Friday, June 28, 2013

'How Much Would You Pay To 'Look Good and Feel Mah-velous' Versus Just Being Healthy?

'It is better to look good than feel good'

That is all it takes to get a person to do something different when it comes to health care cost containment.

We found out yesterday from a veteran of medical billing services that everyone 'says' they want their own doctor, their own prescriptions from their local pharmacy, their own local hospital....until they can find the same level of service somewhere else for $20 less.

So much for 'loyalty' in the medical field, huh?

You hear it said so often that it has become almost a mantra in the healthcare debate: 'People want the freedom to choose their own doctor.'

That being said, how do most people go about 'choosing their own doctor' in the first place?

Many people use the same doctor their family has used for decades if they live in the same locale much of their lives. When the older doctor retires, the people keep going to the same doctor's office where over time, a young family member has taken over the practice or other doctors have come on-board and 'assumed the mantle of physician/patient confidentiality' from the senior physician in the practice.

Hardly anyone actually 'chooses' their own doctor based on things like 'price' or 'quality' as they do in the local grocery store, do they?

'I'd like to see your cost sheet first before I come to see you for my annual check-up, Doc. Can you give me a list of all the adverse outcomes your patients have had over the past decade please? How many of your patients have left your practice versus how many new patients have started coming to see you for services because you are so great?'

You wouldn't buy a kumquat from your local Harris-Teeter if they were all spoiled and cost $25/each, would you?

Then why don't we do more 'shopping' in the medical field before 'purchasing' their services?

That is what is needed in American medicine today. 'Managed care' has come of age in ways that HMOs (health maintenance organizations) tried to do and failed in the 1990's to contain and control health care costs.

Nowadays, managed care groups focus more on helping people get healthy and stay healthy and therefore stay out of the emergency rooms or hospitals altogether. They act more as 'negotiators', 'advocates' or 'concierges' for the patient and less like green eye-shade accountants in the back room denying services right and left without any regard for the patient's health or well-being.

The rise of 'third-party payors' such as your insurance company, Medicare and Medicaid have done a lot to discourage responsible health care consumption in America over the past 40 years.

'If someone else is paying for it, what the heck? I'll go check myself in for a bloody hangnail if I want to!' has been an example of the prevailing attitude or our collective sense of entitlement when it comes to 'perfect' health care delivery, not just competent delivery of services.

Now consider this:

A company comes along and signs you up as a plan participant. They go over your current health care status with a fine-tooth comb and find out what you are doing right to take care of your body and what you are not doing well to take care of yourself (smoking, boozing it up, drug abuse, lack of exercise, diet of a box of Twinkies everyday now that they are coming back on the market)

When it comes to buying your monthly medicine for high blood pressure, whathaveyou, they suggest you consider a generic drug for your prescription.

'I want my name-brand medicine!' you protest. 'I feel great when I take XYZ every day!'

'It will save you $20/month. That is $240 year you can spend on something else you like to do' they inform you.

'I'll take it. Where do I pick it up?' you will say almost every single time according to this expert we spoke with yesterday.

How about a larger procedure?

'Your biopsy will cost $250 if we do it here in the office. Your co-pay will be $50. If we do it down the road at our other out-patient clinic, we can do it for $200 and your co-pay will be $30. Which will you choose?'

'If it means me saving $20, I'll go down the street, Doc, if you don't mind, of course!'

The problem is that none of us does that 'shopping' comparison now when it comes to health care because A) It is so confusing to begin with; B) We don't know what we are doing; and C) We are a tad bit 'lazy' when it comes to shopping for medical services, aren't we?

We will walk out of a grocery store if the shrimp is $22/lb. 'Heck, I can drive to Morehead City and back and pick up a couple of pounds of shrimp the next time I am down there and freeze it for later!' is the rationale we use to avoid such high-priced shrimp.

We will walk out of a car dealership if the $200 add-on feature in the new Nissan is not given to you 'free' as part of the final deal.

