Category: Health Care

Tiggers

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The stock market has crashed. Unemployment is skyrocketing. The number of confirmed Wuhan Virus (that’s what I call it) cases is growing exponentially. Grocery store shelves are bare. Gun sales are going through the roof. Office buildings in Manhattan are empty. People are walking around with masks. Schools are cancelled. The internet is bogging down because so many people are home its vaunted capacity (bandwidth) is proving to be inadequate for the demand. California is “locked down”. Hell has broken loose.

However… “The wonderful thing about Tiggers is, tiggers is wonderful things. Their tops are made of rubber, and their tails are made of springs. They’re bouncy, flouncy, trouncy, pouncy, full of fun, fun fun. The wonderful thing about Tiggers is, I’m the only one.” Substitute Americans for tiggers and you’ll have a hint as to why despite the misery and impending doom I’m optimistic for the future.  

My thoughts…

1.            As bad as the pandemic is, it’s not as bad as you think. Simple arithmetic coupled with basic critical thinking points to the conclusion that greater than 99% of everyone who contracts the disease will recover, and we don’t know of course how many people WILL or WILL NOT contract it. Thousands get sick and many die each day from heart disease, cancer, jaywalking, ‘regular’ flu and chronic lung disease from smoking, etc. As of this morning, ~a quarter of a million people WORLDWIDE have been confirmed to have the virus, ~10,000 people WORLDWIDE have died from the virus, and ~86,000 have recovered. These numbers are DWARFED by regular flu.  In the U.S., ~15,000 people have confirmed cases and ~100 people have died. This flu season alone (roughly from October 2019 to the present) 31MM people IN THE UNITED STATES (!) have had the flu. Somewhere around 275,000 give or take have had to be hospitalized, and as many as 30,000 (vs. 100) have died from run-of-the-mill flu! (See  https://www.health.com/condition/cold-flu-sinus/how-many-people-die-of-the-flu-every-year for a plain language discussion.) Translation – this isn’t anywhere near as bad as the media and politicians would have you believe.

2.            Despite what you hear or see, the government is doing the right things. They may not in all cases being doing things right, but the medical, logistical, economic and societal response is “gettin’ ‘er done”. I expect the response is even overdone if you look at the statistics in the previous paragraph. So, for example, NOT EVERYONE NEEDS A TEST! If you get sick, sure, go get a test. But it’s self-centered, selfish and “looking out for number one” just to confirm you’re NOT sick, and may deprive someone who really needs to be tested from getting the help they need. Testing is NOT a cure, and satisfying statistical number crunching is nowhere near as important as preventing and treating the actual disease. Mobilization and coordination among all the health care agencies, departments and the private sector is exactly what is needed, and again, no matter what you hear, there are very competent people who care about others and this country hard at work on the problems. Have some faith in them!

The backstopping of employers in various ways and the anticipated support given to individuals and families is being matched by lenders, landlords, tax collectors… you name it. Everyone’s in this and making accommodations following the lead of the federal, state and local governments.

Just remember that “the government” is made up of people who have the same hopes, dreams, fears, constraints, problems as everyone else in the country. The vast majority are working their asses off to help and do what’s right within their on organizations and spheres of influence. I had to go to the department of motor vehicles the other day. Everyone there had taken a large dose of patience pills and I was both shocked and thrilled to see how both the people behind the counter and in front of it were behaving.

The government, of course, is damned if they do and damned if they don’t, but on balance, its response to this crisis has been overwhelmingly appropriate and helpful. Its communications, despite the handwringing and teeth-gnashing of a “if it bleeds it leads” media has been solid, optimistic, informative and suitably cautionary as to get virtually the whole nation (except the Florida beach Spring Break party animals) to respond as it should. This all happened in a matter of days, unlike the responses during the H1N1, SARS, MERS and other pandemics.

3.            Gas prices and interest rates are falling. The one commodity everyone needs is fuel, and the stimulating effect of a drop in gas prices to the ~$2.00 – ~$2.50 level is incredibly impactful on regular budgets. This will benefit us all, except of course for oil producers. But Washington is on to the Russian and Saudi’s game to try to destroy our energy-independent status and crush our shale industry, and are NOT going to let them get away with it. Similarly, we’re not standing idly by while China spews its propaganda and stomps its feet and blames our military for what they caused or worse, threatens us with withholding drugs such that we become “awash in a sea of Coronavirus”. We’ve thrown the bull#%*& flag on that already and will continue to rub China’s nose in the mess they’ve created and left on the world’s floor. Xenophobic? No, just highlighting the truth in the face false accusations.

