Our Next President?

[vt]

Re: Our Next President?

"France briefly had a 75% rate a few years ago but it was scrapped in 2014 because it raised less revenue then anticipated"

Economist 2/3/19

Anytime you raise rates you have to consider what the negative consequences might be. Will you hurt business formation and thus limit good paying jobs that might provide more revenue?

As the Economist says "any change should be incremental". It's totally counterproductive to raise rates to real high levels overnight.

[jk]

Re: Our Next President?

They lobbied hard to make it illegal for the government to negotiate and illegal to import from countries which can and to make it legal to price gouge at will.

billy tauzin came really cheap considering the money involved.

[dcarrigg]

Re: Our Next President?

It's not a terrible idea, but you'd have to at least take it to international waters, and you'd risk the US shutting it down regardless. Dump it on terra firma on a constituent part of France and it's a bit tougher to shut down. Not impossible to apply pressure. But I imagine more difficult. The whole thing that makes it possible is that other countries negotiate prices, and the US lets providers and pharma charge whatever the hell they damned well please. So the same insulin that's 48 Euros in France or 25 dollarydoos in Australia might easily cost you 1,000% more in the US. And your anesthesiologist is always out of network and always wants a few grand. They lobbied hard to make it illegal for the government to negotiate and illegal to import from countries which can and to make it legal to price gouge at will. What's the market rate on a bullet in the chamber when the gun's cocked and pointed at you but whatever the guy with your life in his hands demands? So I figure they'd lobby hard to shut the boat down too. Ethics and oaths aren't going to keep these people honest.

[touchring]

Re: Our Next President?

How about a cruise ship hospital?

[dcarrigg]

Re: Our Next President?

He knows that good and well.

They will do anything to protect and defend their precious tax cuts. They are not patriots.

[thriftyandboringinohio]

Re: Our Next President?

if howard schultz runs he will succeed in re-electing trump.

He knows that good and well.

[jk]

Re: Our Next President?

if howard schultz runs he will succeed in re-electing trump.

[vt]

Re: Our Next President?

More voters are seeing an independent party as a good idea:

https://www.nbcnews.com/politics/mee...didate-n966296

[jk]

Re: Our Next President?

France should build out a big hospital complex on St. Pierre and run weekly direct flights out of Boston and NYC. They could provide high quality care to Americans at a fraction of the cost. With the tourism it would bring in alone, it would probably pay for itself and still be considerably more affordable. Do dental work too. At 50 euros per filling vs $300, one would probably cover the flight. A root canal and crown would definitely be worth a week's vacation with money to spare. Canadians pay way too much for dental work too. I'm sure they'd come out. Make it the Los Algodones of the northeast. Run specials in the winter. Throw up a couple hotels and some nice French restaurants. If Al Capone could use it a hundred years ago to smuggle hundreds of thousands of cases of hootch in, I figure converting it to a medical tourism destination can't be too much more difficult. Easy potential for a multi-billion dollar arbitrage opportunity you could feel good about.

put it in martinique or guadaloupe.

[Chris Coles]

Re: Our Next President?

France should build out a big hospital complex on St. Pierre and run weekly direct flights out of Boston and NYC. They could provide high quality care to Americans at a fraction of the cost. With the tourism it would bring in alone, it would probably pay for itself and still be considerably more affordable. Do dental work too. At 50 euros per filling vs $300, one would probably cover the flight. A root canal and crown would definitely be worth a week's vacation with money to spare. Canadians pay way too much for dental work too. I'm sure they'd come out. Make it the Los Algodones of the northeast. Run specials in the winter. Throw up a couple hotels and some nice French restaurants. If Al Capone could use it a hundred years ago to smuggle hundreds of thousands of cases of hootch in, I figure converting it to a medical tourism destination can't be too much more difficult. Easy potential for a multi-billion dollar arbitrage opportunity you could feel good about.

My understanding is the very best pace to go, high quality for moderate costs for surgical work is Thailand and for dental, Hungary.

[dcarrigg]

Re: Our Next President?

France should build out a big hospital complex on St. Pierre and run weekly direct flights out of Boston and NYC. They could provide high quality care to Americans at a fraction of the cost. With the tourism it would bring in alone, it would probably pay for itself and still be considerably more affordable. Do dental work too. At 50 euros per filling vs $300, one would probably cover the flight. A root canal and crown would definitely be worth a week's vacation with money to spare. Canadians pay way too much for dental work too. I'm sure they'd come out. Make it the Los Algodones of the northeast. Run specials in the winter. Throw up a couple hotels and some nice French restaurants. If Al Capone could use it a hundred years ago to smuggle hundreds of thousands of cases of hootch in, I figure converting it to a medical tourism destination can't be too much more difficult. Easy potential for a multi-billion dollar arbitrage opportunity you could feel good about.

[Chris Coles]

Re: Our Next President?

pills are definitely elastic. i've had many patients call me saying they couldn't afford the copay on their meds, could i switch them. sometimes there's an alternative [usually with more side effects], sometimes no alternative [they've already tried multiple alternatives without success]. i have a significant and growing number of patients ordering meds from canada.

even procedures may be elastic. a law school classmate of one of my kids fell down some subway steps and injured himself. it was late december and he was going to have new, better healthcare coverage on jan1, so he decided to delay going to an e.r. he had injured his spine and the swelling, untreated, led to sig damage to his spinal cord. he became paraplegic. it is now several years later and he is dead. i don't know if it was complication, something unrelated, or suicide.

Very sad, he should have caught a flight to the UK and walked into the nearest hospital out patients. yes, he would have, eventually, got a bill; but I bet it would not have cost as much as he would have had to pay in the US.

