A Faltering System

[Sukerkin]

Whilst I passionately support the method of funding of the NHS and it's attendant General Practise system, I have noted for some time that things are getting less good. Indeed, whilst I am not the sort to sue over it or take some other legal action, I hold some of our local doctors as complicit through professional negligence, in my wife's death from cancer - they should have seen it earlier when we might have had more of a chance. It is simple over-work - too many patients to be seen in too short a time. Immigration has a role to play in that as well as a 'target' based system that leads to meeting the targets rather than taking care of the people.

http://www.bbc.co.uk/news/health-21885428

I can testify through bitter personal experience that the Out of Hours service is deplorably bad, that some doctors waste resources rather than spend their own time, that trying to make an appointment is an exercise in patience and when you finally get through you often have to wait a week to actually get seen.

 

[Sukerkin]

But perhaps the medical systems faults are merely symptoms themselves of a wider malaise in the very nature of capitalist economics itself?

When unimaginable sums of money are sucked into the maw of 'traders' fronting for casinos that call themselves banks, in the end the flow of income from the real economy to the virtual falters. Particularly so when the real economy is raided to pay for the failures of those who play in the markets. That is why there is no recovery to be found in those countries where the bankers have been paid for their mistakes rather than being made to pay for their mistakes. They took the profits when they won and have stolen the money of the rest of us when they lost - the trough has been licked clean and, without a real economy to actually do the real work, the myth that is 'wealth' from the financial system is revealed.

Politicians, even discounting their inherent fallibility, can do nothing to fix this because they will not do what needs to be done, which is either reset the whole thing to zero or radically alter the way that business is conducted. The produce-to-consume and maximise-profits-regardless-of-consequences cycle needs to be broken before we all go the way of the dinosaurs on a planet depleted of it's resources and polluted into global environmental shifts.

http://www.bbc.co.uk/news/uk-politics-21908677

Sorry Ed, heard it all before.

 

[DennisBreene]

If you would like to follow up with more detail, I would recommend:Lives at Risk; Single-Payer National Health Insurance Around The World, Goodman, Musgrave and Herrick. A fairly detailed and balanced evaluation of the economics and distribution of health care of a significant number of systems (Including the US) throughout the world. Published in cooperation with the National Center for Policy Analysis (in case someone is aware of relevant agenda issues with that organization). As a practioner in the US, who started in the US Navy (one of our largest single payer systems), I found it eye opening.

 

[arnisador]

I don't know enough about the NHS to really comment beyond saying things get overlooked and shortcuts are taken here too and it costs many lives. Industrialized medicine is probably here to stay though, for better or worse.

 

[billc]

Honestly Sukerkin, I don't think capitalism is the problem. Nothing under the control of the government, which means greedy corrupt politicians is going to work well, that includes healthcare and oversight of criminal abuses of business. As far as healthcare is concerned, you have too many layers between the patient and the doctor because the government is responsible for running the system. it is too easy for people to not care, or to push the job off on another layer of people remote from the actual patient and their needs. Like any other business that actually does it's job we'll, direct responsibility to the customer and direct consequences from that contact are the only way you will ever get decent service from the business wether it is a doctor, or a bank. You will never see quality behavior when politicians and their appointed beuracrats are in charge of making the decisions. There are too many ways they can't be held responsible, for bad decisions. hen change needs to happen, there is no incentive to make them quickly, because again, the consequences will never be able to touch the people who fail to make them quickly because of the layers between patient and decision maker.

Particularly so when the real economy is raided to pay for the failures of those who play in the markets. That is why there is no recovery to be found in those countries where the bankers have been paid for their mistakes rather than being made to pay for their mistakes.

Who is making the decision to pay the banks for their mistakes...the politicians...

The Problem is that the politicians have too much power, and that they can be bought without real consequences when they are caught. To fix the system, you need to reduce the power of the politicians...they are the point where the problem starts. Here in the states, the politicians create a high tax rate...to generate revenue...no...because lower tax rates bring in more money. They want high tax rates so that businesses have to go to them to get exemptions, thus making the politicians powerful and forcing businesses to buy their protection. Control politicians more effectively, and you solve the majority of the problem. It takes corrupt politicians to rig the system...