4.            One of the silver linings in this mess is the awakening that has occurred among government, industry and the American people that we must no longer be held hostage by foreign manufacturers and suppliers. The Globalist agenda has been thoroughly trounced by this exposure of its flaws, and bringing our manufacturing and supply chains home may result in higher priced goods, but we’ll all benefit in the long run.

5.            Kids are getting educated again. Home schooling is exposing the inadequacies, biases and absurdities of the current state of our education system. Parents are waking up to what is being taught, and what is NOT being taught to our children. I predict that for whatever time period home-schooling prevails, our kids will get a BETTER education than what they’re getting at school, and teachers will be astonished when students return at how far they’ve advanced. You heard it from me first.

6.            Neighbors are helping neighbors. Our little local email chain is lit up with offers of help and assistance. People are getting outside and checking on each other from afar (i.e. more than six feet). Kids are teaching parents and grandparents about Facetime, Skype and Zoom. And Animal Planet is running shows about carefree kittens and puppies. Come on…how much better is it to watch than the gloom and doom on broadcast tv?

7.            People are learning who their leaders are. Not the ones with the titles, but the ones who are true leaders as opposed to managers and demagogues. True leaders step up in times of crisis and go to the front of the crowd, carry a light and turn back to shout encouragement and instill confidence in others. People who may have labored in the shadows or punched well below their weight are now emerging as the shepherds of our society. This separating of the leaders from the followers can only be a positive development.

8.            The Silent Majority is silent no more. Having to adapt to the situation, conservatives and the Right who normally are head down working and caring for themselves and their families are speaking up and speaking out. They are not just throwing the BS flag on politically correct nonsense, they are ignoring social engineering and all its related evils and practicing true philanthropy and real, beneficial community activism.

9.            Complacency is evaporating. It’s amazing what being forced to rely on fundamentals and things that matter will do to a spoiled and coddled population. In the face of what’s going on, do people really care what the Kardashians think?

10.          Faith is making a comeback. It’s sad but true that there are no atheists in foxholes. We’re rediscovering our faith despite not being able to attend Church. And whether it’s one religion or another, it’s the common principles of right and wrong, goodness versus evil and a belief in a set of universal truths that are moving back into the public consciousness. This is a good thing.

11.          Families are getting to know one another again. Yes, we’re cooped up and hunkered down. And things get testy at times as we bumble around in each other’s way. But for many of us, we’re forced to seek virtue: patience, understanding, caring for one another, and learning anew about each other. It doesn’t take a village, it takes a family, and families are binding together out of necessity and love.

And finally, THE MOST IMPORTANT REASON I’M OPTIMISTIC ABOUT THE FUTURE is that America has the most natural and other resources of any nation on earth. We can produce enough of EVERYTHING to take care of ourselves and help the rest of the world to boot. We have the smartest people. We have a spirit of “can do” that is unparalleled on the planet. Many nations think we’re brash, loud, obnoxious, overly proud and nationalistic and hate us for our bad manners and profligacy. So be it. I’d rather live in the United States than in any other country. We will not only get through this, but emerge stronger than ever and once again, we’ll be the city set on a hill letting our light so shine as to be a beacon of freedom and prosperity to the entire world.

I’m a pragmatist, and I recognize the challenges that lie ahead to recover from this mess. But I believe with every fiber of my being that things are going to be better than ok, and sooner than the so-called experts predict. I’m not suggesting we all go Hakuna Matata on this, but let’s put things in perspective shall we?

May God continue to bless us. And may God continue to bless America.

I’m Envious of Billionaires Too!

America, Economy, Government, Health Care, Science, Society & Culture, Values

At last night’s Democrat debate schoolyard brawl/whine-fest, the unifying theme was, “Let’s bash millionaires and billionaires!” No, wait a minute…let’s just bash billionaires because everyone up there, perhaps with the exception of Boot Edge Edge, (although his CNN or MSNBC contract is waiting) is already a millionaire.

