Health Greed Can Be Good

HEALTH CARE CAN’T BE HEALTH GREED… BUT LIFE IS EXPENSIVE… So Some Greed Is OK.. 

Confusing care and greed is a flaw of the US healthcare system.

This is why, per capita, US healthcare costs 50% more than the most expensive European health care systems.

This being said, there should be room for expensive medical experimentation. A long article in the NYT bemoans apparent fraud in the case of surgical blood system rather experimental therapies.

OPERATING PROFITS. They Lost Their Legs. Doctors and Health Care Giants Profited.
Medical device makers have bankrolled a cottage industry of doctors and clinics that perform artery-clearing procedures that can lead to amputations.[1]

In 1955, Einstein refused an experimental procedure to treat an aneurysm which he was affected by. He didn’t want to foster research in that medical procedure. He died within weeks at 76 years old. “It is tasteless to prolong life artificially. I have done my share; it is time to go.”

Now that procedure for abdominal aortic aneurysm is standard. 

Some state of the art treatments cost millions of dollars. In the future, they will cost little and be very effective. I am prescribed a monoclonal antibody treatment which used to cost $15,000/year eight years ago, when it got authorized.  Now it costs me (after insurance) $480 a year. And it is extremely effective. 

I am moving to Europe to one of the most renowned health care systems in the world (for other reasons)…  I am actually nervous that France’s health care will cover the treatment… Although the drug is made by a French pharmaceutical in collaboration with a US biotech firm… US health care has been a great source of profits for equipment makers, biotechs and pharmaceuticals, worldwide.  

The argument that extravagant US health care spending has a good side, by fostering expensive progress can then be made… and must be kept in mind.

Patrice Ayme

French neurologist Guillaume-Benjamin-Amand Duchenne (1806–1875), in the 1861 edition of his book Paraplégie hypertrophique de l’enfance de cause cérébrale, described and detailed the case of a boy who had this condition. A year later, he presented photos of his patient in his Album de photographies pathologiques. In 1868, he gave an account of 13 other affected children…

Elevidys was approved through the Accelerated Approval pathway, under which the FDA may approve drugs for serious or life-threatening diseases where there is an unmet medical need and the drug is shown to have an effect that is reasonably likely to predict clinical benefit to patients (improving how patients feel or function, or whether they survive longer)… This pathway generally provides patients earlier access to promising new drugs while the company conducts clinical trials to verify the predicted clinical benefit.

Elevidys delivers a micro-dystrophin-encoding gene into a patient’s muscle tissue to prompt production of the micro-dystophin protein, which is necessary for patients with the disease because they can’t make the protein properly on their own.

The lack of this protein leads to a progressive loss of muscle strength. Sarepta’s treatment is meant to change the disease trajectory to a milder form., by providing with a shorter gene which is good enough…

***

From NYT, linked article:

Kelly Hanna’s leg was amputated on a summer day in 2020, after a Michigan doctor who called himself the “leg saver” had damaged her arteries by snaking metal wires through them to clear away plaque.

It started with a festering wound on her left foot. Her podiatrist referred Ms. Hanna to Dr. Jihad Mustapha. Over 18 months, he performed at least that many artery-opening procedures on Ms. Hanna’s legs, telling her they would improve blood flow and prevent amputations.

They didn’t — for Ms. Hanna or many of his other patients. Surgeons at nearby hospitals had seen so many of his patients with amputations and other problems that they complained to Michigan’s medical board about his conduct. An insurance company told state authorities that 45 people had lost limbs after treatment at his clinics in the past four years

US Healthcare Is Too Corrupt And Too Drunk, To Fight This Epidemic Optimally

Right now the epidemic is under control in Europe (except England). Yet Europeans have to test and track more, as in South Korea… And as Germany has been somewhat doing.
Part of the problem in the USA: it’s an UNION of STATES, which do as they please. Compare with Europe: the UK, or more exactly England, has been doing terribly, with a death rate more than 50% higher than the USA. Reason? The scientific council in charge, as in Sweden, believed, all too long, in “herd immunity”. The results were even worse than Sweden. By contrast a strict Germany has been doing way better, with a death rate less than a fifth that of England.

Then there is the problem of US for-profit healthcare. A characteristic of this is that healthcare is viewed in the USA, but for the old, as one more privilege from employment (instead of a human right, as in all other advanced countries). The idea, apparently, is that employers will not just give you the pursuit of happiness, but also will provide you with life itself.

Doctors can do a lot against COVID. Problem: in the US, people do not have the habit of going to see their doctors… until it’s too late. And that has to do with the greedy, lawyery, private insurance dominated nature of the US medical system…

The for-profit aspect has been going from very bad to even worse in recent years (18% of GDP in healthcare; Europeans don’t go over 12%; the difference between 18% and 12% is all corruption, for want of a better word.) Conclusion: in this crisis, US patients have been reluctant to see doctors. It’s not just the “co-pays”, and “deductibles”. Now there are “facility charges” (even while seeing your old doctor)… which can be hundreds of dollars.

Inconvenient truth? The US vision of healthcare is too greedy, and too drunk, to fight this epidemy optimally.

Patrice Ayme

***

***

P/S 1: The preceding was a comment sent to NYT Krugman (who had written an essay with some of the usual “Trump = Devil” stuff). To my surprise, the comment escaped the censorship terrorists ate the NYT and was published fast (not the usual 24 hours plus delay; my recent comments to Krugman were all censored… This was recommended by 43…)

JPH

USAJuly 13

@Patrice Ayme US health care quality is ranked number 38th. But its cost is number 1 in the world. As comparison French health care’s cost is 34th world ranking but quality is number one.

Reply23 Recommend

Answer: Patrice Ayme

Berkeley | Pending Approval

@JPH So we agree. I actually had a very difficult pregnancy with my daughter. After finding French doctors in an Alpine hospital very disponible and helpful by phone (whereas Californian doctors couldn’t be reached!). We flew there and then directly, three hours after landing, to the hospital. A young doctor (who was Italian) looked at the US file, and gave a clear and precise conclusion: although this hospital was proud of its very low C section rate, in this particular case, a C section was extremely likely (that was news to us). Then he proceeded to examine the patient. The expert delivery was made by a lady surgeon. I have no doubt the baby would have been lost in the US. Besides the (public) hospital was like Club Med, with great Alpine scenery, a huge private room and bathroom, and a stay of nine days… And it cost much less than a normal delivery in the US… People who can fly to France buy their US prescribed drugs there, as they cost less than US copays (French pharmacists, who are private owners with doctorates, both by law: pharmacy monopolies are illegal in France have the freedom to prescribe, and accept US prescriptions as if they were written in France). The French healthcare system is a mix of private and public, and the US healthcare could be morphed into it (that is, differently from the UK, Sweden or Canada, the French system is not 100% socialist; what happens is that fundamental healthcare is 100% covered; private health insurance supplements services).

***

P/S 2: The New York Times, a private media company, is the newspaper of record of the USA. New York Times opinion columnist and editor Bari Weiss published the resignation letter she sent to Times publisher A.G. Sulzberger on her personal website. The Sulzberger family has controlled the New York Times since the nineteenth century (through a special share arrangement). The preceding Sulzberger had banned, apparently from my opposition to the Bush-Biden Iraq invasion (which NYT encouraged).

Bari said:, “Showing up for work as a centrist at an American newspaper should not require bravery.” She wrote she was bullied by colleagues in an “illiberal environment,” “Stories are chosen and told in a way to satisfy the narrowest of audiences” and “intellectual curiosity” is a liability at the Times, among a variety of other devastating feedback.