But he added: "Many GP practices are struggling to cope with a combination of government targets, falling resources and rising workload."
Health Minister Lord Howe said: "The local NHS has a legal requirement to make sure high quality out-of-hours care is in place.
"If this is not happening, it is totally unacceptable and we expect action to be taken immediately to improve these services."

Government targets, falling resources and rising workload...all will be traced to foolish government policies from people in the government remote from the actual patient and doctor in the hospital. Centralizing the process in the government just centralizes and mainstreams the problems. To fix the system, you have to get the politicians and their minions out of it...They should be no more than the police officers of the system to make sure no one is being cheated or abused...everthing else should be in private hands...then, individual cases of problems will occur, but it won't be throughout the whole system...and the government will have the resources and the focus to work on the actual problem...not worrying about how many hours doctors need to work or how many patients per hour a nurse has to have under her care...which no beuracrat in an office in a government building will have any real clue about because they don't know what is actually happening in particular hospitals in particular wings of those hospitals on specific days or nights when more or fewer people will be coming in for treatment based on the number and type of people in the community the hospital is in. The guy in the Department of patient care will never know that on thursday nights in this particular community they get more patients and thus need more nurses on duty between 7 and 11, but on Monday between 2 and 9 they have almost no patients coming in and need fewer nurses and doctors on call...why...no one knows but that is the pattern at that hospital. The beuarcrat can't make a detailed decision like that...he just decides that all nursers in all hopitals need to see X number of patients everyday, regardless of the realities on the ground, because X makes sense to him...even though his predecessor thought the real number should be Y because they thought it was a better number...see the problem...

 

[Sukerkin]

It is true that any bureaucracy is going to creak and groan under the strain of administering the system. But that will be true however the system is funded.

The NHS is funded through taxation; the US system is funded by insurance company leaches. I would imagine the accountability of the medical staff for the people under their care is largely the same.

The reason why things will not get fixed in the wider economies at large is because capitalism has been running free of the trammels of economic reality for a century. Money became decoupled from the value of goods and services in an economy and came to be traded as a commodity in it's own right. The money supply ballooned like you would not believe and, slowly at first, centres of fiscal 'gravity' began to appear. At first these were due to the actions of general market forces that are down to reasonable things like production efficiency, a superior good or service or excellent marketing. But as those centres got larger and more powerful they pulled in the vast majority of the flow of income, were leveraged upon themselves with creative fiscal instruments and in the end lead us to the frozen state we are in now.

That's why I say that the whole shell game needs resetting to zero or we change utterly the way we do business to one where utility and longevity are the key drivers rather than maximum profit and turnover. For the present way depends upon infinite resources to work and that is what we don't have.

The best analogy I can use is that money is the oil of the wealth creation engine and all the oil has been siphoned off up into a storage tank from where, because of a stuck return valve, it is being leaked onto the ground rather than being fed around the motor. In the end, the engine seizes up.

How to un-seize the engine without punishing those who have succeeded legitimately under the old 'rules' before it locked up is a true Gordian Knot of a problem.

 

[billc]

Capitalism is the only system that deals with economic reality. The problem comes in when the government starts putting it' nose into the economy in anything other than a law enforcement component. Take our mortgage meltdown...our politicians decided it wasn't fair that people with no money to buy a house couldn't buy a house...so they mandated that banks make loans to people the banks knew couldn't pay back the loans...or face government law suits and interference in their agiltity to conduct their business (mergers and acquisitions and such ) according to "economic realities." So banks made loans to people who couldn't pay them back, and the banks knowing this, got rid of the bad loans so they wouldn't be caught holding them when the "economic reality," of people defaulting on loans they couldn't pay back came due. A bubble was made, because of politicians interfering with the banks ability to say "no," to people who couldn't afford loans. Then, when the banks were looking at crashing because of this and other interference by politicians...they paid politicians to give them money...the "too big to fail," policy, and the politicians gave them the money.

The focus of the problem should be on getting as much power out of the hands of the politicians...they should only have the power needed to act as the police, and they shouldn't have the power to tell businesses how to run their businesses...that is where it all breaks down...


Take "green energy," for example...where do politicians get the power to give money to green energy companies? Most of these companies go bankrupt and take our money with them....they get the power because we let them have it by who we vote for. they use our money as incentives to get donations to their political campaigns by their ability to grant favors to business. Get rid of that power, and you solve a large part of the problem.

