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Things happening in the world today

2015-01-02_08-41-50Concierge care was originally conceived before Obamacare, and it revved up in response to the Great Recession as an escape hatch for doctors fleeing the status quo. The existing fee-for-service system pays caregivers a certain amount for each test, diagnosis and procedure–which, according to critics, encourages overtreatment instead of preventive wellness care. Qliance, along with a growing number of similar operations, aims to be more than an escape. It seeks to be the answer to the quest of health care reformers: healthier patients at a lower cost. Fix the way primary-care doctors are paid, the Blisses argue, and we can cut unneeded tests, premature procedures and excessive ER visits.

The driving insight here is that primary care and specialized care have two very different missions. Americans need more of the first so they’ll need less of the second. And each requires a different business model. Primary care should be paid for directly, because that’s the easiest and most efficient way to purchase a service that everyone should be buying and using.

SOURCE: Medicine Is About to Get Personal | TIME.

I don’t think I am the only person who believes that insurance companies stand between me and my doctor and tell us both how we will do business together. Of course that business is keeping me healthy, or at least as healthy as I can be given my circumstances. The above article is several thousand words long so it was difficult to pick just a few of the words to illustrate the change but I tried to compress it here.

Doctors are leaving primary-care practices in droves. They don’t like being told that they can only spend 11 minutes with a patient and that a major part of their practice is geared toward a massive amount of paperwork to the insurance company to justify what they are doing.  The solution to this problem is to cut out the middleman. That is to remove the insurance company from this interaction. That seems to be just what Dr. Bliss has successfully done with over 35,000 patients in the State of Washington. Instead of paying an insurance premium you pay a monthly fee directly to your doctor and he can then significantly cut his costs and spend whatever time is necessary with each patient.  As a result his patients only need to buy a much less expensive hospital and speciality doctor insurance policy.   It is a win-win situation for both the doctor and the patient.

We definitely need something to change in our current U.S. healthcare industry and this might be that accomplishable change. It would be great if we could finally get into a single payer system much like the rest of the world does and how we in Medicare are currently getting our healthcare needs. But until that time comes cutting out the middleman seems to make a lot of sense.  If you are interested in this sort of thing I would advise you to click on the source above to get more details.

About Those Greeks…

January 27, 2015 — Leave a comment

I see where the Greeks elected a new government this week to help them reduce austerity that was forced upon them by the European Union bailout.  This reminded me of a book I read a few years ago entitled “Boomerang” by Michael Lewis. One chapter in the book was about Greece. The book is very enlightening and well written. Here are some selected snippets about Greece.

2015-01-26_11-43-52The average government job pays almost three times the average private-sector job. The national railroad has annual revenues of 100 million euros against an annual wage bill of 400 million, plus 300 million euros in other expenses. The average state railroad employee earns 65,000 euros a year….

The Greek public-school system is the site of breathtaking inefficiency: one of the lowest-ranked systems in Europe, it nonetheless employs four times as many teachers per pupil as the highest-ranked, Finland’s. Greeks who send their children to public schools simply assume that they will need to hire private tutors to make sure they actually learn something. 

The retirement age for Greek jobs classified as “arduous” is as early as fifty-five for men and fifty for women . As this is also the moment when the state begins to shovel out generous pensions, more than six hundred Greek professions somehow managed to get themselves classified as arduous: hairdressers, radio announcers, waiters, musicians, and on and on and on….

The Greek people never learned to pay their taxes. And they never did because no one is punished. No one has ever been punished. It’s a cavalier offense— like a gentleman not opening a door for a lady.” The scale of Greek tax cheating was at least as incredible as its scope: an estimated two-thirds of Greek doctors reported incomes under 12,000 euros a year— which meant, because incomes below that amount weren’t taxable, that even plastic surgeons making millions a year paid no tax at all….

The problem wasn’t the law there was a law on the books that made it a jailable offense to cheat the government out of more than 150,000 euros but its enforcement. “If the law was enforced,” the tax collector said, “every doctor in Greece would be in jail.” I laughed, and he gave me a stare. “I am completely serious.” One reason no one is ever prosecuted— apart from the fact that prosecution would seem arbitrary, as everyone is doing it and that the Greek courts take up to fifteen years to resolve tax cases. 

Lewis, Michael (2011-09-28). Boomerang: Travels in the New Third World – Norton. Kindle Edition.