 

Progressive Medicare For All, Or How And Why To Morph US Healthcare Into French Healthcare

European universal health care systems vary, from fully socialized (UK, Sweden) to mixed (France) to rather peculiar (Germany, universal health care from Bismarck, before 1880). The best and most expensive systems (Germany, Italy, France) amount to 12% of GDP, UK only 8%.

As the achievements of the US are objectively inferior (say relative to the UK NHS, and all other European systems), one can deduce that more than half of the US healthcare system is profits.

The European health care systems all have this in common: they are not profit centers. instead, they center around care. In the USA, in 48 states out of 50, the wealthiest profession is Medical Doctors. The naive will think that brings the best. In truth, it tempts those who are the greediest to become MDs.

 

Life Expectancy peaked in the USA in 2015 (above). Since then, it has been going down, demonstrating Obama’s Affordable Care Act didn’t work.[1]

The US system as it exists, with HMOs, was organized by president Nixon, under the guidance of his good friend, plutocrat Kaiser. (who founded the eponymous HMO, thanks to Dick’s help: dicks help dicks). Some US contemporary tycoons, such as Warren Buffet, one of the world’s wealthiest men, have made billions, personally, by investing in US healthcare. Buffet is revered in Democratic circles, but his advice may not be beyond any suspicion, as he and his ilk can only be grateful of the rewards US “care” brought them.

The French system provides a universal coverage of basic healthcare. The US equivalent would be Medicare For All, completed by private insurance for elective services and procedures. Average French doctors attached to public hospitals have often a private practice attached to a private clinic (say for a surgeon). When publicly serving. Fees are limited by law. In private practice, payments can be much higher (and are then paid with a mix of public reimbursement and private insurance, or more often, “mutual” insurance… The French are always comparing those “mutuelles”).

A progressive instauration of Medicare For All (as an elective in the beginning) would allow to morph the US healthcare system into the French one… without the dramatic, hence impossible, change that going to a socialist system like the Canadian, British or Swedish system would force.  

All this is current and hot. Nancy Pelosi, the quasi-Prime Minister of the USA (she decides the US budget, Trump proposes it) recently was claiming that Obama’s ACA was much better than Medicare For All. Sure. For her and her class of the .01%.

Medicare For All is the only reasonable solution for the USA. The beauty is that it can be introduced progressively, without economic disruption, a bit like better mileage for cars…

Patrice Ayme

***

***

The preceding was a comment sent to NYT which had compared US healthcare with Singapore’s. Singapore’s population is mentally enslaved, obedient, and 1.7% of the size of the USA. It’s a mix of disciplined Han Chinese, grateful to exist thanks to their government, considering the enormous alien countries around, and foreigners also grateful to have been allowed in to enrich themselves… Plus 1.7 million quasi slaves for underclass work…

***

***

[1] Obama’s ACA was supposed to have a Public Option offered, the prospect of which handily enabled to dodge the threat to the plutocracy presented by Medicare For All. Once socialist Medicare For All was safely taken care of, profits for professional politicians, lobbyists and plutocrats turned out to be more important than the health of citizens. Overall, ACA is disastrous: a member of my family died from it, he was 45. What the pseudo-“Democrats” will not tell you, is that doctors, or their groups, or organizations, will refuse to see you, when on the local version of ACA, like “Covered California”. So Obama covers you with words, while he drinks martinis on a yacht, watching the sun set among the paradise tax haven islands he loves. My brother-in-law, a proud, but somewhat destitute artist, who refused my personal financial assistance got a complication of heart disease, and got minor treatment after a second major heart attack, then was sent back home. When he started to die, the hospital rejected him, because he was no juicy profit center, but a drain, after a few more stents. He died at 2 am, in a parking lot, in his car, close to another hospital he tried to drive himself to.

Mention any of this to pseudo-Democrats, and they will bleat, as the good Sheeple they are. None of them is on Obama’s ACA. Their leaders, the great pseudo-Democrats, is immensely wealthy (more than 60 million dollars admitted), while her colleague great pseudo-“Democrat” Feinstein is outright a billionaire (she made it so that her husband was a go-between with China, while she oversaw business with the PRC, from the Senate…)

US Has Health Greed, Not Health Care!

The New York Times ponders “The New Health Care, a Medical Mystery: Something Happened to U.S. Health Spending After 1980
The spending began soaring beyond that of other advanced nations, but without the same benefits in life expectancy. [By Austin Frakt, May 14, 2018.]
The United States devotes a lot more of its economic resources to health care than any other nation, and yet its health care outcomes aren’t better for it.

That hasn’t always been the case. America was in the realm of other countries in per-capita health spending through about 1980. Then it diverged.

It’s the same story with health spending as a fraction of gross domestic product. Likewise, life expectancy. In 1980, the U.S. was right in the middle of the pack of peer nations in life expectancy at birth. But by the mid-2000s, we were at the bottom of the pack.

What happened?”

What happened is that Reagan became president in 1980. President Greed.

The more greed one has, the shorter the life, the sweeter, both for victims and perpetrators…

Other nations have health care: the mission of doctors, nurses and supporting medical staff, in these nations is to optimize health of the citizens. However, in the USA, starting with the presidency of Reagan, greed came to be viewed as the best motivation for everything. Reagan himself, as governor of California had made it sure it would be so, in a breakthrough case: Reagan forced the University of California to charge for education. Initially the University was public, that is 100% publicly financed and 100% free for qualified Californian students. Reagan made sure only the wealthy could attend, in the long run: now only 13% of the University of California financing is from the state.

The greed modelization of everything, in the modern US, enforcing the principle that only the wealthy can pretend to full human rights, be it education or health, has been extended to the entire society. “Your Money Or Your Life!” works best when people are dying, or in pain!

The propaganda of the powers that be, the propaganda of the power of greed, is incredibly deep. It’s a programmation not just of ideas and systems of ideas. It is a programmation of feelings, emotions, occupations. A programmation of moods and inclinations. A programmation of souls and hearts!

We the People of the US has not understood that we are confronting the formation of a new aristocracy, the aristocracy of wealth. Some individuals, famous and esteemed, in the US, have made billions of profit in health care. One year, a hopital executive made half a billion.

Want to improve US health care? It’s time to understand that greed is antagonistic to care.

Patrice Ayme

Note: My preceding observations are supported by the NYT as follows:

.…”differences in public policy on health care financing. “Other countries have been able to put limits on health care prices and spending” with government policies, said Paul Starr, professor of sociology and public affairs at Princeton. The United States has relied more on market forces, which have been less effective.

“Confronted with fiscal pressures, as the share of G.D.P. absorbed by health care spending began to get serious, other nations had mechanisms to hold down spending,” said Henry Aaron, a health economist with the Brookings Institution. “We didn’t.”

One result: Prices for health care goods and services are much higher in the United States. Gerard Anderson, a professor at Johns Hopkins and a lead author of a Health Affairs study on the subject, emphasized this point. “The differential between what the U.S. and other industrialized countries pay for prescriptions and for hospital and physician services continues to widen over time,” he said…

According to a recent study, the United States has higher health care administrative costs than other wealthy countries.

“We have big pharma vs. big insurance vs. big hospital networks, and the patient and employers and also the government end up paying the bills,” said Janet Currie, a Princeton health economist. Though we have some large public health care programs, they are not able to keep a lid on prices. Medicare, for example, is forbidden to negotiate as a whole for drug prices, as Ms. Currie pointed out.

But none of this explains the timing of the spending divergence. Why did it start around 1980?”

