Thursday, 15 November 2012

08:00 – ObamaCare strikes. The top headline in our paper this morning was “Wake Forest Baptist Medical Center Cuts 950 Jobs“. The spokesman made a point of saying that the cuts were preemptive, and not a result of any financial difficulties. WFU/BMC is preparing itself for the new economic realities. As the article pointed out, we can expect to see similar cuts at other hospitals across the state and the nation.

That’s just the beginning of the destructive and distorting effects that ObamaCare will have on our economy and our society. I have many acquaintances who own small businesses, and several of them have told me that they’ll be making changes to minimize the effects of ObamaCare on themselves and their companies. These range from shifting away from using all full-time employees toward temporary/part-time/contract labor to cutting payrolls to get under the 50-employee statutory minimum to splitting their companies into two or three smaller companies. Two or three that currently provide health insurance have said that they plan to eliminate it because it’ll be cheaper to pay the annual fine than to continue to pay health insurance premiums. One thing is sure: ObamaCare is going to hurt small businesses and their employees.


10:04 – Well, that was interesting. They’re still re-roofing the house across the street. Colin is terrified of popping and banging sounds, so I’ve been taking him downstairs and out the back door.

The instant we went out the back door, Colin froze in his alert position. I followed his sight line and saw what I at first thought was a stray dog down in the corner of our back yard. But Colin wasn’t barking frantically, as he would if there was another dog in his yard. Instead, he froze and snarled. Let me tell you, Colin has an absolutely vicious-looking set of fangs and a low, rumbling growl that should scare anything.

It was a coyote, of course, and it quickly decided that discretion was the better part of valor. I could just see what was running through its mind in the instant before it turned and ran for its life. “Holy Shit! That thing is twice my size and its ears stick straight up. WOLLLLLFFF!”


11:31 – Well, crap. I just finished making up three liters of IKI (iodine/potassium iodide) solution for the kits. I make this solution and many others up in gallon orange juice bottles that Barbara provides me at a rate of about one a week. So, I just finished making up the three liters of IKI when I realized that I’d need to transfer it to glass bottles because the IKI penetrates the orange juice bottles if it’s left in them for more than a few days. So off I went in search of six 500 mL glass bottles with cone liners. I found six of them, all already filled with IKI solution. So now I have six liters of IKI, which is enough for about 200 kits. Oh, well. The stuff keeps forever, and fortunately I have many spare glass bottles to transfer it to.

36 Comments and discussion on "Thursday, 15 November 2012"

  1. BGrigg says:

    If only more people who care, would have voted against Obama…

  2. Robert Bruce Thompson says:

    As OFD said, best get it over and done with.

  3. Chuck W says:

    It was Romney’s people who devised the Nobama plan, anyway. Strange how they think they can raise taxes, up the price of insurance, and that everyone will stand still to be raped without taking any action at all to avoid it.

  4. Chuck W says:

    There are 2 new dogs in the neighborhood as of earlier in the week. One of them is left outside and barks constantly all throughout the day. I read somewhere once, that barking is an effortless activity for dogs—it does not stress them physically, nor does it tire them in the least. Don’t know how the owners can be 100% oblivious during the entire daylight hours, but it is getting beyond tiresome. Going to have to call the city if this keeps up. They do take animals away from people around here, if they cannot control them.

  5. ech says:

    From yesterday:
    Heck, they’ve found 4,000 year old Hostess Twinkies in Egyptian tombs, and they were still edible.

    Well, given that Hostess could go into liquidation Monday, stock up now. They are in banruptcy for the second time and the baker’s union turned down a contract offer. The bankruptcy court imposed it on the union after a petition from management, and the union struck. The Teamsters had accepted a similar contract change, but may start honoring the picket lines. So, management will file for liquidation Monday if the strike doesn’t end.

    Expect to be able to get Twinkies, Ding Dongs, and HoHos in a few months, as they will auction off the plants, trademarks, and recipes in liquidation.

