Thursday, August 16, 2012

Barker's Newsbites: Thursday, August 16, 2012


Did I mention what a great time I had at Gail's wedding last Saturday...?

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8 comments:

William R. Barker said...

* TWO-PARTER... (Part 1 of 2)

http://online.wsj.com/article/SB10000872396390443404004577578980699719356.html?mod=WSJ_Opinion_LEADTop

Are you having trouble finding a doctor who will see you? If not, give it another year and a half. A doctor shortage is on its way.

Most provisions of the Obama health law kick in on Jan. 1, 2014. Within the decade after that, an additional 30 million people are expected to acquire health plans — and if the economic studies are correct, they will try to double their use of the health-care system.

Meanwhile, the administration never seems to tire of reminding seniors that they are entitled to a "free" annual checkup.

Its new campaign is focused on women. Thanks to health reform, they are being told, they will have access to "free" breast and pelvic exams and even "free" contraceptives.

Once ObamaCare fully takes effect, all of us will be "entitled" to a long list of preventive services — with no deductible or co-payment.

Here is the problem: The health-care system can't possibly deliver on the huge increase in demand for primary-care services.

(The original ObamaCare bill actually had a line item for increased doctor training. But this provision was zeroed out before passage, probably to keep down the cost of health reform.)

The result will be gridlock.

* ACTUALLY, WHAT I PREDICT THEY'LL DO IS ALLOW RNs AND NPs TO "PLAY DOCTOR" WITH THE ACTUAL DOCTOR "REVIEWING" THE EXAM NOTES AFTERWARDS AND SIGNING OFF. (OF COURSE THIS MEANS YOU'LL BE PAYING TO SEE A DOCTOR AND INSTEAD ONLY GETTING TO SEE A NURSE...) (AND OF COURSE IN TERMS OF LIABILITY THIS PUTS DOCTORS IN A CATCH-22 SITUATION...)

(*SHRUG*)

Take preventive care. ObamaCare says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. What would that involve?

* I HAVE NO FRIGGIN' IDEA...!

And all of this time is time spent searching for problems and talking about the search. If the screenings turn up a real problem, there will have to be more testing and more counseling. Bottom line: To meet the promise of free preventive care nationwide, every family doctor in America would have to work full-time delivering it, leaving no time for all the other things they need to do.

[T]he average wait to see a new family doctor in this country is just under three weeks, according to a 2009 survey by medical consultancy Merritt Hawkins. But in Boston, MA., which enacted a law under Gov. Mitt Romney that established near-universal coverage, the wait is about two months.

* OOPS!

* TO BE CONTINUED...

August 16, 2012 at 8:37 AM
William R. Barker said...

* CONCLUDING... (Part 2 of 2)

When people cannot find a primary-care physician who will see them in a reasonable length of time, all too often they go to hospital emergency rooms. Yet a 2007 study of California in the Annals of Emergency Medicine showed that up to 20% of the patients who entered an emergency room left without ever seeing a doctor, because they got tired of waiting. Be prepared for that situation to get worse.

When demand exceeds supply, doctors have a great deal of flexibility about who they see and when they see them. Not surprisingly, they tend to see those patients first who pay the highest fees. A New York Times survey of dermatologists in 2008 for example, found an extensive two-tiered system. For patients in need of services covered by Medicare, the typical wait to see a doctor was two or three weeks, and the appointments were made by answering machine.

However, for Botox and other treatments not covered by Medicare (and for which patients pay the market price out of pocket), appointments to see those same doctors were often available on the same day, and they were made by live receptionists.

* HOW TERRIBLE, RIGHT? WRONG! IT'S CALLED FREEDOM! IT'S CALLED THE LAW OF UNINTENDED CONSEQUENCES - EVEN TH0UGH ANYONE WITH HALF A BRAIN ANTICIPATED - AND WARNED - OF THESE CONSEQUENCES AT THE TIME ROMNEYCARE/OBAMACARE WERE BEING DEBATED.

As physicians increasingly have to allocate their time, patients in plans that pay below-market prices will likely wait longest. Those patients will be the elderly and the disabled on Medicare, low-income families on Medicaid, and (if the Massachusetts model is followed) people with subsidized insurance acquired in ObamaCare's newly created health insurance exchanges.

Their wait will only become longer as more and more Americans turn to concierge medicine for their care. Although the model differs from region to region and doctor to doctor, concierge medicine basically means that patients pay doctors to be their agents, rather than the agents of third-party-payers such as insurance companies or government bureaucracies.