[jk]

Re: Our Next President?

jk, I totally agree with your points. It's part of why I say there's a lot of room for "downward pressure" (e.g. sector deflation) in healthcare. Even if you make those $2,000 MRIs cost $200, you're not really going to get people wanting to spend more time in the machine. Stuff's not super elastic. Maybe pills are. But just about everything else isn't. As far as the numbers go, I was using whole numbers for simplicity's sake to make the point. But iirc my CMS news, we crossed $3.5 trillion in healthcare spending back in 2017, and we're still chugging up.

pills are definitely elastic. i've had many patients call me saying they couldn't afford the copay on their meds, could i switch them. sometimes there's an alternative [usually with more side effects], sometimes no alternative [they've already tried multiple alternatives without success]. i have a significant and growing number of patients ordering meds from canada.

even procedures may be elastic. a law school classmate of one of my kids fell down some subway steps and injured himself. it was late december and he was going to have new, better healthcare coverage on jan1, so he decided to delay going to an e.r. he had injured his spine and the swelling, untreated, led to sig damage to his spinal cord. he became paraplegic. it is now several years later and he is dead. i don't know if it was complication, something unrelated, or suicide.

[dcarrigg]

Re: Our Next President?

2 comments on just this issue of funding universal health care.

1 first, if all the dollars currently spent on healthcare were funneled through a universal program, and providers were paid for ALL their services as the medicare rate, i don't think it would add the deficit at all. it might even make a profit. [note, too, below that if current expenditures are 3.4trillion, a 4trillion program- if that indeed is what it cost- would have a net cost of ONLY 600billion.]

2. second, the u.s. currently spends 17.8% of gdp on healthcare, while gdp is $19.3 trillion. if the gov't prints and spends the $3.4trillion implied by these 2 numbers, it means that people and companies suddenly have an extra $3.4 trillion in their pockets. That is one huge stimulus, and gov't revenues will rise substantially. i'm not going to say it will pay for itself, though given my first consideration, it could. nonetheless, the cost is much lower than it first appears.

=================
on another, related, topic: mmt and the usd

Is US media beginning to set the narrative for the implementation of MMT or MMT-like easy money policies?
“Who’s afraid of budget deficits?”: Foreign Affairs magazine - 1/27/19
https://www.foreignaffairs.com/artic...udget-deficits
White House adviser says Fed board nominees should support easy money policies: WSJ – 1/24/19
https://www.wsj.com/articles/white-h...es-11548375931
CBO unveils apocalyptic long term debt picture – 1/28/19
https://www.zerohedge.com/news/2019-...rillion-second
TBAC is suddenly worried about who funds $12T in US deficits in next 10 yrs (assuming no recessions) – 1/30/19
https://www.zerohedge.com/news/2019-...reserve-status


Luke Gromen: The US media began setting the narrative that “China is bad” in mid-2017. Fast-forward 18 months, and voila! China is now bad. It now appears that the narrative of “US deficits are a problem but don’t need to be if we just use easier money” has begun being established among “serious people” (see Foreign Affairs, WSJ articles above.) Our guess is this is not by accident, and speaks to an understanding at a high level that the end game of a much weaker USD is now coming into sight. Let’s watch.

jk, I totally agree with your points. It's part of why I say there's a lot of room for "downward pressure" (e.g. sector deflation) in healthcare. Even if you make those $2,000 MRIs cost $200, you're not really going to get people wanting to spend more time in the machine. Stuff's not super elastic. Maybe pills are. But just about everything else isn't. As far as the numbers go, I was using whole numbers for simplicity's sake to make the point. But iirc my CMS news, we crossed $3.5 trillion in healthcare spending back in 2017, and we're still chugging up.

[jk]

Re: Our Next President?

Conversely, debt funding universal health care at current prices without tax increase looks like $4T, which capsizes the ship. .

2 comments on just this issue of funding universal health care.

1 first, if all the dollars currently spent on healthcare were funneled through a universal program, and providers were paid for ALL their services as the medicare rate, i don't think it would add the deficit at all. it might even make a profit. [note, too, below that if current expenditures are 3.4trillion, a 4trillion program- if that indeed is what it cost- would have a net cost of ONLY 600billion.]

2. second, the u.s. currently spends 17.8% of gdp on healthcare, while gdp is $19.3 trillion. if the gov't prints and spends the $3.4trillion implied by these 2 numbers, it means that people and companies suddenly have an extra $3.4 trillion in their pockets. That is one huge stimulus, and gov't revenues will rise substantially. i'm not going to say it will pay for itself, though given my first consideration, it could. nonetheless, the cost is much lower than it first appears.

=================
on another, related, topic: mmt and the usd

Is US media beginning to set the narrative for the implementation of MMT or MMT-like easy money policies?
“Who’s afraid of budget deficits?”: Foreign Affairs magazine - 1/27/19
https://www.foreignaffairs.com/artic...udget-deficits
White House adviser says Fed board nominees should support easy money policies: WSJ – 1/24/19
https://www.wsj.com/articles/white-h...es-11548375931
CBO unveils apocalyptic long term debt picture – 1/28/19
https://www.zerohedge.com/news/2019-...rillion-second
TBAC is suddenly worried about who funds $12T in US deficits in next 10 yrs (assuming no recessions) – 1/30/19
https://www.zerohedge.com/news/2019-...reserve-status


Luke Gromen: The US media began setting the narrative that “China is bad” in mid-2017. Fast-forward 18 months, and voila! China is now bad. It now appears that the narrative of “US deficits are a problem but don’t need to be if we just use easier money” has begun being established among “serious people” (see Foreign Affairs, WSJ articles above.) Our guess is this is not by accident, and speaks to an understanding at a high level that the end game of a much weaker USD is now coming into sight. Let’s watch.