  6. bgrigg says:

    “As OFD said, best get it over and done with.”

    Get it over and done with what exactly? Getting it over and done with does not seem to include doing nothing, except for complaining. Imagine if the Founding Fathers sat about on their asses, and just bitched and moaned and waited for the British to leave?

    I can understand being prepared to take over after the fall, but my Judo training taught me to break the fall, not smash headlong into the ground.

    ——————————————

    “I read somewhere once, that barking is an effortless activity for dogs—it does not stress them physically, nor does it tire them in the least.”

    I rarely get as tired talking as I do when I’m listening. I think it’s listening that’s the actual tiring part. OTOH, I have seen (heard?) dogs bark themselves hoarse, so it must be tiring at some point. Especially for the lapdogs that jump every time they bark.

  7. ech says:

    It was Romney’s people who devised the Nobama plan, anyway.

    Well, some of it. The mandate and preexisting conditions provision was part of the Massachusetts plan.

    The really, really bad parts – medical device taxes, payment cuts, “death panels”, accountable care organizations (a doubleplus ungood feature), the electronic medical records mandate (with an unrealistic deadline), pushing millions from Medicare to Medicaid, etc. was all the result of tinkering in the House and Senate.

    Look, it’s all a stalking horse for one thing: a single payer system like in Canada. It’s also a system to force doctors to become part of large, corporate group practices. It’s a lot easier to bully, monitor, and control a handful of regional corporations than hundreds of thousands of individual practicioners.

  8. rick says:

    I have an unopened package of Twinkies at my desk at work. They’ve been there about ten years. They are rock hard, definitely not edible. No visible sign of deterioration, though.

  9. Robert Bruce Thompson says:

    Ah, you must have forgotten to embalm them.

  10. rick says:

    The pre-existing condition provision of Obamacare will ultimately bankrupt insurance companies. As long as the penalty is much cheaper than insurance, there will be an incentive for healthy people not to carry insurance. After all, they will be able to buy insurance as soon as they are diagnosed with a serious illness. It would be like being able to buy fire insurance as the fire department is on the way to your burning house. While I think there should be a way to easily move from one insurance plan to another without limitations for pre-existing conditions, failure to carry insurance should not be rewarded.

  11. Robert Alvarez says:

    RBT:

    I recently read that wolves are smarter than dogs, and on average larger too. These were the results of domestication. What say you?

    Robert

  12. ech says:

    The pre-existing condition provision of Obamacare will ultimately bankrupt insurance companies.
    That’s not a bug, it’s a feature. It’s intentional.

  13. Robert Bruce Thompson says:

    Insurance that covers pre-existing conditions (including being female) at standard rates is not insurance by any normal definition of that word. People with existing medical problems cost insurance companies more, as do women (who use medical services much more heavily than men, both during their child-bearing years and later), and older people. Forcing others to subsidize them isn’t right, it isn’t fair, and it isn’t insurance. It’s a gift, extracted from healthier, younger, and maler people.

  14. Robert Bruce Thompson says:

    I recently read that wolves are smarter than dogs, and on average larger too. These were the results of domestication. What say you?

    I suppose it depends on how you define intelligence. Dogs have evolved with humans for the last 30,000+ years, and they’re well adapted to be our companions. Dogs understand people (and vice versa) in a way that we share with no other species (except, possibly, human women). Dogs, for example, understand a human pointing his finger. No other animal understands that, not even chimps and gorillas, and certainly not wolves. And even wolves that have been raised from puppies by humans don’t come close to having the language skills of the average dog, let alone a Border Collie. Wolves are also utterly incapable of the kinds of thinking that smart dogs are capable of. For example, until recently the prevailing wisdom was that dogs were incapable of interpreting two-dimensional images as three-dimensional objects. Some recent work with Border Collies shows that to be false. Experimenters used hundreds of dog toys in another room, showing a Border Collie a picture of a specific toy. The BC would then leave the room and reliably return with the toy that it had been shown a picture of. So, yeah, I’d say that at least the smartest dogs make wolves look like morons.