For a fee of roughly $1,500 to $2,000, for example, a Medicare patient can form a new relationship with a doctor. This usually includes same day or next-day appointments. It also usually means that patients can talk with their physicians by telephone and email. The physician helps the patient obtain tests, make appointments with specialists and in other ways negotiate an increasingly bureaucratic health-care system.

(*SIGH*) SAD, ISN'T IT? FOLKS... THERE AIN'T NO FREE LUNCH! ALL THESE SNAKE-OIL-SELLING POLITICIANS SHOULD BE PUT AGAINST A WALL AND SHOT!

Here is the problem. A typical primary-care physician has about 2,500 patients (according to a 2009 study by the Centers for Disease Control and Prevention), but when he opens a concierge practice, he'll typically take about 500 patients with him (according to MDVIP, the largest organization of concierge doctors): That's about all he can handle, given the extra time and attention those patients are going to expect. But the 2,000 patients left behind now must find another physician. So in general, as concierge care grows, the strain on the rest of the system will become greater.

I predict that in the next several years concierge medicine will grow rapidly, and every senior who can afford one will have a concierge doctor. A lot of non-seniors will as well. We will quickly evolve into a two-tiered health-care system, with those who can afford it getting more care and better care.

* WHILE ALL THE WHILE THE "PUBLIC" SYSTEM CONTINUES TO BURDEN THE "TOP TIER" PATIENTS WHO WILL EFFECTIVELY BEING PAYING MORE JUST TO STAY EVEN IN TERMS OF CARE RECEIVED WHILE THE "LOWER TIER" PATIENTS WILL BE GETTING DELAYED, SUBSTANDARD CARE. SOUNDS LIKE A GREAT SYSTEM, RIGHT! HOPE! HOPE AND CHANGE!

[T]he most vulnerable populations will have less access to care than they had before ObamaCare became law.

August 16, 2012 at 8:38 AM
William R. Barker said...

http://www.forbes.com/sites/realspin/2012/08/14/americas-alleged-economic-recovery-is-slower-than-japans-during-its-lost-decade/

In light of claims that we’ve been in an economic "recovery" since late 2009, news such as the unemployment rate bumping up to 8.3% is disconcerting.

* YEAH... (*SNORT*)... THAT'S ONE WORD FOR IT!

Our so-called “recovery” is slower than Japan’s during its Lost Decade.

Since the beginning of the recession, the Federal Reserve increased the money supply over 64% — by $3.4 trillion.

Annual federal government spending increased by over $875 billion - 32%.

Our national debt increased $5.8 trillion from 2007 through 2011.

* LET'S SEE... DEMOCRATS CONTROLLED BOTH HOUSES OF CONGRESS IN 2007 AND 2008... AND DURING 2009 AND 2010 OBAMA WAS PRESIDENT WHILE DEMOCRATS CONTINUED TO CONTROL BOTH HOUSES OF CONGRESS. (WHAT DOES THIS TELL US, FOLKS...???) (*SNORT*)

These "stimulus" efforts have provided little in the way of sustainable economic progress.

A full three years into the so-called recovery, official unemployment remains stuck above 8%.

* PRESENTLY 8.3%

The employment situation is not even as good as the official rate indicates. Monthly job creation during the second quarter of 2012 averaged only 75,000 per month — less than half of what it was a year ago.

The average duration of unemployment has been fluctuating around 40 weeks since last March. Of those unemployed, 40% have been without work for at least 27 weeks — one tenth of a percent less than where it stood this January.

* AND...! AND...! AND...! (*DRUM ROLL*)

The unemployment rate would be much higher had not the labor force participation rate been at a 30-year low.

(*CYMBAL CRASH*)

The problem is that any sustainable improvement in employment must be predicated on private productive activity, because labor demand is directly related to the value workers help to produce. Private business activity has improved since 2009; however we have yet to return to where we were before the crash.

Net domestic private business investment, the amount of investment over and above what is necessary merely to maintain our current stock of capital, peaked in the third quarter of 2007 and began the downhill slide into the Great Recession. ... [N]et investment is still 32% below its pre-recession peak three years after "recovery" was declared.

For the past two months, the ISM manufacturing composite index has indicated declines in industrial production. Manufacturing had not decreased for two successive months since 2009, but June’s ISM survey of heavy industry revealed the largest single monthly decline since 2001.