This is what is going to happen to our healthcare system and our business community because the politicians are taking more control over it...

http://www.breitbart.com/Big-Journalism/2013/03/22/Top-Ten-ObamaCare-Stories-Media-Covering-Up

In no particular order…
1. Millions are and will lose the insurance Obama promised they could keep. Because ObamaCare forces employers to offer expensive Cadillac plans but also offers the option of paying a fine for not providing health insurance that can be cheaper than providing it, between seven and twenty million Americans are likely to lose their health insurance coverage according to the Congressional Budget Office. The original estimate was closerto four million.
2. The cost of healthcare premiums is about to further skyrocket. Premium costs have already exploded, but that is a slow-motion explosion. In the near future, we could see costs double or worse. Naturally, these costs will hit an already burdened middle class hardest.
3. Lost jobs. Lost jobs.
The Federal Reserve's March beige book on economic activity noted that businesses "cited the unknown effects of the Affordable Care Act as reasons for planned layoffs and reluctance to hire more staff."
Meanwhile, human resources consulting firm Adecco found that half of the small businesses it surveyed in January either plan to cut their workforce, not hire new workers, or shift to part-time or temporary help because of ObamaCare.
4. Potential doctor shortages that will mean rationing: The healthcare industry is already a bureaucratic quagmire. ObamaCare is about to add steroids. As the profession becomes tyrannized by government, the talented people currently practicing medicine plan to get out sooner than expected. Who knows how many will choose not to get in.
Doctor shortages are what lead to the nightmare known as rationed care. Here's an unsettling example already being practiced.
5. Somewhere around $800 billion in tax increases will hit America's middle class. This added burden will not only further oppress a middle class already reeling from a drop in wages over the last few years, but could damage the overall economy.
6. Inflation, the cruelest tax on the poor. When businesses get socked with added costs brought about by higher taxes and burdensome government mandates, they pass those cost along to the consumer in the form of higher prices.
7. Added bureaucracy. Even those Obama lapdogs over at the Washington Post's Wonk Blog are admitting that applying for health care is about to get more burdensome than the byzantine paperwork involved in buying a home.
8. To cut costs or to avoid having to provide insurance, workers on the economic margins are already losing hours, which means a lower paycheck. There are a million sad stories in ObamaVille; here are just a few of them.
9. ObamaCare is projected to add $6.2 TRILLION to a deficit the GAO has already declared "unsustainable." That's "trillion" with a "t".
10. More taxes than currently estimated are likely to hit because of situations like this one.
Three years ago, Obama, Democrats, and his media lied to us about cutting the cost of health care, being able to keep our insurance, and not taxing the middle class.
Today, those lies and what ObamaCare is and will do to the working and middle class are the biggest untold story in America.
The media is currently engaged in an ObamaCare cover-up every bit as big, corrupt, and damaging as the ongoing Libya cover up.

How in the world does this make sense...

Millions are and will lose the insurance Obama promised they could keep. Because ObamaCare forces employers to offer expensive Cadillac plans but also offers the option of paying a fine for not providing health insurance that can be cheaper than providing it,

These new problems, making the situation worse for more people. (80% of Americans in surveys said they liked their healthcare before obama and the democrats passed obamacare to "fix," the problems in the system)

The cost of healthcare premiums is about to further skyrocket.

This interference in the healthcare business by politicians creates this...

To cut costs or to avoid having to provide insurance, workers on the economic margins are already losing hours, which means a lower paycheck. There are a million sad stories in ObamaVille; here are just a few of them.

3. Lost jobs. Lost jobs.
The Federal Reserve's March beige book on economic activity noted that businesses "cited the unknown effects of the Affordable Care Act as reasons for planned layoffs and reluctance to hire more staff."

We need to stop politicians from meddling with businesses. They should simply be the cops to guard against abuses and cheating...they shouldn't be allowed any decision making powers...they only screw it up, intentionally or unintentionally...

 

[Sukerkin]

It's an aspect, certainly, that does need careful consideration. But I would beware of placing all the "Eggs of doom" in the sub-prime-mortgage basket.