Interestingly, the NYT doesn’t point at Reagan directly… although it does, indirectly, by saying the USA started to spend less on social services… that would include Reagan getting the crazies out of mental hospitals, and into the streets… although the NYT, once again, doesn’t say it… Instead it points out the lag in social spending of the USA with rich countries went from 4% GDP, to 6% GDP…

“

Doctor Ordered: Roman Baths Alive Again

Roman baths were one the most striking features of Roman civilization. After the Roman state collapsed, so did the baths, bathing, and the will to bathe. This was partly due to the destruction of the Roman hydraulic system. But it was also due to Christianism, an artificial ideology, antinomic to humanity, which the Roman emperors imposed to turn We the People into We The Sheeple. It’s high time to become reunited to elements of Middle Earth Civilization, neglected ever since Christian derangement syndrome took over.

ASICS & The Dirt On Christianism:

Early Christians tended to cultivate dirt and inaction. Individuals, male or female, achieved sainthood, just because they stayed on top of a column, for years, or just because they never washed, nor washed their clothes, nor changed increasingly dirty clothing: they just waited for dirt to flake off. Not interfering with the will of god was viewed as a high achievement.

(Part of) Grand Bains in front, proud successor of their 2,500 year old Allobroge and then Roman predecessors. Two 1,000 year old churches behind. Roman Tradition & Divine Aspirations United in a multi-millennial embrace, in the middle of the Alps. In 2017, the French government minds the ecology fiercely, in its own special way, by assassinating wolves around this village, in full tourist season, and planning dams… (In complete and direct violation of European law protecting wolves, an endangered species, thus demonstrating that, when the French government favors plutocrats, under the pretext of European law, it’s because it wants to…)

Christianism despised the world, and, in particular, the human body. What is despicable shouldn’t rule! Thus Christianism made despising We The People, into a religion, debasing the masses into submission! Taking care, either of the world, or the human body, was to be condemned, such was the mood of early imperial Christianism. That was the reason of being of imperial Christianism.

Once the Christians took over the small emirate of Granada, they closed the 3,000 public baths of this Muslim enclave. (I hope foaming at the mouth Jihadists read this before attacking modern baths; knowing history has not been their forte).

Christianism’s mood of submitting to fate, by rejecting the existence of the real world, was the  exact opposite of the mood of the Roman Republic. And that was exactly Christianity’s main point: submit to fate in general, and the emperor in particular. Such is the will of god.

An important aspect of Roman mentality, ASICS: Anima Sana In Corpore Sano, a healthy soul in a healthy body, was particularly repugnant to Christian fanatics. (A variant from Juvenal’s “Mens sana, in corpore sano…”) After the collapse of the Roman State, Christians would spend much efforts, in the following millennium, trying to close baths, until public hygiene became abysmal.

***

The Christian anti-ASICS mood was also a completely degenerate mindset:

De-generate: what generates not, what undoes generation. What generate human beings in full was ASICS.

A portion of the exterior part of Monêtier-les-Bains Baths. Glaciers in the background High Alps are melting at a torrid pace. Entire glaciers are now fields of stones, after two decades of melting… I have computed that elevating the melt zone by 100 meters is roughly equivalent to shrinking the permafrost zone 100 kilometers to the north (or south…)

The destruction of the baths was actually progressive: early “Christian” civilization was not that “Christian”, and resisted Christianism for many centuries (Charlemagne was very Christian when Christianism was useful to conquer the Saxons and persuade them they were of an inferior moral sort, and intellectual primitives; however, in his personal life, and in his pushing of secular education and private fuming about the Pope, Charlemagne was not at all Christian, or then just Christian in a noble form…) It took many centuries for full Christian hatred of body, mind, health and world to take over. By then, even inside the “Church”, entire traditions of resistance to that sort of Christianization had risen. “Men in Black”, a sort of fanatical monks, destroyed books and libraries and intellectuals by 400 CE, but soon other monks were secretly saving around 93% of the texts of Antiquity which got preserved.

The hot, mineral laden baths have great curative properties, known probably already to Neanderthals (people used to have lots of skin disease). The destruction of bathing and basic hygiene in the Late Middle Ages, due to mass Christianization, brought massive epidemics. Proof? The nobility was often unaffected, because they bathed, and lived according to un-Christian morality, as Nietzsche, following Sade, forcefully pointed out…

Those texts were rediscovered in monasteries by the Late Middle Ages, including many by the secretary of several Popes, who detected the one and only copy of Lucretius’ De Natura Rerum, Of the Nature of Things, the only compendium of Greco-Roman science we have. Indeed the story of the Catholic Church was immensely complicated.  

***

Experiencing The Baths:

The Roman baths had many traditional sub-elements, such as the Tepidarium (tepid), the Frigidarium (frigid), the Calorarium (caliente! very hot). Going from the frigid bath to the super hot bath is really to be experienced: there is a variant where one walks through an even colder leg bath, before going back to warm water. One can feel nerves twinkle…

The high Alpine village of Monêtier-les-Bains has had baths, from natural hot water springs, for more than two thousand years. The Romans knew it well: the valley in which Monêtier-les-Bains sits had a major Roman road going through 150 miles of massive mountainous landscape, complete with passes above timberline and enormous canyons (in the flanks of which the Romans dug their roads, and their mines).  

One becomes more fully human by experiencing more and more significantly, as long as it’s rather innocuous. Experiencing the games one’s neurology plays from just changes in water, or air, temperature or the impact of powerful jets is instructive.

Les Grands Bains du Monêtier are strangely addictive. Maybe that’s the wrong adjective: why should it be strange to feel fully human? The Romans didn’t think so. But the Christians did, and that’s why Christianism put civilization in full reverse in crucial ways, and why it had to be wiped out as a ruling cult. Ruling out Christianism is what the Enlightenment did, but it took a while: teaching the theory of evolution was forbidden in English universities for most of the Nineteenth Century (although it was allowed, in Scotland, to teach the evolutionary theories of the French research professors of the Museum d’Histoire Naturelle in Paris: Buffon, Lamarck, Cuvier, etc…).

I am not the only one so addicted to Les Grands Bains: although the price is above 24 dollars for the shortest visit (including going through change of clothing, shower, etc.), I had to share the baths with at least one hundred other happy souls. However, the baths are very large, so it didn’t feel crowded. Although not as large by a very long shot, than the largest baths in the Roman empire, such as Caracalla’s Baths, the present baths have absolutely mesmerizing pools, such as the one where one can enjoy underwater music, while contemplating lighted wave patterns, made by underwater lights, on the domed ceiling, far above.

***

A whiff of pre-Christian religions, the religion of the baths, among others, is exactly what the doctor ordered, because it is a return to human sense, as evolved over millions of years, before the Abrahamism madness which devastated civilization, when the Middle Earth civilization nearly collapsed from a conjunction of factors where theocratic fanaticism, and rejection of reality, played an important part.

Right, it all originated from too few men having too much money, and then, power.

Nowadays, the stakes are higher: mad, yet powerful cretins play with, and brandish, thermonuclear bombs, and can throw them to the other side of the Earth. Ignore them to one’s own, and goodness’ peril. Antidote? Everyday I walk and take a long hot bath, reading in either case…

Patrice Ayme’

 

With Intellectuals Like That, Who Needs Savages?

With Progressives Like That, Who Needs Conservatives?

With “Democrats” Like That, Who Needs “Republicans”?

How did the West, so superior in nearly all ways in the 1950s, got in its present predicament? The main predicament being the educational system: in the 1950s, France, Britain or the USA had, by far, the best educational system in the world.

Now they are far, far behind. More exactly three years behind by the age of 15, says the UNESCO’s on-going PISA comparison study of more than 65 states.

How did the West, progressing by leaps and bounds technologically around the 1950s, came to stagnate relatively speaking? How come we are stuck with an energy system which kills the planet? When alternatives exist?