This is one of the big problems of the Democrats. SUCCESS ENVY. Does anyone honestly think, if having invented a product or service that makes a billion dollars, Klobuchar, Buttigieg or Sanders would say, “No, I’ve made too much money?” The hypocrisy of the Left stinks to high heaven.

Hey, I’m envious of billionaires too. I wish I had invented a better service than Quotron (the predecessor to the Bloomberg product/service) and made billions. I’ll bet the “My Pillow” guy is doing ok too!

The problem with the Left is their envy has always manifested itself in a Robin Hood complex. Unable to achieve success on their own, they demand that those who have it give the fruits of that success to them. They argue that those who succeeded either gamed the system somehow, or stepped all over exploited workers, cheated, or were successful because the government was responsible for that success (“You didn’t build that.” – Barack Obama).

It’s the winners against the losers. Irrespective of how the billionaires made their money, let’s think through what would happen if Sanders or Warren were elected and able to impose confiscatory taxes on people making, I think one of the suggestions is, more than $600,000 per year.

  1. The arithmetic is extremely simple and everyone with half a brain already knows that even if you taxed ALL of that income at 100% there wouldn’t be enough money to fund the Democrat utopian dream list.
  2. If you imposed those taxes, would the high income earners put the same amount of money away in private equity, venture capital, hedge or mutual funds, the pools of capital that fuel innovation, job creation, and which indeed trickle down (sometimes flash flood down) to employees thereby boosting the economy and growth in general? And what would that do to the American Spirit and the American Dream? Would people still work hard to advance their careers, think out of the box, invent new things, hire employees, shop more at Saks or WalMart? Of course not. Their consumption and spending would decrease as they would be deprived of the incentive to make more than the specified threshold.
  3. If you actually confiscate wealth as some Leftists have suggested, i.e. say to the wealthy…”I’m going to demand you give us X% of your 401(k) or stock portfolio or savings account so we can redistribute it by providing healthcare or tuition free college for all” for example, how hard will you want to work knowing you’ll be penalized if you’re actually successful?
  4. Look at those people on stage in South Carolina last night. Even if you’re the most altruistic person in America, would you really want ANY of them to decide how to redistribute and allocate the money they’ve taken from you in taxes?

For further understanding of what happens when Democrats take your money and redistribute it, you need look no further than Obama’s 2012 $800 billion, “shovel ready projects”, so-called “stimulus package”. Here’s the breakdown of how that our money was spent:

First of all, it galls me that “Individual Tax Cuts” are called “stimulus” at all. TAX CUTS ARE THE ABSENCE OF INCOME OR WEALTH CONFISCATION, NOT GOVERNMENT SPENDING! (TAX REBATES, by the way, are a RETURN OF YOUR OWN MONEY THAT THE GOVERNMENT PREVIOUSLY CONFISCATED) It’s RELIEF, not STIMULUS. Are you stimulated by the act of a government bureaucrat taking out the nail they drove into your forehead?

Same goes for Alternative Minimum Tax Relief, the second item in the chart. It too was just the absence of additional taxation and had nothing to do with “shovel ready projects”.

State Fiscal Relief wasn’t infrastructure spending either – it was handouts to fiscally irresponsible states, particularly Democrat-controlled states. As with “Aid to Directly Impacted Individuals”, it trickled down only to the public sector unions to fund their entitlement (pensions and healthcare) spending shortfalls and to shore up welfare spending as well.

The final category…Public Investment Outlays… paid for the signs you saw on some of the highways and parkways around you. Did we really see much of any benefit to our nation’s roads and railways from that $270 billion? No. And so only 1/3 of the so-called “Stimulus” went to “infrastructure projects”. The rest went to reward favorite Democrat constituencies, i.e. into the ether.

I used to think Liberals were altruistic. I’ve learned over the years that their motivations are either the garnering of power for power’s sake, or an unbounded arrogance that if they have power and control of our money, they can make everybody happy. Both are evil because they deprive us of the impetus to work hard and achieve success for ourselves, and by extension, our families, communities and our country.

So do we really want Bernie Sanders, Elisabeth Warren, Joe Biden or any of the other megalomaniacal, power-famished hypocrites who were on that stage last night in charge of the government?

