Tag Archives: economics

The Veteran’s Choice Program

Posted on by
Reply

This is a program that would give veterans the option of going to a private sector doctor in lieu of playing the delay wait game at a Veterans Administration facility, after the veteran has jumped through the requisite VA hoops.  After a political tussle in Congress over increasing/renewing its funding, some additional money was provided.  That additional funding was necessitated because

its popularity depleted the allocated funds more quickly than anticipated. Patient visits through the program increased more than 30% in the first quarter of fiscal year 2017, according to the VA.

Extra points for those of you who can say why the program is so popular.

Despite the success of this limited program, the Progressive-Democrats in Congress want to get rid of it.  Congressman Mark Takano (D, CA), for instance,

argued on the House floor in July that it’s a “mistaken belief that the private sector is better equipped to care for our nation’s veterans than specialized VA doctors.” But while the VA provides high-quality specialized care in certain areas, for the most part veterans’ needs are similar to everyone else’s.

Indeed.  Takano and his fellow Progressive-Democrats just want to maintain control over OPM. It’s a mistaken belief that the private sector cannot care for our nation’s veterans better than specialized VA doctors. As Burgess and Cleland (authors of the piece at the link) note, mostly our veterans’ needs are similar to everyone else’s.

Those few specialized needs unique to a veteran’s particular military history? The VA’s specialists, functioning in the private sector, can deal with those at least as well as they do now, and probably better and faster without the VA’s bureaucratic impediments.

Make the Veteran’s Choice Program functionally universal: privatize the VA, and use its current and what would have been its future budgets for veterans’ vouchers.

Veteranos Administratio delende est.

“Insurance” Costs

Posted on by
Reply

My Medicare-aged wife broke her wrist, which necessitated surgery, and our health plan provider sent us an accounting of the costs involved.  Following are the high points of those costs.  It’s necessary to emphasize that the surgery is relatively routine following a wrist “fracture,” since the wrist is little different from a sack of pig’s knuckles, and where the arm bones, the ulna and radius join the wrist is more of an abutment than a joining.  The “fracture” was more of a slight jumbling of those pig’s knuckles and small breaks of the ends of the ulna and radius; the surgery was to rearrange the knuckles and repair the fractures with a plate and some bolts.  Really quite routine and minor (save the post-op pain and the long recovery time and discomfort); that emphasizes the nature of the costs.

The initial care was in the ER of a hospital not “in network;” the injury occurred, also, 100 miles from home.

ER Service Provider’s bill to the Plan Total cost
(Plan approved)		 Plan paid We paid
Wrist X-ray $342.31 $0 $0 $0
Apply splint $479.34 $0 $0 $0
ER Visit $764.99 $193.01 $115.65 $75.00
Totals $1,586.64 $193.01 $115.65 $75.00

 

Actual treatment:

Service Provider’s bill to the Plan Total cost
(Plan approved)		 Plan paid We paid
Wrist X-ray $33 $873 $8.56 $0
Surgery* $24,691 $1,021 $757 $264
New Office Outpatient $285 $166.51 $143.58 $20**
Follow-up X-ray $94 $30.74 $30.13 $0
Elbow X-ray $102 $27.04 26.50 $0
Long arm splint $132 $90.13 $88.13 $0
Cast supporting splint $125 $12.27 $12.27 $0
Totals $738 $326.69 $300.81 $20

*Two separate charges, for two separate actions in the wrist’s surgery. I’ve lumped them together here.
**Copay

Just summing those high points, here are the totals.

ER Service Provider’s bill to the Plan Total cost
(Plan approved)		 Plan paid We paid
Totals $27,316.64 $2,413.70 $1,182.02 $359

Notice that: the hospitals and the surgeon paid that vast majority of the costs of the provided health services.  Our health plan provider refused to pay them and the health providers were not allowed to bill us under the terms of their contract with the plan provider.  There’s no doubt, too, that the basic charges are inflated to cover those lost costs and the costs these entities incur when patients are uncovered or prove to be scofflaws.