One way to get mentally despondent, is to be submitted to heavy propaganda… From thinkers who are paid, or appreciated, to not be that smart. This started long ago, and affected philosophical circles first; the fish rots by the head.

The poster example is “French Theory”, and the anti-“colonialist” movement. Both have excellent things about them. However both made the truth short-circuit.

Short-circuiting the truth is never a good idea… If you want real progress. So it should really be a no-no, no matter what. On the other hand, the “Big Lie Technique” as Hitler called it, works very well. As Hitler explained, common people expect only little lies, not gigantic ones.

In 2008, Obama was elected for “Change You Can Believe”. Indeed: namely no change.

It’s painful to see proto-intellectuals such as Paul Krugman, crawl desperately in search of the truth which keeps on eluding them. Or maybe they are paid to find truth elusive?

In “Democrats Against Reform”, Dec. 4, 2014, Paul Krugman is mystified:

“It’s easy to understand why Republicans wish health reform had never happened, and are now hoping that the Supreme Court will abandon its principles and undermine the law. But it’s more puzzling — and disturbing — when Democrats like Charles Schumer, senator from New York, declare that the Obama administration’s signature achievement was a mistake.

In a minute I’ll take on Mr. Schumer’s recent remarks. But first, an update on Obamacare — not the politics, but the actual policy, which continues to rack up remarkable (and largely unreported) successes.”

A dog with a bone. And like dogs with bones, indeed the “Democrats” were treatd in the last elections. They are now cruising towards a full right wing Republican government, effective January, and probably with the presidency added, in two years. Why? Because they have been lying.

Krugman: …”health reform’s efforts to create meaningful competition among insurers are working better than almost anyone (myself included) expected. Premiums for 2014 came in well below expectations, and independent estimates show a very modest increase — 4 percent or less — for average premiums in 2015.”

It’s painful to read such “faint praise” for Romneycare, aka, Obamacare.

Yes, Obamacare is a great success! Oyez! Ten millions insured. The lie? Only Another 40 million uninsured to go. But who is counting?

Krugman exults: “independent estimates show a very modest increase — 4 percent or less — for average premiums in 2015.”

The lie? The latest inflation forecasts for 2015 are less than 1.5%. So what the honorable professor is telling us is that health insurance premiums will augment more than twice faster than inflation. What a success! Calling that a success is a lie.

Said otherwise, Krugman forecasts an augmentation of premiums of 50% over ten years. As average American family income is stagnating, the wisdom of Obama is clear: his friends from the insurance cartels will be able to make 50% more profits within ten years! Alleluia!

In short, if you think of Obamacare as a policy intended to improve American plutocrats’ lives, it’s going really well. Yet it has not, of course, been a political winner for Democrats, as We The People can now see for itself that plutocrats’ heaven is not necessarily a decent place for We The People to be.

The real killers in Obamacare are not the premiums, but the deductibles (what you have to pay before the “insurance payments” kick in). They are stratospheric.

In some of the policies I looked at for my family, they were up to $9,000. That meant one had to spend $9,000 from one’s own pocket, before “insurance” would kick (over a year, for the whole family).

Finally, we need to ask, what is the purpose of winning elections? The answer, is to do good fund raising , with the president going to Silicon Valley, sleeping (in the homes of) the rich, famous, and NSA connected— not simply to set yourself up to win the next election. In 2009-10, Democrats had their first chance in a generation to do what we should have done three generations ago, and ensure adequate health care for all of our plutocrats. It would have been incredibly cynical not to have seized that opportunity, and Democrats should be celebrating the fact that they did the right thing, insuring handsome profits for their health care plutocracy sponsors, for generations to come.

Or come revolution, or high water. (Wait…)

Overall, the Obama presidency reminds me of a plane making lots of noise, and smoke, barreling down the runway, while the pilot and his aides are accusing Republicans, but, having reached the end of the tarmac, it never gathered enough speed to take off. A sort of Guantanamo of hope, all about posturing, not substance.

Logically, and probably deep down in the hearts of hearts of extremely wealthy democratic sponsors, this Obama presidency fiasco, far from being embarrassing, promises what they truly want, a total “Republican” lock-down for a generation to come.

Obama has boasted that his health care program was actually Romney’s invention (when the latter was governor of Massachusetts). That is the ultimate silliness, the Freudian slip which reveal “Republican” “Drag queens” to be the “signature achievement” of the present “Democratic” Party.

After all, if the “signature achievement” of the democrats is to implement the health care program of the Republican presidential candidate, why not to elect a Republican outright?

A simple question that the American People have started to answer.

Patrice Ayme’

De Par Dieu: World Plutocrats Unite

The richest Greeks are buying the most expensive apartments in Berlin and London. “Shameful” says the president of the European parliament. The president of EU parliament, Martin Schultz, a German SPD member, calls attention to the breakdown of Greek society, with the poorest dying of lack of food and health care, while the richest and mightiest Greeks do not pay taxes (but the Germans and the French certainly do to back-up the European Central Bank Quantitative Easing, and various direct loans to Greece).

One week in December 2012, French actor Depardieu established residency in Belgium. Belgium is a country very friendly to plutocrats. The world’s fourth richest man, Arnault, another Frenchman, owner of all sorts of luxury brands, established residency there last year. The day Arnault announced it, there was a demonstration below the windows of his private residence. By thousands of enraged Belgians.

Reason? Plutocrats are spared taxes on capital gains and inheritance in Belgium. This is only normal: after all this plutocratic status is enjoyed by members of the Royal Belgian family, who are corrupt, and inherited this disposition, free of taxation.

Yet, someone has to pay for the state. Salaried Belgians pay some of the highest taxes on income in the world. This is directly related to others paying nothing: the hyper rich don’t pay taxes, because salaried persons pay them on their behalf. Such a system can perdure. After all, the plutocrats did not pay taxes in Europe for more than a millennium. They called themselves “the best who rule” (aristocrats).

This lack of taxation in the upper reaches brought ever more powers to the powerful. In the end, even when the king and government of France used everything in their arsenal to make the wealthiest pay taxes, they failed.

That unbalance at the top is why all of Europe underwent a succession of serious revolutions, among which those of the Netherlands (16 C, and a 75 year war against Spain) England (three revolutions and civil wars in the 17 C), the North American colony (1776-1791 + Secession War 1860-65), France (1789-1792 + 1830 + 1848 + 1871), Russia (1917), Germany (1918).

Perhaps suddenly aware of this problematic Belgian situation, Depardieu met in a private dinner the Czar of All Russias, Vladimir Putin in his gigantic palace (with TV, microphones and interpreters present, recording the very familiar tone). That was in Sotchi, a ski resort on the south side of the Caucasus. Sotchi and Putin have been officially celebrated by international sport authorities. A bit as Hitler organized the 1936 Olympic Games, in Berlin, to celebrate Nazism, Putin is organizing the next winter Olympic games, to celebrate Putinism, a crow’s flight from where he is waged heavy war in Georgia, and exerts mighty military occupations of many a country of the Caucasus.

Pontificates Depardieu: “Ceux qui disent du mal du president Putin ne sont jamais sortis de chez eux, ils sont restes en arriere depuis lontemps” (“Those who say bad things about president Putin never got out, they stayed stuck in the past for a long time”). Sorry that we confuse Stalin and Putin. Both are ending the same.

Putin gave Depardieu Russian nationality, and a Russian passport. Such is the power of the Czar. “Czar” is a deformation of “Caesar”. But Caesar could not make an alien into a Roman citizen overnight. Putin has more powers.

Depardieu has been protesting high taxes in France. His father was a French Communist Party member. Depardieu himself was a truant, delinquent and drunkard, who left school at 15. He was saved by the French movie industry, which is heavily subsidized by the French state, hence French taxes. Depardieu is a first class ingrate.