To Buffet and Gates’ credit, they’re working hard to give much of their wealth away and there are a lot of true needs and programs where philanthropy is the beginning of a solution. The various charities that build water purification plants in Africa such as “Action Against Hunger” or Doctors Without Borders are good examples, or here at home, the Tunnel to Towers Foundation or the Appalachia Service Project. Do you really want any of those Democrat candidates determining how money should be doled out for such projects? Not all, but the vast majority of Democrat controlled spending consists of handouts to “victims” who with hands out will vote to keep them in power.  

I’d like to be a billionaire too. I wouldn’t buy a yacht. I wouldn’t buy a bigger house. I would still insist that my kids and grandkids work at McDonalds when they turn 16, or stock shelves as mine did. And I’d find those meaningful charities that TRULY support the TRULY needy, or that promote self-reliance, meritocracy, the production of goods and services that advance the frontiers of science and health, human longevity, and natural resource renewal and preservation (NOT ENVIRO-FASCISM BUT CLASSIC CONSERVATION).

Please let’s stop allowing the Left to serve as our nanny, putting spoonful’s of pablum in and wiping the corners of our mouths while congratulating themselves over champagne on how well they’re taking care of us. Please America, just at the point where we’re starting to get back to basics, let’s not empower demagogues such as we saw at the debate last night to spew their utopian fantasies or, God forbid, enact more of their soul-crushing plans.

Fake (Medical) News

Health Care

Should I or shouldn’t I get a PSA test? Should my wife get a mammogram or not? Is coffee bad for me, or good? Will I die sooner if I eat bacon and eggs? What about red wine? One day the gurus pronounce one thing. The next it’s 180 degrees the opposite. Can we trust ANY experts in medicine?

My kids used to tease me, chanting in unison “Gingko” whenever I exhibited a brain cramp. Gingko, a few years ago, was supposed to improve mental acuity. Now it’s apoaequorin (the stuff “originally found in jellyfish”). Since no one knows how to pronounce apoaequorin everyone just says “Prevagen”!

Resveratrol (in red wine) is another of these miracle supplements. It falls under the category “anti-oxidants”. These are supposed to purge those free radicals from our bodies and help us resist all kinds of nasty things like cancer and heart disease. (I wish there was resveratrol for free-radical LEFTISTS)!

I moved a few years ago and changed doctors. One insisted at my age getting a PSA test for prostate cancer was useless. “What would you do if you it came out positive? Prostate cancer is so slow growing that you’re likely to be gone before it does you any harm,” he said. My current doctor says, “If it were me, I’d want to know and go ahead and treat it!” Who’s right?

As with most things, we have to make our own decisions. For my part, I go to the Mayo Clinic website and WebMD. If what they say about one thing or other is consistent, I figure it’s pretty good advice. If they conflict, I keep on researching until I either get frustrated or bored, then usually make a non-decision or flip a coin.

But it’s confusing, and if you really need medical advice and want to do some homework on your own, you have to really really use critical thinking and good judgment before coming to any conclusions.

Bear in mind that many physicians and health care professionals have gone from Hippocrates (.sic) to Hypocrites (.sic). Follow the money. Physicians have been forced to practice not just defensive medicine, but also profitable medicine. Even solo practitioners can’t survive unless they PRACTICE so as not to lose money!

One of the unique features of medicine is that physicians and other health care professionals can prescribe demand for their own services. “Take two aspirin and come back to me in a week. Sally, please make a follow up appointment for Mr. Smith for next week.” What are you going to do? Say, “No doc, I don’t want to have to pay another out-of-pocket co-pay in a week. I’ll call you if I need you.” Well, some might say that, but the majority of patients do not.

Doctors used to plan on 20 minute time slots per patient. That then went to 15 minutes. At 10 minutes the doctor shuffles between examination rooms and you can see he or she is rushed. At 8 minutes you’ve come to understand the meaning of one of my favorite terms: “Mis-managed care.”

The layering of regulation, bureaucracy, profit motive, misleading, false or downright harmful information in social media or on quack websites have all contributed to a general decline, in my opinion, of our health care system. The Left, of course, to which is attributable most of the destruction, is trying to capitalize on the deteriorating system as they usually do, by claiming that if they control the system (i.e. universal or single-payer government health care) they will take care of all of us.