That was only one more highly visible symptom of the problem and it wasn't really down to the governments 'forcing' the bankers to make bad loans. Banks over-leveraging and under-capitalising is what really made the system spring such a catastrophic leak. Computerised trading and flawed fiscal instruments, that everyone gambled with as if they were immune from risk, acted upon an unsupportably large 'bubble' that anyone with any sense (i.e. economists like me ) could see was going to go "BOOM!".

The real catastrophe is that those who profited from the false accounting are, in the main, the ones who have not had to pay the price for their greed and ineptitude. It's us, the ordinary folk with jobs and sensible mortgages that we can pay (just about) that are suffering. Even now the exchanges are making record heaps of cash for their croupiers whilst the real economy rots and most of the population languishes.

 

[billc]

the ones who have not had to pay the price for their greed and ineptitude.

And why haven't they had to pay this price? The politicians who run interference for them...Who authorized the bail outs for the big banks?...the politicians...

 

[billc]

Here is another example of politicians spending money they shouldn't have control over...

http://www.breitbart.com/Big-Journalism/2013/03/23/Taxpayer-Money-Finances-IRS-Star-Trek-Parody

If you are about to land at a small airport, watch the reason why you might be dead in a few minutes -- and it has nothing to do with anyone not paying their "fair share":

On the same day the media-collective coordinated to crybaby over 140 or so airport control towers being shut down due to sequester cuts, over at CBS News, investigative reporter Sharyl Attkisson was digging for a real story. And then she did something amazing. Instead of playing stenographer for The State about the sequester cuts, Attkisson turned a story about frivolous government waste into a sequester story.
How does the federal government -- she asks in so many words -- have all kinds of moneyto waste $60,000 on a "Star Trek" spoof, but not enough to ensure planes land safely?
Thus begins a six-minute "Star Trek" parody starring IRS employees and paid for with your tax dollars. It's not likely to go over well with some Americans and members of Congress, especially since federal agencies have been complaining that it's difficult to find trims under forced sequestration.
CBS News filed a Freedom of Information request asking for the video after the IRS earlier refused to turn over a copy to the congressional committee that oversees tax issues: House Ways and Means. According to committee Chairman Charles Boustany, Jr. (R-LA), the video was produced in the IRS's own television studio in New Carrollton, MD. The studio may have cost taxpayers more than $4 million dollars last year alone.
Finally, a legitimate sequester story!
By the way, that video was produced in 2010 when the federal budget was smaller than it is today.
The federal government is currently running annual deficits of a trillion dollars-plus, and yet Obama's Media wants us to believe the budget is so lean and mean that a two-percent cut will force control towers to close.
That's horse-hockey, and everyone knows it -- including Obama's Media.
The real sequester story is how trillions of dollars can be so horribly mismanaged that a measly budget cut of two-percent results in gaping holes in airline safety.
As I wrote here, any mainstream media story about sequester cuts that does not reference the penis of a duck is outright propaganda and journalistic malpractice.

And yet another story of how politicians trying to run healthcare is going to damage the way individual citizens run their privately owned businesses...

http://pjmedia.com/blog/small-businesses-brace-for-healthcare-laws-effects/

Failure to offer affordable health insurance to employees could cost some business owners thousands of dollars in fines depending on whether those employees receive federal insurance subsidies.
“Shaving valuable dollars off a healthcare tax credit for small employers is more than disappointing,” said Rhett Buttle, national outreach director at the Small Business Majority, a research advocacy organization that supports the health law. Blaming lawmakers for their “self-imposed deadline,” Buttle said that many other critical small-business programs and incentives are also slated for cuts.
“This is not what small businesses need right now,” he said.
Kevin Kuhlman, manager of legislative affairs at the National Federation of Independent Business and an opponent of the ACA, is making time to educate small-business owners about the impact the law will have on their businesses. The NFIB is currently trying to repeal the law, and lobbying to gather at least 30 congressional co-sponsors.

This year small employers must first determine whether their business has the potential to be penalized based on their employee size and the amount of hours each employee works. If employers offer health insurance, it must be affordable, or 60 percent of the actuarial value of the insurance must be covered by the employer. If employers do not offer insurance, they will be able to purchase policies through a new health insurance marketplace set to open next year, but employers should research what type of policies they may need for their employees.

 

[Sukerkin]

And why haven't they had to pay this price? The politicians who run interference for them...Who authorized the bail outs for the big banks?...the politicians...

Aye, can't argue with that :nods:.