The quotes above give you an idea as to why Greece might be in the troubles it is. As the book implies actions have consequences and Greece apparently needs to learn that lesson.

Greece is the birthplace of democracy so let’s end this post with a quote from the ancient Greek philosopher Isocrates:

“Democracy destroys itself because it abuses its right to freedom and equality. Because it teaches its citizens to consider audacity as a right, lawlessness as a freedom, abrasive speech as equality, and anarchy as progress.”

Sounds kind of familiar doesn’t it?

2015-01-02_09-01-08

With this post I will conclude my discussion about what might make the wealthy among us seem so callous to others needs. The source for these posts came as a surprise to me. Here is some more quotes from that article.

A UCLA neuroscientist named Keely Muscatell has published an interesting paper showing that wealth quiets the nerves in the brain associated with empathy: If you show rich people and poor people pictures of kids with cancer, the poor people’s brains exhibit a great deal more activity than the rich people’s. (An inability to empathize with others has just got to be a disadvantage for any rich person seeking political office, at least outside of New York City.) “As you move up the class ladder,” says Keltner, “you are more likely to violate the rules of the road, to lie, to cheat, to take candy from kids, to shoplift, and to be tightfisted in giving to others. Straightforward economic analyses have trouble making sense of this pattern of results.”…

THERE IS AN OBVIOUS chicken-and-egg question to ask here. But it is beginning to seem that the problem isn’t that the kind of people who wind up on the pleasant side of inequality suffer from some moral disability that gives them a market edge. The problem is caused by the inequality itself: It triggers a chemical reaction in the privileged few. It tilts their brains. It causes them to be less likely to care about anyone but themselves or to experience the moral sentiments needed to be a decent citizen….

There is a growing awareness that the yawning gap between rich and poor is no longer a matter of simple justice but also the enemy of economic success and human happiness. It’s not just bad for the poor. It’s also bad for the rich. It’s funny, when you think about it, how many rich people don’t know this. But they are not idiots; they can learn.

SOURCE:What wealth does to your soul – The Week.

I’m still not convinced that the lack of empathy is a result of a chemical change in the brain but it is interesting to think about that possibility. What happens if the rich person looses all his wealth? Will empathy come back? I kind of believe that it is more of a learned thing or maybe one of a rationalization based on greed. Yeah this is kind of chicken/egg thing. Which came first the riches or the lack of empathy?

My empathy is such an important part of my life I can’t imagine someone who doesn’t embrace it in themselves. It just seems too cold and callous to think only of yourself. To me that wouldn’t be a life worth living.

The gap between the rich and the poor grows daily now and since the rich have consumed almost all of the political and economic power it will only get worse unless something radical changes it. Wall Street is driven almost totally to providing profits to their share owners. There is little regard for workers in today’s world. As the highlighted area says I don’t think the rich are idiots but I can’t fathom why they don’t understand that when you put a stranglehold on consumers by not letting them share in the prosperity you endear you are drying up the well that give you your wealth.

They Got Hutzpah….

January 14, 2015

2015-01-14_08-10-09New Charlie Hebdo Issue Sells Out

Charlie Hebdo’s defiant new issue sold out around Paris on Wednesday, with scuffles over copies of the paper fronting the Prophet Muhammad. The issue hit newsstands just as the Yemen-based branch of al-Qaeda officially claimed responsibility for attack

SOURCE: TIME – Breaking News, Analysis, Politics, Blogs, News Photos, Video, Tech Reviews.

I gotta hand it to the French. They might be arrogant but they got hutzpah. They definitely fit the moniker that “fools rush in where angels fear to tread”. If what happened in France last week had happened here we would all most likely be hiding in fear of going anywhere near Charlie Hebdo’s stuff.  I kind of wish we had that level of hutzpah too.

Instead we would likely be doing one of two scenarios. One, we would be assigning congressional committees to study on how we can prevent it from happening again. And of course that action would result in a coupe billion more bucks in the NSA’s pocket. The second scenario would be assigning another committee to determine why Obama recklessly allowed it to happen.

Maybe the French are just more grass-roots than we are. They take it personally when they are attacked and line up in defiance of the terrorists. They refuse to be stricken with fear as they know that is what the terrorists are trying to accomplish.  Here is to you France. I will gladly go to lunch now and get a big order of french fries to honor your guts in this matter.