On that I throw the BS flag. Competition, rewards for practicing medicine based not on effort or cost but on OUTCOMES is what’s needed. Transparency and understandable-to-the-layman report cards and performance indicators will make that possible, not “Medicare for All”.

Keep dreaming and lying and pushing your utopian nonsense Leftists…I’ll do everything I can to take care of myself, take aspirin, put on a sweater like my mother taught me, and tune out all the fads and above all the FAKE MEDICAL NEWS.

Be well.

Stuff That Matters

Economy, Entertainment, Family, Finance and Investments, General, Health Care, Politics, Society & Culture

With a salute and due credit to Charles Krauthammer (1950-2018) whose book Things that Matter (New York: Crown Publishing, 2013 available from Amazon here) was the capstone of his exemplary life and the inspiration of this and future related posts, I’ve begun my own list.

New items come to mind daily so it is a work in progress. They’re in no particular order, although Truth, God and Right would be right up there at the top of any ordered list. From time to time I’m going to address these topics in more detail but to get started, here’s a first stab.

Truth matters.

God matters.

Right and Wrong Matter.

Our word matters.

How we think matters.

People matter.

What we teach our children matters.

What we do as a family matters.

Helping others matters.

Being friendly matters.

Courtesy matters.

Being considerate matters.

Our reputation matters.

Loyalty matters.

Being kind to animals matters.

Conservation matters.

Courage matters.

Catching someone doing something right matters.

Thrift matters.

Obeying/Respecting our parents matters.

Respecting our elders matters.

Respecting authority matters.

Saying what we mean and meaning what we say matters.

Words matter. What we say and how we say it matters.

Listening matters.

Perseverance and determination matter.

The choices we make matter.

Temperance matters.

Anticipation and thinking ahead matters.

Knowing ourselves matters.

Our health matters.

Controlling ourselves matters.

Deferred gratification matters.

Grooming matters.

Situational awareness matters.

Whom we choose as friends matters.

What we read matters.

What we watch on television matters.

What we tweet/post/email matters.

What we eat matters.

Our morning routine matters.

How we spend our non-working time matters.

Hard work matters.

Honoring our spouses matters.

Standing up for what we believe in matters.

How we treat those above us and how we treat those below us matters.

What we value and how we spend our money matters.

Where we live matters.

What we don’t say matters.

Please send us your additions to this list by email to admin@grumpsreport.com !

The Real Problem with Healthcare

Health Care

First, let’s get something straight. There’s a difference between health INSURANCE and health CARE. The politicians and talking heads continuously either conflate or misuse the terms. Providing healthcare insurance does not mean providing health care. Conversely, health care does not necessarily have to be linked to or paid for with insurance!

Oh and by the way, health insurance doesn’t (e)nsure health any more than life insurance covers life. Both are tortured marketing labels that have, over time, become universally but naively accepted.

Perhaps the most influential and lucid book ever written on the subject of healthcare policy was written in 1986 by Joseph A. Califano, Jr., who, among other things, served as U.S. Secretary of Health, Education and Welfare. The book is entitled America’s Health Care Revolution: Who Lives? Who Dies? Who Pays?  Califano, Joseph A. (1986) NY:Random House. Although out of print, it can still be obtained through Amazon. In plain language, Califano describes the various players, forces, complexities and problems of the system. He too makes a distinction between health insurance coverage and the delivery of health care.

Back in the 80’s the crisis was rapidly escalating cost and how that was reflected as a percentage of Gross National Product. Califano cited numerous drivers of the inflation, among them: an aging population, advancements in medical technology and drug therapy.

But the biggest driver of healthcare inflation and the root cause of all of the health care delivery and payments system’s problems is intrusion into the doctor-patient relationship.

Why? The answer is complex, but greatly simplifying the story and the history, it all began in 1929 when Baylor University Hospital initiated an insurance plan for 1,250 schoolteachers. Each teacher paid 50 cents (!) a month and received up to twenty-one days of hospital care each year. In 1932 Blue Cross came into being, largely supplanting individual hospital plans and by 1937 had 800,000 subscribers, which rapidly increased to over 6 million by 1940.

Commercial insurers, who primarily wrote property & casualty and life insurance policies, were initially skeptical, but with the success of Blue Cross, entered the arena aggressively, taking the not-for-profit characteristics of Blue Cross plans into the for-profit realm.