But when it comes to paying for medical services, as long as you have a pretty decent plan or the taxpayers pay for your medical care through Medicaid (100%) or Medicare (85%+):

'Whatever you say, Doctor! Sign me up! You know, it it better for me to look good than feel good and look mah-velous!' as Billy Crystal's 'Fernando' used to intone on SNL.

Managed care where people can help us all take better care of ourselves and save money in the process is one major way to do it. It is coming in the wake of Obamacare at every level of medical delivery as almost an inevitability.

When you see where you can save $20 on any medical procedure, you'll do it. Try it and see.

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Saturday, June 22, 2013

'Well, What The Hell We S'posed To Do, You Moron?'

Well, what the hell we s'posed to doyou moron?
Rob Christenson, long-time political commentator at the Raleigh News & Observer wrote a long piece recently entitled: 'NC GOP Rolls Back Era of Democratic Laws'  

Such a headline brings to mind the immortal words of The Stork in 'Animal House' when John Belushi (Bluto) starts his 'Germans Bombed Pearl Harbor' speech:

'Well, what the hell we s'posed to do, you moron?'

Does Mr. Christenson expect the NC GOP, now with the first veto-proof majorities in both the state House and Senate in close to 140 years PLUS a GOP Governor in the Mansion for only the 3rd time since Reconstruction, to 'expand the era of Democratic laws' somehow?

Electoral leadership is not like judicial precedent in the Supreme Court. Legislators write laws and they can change them at any minute. They can change the Constitution through the amendment process and thereby trump the Supreme Court whenever 2/3's of both the Senate and the House in Washington and 3/4s of the states ratify an amendment.

Elections are held every two years to hold the vast majority of our elected representatives accountable to the people. The people who 'vote' that is. People who do not vote and are not officially registered to vote do not count in that bi-annual calculus.

Which makes it even more important that everyone is legally and officially registered to vote, but that is another whole column or two or a hundred.

We'll let you read Mr. Christenson's work and form your own opinions about whether he is right or wrong.

Here's some things to consider, not only for government but for any life activity from your business to your family to your faith to your personal integrity:

  1. If things are not working out the way you had hoped, do you continue doing what you are doing...or try something different?
  2. How do you re-allocate your time and resources to improve your lot in life?
  3. Will you wait for someone else to do it for you first?
  4. At what point do you declare defeat, put up the white flag of surrender, and beg for mercy?
  5. What is America if not a place to try, try and try again if at first you don't succeed?
There are some things in Mr. Christenson's piece that are fair game and worthy of discussion. Just because there is a difference of opinion about the size of government doesn't mean that the other side is wrong about everything. There are some functions that government alone has to do since the private sector is incapable of providing the service, as in the case of national defense. (It would be a very bad idea to ever have privately paid legionnaires or militia running our national defense for example)

However, here are some unassailable facts that more and more government has yet to solve in North Carolina at least over the past 140 years and more particularly, in the last 40 years of the modern era:
  • Public education
  • Rising tide of high school dropouts
  • Income and job opportunity disparity across the state
  • Increasing numbers of people trapped in a welfare dependency cycle
  • Expansion of Medicaid costs that threatens to crimp or crush other budgets such as education, transportation, public safety and environmental protection
  • Exportation of the vast majority of textile and furniture jobs overseas
You can add a list of your own: tax reform, over-regulation, excessive licensing comes to mind. Maybe government programs such as the Rural Economic Development Center need to be done away with simply because they are not doing the job they were formed to solve.

But the point of this thought-bomb is to impress upon you the importance of having the freedom through our electoral process to 'do something different' and not be tied to the tried-and-failed ways and policies of the past. If we ever get to the point where we can not try new approaches to solve our nation's problems, we will truly be in a pickle we may never get out of.

You know who really tried something truly 'bold' and 'different'? Our Founders in 1776 and then in 1789 when they ratified the US Constitution.