Now Depardieu, who made perhaps half a billion dollars in France alone is peeing on France. Literally so. Not only does he drive the wrong way on one way streets while cameras are rolling, but he actually peed in a plane, and not in the toilet.

Hey, who needs France when you can sing with the daughter of the dictator of Uzbekistan, do business with the Castro brothers, cheer for the dictator of Chechnya, enjoy payments throughout the dictatorships of Eastern Europe?

5403 French cheaters, a few thousands Germans, 1831 Italians, according to Eurostat, have become Russian citizens in 2010. Most of them are wealthy tax evaders. Rushing to take advantage of the Russian 13% flat tax rate on income and capital gains, a dream come true for plutocrats. Ironically the 13% rate was instituted to induce wealthy Russians to pay taxes. It is understood that it will be phased out in the future. Putin recently said that, as in France, taxes on luxury items ought to be introduced soon.

Depardieu was offered by Czar Putin a vast terrain to build a mansion, a car, and a job of minister of culture. As a quasi billionaire, Depardieu is happy to accept these free gifts from the Russian people. His residence will be next to where the Pussy Riot protesters are imprisoned. He immediately left Russia for Switzerland to encounter the head of the international soccer association to promote Russia for some world cup.

And yet, the glorious Depardieu vacation in Sotchi and Switzerland could not be all what it could. Not only is Depardieu obviously too obese to ski, but he has a justice convocation on Tuesday, 2 days after getting Stalinist citizenship.

French justice ordered Depardieu to appear in Paris regarding a charge of driving under the influence of alcohol. He actually got into an accident, with nearly four times above the legal alcohol limit. Here is the Dark Side reappearing again.

Depardieu used to be the darling of the French left (when that was profitable to both parties). Now he has become satanic for all to see. How come? This is a particular example of the genesis of the plutocratic effect, in the case of one individual’s psychology. The same happens to entire classes of individuals.

Basically, the persons affected get seduced by the Dark Side, and then so thoroughly enjoy it, that they want more, ever more. Being a leader, and enjoying the leadership status is one of the main component of the Dark Side. Nietzsche used to call that the Will to Power, and deify it (an idea Hitler followed single-mindedly).

The Will to Power is old, very old. It is even older than when it made baboon style, war-like primate societies possible, by perfecting fascism into a world conquering superior psychobiology. So it is completely ingrained in human psychology.

But there are many ways to lead. The ultimate leadership being, of course intellectual, as this is what the species is. Yet all forms of leadership call onto the Dark Side. Hence the fierce battles in academia. Hence the nomination of Stalin and Hitler to the Nobel Peace Prize. All humans confusedly sense that, without the Dark Side, nothing of consequence ever gets done (as Mahatma Gandhi, or Barack Obama, found out). The unfolding of the exact reasons of why this happens is quite elaborate.

One of these reasons: the Dark Side makes tribalism possible. Tribalism is central to humanity: it evolved from it. Tribalism makes human institutions possible. Including science, medical associations, or dignified philosophical societies.

Some will scoff: and how do I dare seize the noblest human institutions, and tie them to the Dark Side? But look at the Catholic church, or whichever Muslim hierarchy: in the fullness of history, although peace is their mouthpiece, they caused, directly, the death of dozens of millions of dead, and more than a millennium of terror.

And the case of Gandhi is famous: he brandished non violence against the British, while infuriating the Muslims, thus causing the partition of the subcontinent, leading to maybe ten million dead, while waiting for the great Indian subcontinent thermonuclear war.

By the way, Martin Schultz, a perfect anglophone and francophone, may well be elected head of the European Commission by the European Parliament after the next European elections. And why not? Listening to him, in French, one has more the impression of listening to a Frenchman more than when listening to Sarkozy the American, or Depardieu the Stalinist.

What is sure is that the European parliament will elect the next head of the European Commission, as per the Lisbon Treaty.

So why the English Europhobia? Very simple: up to 15% of English (in contrast to British) GDP is from financial services. And more than that is directly tied to plutocracy, if one includes English tabloids (controlled by the likes of Murdoch, a newspaper heir initially from Perth, Australia, in the lineage Maxwell, a scientific publishing tycoon, riding the public purse). One now knows that PM Blair got brainwashed into the Iraq War. And why not? left to himself, Blair was nothing. Murdoch was an empire, a sort of monarch who already told PM Thatcher what was up and what was down.

Instead, Blair was a good boy, as PM John Major had been before him. Major became a major at major USA based hedge funds. Blair “retired” and made 50 million dollars in just one year.

So now, exposed to continual disinformation, the majority of British stupidly attribute their problems to the European Union. Verily, their problems are not caused by the EU. Great Britain barely belongs to it; it has opted out of mostly all European institutions. it is not the EU that explains why Italian industrial production is vastly superior to the British one. It is rather finance supreme.

Britain blocks European construction at every turn. 25 countries have engaged the European Monetary system, three more are associated to it, 17 countries belong outright to the Eurozone. However, British vetoes block European construction, including that of a banking union. While everybody can see that a private banking speculation crisis caused the European financial crisis (the states got dragged into it while trying to save the private banks with public money).

Britain is like Depardieu: rendered grossly insane by the plutocratic phenomenon. meanwhile in the USA, health insurers are starting to crank up their rates by up to 22% in 2013. Poor Obama found a fancy name for his health care: the AFFORDABLE Care Act. However, in his naivety, he forgot about cost control of those he entrusted with the care of Americans as the farmer entrust the hens to the wolves (a well known method in Hawai’i). When I write “naivety”, I am charitable. A more ominous explanation is that Obama played golf with the wrong people.

Something that happens to people who live in big mansions paid by taxpayers, surrounded by armies of bodyguards, and they believe their minds extent to the end of the universe.

Satan is very crafty, and very cruel. Therein his strength and virtue. It’s the only god some deserve.

On January first 2013, the French government decided unilaterally to tax those of the 5,400 French citizens who pay very low taxes in Switzerland while earning their living in France. Excellent. The Swiss authorities are livid: after all the Canton de Vaud (capital: Lausanne) alone makes 300 million dollars from such tax evaders. No more free ride, no more living like a vampire, sucking French blood, Suisse!

Not that this new found will to resist tax evasion by the wealthy exclusively French. The USA has put increasing pressure on Switzerland, encouraging Italy, Germany and France to do the same. (This is one of the rare sectors where Obama has acted as a real democrat instead of a playing as dead as a plutocratic carpet.)

PM Cameron, the lazy and cowardly Europhobe, did something like this in Jersey, an island tax haven, a few Weeks earlier. He insisted that some Brits in London who insisted to pay (no) tax in Jersey, ought to be taxed in the UK (that can be up to 50%).

Some Jerseyists (?) spoke of independence (from Britain). A problem easy to solve by sending a few Royal marines, or French gendarmes. Who do these parasites think they are?

Why can Belgium or Switzerland, and many other banana haven countries afford low taxes? Why does France (or Britain or the USA) have high taxes? Well, very simple; in 1939, there were only four large modern armies in the world: Hitler’s, Japan’s, Stalin’s, and France’s. Only one democracy, and three dictatorships were well armed. We know what happened next: more than 70 million dead, nearly 5% of mankind.

The situation has not really changed. If we reverted to the military situation of 1939, with only the French republic with a serious army, the result would be quickly the same.

This is in no way surprising. The Roman legions were withdrawn from Britannia, Germania, and Gallia, for budgetary reasons in 400 CE. It is not that the economy was collapsing. The plutocrats were refusing to pay enough taxes to keep the dozen legions concerned.