Fast forward to World War II, when strict price controls on salaries and wages were enforced but there were little, if any controls on “fringe benefits.” Corporate America, competing for qualified personnel, offered better varieties of often ‘free’ health care insurance benefits to prospective and existing employees in lieu of higher wages.  

In 1947 the Taft Hartley Labor Relations Act opened the door for unions to include fringe benefits like health care insurance plans in their collective bargaining negotiations. That really put fuel on the fire.

Since neither companies nor the government wishing to hire or retain employees could compete with each other on wages, they tried to outdo one another on fringe benefits. Promises of lifetime healthcare insurance coverage that paid 100% of the costs of health care for workers and, eventually, their families as well, became the norm, and health care insurance quickly moved from benefit to entitlement.  

Guess what? Now, decades later, those promises are coming due, with the cost of providing coverage to both workers and retirees not just dwarfing original cost estimates, but now threatening our national solvency!

With the spotlight when Califano wrote his book on costs, the solutions proffered by our benevolent federal government included greater regulation and control over the system, which in turn, predictably, gave rise to “managed care”, or what I refer to as “mismanaged care”. This not only added to health care cost inflation by layering in an administrative bureaucracy but more importantly, exacerbated the intrusion between providers and patients and rapidly advanced the already existing “Triangular Health Care System”.

In no other industry or system are the basic principles of economics more violated than in America’s health care system. What the advent of insurance, whether purchased by an individual, provided by an employer, or granted by the government (i.e. Medicare and Medicaid) does is largely eliminate the economic discussion between the provider of goods and services and the consumer of those goods and services.  

What’s pernicious about this system is that health care providers are incentivized to do everything and anything for their patients, whether medically necessary or not, and without concern for the cost. Since physicians can prescribe and create demand for their services (“I want to see you again in two weeks”), any attempts to reduce costs through price control mechanisms are easily offset by what we’ve seen, i.e. more services rendered in less time, and unavoidably, with reduced quality. Who hasn’t noticed that instead of 15 minute time slots allocated to routine doctor visits, the norm is now 10?

What’s also pernicious is that consumers are for the most part insulated from the basic economics of the transaction/interaction between them and their physician, hospital, pharmacist, optician, etc. until a bill comes in the mail for the “balance due, not covered by insurance.” Most people naively believe that “more care” is “better care”. Thus, the insulation further increases demand.

Whereas in most economic transactions there’s a bargain reached between buyer and seller, in the Health Care Triangle there are two bargaining activities: one between the patient/consumer and their insurance company (or their employer) and one between the insurance company and the health care provider. Again, the provider and the patient rarely, if ever, discuss cost.

In short, what insurance does is both intrude and distort the normal business equation. It turns over, increasingly, the responsibility for individuals’ health to Nanny, until now, the Left has abandoned all pretense of requiring people to care for themselves, and the freedom to elect how to select and acquire health care. Instead, they opt, as they usually do, for solutions like “Medicare for All” which is not about delivering cost and quality health care at all, but about CONTROL. (Come on over for a sit down and single malt to have a different discussion about that problem!)

So what can be done about this?

Due to ingrained and pervasive attributes, agendas and conflicting motivations among the participants, this Gordian Knot with a Rube Goldberg contraption on top will be very difficult to unravel. There is no simple, sweeping solution. However, the long climb back up this slippery slope starts with the application of free market principles, including both restoration of the economic discussion between consumers and providers of health care and disclosure and transparency among market participants.

Meanwhile, channeling Hippocrates, we need to stop doing harm. We must insist that legislators do the precise opposite of what they’re programmed to do…interfere. Rather, we need to legislate less, continue to relax or retract the straight-jackets being applied to the system and, carefully but decisively take away “nanny’s security blanket”, i.e. government hand-holding through regulation and tax extortion. Finally, we need to insist on personal/individual responsibility for HEALTH so that the need for CARE will be reduced. Only then can the inbred bureaucracies be successfully dismantled.

Health care is not just an art, or science, but also a business. The more regulated it has become, the more inefficient, unfair, arbitrary, expensive and messed up it has become, and the more intractable the problems. The less regulated it can be made, the more individual responsibility will be restored, the less demand there will be for care, the better its quality will be, and the more equitable its provision will be.

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