* FOLKS... BOTTOM LINE... OBAMANOMICS HAS BEEN A DISASTER.

August 16, 2012 at 8:51 AM
William R. Barker said...

http://www.jeffjacoby.com/12095/the-rich-pay-their-fair-share-in-taxes-and-then

[M]easured by any reasonable yardstick, rich Americans pay their fair share. And then some.

One reasonable yardstick might be the average rate paid when all federal taxes - including not just income taxes but also payroll taxes - are considered.

The Congressional Budget Office reported last month that in 2009, the top 20% of taxpayers paid an average of 23.2% of their income in federal taxes - more than double the 11.1% paid by the middle quintile, and 23 times the 1% paid by the lowest quintile.

Even within the top 20%, average tax rates rose with income: The richest 1% paid 28.9% of their earnings in federal taxes.

In 2009, more than 90% of individual income taxes were paid by just 20% of Americans.

When all federal taxes (including Medicare, Medicaid, and Social Security taxes) are accounted for, the top 20% paid 68% of the total.

Or perhaps a more reasonable yardstick would compare the share of federal taxes paid with the share of national income earned.

The CBO ran those numbers too.

In 2009, the bottom 20% of taxpayers earned approximately 5% of the nation's income but paid just 0.3% of all federal taxes.

Households in the middle quintile, which earned almost 14.7% of national income, paid only 9.4% of federal taxes.

Yet Americans in the top quintile... [those] who earned 51% of the nation's income.. [they] paid a whopping 67.9% of all federal taxes.

(*SHRUG*)

And the much-demonized 1%?

* THIS SHOULD BE GOOD...

They took in 13.4% of all income in 2009 - [yet] shelled out 28.9%of all federal taxes.

Reasonable minds can debate whether income inequality is good, bad, or neutral; whether "fair" tax rates should be flat or graduated; whether income-redistribution is a legitimate function of government.

(*NOD*)

But what's clear is that wealthy Americans pay plenty - far more than plenty - in taxes.

August 16, 2012 at 10:29 AM
William R. Barker said...

* TWO-PARTER... (Part 1 of 2)

http://www.jeffjacoby.com/10004/motor-voter-dumbs-down-democracy

* READ THIS ONE! IT'S IMPORTANT!

Jeminma is not yet 25, so she never had a chance to "vote often and early for [infamous Boston politician] James Michael Curley," who died in 1958. But the crooked legend of Boston politics - who was, not always at different times, a congressman, a mayor, a Massachusetts governor, and a prison inmate - would surely have admired Jemima's electoral diligence in 1996.

* CURLEY WAS OF COURSE A DEMOCRAT... (*SHRUG*)

Not that Jemima went to the polls last week.

She didn't even leave the house.

She didn't have to. Weeks earlier, she had gotten an absentee ballot from the Board of Elections in Cleveland. And from the Board of Election Commissioners in Chicago, Ill. And from the Election Department in Brookline, Mass.

For the price of three stamps, she was able to vote in three cities - without being a legal resident of any of them.

It was easy[!]

Under the National Voter Registration Act - the "motor voter law" - states are required to accept voter registrations by mail. No longer can citizens be asked to make a trip to town hall or the county office. No longer do they have to provide proof of residence or citizenship.

In fact, they don't have to exist.

* WHICH IS THE POINT OF THIS EXPOSE!

Motor voter obliges election officials to add to the voter list any name mailed in on a properly filled-out registration form.

* AND THEN... (*SIGH*)... KEEP READING...

Anyone so registered can then request an absentee ballot - by mail, of course.

The system is not only open to manipulation, it invites it[!]

Which is perfectly fine with the "activists" who clamored to get motor voter on the books. Just ask Richard Cloward, executive director of Human SERVE, the New York-based lobby that led the fight. "It's better to have a little bit of fraud," Cloward told CBS News, "than to leave people off the rolls who belong there."

(*PURSED LIPS*)

There was a time when the only people who "belonged" on the rolls were those who made it their business to register. If that involved some slight effort, such as a one-time visit to the town clerk's office, it was a small enough price to pay for the great privilege of becoming a voter.

No more.

The theory behind motor voter is no one should ever have to overcome any hurdle, however trivial, in order to register to vote. A trip to city hall? Too arduous. Some evidence of legal residence, such as a driver's license? Unreasonable. A birth certificate or passport to prove U.S. citizenship? Too onerous.