There were the Rob Christensons of the world back then headlining the Lexington Gazette:

'Minutemen Try to Roll Back the Safety and Comfort Offered to Us by His Excellency, King George III'

And we are sure there were some nuts in the back of the crowd shouting out just like the Stork: :"What the hell we s'posed to do when they won't let us have our freedom?'

Good for them then. What about today?

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Saturday, June 15, 2013

What Is The Most Likely Way Out To Pay For The National Debt We Now Owe?

'President Jimmy Cahta', 1978:
'Inflation is Our Friend!' (Not!)
Inflation. Pure and simple.

Inflating the national currency is the tried-and-true way that governments have used for centuries and millennium to get their way out of budget problems caused by excessive debt.

But it is a dangerous bet and one that would not be necessary had we been responsible adults about our budgets and not run much debt or any at all over the past 40 years.

No budget deficits, no national debt. No need to borrow...from anyone. Case closed.

Here's a clip from Democratic President Jimmy Carter in October 1978 talking about his anti-inflation program:

Soon thereafter, inflation hit the stratospheric level of 12% per year in 1980-81. Interest rates spiked up to 21%. President Jimmy Carter's anti-inflation policies were an abysmal, absolute, abject and total failure.

Ronald Reagan ran the electoral table against President Carter in the 1980 election as a result of both high inflation and interest rates by 489 votes to 49. His was the largest margin of victory until Reagan swamped poor old Walter Mondale in 1984 by the score of 525-13 which was the highest margin of victory in the electoral college ever recorded since George Washington was elected unanimously.

Dan Aykroyd of 'Saturday Night Live' had a memorable spoof of President Carter's anti-inflation speech where he was 'quoted' as saying:
'Last week, I delivered a message on inflation. Since then, the dollar has dropped in value, the stock market has sustained record losses, and the whole sow price index increased 0.9%. In other words, our economic system is screwed, blued and tattooed!
We just have to face the fact that there is simply no way to fight inflation in a capitally-intensive, highly-technological, conflict-riddled, anything-for-a-thrill world of today. That's why, tonight, I want you to try to look for in inflation, an entirely new word:
'Inflation is our friend'.
Inflation is not our friend. Inflation is about the most destructive force of nature any democracy can ever be hit with far exceeding the damage any Hurricane Sandy or Oklahoma tornado can exact on any community.

Inflation destroys purchasing power, especially for the poor and the elderly on fixed incomes. It limits trade exports to other nations. It drives business people nuts because they don't know if they will have to buy something for 2X what it cost last week or 10X.

Inflation is only the friend of the debt-payor. Not the debt-holder. The higher the inflation, the cheaper the future dollars will be that will be used to pay off the past debt obligations of any government or company or household.

After a month of 'secrecy' and nefarious deeds emanating out of Washington under the Obama Administration, do you think there may be a 'secret' way to pay with inflation all the debt that has been accumulated over these past 4 years? We just don't know, do we?

We have had several people, people we respect in the business world who have been on regional Federal Reserve Boards or working in the Federal Reserve itself, say the same thing over and over again for the past 4 years:

'Ben Bernanke knows what he is doing and he is the right man at the right time in the right position to make sure inflation doesn't spiral out of control'.

Well, we certainly hope so. Alluding to Mr. Bernanke's Jewish faith, we have to believe that if he is successful in guiding us through this period of American history without explosive inflation rates, he will become the second Jew to 'walk on water', Jesus being the first.

However, we think it is important to show the downside of what we are facing today in order to help everyone understand what could happen if inflation gets out of control. It may spur you on to take action such as contacting your congressman or senator and telling them in no uncertain terms to act like a national leader now and get our economic and budgetary houses in order and not act like a squeamish infant hiding in the corner sucking his/her thumb.

Let's take a look at how this would play out in real-time if it were allowed to happen:

Failure to control federal spending means Congress has to do 1 or 2 things or both to pay for it: 1) raise taxes and/or 2) borrow more money.

Raising taxes is painful enough. Those who do pay them feels it every time they write out a higher tax check to send to the government to be spent most likely in less than optimal ways.