The Roman state left the Franks in charge of defending much of Western Europe. Although the Franks were initially successful in Germania, they then ran out of luck, and massive invasions followed within six years. Then, and only then got the land ravaged in Britannia, Germania, Gallia, Iberia, and 4 years later, in Italia itself, and soon enough, Africa when the vandals made it there.

Thus one has to conclude that taxes are not just about fairness, and preventing the plutocratic effect. They are also about preserving the appearance of a republic.

France, the USA, Britain, Germany, and Italy have used increasing force to combat tax evasion and thus plutocracy, in recent years. They should not hesitate to use maximum force. After all the military force of France is about a billion times greater than that of Switzerland.

It is not just a question of defending democracy, or civilization. It is a question of not being dominated by the Dark Side. Without the rule of love supreme, humanity cannot go on. It’s love who has to tell the Dark Side what to do, and not the converse. Therein true goodness and wisdom.
***
Patrice Ayme

Money Does Not Care

And Those Who Follow It Don’t Either

PHILOSOPHY SAYS OBAROMCARE WILL NEVER WORK

***

Paul Krugman wrote an editorial Hurray For Health Care, in the New York Times lauding the effort of Obama on health:

“Now, the “Affordable Health Care Act” — known to its foes as Obamacare, and to the cognoscenti as ObamaRomneycare — isn’t easy to love, since it’s very much a compromise, dictated by the perceived political need to change existing coverage and challenge entrenched interests as little as possible. But the perfect is the enemy of the good; for all its imperfections, this reform would do an enormous amount of good. And one indicator of just how good it is comes from the apparent inability of its opponents to make an honest case against it. “

Yes, maybe, but another interpretation is possible, and it’s much more sinister. Indeed the “entrenched interest” is a code word for the extractive, exploitative right wing. Krugman just said the “Affordable Health Care Act” was about challenging the “entrenched interests”, that is, the health care lobby, as little as possible. So the opponents cannot make a honest case against it because, deep inside, they are delighted by it. As simple as that.

Krugman situates the problem:

“The fact is that individual health insurance, as currently constituted, just doesn’t work. If insurers are left free to deny coverage at will — as they are in, say, California — they offer cheap policies to the young and healthy (and try to yank coverage if you get sick) but refuse to cover anyone likely to need expensive care. Yet simply requiring that insurers cover people with pre-existing conditions, as in New York, doesn’t work either: premiums are sky-high because only the sick buy insurance.

The solution — originally proposed, believe it or not, by analysts at the ultra-right-wing Heritage Foundation — is a three-legged stool of regulation and subsidies. As in New York, insurers are required to cover everyone; in return, everyone is required to buy insurance, so that healthy as well as sick people are in the risk pool. Finally, subsidies make those mandated insurance purchases affordable for lower-income families.”

Well that should  look good on paper, for the naive idiots who, apparently, Krugman believes his readers are.

“Affordability” indeed depends upon the health care plutocracy seeing the light and showing some restraint. Because nothing forbids it to keep on squeezing those who can pay, until everybody is poor and needs subsidies, themselves obtained through taxes or borrowing from the rich against interest. In other words, nothing prevents the runaway plutocratic train to keep on rolling ever faster. This is the likeliest economic development, which, believe it or not, neither Krugman, nor the president or his advisers seem to have prepared for.

But I must admit that the “analysts” at the “Heritage Foundation” are plenty smart enough to have foreseen what will happen. Namely their plutocratic sponsors will get richer, and thus the rewards will come their way some more.

Can philosophy help? Sure. The philosophical method is about big thinking, not getting bogged down in the details and debris, as ants are wont to do, per their nature. Notice that Obama uses the adjective “affordable“. Health care is like a hotel, as far as Obama and company are concerned. And the question is: “Is it affordable?”

I will use the following neologism, which, I hope audaciously, will be forgiven: Obaromcare.

Obaromcare was suggested by the “ultra right wing Heritage Foundation” because it is perfect for that branch of plutocracy that feeds off health care. Any vampire feeds off fresh blood, and Obaromcare brings 50 million new victims to suck dry… The subsidy thing changes nothing as it simply means more resources will be siphoned off the middle class, through taxes.

That the “Heritage Foundation” brought the idea should have been a hint to the clueless. Maybe the president and the honorable Paul Krugman should refresh their critical abilities by reading Homer, and learn to beware of the Greeks and the gifts they bear. That was the lesson of the Trojan Horse. Greek boys used to learn that kind of things, 28 centuries ago. Now big boys are going around, steering the world, and they take the world’s most expensive plane, Air Force One, to go watch a baseball game, in Ohio. If that’s not a collapse of the idea of civilization, what is?

Obaromcare will not be the first time in the history of civilization when the public is forced to serve the private, while claiming it’s a public service to do so. It’s actually very much an heritage of the oldest plutocratic tradition.

Philosophically speaking, Obaromcare is close to the definition of the most abject plutocracy. It’s a desperate attempt to give a veneer of respectability to the plutocratic notion that profit primes care. All other developed countries know that, care, per se, is a fundamental notion living in another dimension than profit. This is the essential point.

Will Obaromcare work? First one has to settle what “working” means. The present system works splendidly for the for profit health care industry. What Obaromcare will do, for sure, is to make the present system bigger, not change its nature.

So, for the average people and the larger economy, Obaromcare will probably not work, because profit is at the center of it all, and nothing will stand in its way anymore than it does today. Obaromcare may have already increased national health spending.

In other developed countries, the will to care is what masters the search for profit. In any case, the numbers are talking louder than propaganda: the cost of health care in the USA is ascending at a completely unsustainable pace.

Obama could have made a reform that would have worked, if he had put the private plans in competition with MEDICARE FOR ALL: opening the existing Medicare, by far the largest health plan in the USA, and public, for people more than 65. The idea was to allow anyone to pay for Medicare. Just by economy of scale, Medicare would have been cheaper, while making a profit… for the public (by opposition of making a profit by whom Krugman himself calls “entrenched interests”, the plutocrats).

But Obama did not boost the existing public plan, Medicare. Medicare has efficiencies of size (it’s by far the largest health plan in the USA), but it is handicapped by not having the full negotiating capabilities of negotiating for lower costs that its peers in other countries have. One would have expected a democratic president to give full negotiating capability to Medicare. But that did not happen.

As usual, all Obama did, with health care, as he did with the banks, or with the military-industrial complex, or with the energy or transportation policies, was to follow the money, and bleat.

It would seem that neither Obama, nor Krugman, their kind, or entourage, understand that the economy is more than a one dimensional object. It is true that the search for profit is one of the dimension of the economy. But it is not the only one. Caring is another, and it is what health care is all about.

Chancellor Bismarck understood this perfectly well in the 1860s, when he created a national health care system for Prussia. That universal health coverage was extended after 1871 to the entire “Second Reich“. That system was so good that, after Loraine and Alsace got reintegrated inside France in 1918, they kept the Bismarck system (and have it to some extent, to this day).

The conflation of the notion of economy and the obsession with profit, shows up in the Obama’s administration naïve approach to whatever, including in its approach to space exploration: it believes, with some extreme right wing politicians, that the search for profits will render space easily accessible. According to this plutophiles, the economy responds only to profit, so augment the opportunity for profit, augment activity.

So the Obama administration has been heaping vast amounts of taxpayer money and property towards Elon Musk, a non American born immigrant based in the Silicon Valley, who, stupidly, believes that his primitive technology (already used by the Nazis 70 years ago) will open up space to his conniving mind.