    Size-wise, average wolves, depending on species and geographical location, are larger than most dog breeds, but by no means all. Gray wolves are the largest wolf species. At 75 pounds or so, Colin is roughly the size of an average gray wolf in North America.

  15. Chuck W says:

    No, that IS insurance. Insurance is not insurance when bad risks are removed from the pool. That is what Allstate and other companies were able to do back in the ’50’s when friendly lawyers in the legislatures conspired to allow Allstate and other companies to eliminate bad risks altogether, and destroyed “insurance”. Yeah, Allstate’s profit margins soared, while other insurance companies saw theirs decline significantly, and everybody who was not with Allstate paid more for insurance, but back then, Allstate cancelled you after one accident. Now, they just double your rates, because legislatures had a hot potato on their hands with unprincipled people running a company.

    Somehow over the years, this crazy idea developed that free markets mean any company is able to do anything they want, and it is contrary to the fundamental principles of how insurance works. Fortunately, Nobamacare moves us to everyone being in the same risk pool. Overall costs are much lower that way, but then, so are profit margins for companies like Allstate. Which is good.

  16. Chuck W says:

    Well, I did not have to make any calls to anyone; somebody else apparently did. The cops came about a half-hour ago and there was a heated discussion at the house of the barking dog—while the dog continued barking throughout. After a short time, the barking stopped. Well, it didn’t, actually; I went outside and the dog is still barking continuously, but INSIDE the house of the owner. Whew!

  17. Robert Bruce Thompson says:

    Chuck, you understand absolutely nothing about insurance.

    Insurance is all about pooling risk. The keys to insurance are establishing risk level and setting rates that allow the insurance company to pay claims and make a profit. To be able to do that, insurance companies need to be able to classify large groups according to risk level. That’s why teenage boys are charged more for automobile insurance, why men pay more than women for life insurance, and why women pay more than men for health insurance. It’s all based on expected outcomes, with rates set to make a profit after claims by the group in question.

    It’s clear from this and many of your other posts that you do not support the free market. You want to force companies and individuals to do things the way you consider proper. In a free market, if an insurance company wants to cancel someone’s coverage for any reason or for no reason at all, that’s their right. The individual can go elsewhere. He may have to pay much higher rates, but he’ll be able to find someone who’ll cover him.

    It’s when the government gets involved, as you want them to, that things end up distorted and screwed up. Take, for example, the flood insurance program, which provides a gigantic subsidy for people who own beachfront property. You and I are paying to subsidize them in our own taxes and insurance premiums. If left to themselves, the insurance companies would be happy to write policies on those beachfront homes. It’s just that those policies might cost literally a hundred times more than they now cost. And that’s as it should be, because the actual cost of insuring those homes is probably a hundred times what they’re paying now.

  18. Lynn McGuire says:

    Being female is a fairly serious pre-existing condition. I read somewhere recently that 80% of the babies here in Texas are now being paid for by Medicaid (60% feddies, 40% state). Our legislature here in the Great State of Texas tried to keep young females insured by allowing them (and young males) to stay on their parents insurance until they are 25 about 5 years ago. But, I am afraid that it just did not work out. Actually, from a financial viewpoint of the young ladies, it is cheaper if they drop off their parents insurance and let Medicaid cover the average $20K birth costs. No copays, no other costs unlike regular medical insurance.

    I have a disabled 25 year old daughter who lives with us. Next year she will turn 26 and I will have a tough time getting her insured. I am willing to pay for her insurance up to a reasonable point but she could easily drop into Medicaid. Her medical expenses are actually not that expensive unless her Lyme disease manages to go into the next stage where she could have seizures. My insurance agent does not even want to talk about it yet as things are changing so fast in that industry.