Borrowing more money has become problematic since the Chinese and other sovereign nations have near about stopped borrowing money without some inflation kicker added onto the premium in order to protect them, the Chinese, from the value of their bond investments in the United States from going down due to inflation. (The value of bonds go down as interest rates rise and interest rates rise when inflation expectations ramp up)

So the Federal Reserve has adopted what we call the 'Robbing Peter to Pay Paul' policy of 'expanding the Federal Reserve balance sheet'. What that means in its simplest form is that the Fed just makes money up out of thin air, declares it 'federal tender' in some legalistic way, and then uses those funds to pay for the overage of federal spending beyond what can be paid for by current tax revenues.

The Fed has been pretty transparent about their policy to 'buy' $80 billion of US bonds this way on the market every single month. That is close to the entire debt being issued this year when you add it up, isn't it?

Whenever you hear the term 'expanding the balance sheet', just think of you being able to increase your credit card limit whenever you want to!  No pre-authorization from American Express; no annoying pre-qualification from Visa or your local bank.

You want to buy a Rolls-Royce? 'Go right ahead, we'll expand your credit limit by $150,000 today right now and expand your balance sheet! You can pay us back later.  We know you are good for it!' says your friendly underwriter at your credit card company.

That is what the expansion of the federal balance sheet is like at the US Federal Reserve. We are 'trusting' and 'hoping' that Ben Bernanke and the others at the Fed know what they are doing because if they are wrong, we might see a colossal mess that will make the 'colossal mess' created by Jimmy Carter and his guys in 1978-81 look like a garden party.

What happens if economic activity picks up and the demand for money and credit starts to go up, as it appears to be doing slowly but surely today in many places in America? When demand for anything goes 'up', so does its 'price', in this case the interest to be paid for the loan or credit you want.

If there are way more dollars sloshing around in the American economy due to the creation of all these new dollars by the Fed to buy federal debt, there is a chance that they may be chasing scarce resources and driving up the prices of everything from homes to food to gasoline to dental services.

When and if the inflation mentality starts to roll unabated in the economic mindset of this nation, watch out.  Because that is exactly what happened when Dan Aykroyd's 'Jimmy Cahta' said we were 'screwed, blued and tattooed' in 1978.

Inflation is not our friend or yours or anyone else's friend. That is why you should contact your elected representatives to tell them to take solid action now and not tempt Fate when it comes to unleashing the Hounds from Inflation Hell.

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Sunday, June 9, 2013

President Obama: 'We Believe In the Free Market and a 'Light Touch' When It Comes To Regulations'

Well, if President Obama believes in a 'light touch' when it comes to regulations, we hope we never see his 'heavy-handed hammer' when it comes to regulating American business.

President Obama went to another fundraiser at another wealthy private residence in Palo Alto, California on June 7 and gave another speech to raise more money for the Democratic Party.

You'd think that with all the problems we are facing as a nation right now; budget deficits, debt, unemployment to name 3, and all of the exploding scandals in Washington besetting his Administration; IRS; AP; Benghazi, NSA snooping into your private records, that President Obama might just forgo fundraising for awhile and focus on doing the job he was elected to do:

'Run the United States of America's civil government'

Instead, we have a President who really and truly and honestly seems to love to campaign more than governing. Bill Clinton liked to campaign a lot as well but he at least had the common-sense to hire people such as Erskine Bowles to do the dirty work necessary such as sit down with 'the other side', as President Obama is fond of calling the 'Dark Side Republicans' in Congress, and wrestle with the hard issues until a true compromise could be hammered out to solve the problems we face.

Mr. Bowles took on the onerous task of actually sitting in rooms with the likes of Newt Gingrich, Dick Armey and Tom DeLay in 1996-97 and they hammered out an agreement to reduce the rate of growth in federal spending by over $500 billion in five years that led to the last balanced budget we are currently projected to see in your lifetime.

