- Life: everyone is entitled to live once they are created.
- Liberty: everyone is entitled to do anything they want to so long as it does not conflict with the first right.
- Estate: everyone is entitled to own all they create or gain through gift or trade so long as it does not conflict with the first two rights.
Tuesday, December 1, 2015
Tuesday, June 16, 2015
Wednesday, November 26, 2014
1. Post prices (not the inflated Charge master) for services to be delivered at hospitals and clinics. Singapore does this on a regular basis. Being patient focused means more than giving a survey at the end of the service. Here is link that shows the prices for SingHealth on regular services: http://polyclinic.singhealth.com.sg/PatientCare/Fees/Pages/Home.aspx
2. Post the quality of the service delivered by institution; if 1 & 2 happen, then the consumer/patient can work the equation: Value = Quality/Price; without this transparency, there is NO MARKET.
3. Change the language; health care loves to throw around the word, "cost," as if this calamity that has absorbed income from the middle class for the last 10 years was foreordained. People who write about health care avoid the word "price" because their costs are not known. If the price of gas goes up, people are ready to riot, while health care "costs: go up, we shrug our shoulders. Nonsense! Let's try a real market!
Monday, November 24, 2014
Friday, October 3, 2014
Tuesday, April 29, 2014
Lovely writing. I then found this Cliff Notes version on Wikipedia:
Below are some summarized ideas relative to the establishment of political parties and advice on foreign relations from Wikipedia:
1. Political Parties
Washington argues that “political parties must be restrained in a popularly elected government because of their tendency to distract the government from their duties, create unfounded jealousies among groups and regions, raise false alarms amongst the people, promote riots and insurrection, and provide foreign nations and interests access to the government where they can impose their will upon the country.”
Friday, February 14, 2014
This morning a friend of mine who owns a small company with 124 employees was told his health care costs are going up 30%. In the past few weeks a lot of attention has been paid to the idea that the "rich are getting richer and the poor are getting poorer." People are rightfully concerned about the "inequality gap" that is growing in America. It appears that the spending on health care and this gap are very much related. David Goldhill in his very informative book, Catastrophic Care discusses this connection:
David introduces us to one of his employees, Becky. He then goes on to break down her salary and benefits:
"Let’s say Becky’s work would be worth around $ 40,000 a year to us; if we can hire her for $ 40,000 or less, we’ll do it. What does hiring her cost? For simplicity, forget about all other benefits and costs for a moment and just focus on health care. Paying our share of Becky’s health insurance premiums will cost us about $ 5,000 a year. So the maximum salary our company will pay Becky is actually $ 35,000— the $ 40,000 her job is worth to us minus the $ 5,000 cost to us of her premiums. The more health insurance costs us, the less our company can afford to pay out to Becky or to any employee as salary or wages. Of course, all Becky knows is that her salary is $ 35,000."
David then goes on to analyze how much Becky will contribute to health care throughout her lifetime:
"Let’s assume that health care costs grow at only 2 percent a year— half of Becky’s income growth. This hasn’t been true for forty-five years, but we can always hope. Given all those factors, how much do you think Becky will contribute into the health care system for herself and her dependents over her lifetime? I’ll give you a hint: Becky will earn $ 3.85 million over her career.
The answer is $ 1.9 million! Now also remember that $ 1.9 million was based on an assumption that health costs were somehow tamed below Becky’s income growth. In recent years , per capita health costs have actually increased 2 to 3 percent faster than income. If health costs grow merely equal to Becky’s income, Becky is looking at an additional $ 1.3 million in expenses over her lifetime— almost $ 3.2 million in total. In that scenario, Becky will contribute one out of every two cents she earns to our health care system."
Back to my friend. At the beginning of the year, he was talking about raises for the people who work at his plant. With this 30% hit on insurance, that pool of money just dried up.
So if you are wondering why we have an income gap and you are not getting a raise, I would recommend a discussion with the folks who are paying for health care on your behalf. The rich will have no problem in absorbing these costs. However, for the rest of us, we will all suffer a loss of income to pay for more health care, which is really sick care, but that is another topic.
Reference: Goldhill, David (2013-01-08). Catastrophic Care: How American Health Care Killed My Father--and How We Can Fix It (pp. 54-61). Knopf Doubleday Publishing Group. Kindle Edition.