sponsored rant-a-thon but I thought I would return to the original subject of this post.

    Interesting fact, the discoverers of the process to produce insulin [Banting, Best, Macleod, and Collip] gifted the patent to the University of Toronto in order to quickly and cheaply have insulin made available to diabetes sufferers world wide. Let’s face it, that would never happen today. Sadly.

  107. 107
    shalimar says:

    @mclaren: this is where you lose the plot. Whether Mayhew is a billionaire CEO or an adjustor making $40k a year, his salary can still be dependent on the current system. Knowing his income tells you less than you can figure out just by evaluating what he writes in a non-insane way.

    As for no one agreeing with you that doctors are murdering terrorists, most of what you argue for is consensus opinion around here. Just about everyone favors single payer over insurance companies, etc. We’re not republicans. When you say something no one else ever says, that should be a tip-off to you that you have entered the insane part of your ranting.

  108. 108
    celiadexter says:

    Back to the original topic (and, by the way, I don’t care how much Richard Mayhew makes): As a long-time insulin pump user, I’m part of a web discussion group addressing all things related to diabetes and pumps. There was a story circulating in the group last year that some pumps were being manufactured with software that would work for only 4 years (the warranty period for pumps) at which time the pump would have to be replaced. I can’t verify the story — I know it’s not true of my pump — but I don’t know why anyone would make that up. I can see why a manufacturer might want to do this to avoid possible litigation, but it certainly seems unfair to people without lots of money or good insurance who are willing to take the risk of a malfunction (vs. no pump at all). Talk about planned obsolescence…

  109. 109
    Enhanced Voting Techniques says:

    @mclaren:

    We must stick with the ACA and eschew single-payer because ZOMG MY KID WILL DIE MY AUNT WILL GET THROWN ON THE STREET DEATH AND DESTRUCTION!!!!!

    May I ask you a person question Mclaren; do you have your head so firmly up your ass you don’t recall the mess it took to just get ACA threw Congress in 2008 and the otherside’s alternative is “the sick should just die already”? Ya, to bad we can’t have single player, but this is Washington were corporations are considered people we’re talking about.

  110. 110
    WaterGirl says:

    @Pogonip: This may have been the thread you are looking for. It’s one of them, anyway.

    http://www.balloon-juice.com/2.....hread-203/

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