Can you imagine that? Someone in a Democrat White House actually sat down in the same room with the Darth Vaders of the Republican Congress and worked with them until an agreement was made.

Hard to believe nowadays, isn't it? Hard to believe.

Here's the text of President Obama's most recent fundraising speech where he talks about how reasonable he and the Democrats are and how they love free enterprise:
'It turns out we're pretty common-sense folks.  We don't think government can do everything.  We don't think that top-down solutions are the right way to go.  We believe in the free market.  We believe in a 'light touch' (our emphasis added) when it comes to regulations.  We don't want to tax all businesses out of business.  But we do think that there's a role to play for government. 
We haven't seen a transformation as stark as this since the Democratic National Convention in Charlotte last year! Why, if you haven't followed the Democratic Party closely for the last 30 years, you would have thought that you were at an Amway convention in Charlotte the way they extolled the virtues of hard work and determination and the American Spirit last September!

Nothing could be further from the truth. There is no 'light touch' when it comes to the heavy-hand of the US federal government coming in to tell you how to run your business better than you know yourself.

The 'light touch' of the Obama White House when it comes to regulations has been a hammer the likes of which Paul McCartney wrote about was used by a disturbed youth named Maxwell Edison in 'Maxwell's Silver Hammer'.

That is not just us talking. How about the conservative Heritage Foundation? Here's what they say about the 'light touch' of regulations under President Obama for these past 4 years:
  • The Obama administration adopted 106 “major regulations” in the 1st term that increased burdens on the private sector, compared to 28 for Bush in his first term.
How about the more liberal 'OMB Watch'? What did they have to say about the 'light touch' of the Obama Administration in their first term?
  • OMB Watch found total regulations adopted by the Obama administration equal to the number adopted by other administrations (Clinton, Bush 43) over past 18 years.
If you know of anyone who has started a business or run a business over the past 4 years under President Obama, you can just sense the angst and frustration they feel every time you speak to them, can't you?

There is this palpable sense of fear that another tax hike, another regulation is just around the corner with these guys and women in the White House. And now with the revelations that the Obama White House has been engaged in a lot of skulduggery and very questionable if not illegal wiretapping, surveillance and targeting of folks they disagree with, that fear has become manifest as truth.

We can go along with people of different political persuasions as long as we think they are being truthful and honest. Lying and duplicity doesn't work for us or for anyone else who has been engaged in the governmental political process for any length of time.

Here's an edited, more likely 'true' version of the President's speech clip above had he been given a truth serum injection before starting to speak at Palo Alto on June 7:
'It turns out we're pretty much elitists who have gone to tony prep schools and been taught by some very liberal professors in the Ivy League.  
We don't think government can do everything.  We KNOW Government can do everything. We don't think that top-down solutions are the right way to go.  We KNOW top-down solutions are the right way to go.
In everything. Forever.
We don't really believe in the free market.  We believe in a monitored, regulated economy where people can't become excessively rich anymore (such as all of you I am raising money from here in this spacious mansion in Palo Alto, the epicenter of the Silicon Valley wealth explosion over the past 30 years).
We believe in a 'heavy hand' when it comes to regulations.  We know most American businesspeople are too stupid and too greedy to do the right thing on their own each and every day when they go to work. We don't trust them to make their own decisions. So we have to make those decisions for them.
We don't want to tax all businesses out of business.  We just want to tax the businesses we disagree with out of business.
But we do think that there's a role to play for government. As in the starring role of 'Evita' or when Michael Jordan played for the Bulls: 'As long as everyone understands I have to touch the ball every time we have possession and I have to shoot the ball almost all of the time, then that is the role I think government should play in your lives in America'
You are free to agree or disagree with this edited version of the President's speech on June 7. If you don't read a Telemachus posting ever again, you will know that the NSA and the Obama White House have taken offense at this version as well.

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Friday, June 7, 2013

'There's Something About Your Phone and Internet Records That Intrigues Me'

'There's Something About Your Life
That Intrigues Me!'
All we can say is this:

'It is a good thing President George W. Bush is not President nowadays!'


