Archive | From the Editor

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The Pain In My Wallet

Posted on 10 April 2011 by Editor

Originally posted 2010-04-25 19:42:21. Republished by Blog Post Promoter

cost of medicineby Norbert Sluzewski
Editor – NakedLiberty.com
April 25, 2010


Ouch! That was pretty much the only sound I could make getting out of bed that March morning after having overdone on the previous day’s lawn work. My back didn’t want to cooperate with what I otherwise needed to do, which included attending several business meetings and other private events. So without considering many alternatives, I dragged myself to my car, painfully scrambled into the driver’s seat of my SUV and drove off to see a local specialist.

I’ve not seen this doctor before, but he came highly recommended by my primary care physician. The office was pleasantly quiet and subdued and the chairs meticulously aligned in the waiting room were all properly hard so as to accommodate folks arriving in conditions similar to mine.

The doctor was quick to call my name and we soon found ourselves in an appropriately sterile but functional examining room, which comprised of nothing more than an examining table, wooden chair and a small supply closet. In a few quick and efficient motions, the doctor felt around my lower back, checked my knee and ankle reflexes and showed me an impressively realistic model of the human skeletal structure, exposing the nerves and arteries which criss-cross its length. I was duly impressed with the doctor’s description of my condition (a story which he likely has memorized from repeating dozens of times a day) and I was prescribed an anti-inflammatory, muscle relaxant pill and a dose of physical therapy. From arrival to departure, the entire episode lasted exactly 11 minutes.

I am fortunate to have a reasonably good medical insurance plan, so the bill for the doctor’s services went directly to the insurance company. At no time was I concerned about the amount of the fee, nor did the pleasant medical administrator in the doctor’s office disclose to me what the fee for the doctor’s services would be.

And so several weeks have passed. My back has recovered to its nimble self (at least until my next gardening adventure) and all is again well in the world. Ah, but there is more.

A letter from the doctor arrived a few days ago, which politely explained that the insurance company will be applying the doctor’s fee against my annual deductible (hmm, how conveniently I’ve forgotten about that part of the coverage provisions). As a result, they are requesting payment of the full amount of the doctor’s services which (now take a deep breath) amounted to $575.

Ok, now this got my attention. At no time was this amount disclosed to me. Frankly, at the time, I didn’t really care. I was in serious pain and, after all, I wasn’t really going to be paying for it myself, right? If I had been told, would it have changed my intention and would I have walked out of the office? I don’t know – maybe, maybe not; but perhaps I would have considered alternatives, like a hot compress or an “Icy-Hot” patch.

Now that it looks like I am going to be out of pocket a few hundred bucks, I am beginning to question the value ascribed to the services rendered. Sure, in the end they provided me with medicine to ease the pain, and the physical therapy (for which I haven’t received the bill yet, but am sure it’s en route to my mailbox) did help me get a bit more strength into those achy back muscles, but $575 for 11 minutes of service? That’s a whopping $3,136 an hour. My expensive lawyer would gasp at an opportunity to bill his clients that kind of an hourly rate. Is there any profession that can top this? (No, not even that one – and I know what you’re thinking).

So it’s clear to me that the doctor’s fee is not driven by market forces, but instead by an opportunity to “get away with it” since in most cases there is very little vested interest by any of the parties in the transaction to keep the amount of the fee consistent with the effort expended or value of service provided.

Is there something broken in this type of a fee-for-service system? You bet there is.

The answers to bring sanity back into the doctor-patient relationship (particularly the financial part of it) are so glaringly simple and have been so widely discussed. Among these the most significant and most consequential solution includes removing employer co-sponsorship of medical insurance coverage for its employees and replacing it with tax deductible health savings accumulation accounts (HSA’s, FSA’s or similar). In this case each individual is directly responsible for maintaining their personal financial reserve for medical care. Supplemental insurance could certainly be offered for extraordinary expenses and catastrophic events, including government subsidies for those not able to afford them directly. Employers could easily continue to sponsor employee health maintenance benefits for their employees by offering contributions to the employees Health Savings accounts, similarly to how they incentivize retirement savings through 401k contributions.

One thing is irrefutably true and has been tested time and time again. The best way to keep costs at a reasonable level is to have parties in a transaction directly involved in agreeing on the cost and value of the transaction itself. Whether for medical services, education, housing or groceries at the local farm stand, the market is the optimal arbitrator of the value of any transaction. The more intermediaries are introduced into the transaction, and particularly when it’s the government acting as a proxy for what it determines to be common good, the less optimal (ergo, expensive) each such transaction becomes. At the scale of a society, these incremental costs attributed to involvement of the intermediaries add up pretty quickly and dramatically.

Now that I have a strong incentive, I amwriting to my doctor to request a reduction of the fee charged to an amount that we can both agree is more reasonable for the 11 minutes of time (and yes, his 6 years of medical school and overhead, etc. etc.) he devoted to me on that painful day in March. Instead of being angry at him for the clearly inflated fee, I actually appreciate this opportunity to engage with him in a conversation about cost and value. We’ll see if he feels likewise.

Stay tuned. I’ll post an update to this article once we’ve resolved our billing differences.