  19. rick says:

    We have had defacto “free” insurance for a large segment of the population through the laws and regulations that require emergency rooms to treat all comers, regardless of ability to pay. People know it and use the emergency room for all of their health care needs. Do we have the will, as a society, to tell people without insurance or other resources that they will get no treatment?

    Our health care system is a complete mess. Back in about 1980 when I was an undergraduate, I took a class in the Economics of Health Care. At the time, health care costs were about 9% of GNP. The professor said that there would be serious problems if it got above 10%. It’s around 17% now and rising. Eventually, something has to give.

    The system insulates most people from much of the cost of health care through “insurance”. Since insured people do not feel the pain of outrageous prices, the prices have soared to the point of absurdity. My son (28 and healthy) has real insurance. It has a $10,000 annual deductible. It does offer negotiated rates with preferred providers, as the “list price” for much medical care is a fiction. He will pay all of his regular medical expenses himself, but he will not be financially devastated by anything serious. The monthly premiums are reasonable.

    The rest of my family (my wife, two kids and me) are covered by a “High Deductible” plan through my employer. The first $3,200 of family medical expenses are my responsibility. There are then co-pays with a maximum out of pocket of around $5,000. It’s not catastrophic coverage like my son has, but it gives us some incentives to watch costs. This year will be the first time in several years where we meet the $3,200 deductible.

  20. Miles_Teg says:

    I’ve been spending some time at Jerry Coyne’s site, and the view of Obama, ObamaCare, and so on is just from another planet. And there’s no give-and-take when it comes to discussion. Say anything against the lunatic left liberal Democrat cause, or even slightly pro-Republican, and the attack dogs start a crescendo of barking. It wouldn’t suprise me if Coyne has an idol of Obama, and Teddy Kennedy, and Hillary, that he prays to morning, noon and night. And sacrifices a few puppies to. I thought he was supposed to be smart.

  21. pcb_duffer says:

    One significant malfunction in the health insurance industry, IMHO, is that in the vast majority of cases the insured does not pay the cost of the insurance. BCBS of FL would be more than happy to insure me, as long as some employer pays the lion’s share of the bill. If I want to live my life as an independent contractor, and pay the bill myself, they absolutely refuse to issue me any sort of health insurance policy. I’m at a loss to explain why working for Uncle Sam, Aunt Florida, or XYZ Inc. would suddenly lower my blood pressure or heal my many orthopedic problems.

  22. SteveF says:

    Speaking of Teddy the Hutt, I had a friend in Boston who was a member of the Harvard Club. On more occasions than he really wanted, he was in the locker room with Kennedy and got to see him in all his naked, flabby glory.

    Enjoy that taste of vomit in the back of your throat, everyone! It’s a special gift from me to you.

  23. SteveF says:

    pcb_duffer, here’s what I think is the explanation to what you observed. (And note that this is just my thoughts; SFAIR I haven’t read anyone else saying the same.)

    If you get insurance as part of a company, you may be healthy and you may be sick. Most likely you’re getting insurance as a matter of course when starting employment. This trend allows insurance companies to statistically figure what premiums to change based on expected outlays. (Subject to regulation and such. The usual.)

    If you as an independent contractor or a guy whose job doesn’t offer health insurance try to get insurance, they fear that you’re trying to get it only because you expect to need a lot of coverage soon. The insurance companies used to offer individual policies at a higher but affordable rate, then at an even higher rate, and now essentially not at all. I’m pretty sure they stuck themselves in a positive feedback loop, making individual policies unattractive unless you thought you were really going to need it.

    Ten or fifteen years ago I looked at getting an individual policy or better yet one covering my young son and myself. The first was available but expensive; the second was unavailable. I ended up self-insuring, setting aside money every month and paying cash for (usually deeply-discounted) services as needed.