Compare, in particular, the cost of similar surgery—nearly all inclusive—at a cash only (no health coverage plans) hospital in Oklahoma.  While the procedure listed isn’t exactly comparable to my wife’s situation, it’s close enough for this exposition.  The Surgery Center of Oklahoma’s price is $4,300; although the pre-op diagnostics like those initial X-rays are not included in the charge.

Keep in mind, too, that while Obamacare has made this situation far worse (and worsening), this sort of thing has been happening much longer than Obamacare’s existence.

One more thing.  A Medicare patient paying cash for a procedure in lieu of a Medicare plan’s coverage in order to get a lower total cost?  My GP tells me that it’s illegal for her to accept cash from a Medicare plan-covered patient.  I have to be uncovered altogether, beyond basic Medicare A, before she can accept legal tender.

It’s time we moved to a market-oriented system of health care and of health insurance.  See that Oklahoma hospital.

The Cynicism of the Left

Posted on by
Reply

And it’s especially stark in the season.  The Wall Street Journal has taken note of the “charities” of the Left and their negative attitude toward the just enacted tax reform.

“The tax code is now poised to de-incentivize the heart of civic action in America,” Dan Cardinali, president of Independent Sector, a left-leaning lobby for philanthropic outfits, told the Washington Post. “It’s deeply disturbing.”

Cardinali is projecting. Most of us donate time and/or money because it’s the right thing to do and because it’s part of our Judeo-Christian obligation to help the least among us, not because we expect some sort of reward for doing so.

Or as one commenter on that op-ed put it,

They think middle class donors who are saving $25 by giving them $100 will stop because it no longer makes economic sense? If that were the case they could save $75 before the tax change.

Cardinali and his fellows of the Left know this full well.

Deficits as Cudgel?

Posted on by
Reply

Gerald Seib says that’s what the Progressive-Democrats in Congress fear the Republicans will use them for.

Democrats worry that Republicans will simply use the rising deficits they are creating as an excuse to cut government spending on domestic programs important to Democrats—in the vernacular, that the tax bill will “starve the beast” of the federal government of the money it needs to keep spending at current levels.

I certainly hope those deficits will be used as the reason for cutting government spending.  The Federal government spends way too much of our money, and it does so without regard for whose money it is and without regard for the amount of revenue that taxes bring in—deficit spending is enthusiastically pursued regardless of tax rates or revenues.

Federal spending needs to be cut back drastically, not just on domestic programs important to Progressive-Democrats, but on all domestic programs (other than defense, which already is so low that our military cannot reliably win a war against a regional power like Russia, much less a rapidly expanding one like the People’s Republic of China.  We’ve even had to abandon our Cold War mission of being able to fight and win two separate wars simultaneously).  A good start would be a 10% across the board cut on all extant programs, and then begin cutting seriously from there.

And yes, that includes privatizing Social Security and Medicare and block granting Medicaid transfer payments to the States without strings—they know better than the Feds how to spend those funds State-domestically, anyway.  After conversion, the Feds then should reduce those Year Zero block grants by [10%] per year after that until there are no more Federal Medicaid transfers.

An additional step for Federal spending curtailment is to consolidate all current Federal transfers into a single block grant for each State and then reducing the size of that grant along the schedule above.  In this way, States like New York, California, and the rest of the dozen or so States that send more of their citizens’ tax money to the Federal government than they get back could keep all of their citizens’ money and spend it within their State in accordance with those citizens’ imperatives.  Surely even Progressive-Democrats could get behind a program that lets their constituents keep their money local—that’s more for the local Progressive-Democrats to spend.

Net recipient States would be able to keep all of their citizens’ tax money, also, reducing the alleged “need” for Federal transfers.

Additional cost saving: the middle-man bureaucracies, with their inherent costs, would be eliminated, too.

The only deviation from eliminating such knee-jerk routine transfers should be in times of declared State or regional emergency.