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Let’s Not Confuse Equality and Fairness

Posted on 10 April 2011 by Editor

Originally posted 2009-06-13 19:56:44. Republished by Blog Post Promoter

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.”

With this opening statement in our nation’s Declaration of Independence, its 56 signers, represented by such great minds as Benjamin Franklin, John Hancock, and John Adams, established a core founding principle for what was to become a new nation; a nation different in its beliefs, values and government structure than any other at the time.

As is the case with many words in the English language, the word “equality” lacks certain precision and has historically been interpreted through different lenses. For example, mathematical equality assures sameness in quantity, but does not ascribe value to the equal results. An equal amount of rain having fallen over a rain forest and over a desert, although mathematically equivalent in volume, does not produce an equal effect. Nor is the magnificence of Niagara Falls’ cascade of water the same as that of a lazy river flowing through the plains, though again the volumes of water may be equal.

Equality as a doctrine in the 18th century was indeed a revolutionary concept. Not since the ancient Greek and Minoan cultures has equality been written into a societal code of beliefs. So therefore, the opportunity to build a new nation on such beliefs was in and of itself a revolutionary step forward.

In order to understand the intentions of our founding fathers, we have to understand the psychology of the times in which this concept of equality was being presented. Indeed, we need to use the prism of an 18th century intellectual to affix the proper meaning to the word. In particular we know that such prism would filter out any notions of equality in the context of modern day social systems such as welfare or affirmative action.

A reasonable and arguably most credible interpretation of the founding fathers intended meaning of equality is one where the goal of equality is defined as one of opportunity and not necessarily of results (or outcome). This is fundamental, in that it underscores the principle of giving each individual an equal opportunity to improve his own state but does not mandate that the results of such efforts be held to the same standard of equality as for others. In fact, an argument can be made that enforcing equality of results is fundamentally unfair in that it unjustly rewards low performance and is eerily akin to Marx’s “from each according to his ability, to each according to his needs” formulation, which would not be written until 100 years later (1875, Critique of the Gotha Program). The distinction between opportunity and results equality was recently taken up and extensively discussed by British Business Secretary Peter Mandelson at the 2009 Fabian Conference at the Imperial College in London.

In our modern society we can observe countless examples of divergence from the principle of equality of results.

  1. Affirmative action, previously mentioned, is perhaps the most glaring example of the up-side-down interpretation of equality, where results trump all other objectives – a starkly Marxist construct indeed
  2. Progressive taxation, though widely accepted as fair and equitable, in fact is not ubiquitously fair as it creates disincentives to higher productivity and redistributes the output of the individual’s labor to those who have not contributed to its creation
  3. Compensation pay grade systems such as within the government and many older companies, where rewards are defined within pay scale boundaries, regardless of the value of an individual’s contribution

A society which does not respect equality of its citizens is frail and cannot sustain itself indefinitely without the degeneration of its social fabric, inevitably leading to massive resentment of government and eventually social unrest. By misinterpreting our founders’ meaning of equality, we are at risk of steering our social policies toward the statist objectives of government welfare and control over our means and our lives. Our Constitution is a finely tuned and time proven instrument of democratic government with ideals interwoven such that in concert they support and amplify each other’s meaning and value. A misinterpretation or misapplication of one of these fundamental ideals not only diminishes its individual value, but also jeopardizes the document’s role as a compilation of our guiding values.

Next time you’re engaged in a discussion with someone who is justifying their position with arguments of equality, make sure to ask them: “What do you mean?”

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On the Health Care System We Aspire To

Posted on 10 April 2011 by Editor

Originally posted 2009-06-24 12:22:44. Republished by Blog Post Promoter

Today I got a call from my Mom. She and my Dad both live in the city I was born in – Warsaw, Poland. They are both elderly and live off of a government pension akin to the US social security system. The reason she called was to let me know of an excruciating pain she has recently been suffering from, resulting from a progressively degenerative neurological condition in her wrist. As all Poles are, she is entitled to free medical care in government health care facilities under the country’s universal health care insurance program. Trying to get help for her condition, she has visited with several general practitioners covered under her free plan, all of whom admit she needs to see a specialist. The last one finally crafted a referral for her and she is now scheduled to see a neurologist … in three months. Ouch !

Her options now include continuing to suffer the intolerable pain for the next 3 months or pay out of pocket to see a private specialist. The fee for a consultation with a neurologist in private practice exceeds two months of her pension income, but under the circumstances she will have to do just that. The costs of any resulting treatments, if not covered under the government health care plan, may have a devastating financial effect on her and my dad’s retirement lifestyle.

My parents could have opted to purchase private health care insurance coverage which provides access to services in private hospitals and clinics with the most skilled specialists but, because the government program is so dominant and pervasive, the cost of the private alternative is beyond the reach of most middle-class Poles. As a result, it is accessible to only the most affluent (or motivated by dire circumstances and lacking other options) individuals.