That general drift is reminiscent of Solyndra, a solar company founded by friends (and financiers) of Obama in the Silicon Valley. The White House sank 550 million dollars of taxpayer money in Solyndra, although that was clearly none of its business. But it was the business of Silicon valley financiers Obama goees visit with his big plane every few weeks. Then the president goes from mansion to mansion, and is introduced to hordes of plutocrats and their broods, who have paid of the order of the median family income in the USA to do so. A four year old can give $40,000 to Obama, but then Obama gives 500 millions to her daddy’s “investment”. Hey, it’s all the same money, freshly laundered taxpayer money.  

The space technology ignorant Musk got in just one contract 1.6 billion from NASA. And many other supports, such as untold secret transfer of technology, that is, of public American property, to a white South African. Some famous astronauts (ex-senator and first american in space Glenn, Cernan, etc.) are furious about it.

On the side, the Obama administration supports Musk, with taxpayer money, for making electric cars for the rich. Musk has got to have good musk: Obama never misses a photo opportunity with him. Musk: smells good. General situation: smells bad.

Basically the same scheme is repeated for Obaromcare health care, as with Solyndra, or Musk, on a much grander scale. Public money for the privates, unlimited. In a few years people like Krugman will say:  We could have never guessed. We just did exactly what the “ultra conservative Heritage Foundation” told us to do. What could go wrong?

None of the 36  countries which have better health care systems than the USA have followed the money to build their health care system. For the very good reason given above: money does not care.  

Once care has been made the master motivation of its own house, health care, care can dictate lots of behaviors which enhance care and that the search for profit cannot dictate.

For example most forms of advertizing by private health care companies is unlawful in Europe (and European authorities are suggesting to crack down on more subtle forms of lobbying). In the USA, lobbying and advertizing has become more costly than research and development, explaining, at least partly, why the development of new drugs and cures has stagnated in recent years.

Here is the classification of health care systems from the World Health Organization:

1         France

2         Italy

3         San Marino

4         Andorra

5         Malta

6         Singapore

7         Spain

8         Oman

9         Austria

10        Japan

11        Norway

12        Portugal

13        Monaco

14        Greece

15        Iceland

16        Luxembourg

17        Netherlands

18        United  Kingdom

19        Ireland

20        Switzerland

21        Belgium

22        Colombia

23        Sweden

24        Cyprus

25        Germany

26        Saudi Arabia

27        United  Arab  Emirates

28        Israel

29        Morocco

30        Canada

31        Finland

32        Australia

33        Chile

34        Denmark

35        Dominica

36        Costa Rica

37        United States of America

So we saw that the motivational space of an economy has at least two neurological dimensions: profit, and care.

Are there others? Sure. Any motivation of human beings will be a factor in house-management (“eco-nomy”). Sex, of course is one, and so are many obsessions. And Will to Power and plain old Curiosity are also important. And so is also the Will to Vice (for a demonstration of that, have a close look at Afghanistan). In particular, pathological lying.

Obama and Krugman pretend to think that Wall Street is a hospital. Is that a medical condition, or something even worse?

***

Patrice Ayme

P/S: (I immediately sent a comment to Kruman’s sycophantic utterances, but the censorship system at the New York Times put me at the end of the line, and a barrage of sycophants at the front. It seems they censored me completely, not to give the idea the great liberals who lead us just follow the money. Of course, the NYT is a private outfit. but, when it reveals itself less honest than Murdoch’s Wall Street Journal, it’s not a good sign that so many people on the left proclaim it be respectable! Maybe they should meditate some that many followers of Hitler were from the left, and that Hitler’s “ultra conservative” re-foundation was designed to appeal to them, and PC them into it.)

MEDICARE FOR MORE.

Abstract: If my "Medicare For All" cannot be had now, because of greedy critters in the way, "Medicare For More" will nevertheless put the USA on the same road to the (French) heaven of the best health care in the world, in the fullness of time. There is no reason whatsoever to obstruct and deny this more modest reform, except from debasing and outrageous respect for the religion of greed of the few as ultimate good for all, forever and ever, Amen.

Even Obama cannot bipartisan his way out of that one, which is to put Medicare on the road of becoming a universal public insurance plan. As proposed below, it’s self financing, and autonomous. In particular, as explained below, it would be public, but independent of the executive branch and elected officials’ direct interference.

***

The democrats are controlling Congress, the Senate and the Presidency. Thus, they are under big pressure to show that they can make the country progress towards better outcomes by taking some significant positive action somewhat, somewhere, somehow, that can seem to benefit the People, and not just their beloved hyper wealthy bankers.

Killing Afghans more efficiently may not be good enough, so those crafty dems are trying to tinker with the health care system, since, after all, they campaigned on making it much better. At the same time, those professional politicians and would be higher elements of society have to satisfy the BIPARTISAN PARTY, the party of the plutocrats, the only way they seem to know to elevate themselves.

The Swiss system is often touted as a template of what leftist American politicians want to do. But, as we will show, they can’t use it as a template. Nor do they want to, come to think of it.

In Switzerland, those who can afford to buy insurance are required to do so by law (as individuals, this has nothing to do with employment). For those who can’t, the government provides subsidies. About a third of the population receives subsidies (40% of households).

Nevertheless, the core reason that Switzerland has universal coverage, and good private health insurance, is that the Swiss people demanded that the Swiss government heavily regulate the health insurance industry and the Swiss people decided to pay more taxes so that the government would provide subsidies. In Switzerland, basic coverage components, very good by American standards, must be included in all plans. Basic health insurance is provided by nonprofit insurers — though some are affiliated with for-profit companies that offer supplemental policies (private rooms, super teeth, etc., similar to Medigap in the United States). The basic benefit package is defined by law and is quite generous. Maximum drug prices are regulated.

Still, Switzerland is trying to push its health care system in the French direction. The reason is that the Swiss system underperforms the French one, it costs more, and ever more so. In frontier areas, the French and Swiss systems are imbricated for practical reasons

It is not easy to go from Swiss to French health cares, although the basic structures are both non-profit: there are fierce debates on how to get the Swiss system more like the French (which is itself a work in progress, with major changes on how to make foreigners pay, and also a new, extremely expensive cardiac care system, to save more lives). That is why it’s important that US health care reform takes the right road, even if it cannot get to its destination now.

The French insurance system looks complicated, to the foreign observer. In truth it is simple in its value system, the dominant value being that LIFE IS A RIGHT. In contrast, Obama recently explained to us that Greed Is Good. Or that a person is never bad as long as profit is the motive.

At this point it’s important to keep in mind the liberal president Obama’s famous quote: "Insurance executives don’t do this [kill people] because they are bad people. They do it because it’s profitable." That’s where Liberal America is at: way out in the twilight zone of smoldering fundamental values, set on fire by bankers and greedsters. Very far from Europe.

Thus, in France, as in Switzerland, basic health insurance is non profit. Just it does not masquerade in France as a herd of private outfits. The main French public insurer is gigantic: the giant public French BASIC HEALTH CARE insurer is ‘Assurance Maladie’. Per its bulk, ‘Assurance Maladie’ has enormous negotiating power, and medical drugs from the USA, purchased as is, without any insurance, cost less in France than the co-pays in the USA with an excellent private insurance plan.

Superb care is given by the French health professional themselves, who are completely detached, physically separated, from the compensation system. Although some doctors, mostly the surgeons and professors in the hospitals are partly paid by the public system, paradoxically, most French doctors are in private practice (but paid by the public insurer(s) and complementary private insurance(s) if need be, for non essential care such as age spots).

Economies are made by endowing personnel with examining and curative powers. For example, midwives run in minutes exams that take many visits to many different specialists in the USA. The French midwives, in their offices (thrice bigger than a doctor office in the USA) have all the machinery, and know how to use it. Results come in seconds. There are also private labs for sophisticated ultrasounds (completely for profits, owned by the local doctors operating them), but the fees are much less than in the USA, although the electronics is much more advanced (straight from Japan, with lower prices negotiated in bulk). The system saves by making no mistakes (decisions are taken collegially, and from protocols), so there are no lawsuits: there is nothing to sue about.

