During the 1970s, I did quite a bit of business with an aerospace company that, for obvious reasons, will not be named. But you would recognize it if I mentioned it. Anyway, I built models for them and also painted quite a lot of manufactured models when they needed a custom color scheme or markings for a sales proposal.

The reason they did business with me (and several other model-builders) was that they did not have an in-house model shop. They still don’t. It happened one day that they needed a model built yesterday and no one was available to do the job. So, they talked an employee…who built models as a hobby, did an excellent job but didn’t want to build for pay…into building this desperately needed model. They set him up with a bench along with all the necessary equipment and our modeler went to work.

A few days later, one of the company employees was giving the cook’s tour to a pair of efficiency experts, otherwise known as bean counters. As they passed the modeler’s bench, with the modeler happily working away, one of them inquired as to what he was doing. Should’ve been obvious, of course, but some people are just a little dense. After it was explained to him, the next question was “How long is it going to take?”

“About a hundred hours” was the response.

At that, the bean counters looked at each other, looked back at the model-builder, turned to the company tour guide and said “You know, it you put 25 men on that, it will only take four hours.”

To them it made perfect sense because it was strictly a numbers game. One man takes a hundred hours. But if you put 25 men on it, 100 divided by 25 equals 4. It’s obvious. Isn’t it?

What they failed to understand was that first you required a model-builder, someone who understood how to build a model. Secondly, it was basically a one-man job and there was no practical way to cut the amount of time involved. By putting 25 men on the job, 24 would’ve set around watching one man build it, thereby turning a 100-hour project into a 2500-hour project.

If you’re wondering where I’m going with this, you won’t much longer. A local talk show was dealing with that wonderful ObamaCare bill currently being fought over in the halls of Congress and various Town Halls. Raucous doesn’t begin to describe the debate, which has reached the level of shouting matches and invitation-only Town Halls. I just read that one Congressman is now resorting to a telephone Town Hall. How that one works, I haven’t a clue.

Along the way, the talk show host, in an effort to show the potential for reducing the level of benefits after this elephant (For those who don’t know, an elephant is a mouse built to government specs.) is enacted said “Think about this. Someone gets the bright idea that if we make people wait 8 weeks to get their cancer treatment instead of two weeks, we can knock another $8 Billion out of this package.”

Think it can’t happen? Think again. Then ask any doctor how much his reimbursements from Medicare have shrunk. Ask any Senior Citizen (what a horrible phrase) how much their co-pays have increased over the years, especially the annual deductible they have to cough up before they receive any benefits at all. And let’s not overlook the number of doctors who no longer accept Medicare at all, leaving their patients looking for a new doctor. Maybe they’ll find a new doctor and maybe not, because many doctors who still accept Medicare are no longer accepting new patients.

“But,” you say, “they all say that you won’t notice any changes in your health coverage, especially if you’re happy with what you have. We have to do something to contain costs.” Uh-huh. Sure. And pigs fly, too. If you believe that, then be sure you get a video of the pig that just flew past my window doing Immelman loops and wingovers. That definitely needs to be the lead story on the ten o’clock news!

There are only two ways to contain costs. Reduce the amount of money paid out to doctors, hospitals, etc., or reduce the number of people seeking health care.

Cutting payouts to providers of all stripes will not be the obvious and first step. The mere threat of some form of health care legislation being passed is already having an effect. Blue Cross/Blue Shield of Texas recently announced the termination of 183 employees and the combining of some job responsibilities. The reason for this little move? Because of the need to contain costs in view of pending health care legislation. Spend a quick ten seconds on Google and you will discover that BC/BS operations in many states are eliminating employees as well.

“Hey! That’s a good thing,” you say, “those nasty old insurance companies are just in it for the money.” True enough, but the alternative, as it stands now, is cradle-to-the-grave government-run health care ala Canada and Great Britain. Of course there is a third choice. Eliminate the insurance companies, let the costs drop back to where they should be and pay cash.