Interestingly enough, in many European countries the Polish medical system as a whole is actually touted as one of the better and when compared with the British system in particular, it receives accolades for efficiency and quality of care. What is underscored is the diminishing role of the public plan option and the progressively increasing percentage of services being offered under private insurance. The availability and increasing popularity of the private health care option is viewed with envy. A good summary of these changes in the Polish medical system can be found in this article from CMAJ (Canadian Medical Association Journal). With this shift, as more competition is introduced in the private sector and the dominance of the government program is lessened (or eliminated), my mom might yet one day be able to afford a private insurance plan and access to the highly skilled medical professionals in Poland, heretofore not accessible to her under her existing plan and her present means.

But in the US exactly the opposite direction is being proposed. There can be very little doubt, and certainly countless examples of dysfunctional government programs across Europe and other countries serve as an example, that a private health care system necessarily offers superior services at a competitive price. As I have written in a prior Naked Liberty article on the Dangers of Comparative Effectiveness, instead of experimenting with proven failed systems, the US should adopt targeted approaches to improving those parts of our current system which offer opportunities for improvement, such as for example the implementation of a national electronic medical records system and tax incentives to support wellness and health awareness.

What’s being proposed is like trading in your comfortable and dependable SUV for a Yugo just because you happened to have gotten a flat tire. Let’s fix the tire and get on with our lives without any more government intervening in it.

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Quotation of the Day:

“We should manage our fortunes as we do our health – enjoy it when good, be patient when it is bad, and never apply violent remedies except in an extreme necessity.“

Francois de La Rochefoucauld (1613 – 1680)

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We welcome your comments and suggestions, either directly inline, or via email to editor@nakedliberty.com. If you would like to have your article published in Naked Liberty, please contact the editor at the above email address.

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Our Tribute to 9-11

Posted on 10 April 2011 by Editor

Originally posted 2009-09-11 11:40:20. Republished by Blog Post Promoter

On this most solemn of days, in honor of the Fallen, we dedicate this presentation to those who perished in the tragedy of 9-11, and those who have since given their lives to insure that such a tragedy never strikes this great nation again. Please be patient while the flash presentation loads.

 

The above presentation is Copyright © 2009 NakedLiberty.com and XCIOS, LLC
All Rights Reserved
If you would like to use this content on your website or blog, you can download it from our site.

We will return to our regular articles format on Monday, September 14.

Please send comments to editor@nakedliberty.com
Link to this page: http://nakedliberty.com/2009/09/our-tribute-to-9-11/

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An American Entrepreneur

Posted on 10 April 2011 by Editor

Originally posted 2012-04-06 01:19:42. Republished by Blog Post Promoter

It seems that every couple of days New Orleans loses one of its treasured ENTREPRENEURS:

obit

Lets get the players straight before we go on with this. Interpretation of data (not verified) but…

LARMONDO "FLAIR" ALLEN
His Companion: Kawanner Armstrong
His Sons : Christian Allen
Kwan Allen
Larmondo Allen, Jr.

His Daughters: Deidra Allen
Larmenshell Allen
Lamonshea Allen
Larmomdriel Allen
Larmerja Allen
Korevell Allen

AT AGE 25 – He had 9 Children.
(Could Kawanner Armstrong Possibly Be The Mother Of All Of His Kids?)

His Father: Burnell Thompson
His Mother: Esther Allen
His Stepfather: Bruce Gordy

His Brothers: Burnell Thompson
Edgar Thompson
Wil Willis
Danta Edwards
Reshe Edwards
Mattnell Allen
Burnell Allen
Lester Allen

His Sisters: Shannail Craig
Lekiksha Thompson
Gwendolyn Carter
Jessica Willis
Katina Gordy

Grandparents: Delors Allen
J.C. Allen
Anna Laura Thompson
Will Thompson

So, lets see now….

His Father, Burnell Thompson, fathered his brothers Burnell, Edgar and his sister Lekiksha.
His Stepfather, Bruce Gordy, fathered his Sister Katina.
His Mother, Esther Allen, must have been unwed when she gave birth to: Larmondo, Mattnell, Burnell and Lester.
We don’t know who fathered Wil Willis and Jessica Willis, or Dante and Reshe Edwards.
Lets hope sisters Shannail Craig and Gwendolyn Carter are married.

GOT THE ABOVE ALL STRAIGHT?

***********************************************

NOW, THE REST OF THE STORY

He was 25 and had 3 sons and 6 daughters.
NINE welfare recipients collecting $950 each…..
That equals $8,550 a month !!! Now add Food Stamps,
Free medical, Free school lunches, and on and on
Do the math… $102,000+ /year.
Anyone out there, sittin’ on their butt while reading this post, making A HUNDRED GRAND doing nothing?

Now that, to me, is a real Entrepreneur.

Also, because of their father’s death, all of the kids will collect social security until they are 18. Even better… if "Flair’s" thirteein brothers and sisters followd his entrepreneurial strategy — that’s an additional $1.3 million per year.

BUT WAIT…THERE’S MORE!

If all thirteen brothers and sisters can duplicate his feat of 9 welfare strategists that breeds 117 new recipients collecting $100,000 per year each!!!… or an additional $11,700,000 per year… And that’s just one family.

(To cover this requires 100% of the Taxes Paid by 1,000 avg. taxpayers)

And THAT is why America is BANKRUPT!!

ANY QUESTIONS?

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