Can you imagine the holy hell that would be breaking loose today from the NY Times to the Washington Post to the Democratic Caucus in both the House and the Senate on Capitol Hill if just even 1 of these 'revelations' about our government surveillance all of our cell phone and internet records in the name of 'national security'?

We can't. The roar would be as deafening as a GE jet engine.

Speaking of which, we think Agent Smith from 'The Matrix' who does those creepy GE commercials nowadays might be a fitting symbol for the Obama Administration for posterity's sake:

The Obama Administration and AG Eric Holder have apparently gone stark raving mad in their abuse of the Patriot Act and decided that everyone is 'fair game' when it comes to protecting us from the real lunatics, the radical Islamist terrorists who have sworn to wipe the Great Satan of America (and Israel while they are at it) off the map of the world.

We thought it might be a good idea to tick off the Amendments in the Bill of Rights to see which ones the Obama Administration has chosen NOT to attack in some way, fashion or form over the past 4 years.

(Granted, the Patriot Act was passed with bipartisan majorities led by President Bush and the GOP leadership in both Houses of Congress post-9/11. But that was to protect us from 'foreign' forces, not to open up a whole can of worms regarding domestic surveillance)

Amendment #1- Where do we begin? The NSA, AP and IRS scandals abridge the freedom of speech, the freedom of assembly and the freedom of the press. The one not abridged recently is freedom of religion and the Obama mandate of birth control in Catholic hospitals took care of that one a couple of years ago.
Amendment #2- It is pretty evident that the Obama Administration wants to have more control over guns in America today. That is why it is called 'gun control' in the first place.
Amendment #3- Well, so far, the Obama Administration hasn't called for the quartering of troops in our own homes to 'protect' us from domestic or foreign terrorism. Yet. But if and when you do see that, will you finally believe that maybe they are over-reaching just a tad too much?
Amendment #4- 'Protection from unreasonable search and seizure'. You can make the believable case that this NSA surveillance of your Verizon cell phone and Facebook, Twitter, Apple and email accounts is 'unreasonable search and seizure' of anything relating to your 'privacy'.
The US Supreme Court found the right to an abortion under the 'penumbra' of privacy they said permeated the US Constitution in 1973.
Well, if that right could be found in a 'penumbra' of privacy, what about the protection of our private phone, email and on-line communications?  Can't they find one smidgen of 'right to privacy' under this Amendment for us all?
Amendment #5- IRS employee Lois Lerner has already abused the 5th Amendment when testifying before Congress when she said: 'I did nothing wrong' Now I am invoking my right to not incriminate myself any further'.
She can't testify to her innocence in all of this IRS turmoil and then recuse herself from hearing where other people think she was not so crystal clean and pure. She has a history of going after conservative groups. Make her testify under oath.
Amendments #6 and #7- Speedy trial and trial by jury has not been abridged. Yet.
Amendment #8-The only 'cruel and unusual punishment' we will see may be that we will be forced to see and hear repeated attempts by White House Spokesperson Jay Carney try to 'tell the truth.... as we now know it.'
When the 'truth' keeps changing daily in the Obama White House, State Department, Attorney General's office and the NSA, that can be truly 'cruel and unusual punishment' for all of us on the nightly news.
Amendment #9-'The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.' Well, give the Obama Administration some time. They'll find some way to 'construe' the denial of rights retained by some people they don't like.
Amendment #10- 'The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people'.
You gotta admit it: The Tea Party folks smoked this one out in 2010 even before Obamacare passed Congress and was signed into law by President Obama. We don't see where there is much respect for the 'powers reserved to the states...or to the people' by this White House.
So, quibble with these if you want to. We always love a good-spirited give-and-take on the issues as long as the arguments are coherent, reasoned and collegial.

Just don't complain about George W. Bush or the GOP anymore when you are talking about Presidents who don't care about your individual rights or the Constitution.

The Obama Administration has taken home the Grand Prize in that category.

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