  24. Rolf Grunsky says:

    I fail to see how ObamaCare can be anything like the Canadian system. The federal government does provide some funding for health care, but it can only do that through the provinces which have the exclusive right and responsibility to deliver and regulate health care. The only exceptions are First Nation Reserves and the military. The feds can and do impose conditions on the provinces for the funding but the provinces are free to refuse both the conditions and the money. None do.

    Of course there isn’t enough money in the known universe to give everyone the health care that they think they deserve. The following is true for Ontario only. The government health plan was originally implemented in the late sixties. Prior to that, there were several private programs, the most successful was PSI (Physician’s Services Inc.) as well as Blue Cross and others. When the government plan was initiated, participation was voluntary but only the government plan could cover the first 24 hours in a hospital. Over the years , funding has been through premiums, payroll taxes and most recently an additional provincial income tax. And from general revenue of course. And the costs keep going up. I expect that the Ontario government will of me a syringe of heroin for my 75th birthday. Times Up!

    On the other hand. Got my flu shot this afternoon. This year it is available from almost any large pharmacy. All that’s required is that you show your Ontario health card. This strikes me as very effective public health move. This is the sort of thing that really doesn’t need a doctor’s intervention and a doctor’s fee. This may be part of a larger trend to make greater use of nurse practitioners. This would be a significant step in getting some health costs under control. We shall see.

    My understanding of the U.S. government and constitution is minimal. It would seem that Obama and his federal programs would result in non-trivial costs to the states. What would happen if the states simply refused to pick up the costs or provide enforcement? An historical example: In the ’70s, the federal government decided that Toronto and Montreal needed new airports. Airports fall under federal mandate. In Quebec, the site chosen was Mirabel. The Quebec government said “ooh federal money!” and the airport was built in the middle of nowhere. The airport was used an air freight terminal for a while. I think it’s closed now. In Ontario, the feds decided they would put it north east of Toronto, about 30 miles from the existing airport. The location made no sense and there was almost universal opposition. The feds said the airport will go there and expropriated the land. Finally the province said that while it could not prevent the airport being built, there would be no services. No transportation, no utilities provided by the province. That was the end of the airport. Do any of the states have sufficient autonomy to do something like that? Just wondering.

  25. Lynn McGuire says:

    The Great State of Texas just refused once again to setup a federally mandated health exchange:
    http://www.chron.com/news/article/Perry-officially-rejects-Texas-insurance-exchange-4041653.php

    Governor Perry is smart enough to know that this will be a total boondoggle. Just make Obama own the entire thing.

    Looks like Israel is going to war again with the PLO, scene 6. Or is this scene 7, 8 or 9? or 15?

  26. Miles_Teg says:

    “The instant we went out the back door, Colin froze in his alert position. I followed his sight line and saw what I at first thought was a stray dog down in the corner of our back yard. But Colin wasn’t barking frantically, as he would if there was another dog in his yard. Instead, he froze and snarled. ”

    I wonder what was going through Colin’s mind. He obviously knew it wasn’t a cat, but does he see coyotes as fundamentally different from one breed or other of dog?

  27. Miles_Teg says:

    SteveF wrote:

    “Speaking of Teddy the Hutt, I had a friend in Boston who was a member of the Harvard Club. On more occasions than he really wanted, he was in the locker room with Kennedy and got to see him in all his naked, flabby glory.

    Enjoy that taste of vomit in the back of your throat, everyone! It’s a special gift from me to you.”

    Okay Bill, you still want to set up a tips jar for this guy?

    (Still cleaning the fruit salad vomit off my keyboard.)

  28. Miles_Teg says:

    Hillary was in Adelaide yesterday, being shown our ship and submarine maintenance facilities by Penny Wong, a SA based federal government minister, and others, with a view to the US bring its warships to Adelaide to get their maintenance done, and hopefully pass us some moolah. I wonder if she tried hitting on Clinton…

    (http://en.wikipedia.org/wiki/Penny_Wong#Personal_life)

  29. bgrigg says:

    Only when he’s funny.