That third choice ain’t gonna happen anytime soon, so we’re stuck with the disaster that ObamaCare will be if Congress manages to ram it down our throats.

There are already problems with physician shortages, particularly where primary care physicians are concerned. You can go to both here and here for informative articles on current and projected shortages.

The sites listed belong to the Atlanta Metro News and Examiner/Dallas. One particularly alarming statistic was a projection in May that primary care income will decline some 15%-20% under the ObamaCare proposal. Who knows how much worse it will be by the time a final bill is written. And don’t forget to Google JAMA (Journal of the American Medical Association) for even more supporting statistics.

If the nationalization of the American healthcare system is carried to fruition, you can bet your Justin Boots that a substantial percentage of doctors will opt to retire rather than be told how little money they will be permitted to earn. If that isn’t enough, would anyone care to project how many more doctors will throw in the towel after panels of bureaucrats begin controlling what kind of treatment they’re allowed to extend to any given patient?

And just how will these panels determine who gets what care? By determining the cost effectiveness of the treatment when balanced against the age of the patient, overall medical condition, medical history and whether or not they’re a contributing member of society. In other words, the numbers will determine your treatment. Incidentally, that also has the effect of reducing the number of people receiving health care. If you go back to the top of this missive and refresh your memory, it won’t take long to understand that those cold, impersonal numbers are the purview of efficiency experts. Those logical bean counters, in other words.

When it comes to the medical care that you receive, this entire argument boils down to one very simple question: Do you want bean counters controlling your life by reducing your medical care to a set of numbers?

I don’t.

Regards,
Richard Marmo

August 31, 2009

Logic of the Bean Counters was originally featured on Whiskey and Gunpowder. Visit Laissez Faire Books for the best selection of libertarian book titles.

What are predictable results of government ramming socialized medicine down our throats?  We can’t stop the programs, so how can we make money from the ineluctable outcome?  A few ideas spring to mind immediately:

1. Has it dawned on anyone in Washington that Socialized medicine just might have some slight effect on insurance companies?  It might be time for us to consider shorting a few viciously…or is that still illegal?!

The health insurance rack…ah, business…is one of the largest in America.  The law as proposed will make it illegal to have private insurance to supplement the government’s “single payer” plan.  A major portion of the GDP will be destroyed in that area alone.  What will happen to those who currently underwrite supplements to Medicare?

No one can prognosticate how many irrational requirements, forbidden activities, and finable offenses will come out of the final legislation, but we can certainly conclude that this shake up and shake down is going to be off the Richter Scale in terms of lost jobs and destroyed capital.  When the government is the HMO there is no place for a private HMO.

2. The proposed law also makes it illegal for doctors to provide services outside of the system and it will determine what doctors and hospitals are paid.  This is certain to lead to staff shortages, probably more quickly than we are anticipating.

A. How many older doctors will retire rather than submit?  Why should they work just as hard for a great deal less money?  Why should they tolerate having their medical judgment overridden by a bunch of penny-pinching bureaucrats?  “First, do no harm” also prohibits doing nothing when treatment is indicated clearly.

B. How many physicians are already considering retiring from the practice of medicine because of the proposed ukases which would require them, under penalty of law, to perform abortions on demand.

C. Any young student with the brains to make it through medical school will tend to decide quickly that it would be far more sensible, faster, and lucrative to become a dentist or a veterinarian.  Any good vet makes at least $100K, but socialized doctors don’t.  This isn’t guesswork; it is the experience in Canada and England.  A quick perusal of the literature reveals also that it is best not to become ill after June and that a dog can get an MRI the same week but people wait months, if they get them at all.

3. What effect will this have on the cost of medical and nursing schools?  Silly question; tuition will go up because it costs the same amount to offer instruction and classrooms whether they are full or half full.  We can prognosticate that less qualified applicants will be admitted because fewer will apply.  Corners will be cut wherever possible.  Fewer courses will be offered.  Why train in procedures likely to be forbidden?  Standards will be lowered.  It may even become a great deal easier to pass the exams to be able to write “M.D.” after one’s name.