The one and essential part of health care reform as proposed in Obama’s electoral platform is a PUBLIC OPTION.

If the Public Option does not happen, as Obama himself more or less admits, there is no reform in the direction of progress, and forcing everybody to pay private insurers would be making the later in a functional equivalent of the French Fermiers Generaux under the Ancient Regime. Those were private individuals in charge of gathering taxes (they paid themselves in passing).

The Fermiers Generaux’ motto was: ‘your money, or your freedom’. By law, everybody had to pay them. In turn, they paid the king. Many Fermiers Generaux were judged and executed during the revolution. Modern American life insurers have assuredly a similar motto: ‘your money, or your life’. If Obama makes paying them mandatory by law, and they, in turn, as they already do, pay the king, the USA would have gone back full circle to the France of the Ancient Regime. (After that maybe we can organize a revolution too? Just an idea.)

Indeed when your private insurer refuses to treat your cancer, that is what he does; take your life (that was a precise example used by Obama). In theory, people could divorce, give up all their belongings, then apply for Medicaid, but, by the time they get to that, they will be dead. Anyway, what is the difference between giving all you have to save your life, while getting half dead in the process, and the worst abuses of slavery?

There is only one way to save the public option: free Medicare from its constraints. Allow people to pay for it before the age of 65, on a sustainable basis (namely allow Medicare to charge as much as it wants: it will always be less than the Wall Street health care insurance plans, because Medicare does not have the necessity to make a profit to stay interested, whereas Wall Street does). The important point is to accept that Medicare (or the somewhat related Medicaid) will grow.

After launching the "Medicare For All" slogan, I propose that the best that can be hoped for now is "MEDICARE FOR MORE". As Medicare grows, it will be able to squeeze out the profiteers, if it is given full authority to negotiate costs with providers. Then, in the fullness of time, it will become "Medicare For All".

Patrice Ayme

https://patriceayme.wordpress.com/

Improving US Health Care For Real, Right Away.

 

Obama addressed a joint session of Congress, a self admiration society. Applause lasted five minutes, to start with, as if Obama had won in Afghanistan, or done something somewhere important.

Obama proposed a huge "plan" for health care: it consists into doing everything right, as long as one accepts the existing health system in the USA, as a pre-existing condition. And taking at least four years to do so. But one does start to solve a quagmire by deciding it will take at least four years, and claiming that one will move in all directions at once. Instead one should find a direction in which to progress, and make small steps that cannot be opposed seriously, right away.

The reforms proposed by Obama will put so much pressure on the profitability of health insurance and medicine as a big business that one can be sure that those businesses will find ways to neuter reform, if given any chance to do so. It is clear that Americans believe that they do not want a globally socialized health system, so the profiteers will be able to successfully argue that the proposed Obama plan is socialized medicine. And they have at least four years, generously offered by Obama, to evade the threat. So Obamacare will go nowhere fast, if at all. It will be the big engine that couldn’t… because of conveniently disposed "special interests".

Instead what Obama ought to do, should he really want to reform health care, is to introduce a public option for health insurance, with provisions about pre-existing conditions and continuation of coverage, while enforcing those same constraints legislatively for all and any health insurance company. I have argued this since ever, and, at first sight, it is nice to see Obama making all the right noises. The problem is that he keeps making noises, even when, having said all the right things, he ought to stay silent.

As Obama himself discreetly pointed out, under the condition of legally enforced health insurance decency, the public option plan will pay for itself. Indeed, it could charge as the privates do, but less so, because it would not have the profit motive to the same ravenous extent that characterizes Wall Street.

That public option plan is part of Obamacare, as proposed, but it is its most important part, because it WOULD prove to be a Trojan horse against the exploitation of patients by the plutocratic beast, should it be given full freedom to roam and grow, feeding on the health profiteers.

Indeed it would grow over time, were it to be open to all those who do not have private health insurance at some points (and many Americans go through this stage as they switch employers). As it would become all the more huge, as it would be, it should be endowed with the ability to negotiate prices with providers, including drug companies. The same would happen with the more or less parallel government health programs of Medicare, Medicaid, and the VA.

Thus the bigger it becomes, the greater the public health insurance would be capable of lowering costs. The French giant public insurer, Assurance Maladie, has very low cost as it negotiates in bulk with anyone, including Japanese electronic companies. In France the very mass, and self checking characteristics of the health system prevent malpractice to a great extent (hence the lawsuits connected to it… All the more since loser pay…)

So why not getting the public option plan launched right away? This is the one and only question to ask Obama: what is keeping you back? There is no need to force everybody to join, the public plan would be so advantageous, everybody would. After all, one does not see too many people refusing Medicare.

So why not keeping things simple? Launch the public plan, damn the torpedoes!

Or is it that Obama wants to fail, while striking a bipartisan pose, and accusing formally “special interests” (which then will fill up the appropriate pockets, namely those of whom falsely opposed them)? Is Obama interested by setting up, once again a new market, and enlarging the markets of private insurers, to the point of tying that up with, and hiding behind, a public insurance option, as a pretext?… He already reduced the later as much as he could, or so it seems…

If one really wants reform, and reform heading the right way, there is only one option: install the public plan, while making it viable by forcing private insurance to behave decently, through LEGISLATION. Forget the rest of the fluff, which would slow things down. Obama can do this now, as he controls Congress (which will not be the case next year, according to polls, and Obama has got to know these polls, and let me add that, after one more year of murderous charade in Afghanistan, his personal popularity will not be soaring).

A careful reexamination of Obama’s version of a public option, though, shows, at this point, so many restraints and constraints on it that it would be carefully declawed, defanged, and kept small. Then the mandate on health insurance (the requirement that everyone gets some) would expand the servitude of US citizens to private, for profit, Wall Street style health insurance, and its ravenous plutocrats.

Another aspect is ethically troubling. Obama always comes up with horror stories where private insurance companies act as death panels, and kill people. For example he brought two such cases in his joint session speech. But then Obama claims that future government death panels could only be a figment of the imagination. Well, according to him, private death panels are already a fact, and he is doing nothing about them, except lip service. We are starting to cut hair mighty fine here: “Me Obama decries private death panels, while tolerating them privately as I loudly claim that the government has no such an intent, but there will be a requirement to purchase insurance from those same private insurers, which, as me Obama just said, operate the private death panels.” Great. With logic like that, who needs madness?

rather than trying to speak too much, what about prosecuting murderers instead? Let’s keep it simple: Obama recognizes private insurers as homicidal, yet decline to prosecute them on behalf of the people, and then throw the people at the mercy of homicidal maniacs.

Legislating the public option plan would be to legislate the possibility and capability to see the health system of the USA converge, in the very long term, with the health system that exists in France (a complex, self regulating public-private beast providing the best health care in the world, with all the advantages of all the systems, public and private, as they coexist, entangled in harmony).

So does Obama want to progress for real, or does he just want to pose? His “plan” (not a bill submitted to Congress!) cost 900 billion dollars over 10 years. But not really, since he promised that it would not augment the deficit. To cost and not to cost, that is the weirdness.

When it came to bankers, it was 24,000 billion dollars (source: TARP overseer), right away, and Congress was not invited to debate and consider. (The 24,000 billions is the full extent of the government exposure through gifts, loans, collateral, etc.; it is not my number, but the official one.)

It is nice to see the priorities straight: bankers as lovers, health as death.

Patrice Ayme.

***