Monday, April 5, 2010

Now They Tell Us.

Some of us had a pretty good idea that this sort of thing was coming. One wonders what number of the voters who supported Obamacare would have supported it had they known or even suspected what was in store. Municipalities are going to be damned if they do, and damned if they don't, since cutting all these massively overpriced health care plans down to size will make public employees feel substantially less well off. Given how many of our fellow citizens are employed by government, it is hard to see how this will not have, at least economically speaking, a depressing effect on local economies.

And yet, not massively paring these bloated plans from the system will bankrupt local government, because, who, in our implacably shrinking economy, can afford twenty five and thirty thousand dollar health care premiums? But wait. Not so fast! The whopping tax penalty on Cadillac insurance plans won't take effect until 2018, when Obama, and possibly Bella Pelosi and Scary Reid, will be long gone from the corridors of power.

So, in the mean time, municipalities can continue to hurtle down the path of bankruptcy, paying enormous premiums for overstuffed health care plans on behalf of employees, retirees, and elected officials. As the gory details continue to dribble out, the more one sees of Obamacare the more one gets the sense that, just as with the response by team Obama to the banking system and financial services sector debacle, another can has been well and truly kicked down the road.


Thai said...

Please delete this after you skim over it. I think this video should make it absolutely clear why we are all doomed to bankruptcy.

Understand, I have to watch this kind of stuff regularly or I'll lose my license.

FYI- there is no evidence helicopters improve mortality, and I mean none. There are lots of example of how helicopters lead to higher mortality when they crash however.

Indeed, I bet there is no cost/benefit data for most of these regs they are pushing.

But at least we now have a built protocol and structure for all this "grey stuff". It is fine to go off a cliff as long as we followed the appropriate protocols and procedures. ;-)

Thai said...

It should also make clear why we spend 30% of our dollars on administration.

Thai said...

To be fair to the helicopter mindset, all of us have seen people who might not have died if they had received definitive treatment sooner and the idea behind a helicopter is to make this happen, but reality is rarely so kind.

Weather, the fact that the helicopter is in use elsewhere, etc... usually end up conspiring against the hope of more timely definitive treatment actually occurring in the very rare instances where it would make a difference.

But of course, helicopters are lots of fun and provide lots of jobs. ;-)

Edwardo said...

Hi Thai, I'm not accessing anything except a page that requests that I enter my name, e-mail address, etc. etc. in order to access the site.

Thai said...

Sorry, I forgot I had to log in. You licked out for I think if you really knew...

And of course, you have to realize the complexity of things like helicopters, etc... for trauma as while they do get used for the accidental car crash you or your sister might be involved in, ask yourself who the most likely person to be involved in a trauma in the first place and need a helicopter top begin with would likely be?

Oh well, the system is good at protecting itself. ;-)

Thai said...

typo I meant to say "lucked out"

Edwardo said...

Well, speaking of bankruptcy, today is more than a little interesting since the ten year note just broke out.
Rates are heading higher.

Edwardo said...

BTW, Thai, we have a crisis erupting in MA now that the state has capped rates by the insurers who are now suing against what they deem an illegal restraint. It should get interesting, in a Krakatoa like way.

As for the Helicopter costs, yes, I imagine renting a a Sikorsky is quite 'spensive.

Thai said...

Yes, I have been peripherally watching this. On the personal upside, I hire a fair number of physicians and I'm optimistic this will speed up the slow exodus of talent/labor from your region to mine that I have witnessed in recent years. You guys have a glut of physicians and training programs in my opinion anyway. On the downside for you, your glut is with the kind of specialists that so few people really need- like using a Rolls Royce when a Chevy Malibu would do fine.

Remember, the real battle in health care is and always will be between the simpletons and the complexitrons... I personally straddle both camps though I do have a slight personal bias/fondness for the simpletons.

In case you're having trouble deciphering Thai speak, This is otherwise known as the battle between primary care and sub-specialty medicine. ;-)

Debra said...

So... I wouldn't have got to see your link anyway Thai..
Just to be contradictory... ;-)
I remember watching a film at the geode in Paris about ten years ago about a climbing crew who got stuck up on Everest during a really bad storm.
One of the guys was on the summit and KNEW that there was no way in hell he was going to get back down to the temporary camp in time..
He knew he was done for..
And they managed to wire some kind of connection for him to say goodbye to his... PREGNANT wife.
Very, very moving. (I'm coming to the helicopter part...)
The other members of the team were really TIRED. EXHAUSTED from fighting the elements.
And one guy was badly injured.
They were crawling back down the mountain.
And they FINALLY got to a spot where... JUST MAYBE a suicidal helicopter pilot COULD POSSIBLY fly in to pick the injured guy up. (His WILL was keeping him alive...)
And sure enough, there was a suicidal helicopter pilot out there who whispered a prayer, and took that copter in, and managed to pick the guy up and take him out. (The guy lost his nose, and was in physical therapy for months learning how to walk after losing his toes too...)
It was pretty moving, watching that.
I didn't even ask myself ONCE how much this was costing... Seriously, I don't think that YOU would have either.
I agree about primary care. I hope that my son will become a GP. I think that this is about the only way that he will save his soul in the upcoming medical meltdown...

Thai said...

Honestly is a very tough call picking who will win the simplicity vs. complexity battle.

When it comes to personal health, traditional alliances tend to throw the baby with the bathwater when push comes to shove.

There is only so much GPs can do

As you say, we are not rational animals but we are self interested ones

Edwardo said...

That movie sounds like "Into Thin Air", but perhaps it was some other flick about yet another misbegotten mission to scale Everest. The whole Everest phenomenon is a story in and of itself.

Apparently the trash left on the mountain is immense. And given the spartan conditions in which the first man to scale Everest, Sir Edmund Hillary, operated in, you would hope that modern boutique mountaineers would just back off realizing that, as difficult as it is to scale Everest, they aren't even coming close to equaling the feet of Hillary.

Thanks, Thai, for the professional medical perspective.

Edwardo said...

Make that feat, not feet.

Debra said...

"Feet" was pretty nifty in that context.
The "feet" of Hillary. It works. GO FOR IT...
I know what you mean about the trash.
But I think that when YOU'RE up there, even if it's with state of the art equipment, you must feel pretty proud. Pretty unique. Why not ?
We're NOT going to bring Hillary back..

Thai said...

You'll get no typo/spelling error comments from me


Edwardo said...

I thought about the "frozen" feet, Deb, but somehow my inner spelling cop took over.