  30. Miles_Teg says:

    A chap I used to work with self insured. He just set up an account and put in some money each pay, and had the self discipline not to touch it unless for medical needs.

    My health fund, Medibank Private. is recruiting at the moment and as I went past the booth they seemed to be saying you could get instant cover, including for pre-existing conditions. Our health funds seem to do that every so often.

  31. ech says:

    I fail to see how ObamaCare can be anything like the Canadian system.

    It isn’t. It’s much more complicated, and is designed to drive insurance companies out of business. It’s a stalking horse for a national single payer system, like Canada’s.

  32. brad says:

    If I can chime in on the definition of insurance: I think both RBT and Chuck are correct. It is all a question of how you pool the risks.

    Let’s take health insurance as an example. Theoretically, insurance company A could charge the same price for everyone. They would simply avoid asking any questions about age, gender or health. One giant pool, with appropriately set rates. It absolutely is insurance.

    This would work fine, until competitor B came along. The competitors would define smaller risk groups. Young people would be offered lower rates than older people. All of the young people would go to company B, leaving company A with too many older customers.

    Company B would promptly have problems with Company C comes along and offers even finer groups, for example, excluding people with known health problems. Then comes company D, which wants a genetic analysis. Ultimately, if you carry this process to its logical extreme, company Z comes along with pools of size 1, i.e., rates tailored to each individual person.

    I contend that – at that point – it is no longer really insurance. Precisely because it *is* about pooling risks. The question is: what is the proper size of a risk pool? This may (possibly) be a proper role for government regulation: setting requirements for the size and composition of risk pools.

    Obviously, the government has gotten far too involved: no longer just regulating the industry, but actively participating in it. This inevitably distorts the market, and screws things up far worse than anything else ever could. Federal flood insurance being a prime example, allowing people to build houses that they *know* will be regularly destroyed.

  33. Robert Bruce Thompson says:

    Exactly. On either extreme–a single pool of everyone or “pools” that are all individuals–it is *not* insurance. In the latter case, everyone pays their own losses in their premiums; in the former, it’s simply a tax paid equally by everyone with payouts according to need.

  34. Lynn McGuire says:

    If you have any kind of assets, you can not go without health insurance in the USA. You do not know when a severe disease or a accident can happen to you.

    My wife had breast cancer in 2004. We and the insurance companies spent $350,000 over the next 18 months. Five surgeries and six months of chemo. Twelve month clinical study on Herceptin effects to four gene positive breast cancer. The costs breakdown is:
    1. $15,000 out of our pocket
    2. $175,000 paid by our insurance company
    3. $35,000 expenses paid by Genentech for her to be in their clinical study
    4. $125,000 cost reduction given by M. D. Anderson Cancer Center with insurance company insistence

    BTW, my wife was 45 at the time which is fairly young for this type of cancer. I spent many hours on the phone trying to get bills paid extending out past six months. It was horribly frustrating to figure out the one inch of bills that arrived each month and who was going to pay or not pay.

    Happily, it worked. She is now a seven year cancer survivor of stage 2b breast cancer. The main tumor was 3 cm diameter and 2 cm thick and growing at 25% per month. Very aggressive so she had a mastectomy and reconstruction. Hopefully, the long term effect of the Herceptin trial is that it will not return at age 65 in the other breast like her paternal aunt.

  35. Alan says:

    If you get insurance as part of a company, you may be healthy and you may be sick. Most likely you’re getting insurance as a matter of course when starting employment. This trend allows insurance companies to statistically figure what premiums to change based on expected outlays. (Subject to regulation and such. The usual.)

    Another variable is that many large companies are actually self-insured and your “insurance company” is just the administrator of the plan.

  36. SteveF says:

    Only when he’s funny.

    The question is, is it funny to make Miles_Teg barf on his keyboard? I know what I think about it, but opinions may differ.

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