* IT'S INSANE, FOLKS... TRULY. AND AGAIN... IT'S DELIBERATE. THE DEMS KNOW THAT EVEN IF SOME REPUBLICANS CHEAT TOO... BY AND LARGE THE NUMBERS ARE GONNA TILT TO MORE DEM VOTES GAINED FRAUDULENTLY THAN REPUBLICAN VOTES GAINED FRAUDULENTLY.

* TO BE CONTINUED...

August 16, 2012 at 10:51 AM
William R. Barker said...

* CONCLUDING... (Part 2 of 2)

* FOLKS... MAKE SURE YOU READ ALL THE WAY TO THE END... THERE'S A SURPRISE!

Had Jemima wanted to, she could have registered and voted in all 50 states. She could have registered not just in Chicago, but in every Illinois town from Rockford to Carbondale. Using 11 different names, she could have voted 11 absentee ballots in Pennsylvania's 13th Congressional District - and if she had voted them all for Democrat Joe Hoeffel, who lost to incumbent Rep. John Fox by 10 votes, she could have changed the outcome.

Motor voter does more than make such election fraud possible. It makes it probable.

Some enthusiasts, not content to trivialize registration, want to do the same to voting itself. In the view of Phil Keisling, Oregon's secretary of state, no voter should ever have to bestir himself to vote. It is too much, he says, to expect citizens to make a 10-minute stop at their polling place on Election Day. After all, that might require "finding a parking space, arranging and paying for a baby sitter, getting off work early, or braving bad weather." Imagine, having to take an umbrella just to go vote.

Keisling's "solution?" Conduct all voting by mail, as Oregon already does for local and special elections. Like L.L. Bean catalogs and supermarket circulars, ballots in Oregon are junk-mailed to every registered voter weeks before Election Day. No attempt is made to find out whether a voter has moved or died - or intends to vote. Cheating has become easier than ever. From partisan postal workers dumping ballots in the trash to political operatives "helping" nursing home patients vote, Oregon's election rules have opened the door to campaign dirty-trickery.

* JEEZUS...

Motor voter and vote-by-mail are hawked as magic solutions to public apathy and declining turnout. Some solutions. Last week turnout sank to its lowest level since the Coolidge administration. The drop was especially severe in Oregon, where turnout fell 12% from the last presidential election - a worse showing than in 45 other states.

Dumbing-down registration and voting does not make elections more meaningful. It does democracy no honor to be treated like a Publisher's Clearinghouse mailing.

(Actually, that's a bad analogy. Jemima could never have tricked Publisher's Clearinghouse into sending her three sweepstakes entries.)

Yet she had no difficulty getting ballots from three different states. Anyone who thinks motor voter enhances elections ought to ask Jemima how easy it was to exploit.

Not that she'll give you an answer. Jemima, I forgot to mention, is my cat.

August 16, 2012 at 10:52 AM
William R. Barker said...

* TWO-PARTER... (Part 1 of 2)

http://www.jeffjacoby.com/602/the-great-bush-deregulation-myth

* BY THE WAY, FOLKS... THIS COLUMN IS FROM NOVEMBER 19, 2008!

We've heard it again and again: The financial crisis was caused by the Bush administration's reckless plunge into deregulation.

House Speaker Nancy Pelosi, for example, blames the mess on "the Bush administration's eight long years of failed deregulation policies."

Billionaire investor George Soros declares that "excessive deregulation is at the root of the current crisis."

Nouriel Roubini, the widely-quoted New York University economist, pins it on "these Bush hypocrites, who spewed for years the glory of unfettered Wild West laissez-faire jungle capitalism."

A New York Times editorial pronounces the American financial system "the victim of decades of Republican deregulatory and anti-tax policies."

President Jimmy Carter attributes it to the "atrocious economic policies of the Bush administration," particularly "deregulation and . . . a withdrawal of supervision of Wall Street."

That's also Barack Obama's view.

"The biggest problem in this whole process was the deregulation of the financial system," Obama said [in October of 2008].

He called the present troubles "a final verdict on the failed economic policies of the last eight years . . . that essentially said that we should strip away regulations, consumer protections, let the market run wild, and prosperity would rain down on all of us."

Deregulators run amok undoubtedly make a flamboyant culprit. But do they exist?

Should we really be taking seriously the claim that the past eight years have been characterized by letting "the market run wild"?