4. What is to be done with the clerks in all doctors’ offices who do nothing except handle insurance paperwork–and keep their doctors up to date on how to write up bills and lab requests to obtain the greatest return from insurance companies?  Some of them may find jobs in the new bureaucracy, but one putative benefit of socialized medicine is that less paperwork will be needed to provide better records.  Good insurance clerks are paid well, and deservedly so, for theirs is specialized work.   We can suppose that those who train typists to transpose doctor’s recorded notes may find less business (knocking out their schools and a good at home source of income for quite a few), because a pretty good guess is that over-scheduled, under-paid doctors aren’t going to generate the sort of records we are accustomed to now.

5. The AMA and insurance companies have enormous lobbies, which makes one wonder why there isn’t any outcry from those areas.  That is really a very interesting point upon which to speculate.  What does the AMA expect to get out of this that is worth the price of tolerating bureaucrats to set fees and determine procedures? Do they think that going along will prevent even more Draconian cuts and restrictions, or can someone in the Bar today come up with a better answer to “Cui bono?”

6. Pharmaceutical companies spend lots of money in Washington; could it be that they do not expect the prices of their products to be cut as proponents of socialized medicine insist is one way costs will be controlled?  Perhaps a lessening of the restrictions that make developing a new drug cost billions has been tendered?  Again, what’s in it for Merck and Roche and Lilly not to scream their heads off? A good prediction is that only generics will be allowed to be prescribed, which is bad news for those of us for whom Synthroid is not an adequate substitute for Armour Thyroid, and a very nasty lump for Armour, which gets $90 from me, alone, every time I fill my prescription, instead of three or four bucks.  What is the point of developing proprietary drugs if the cost cannot be recouped many times over?

7. We old-timers are being told we will simply have to learn to live with our aches and pains and that services will be cut for us in order to care for the younger population better.  Doesn’t it make you feel all warm and fuzzy to know that you may not get a life-saving procedure because it “costs too much at your time of life and the money will be better spent on millions of lawbreakers granted amnesty and citizenship, instead?”  Already there are services to help us find superior medical and dental care at deeply reduced prices in India, for example.  However, if/when “Cap and Trade” is pushed through, what is that going to do to the airline industry?  We may well end up with no viable way to obtain adequate health care at any price short of suborning our private physicians.  I joked with mine when I saw him for routine blood work a couple of months ago that between the coming depression and socialized medicine we might end up skulking to meet in an alley at midnight, me with a chicken in my hand.  My brilliant young physician, with enormous student loans, looked grim, and said, “I’ll take it!”  Back in The Great Depression a chicken was considered a good fee, by the way.

8. Where will peripheral specialties come into all of this?  Lasik surgery, for example.  Will such surgeons be exempted, or will they be driven out of business because glasses were good enough for Benjamin Franklin?

“Is there a lawyer in the house?”  It will, one can only suppose, be forbidden for medical personnel to assist in times of crisis, accident, or disaster since the law as drafted forbids practicing outside of the system.  Few do anyway these days because of the danger of lawsuits.

If anyone here will admit to being an attorney, please take a shot at explaining the Constitutional justification for government controlled medicine, since it obviously isn’t going “to promote the general welfare.”  While you’re at it, explain how anyone can justify making it a crime for a duly trained and licensed doctor to treat patients who seek his care.

For preliminary actions…just off hand, I would not invest in a chain of dialysis clinics or expect MRI apparatus to sell as well.   We should probably be leery of many pharmaceutical companies.  On an individual level, it might even be a good idea to go get heart by-pass surgery now if you expect to need it in the next few years, although there are better choices.

So…I’ll raise my glass of Lambrusco (full of healthful substances and a modest jolt of alcohol), and look forward to hearing your views on how to profit from what is coming our way.

Regards,
Linda Brady Traynham

May 5, 2009

What You Can Expect from Socialized Medicine was originally featured on Whiskey and Gunpowder. Visit Laissez Faire Books for the best selection of libertarian book titles.