Granted, there has been significant recent legislation easing financial restrictions. Most often mentioned is the Gramm-Leach-Bliley Act, which, as The New York Times described it on Monday, "removed barriers between commercial and investment banks that had been instituted to reduce the risk of economic catastrophes."

[H]ow was that George W. Bush's fault? The law was signed by President Bill Clinton in 1999, after being passed by lopsided majorities in both houses of Congress.

* TO BE CONTINUED...

August 16, 2012 at 11:11 AM
William R. Barker said...

* CONCLUDING... (Part 2 of 2)

Gramm-Leach-Bliley's lead sponsors were Republicans, but the 34 Democratic senators who voted for the bill surely weren't scheming to "let the market run wild."

* 34 DEMOCRATIC SENATORS... NOT 3... NOT 4... NOT 14... BUT 34...!!!

Ditto the 151 Democrats - among them future Speaker Nancy Pelosi - who voted for the measure in the House.

* THE 151 DEMOCRATIC HOUSE MEMBERS... INCLUDING NANCY PELOSI...

(*SNORT*)

Then-Treasury Secretary Larry Summers didn't denounce the bill as "laissez-faire jungle capitalism" - he praised it for "promoting financial innovation, lower capital costs, and greater international competitiveness."

* YOU'RE READING THIS - RIGHT, FOLKS? YOU'RE FOLLOWING THIS... RIGHT?

(*SNORT*)

Clinton himself defends the law to this day.

* AT LEAST IN 2008 HE DID!

(*LOPSIDED SMIRK*)

Now, this is not to say that Bush hasn't also been responsible for legislation having a decided impact on the country's regulatory climate. On July 31, 2002, declaring that free markets must not be "a financial free-for-all guided only by greed," he signed the Sarbanes-Oxley law, a sweeping overhaul of corporate fraud, securities, and accounting laws. Among its many tough provisions, the law created a new regulatory agency to oversee public accounting firms and auditors, and imposed an array of new requirements for financial reporting and corporate audits. Whatever else might be said about Sarbanes-Oxley, it was no invitation to an uninhibited capitalist bacchanal.

* LISTEN... BUSH SERVED FOR EIGHT YEARS - SIX OF THEM WITH A REPUBLICAN CONGRESS; BUSH AND THE RINOs SHOULD PLENTY OF THE BLAME!

Like the alligators lurking in New York City sewers, Bush's massive regulatory rollback is mostly urban legend. Far from throwing out the rulebook, the administration has expanded it: Since Bush became president, the Federal Register - the government's annual compendium of proposed and finalized regulations - has run to more than 74,000 pages every year but one.

(During the Clinton years, by contrast, the Federal Register reached that length just once.)

* JEEZ... I MISS BILL CLINTON AND NEWT GINGRICH...

[Bush's] administration [had] broken every previous record for regulatory agency spending.

* I'M CONFIDENT OBAMA HAS TAKEN OVER THAT RECORD!

According to researchers at Washington University and George Mason University, appropriations for federal regulatory functions have soared during the Bush years. Adjusting for inflation, the regulatory budget has grown from $25 billion in fiscal year 2000 to an estimated $43 billion in FY 2009 - a 70% increase.

"In constant dollars," writes James Freeman in the Wall Street Journal, "the Bush regulatory budget increases vastly exceed those of predecessors Clinton, Bush, Reagan, Carter, Nixon, and, yes, Lyndon Johnson." Staffing has skyrocketed, too. Regulatory agencies employed 175,000 people in 2000. They employ nearly 264,000 today. (Some of that reflects the Transportation Security Administration's takeover of airport security screening in 2003.)

Amid the stress and storm of the financial crisis, "deregulation" makes a convenient villain. But the facts tell a different story:

The nation's regulatory burden has grown heavier, not lighter, since Bush entered the White House.

Too little government wasn't what made the economy sick. Too much government isn't going to make it better.

* AGAIN... THIS COLUMN IS FROM NOVEMBER 19, 2008.

** AND THAT "JEMINA THE CAT" NEWSBITE... THAT WAS FROM 1996. (ORIGINALLY I DIDN'T NOTICE THAT THESE COLUMNS - REFERRED TO VIA TODAY'S ORIGINAL JACOBY NEWSBITE - WERE "OLD" COLUMNS. STILL RELEVANT, THOUGH!

August 16, 2012 at 11:18 AM

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