Head of GAO -- World's Largest Employer Lost $450m Last Year

[Finster]

Re: Head of GAO -- World's Largest Employer Lost $450m Last Year

Several people have written in to ask me what I think of this week's Barron's Cover article by Jonahthan R. Laing...

Thank you very much, EJ. I wasn't one of those who asked, but read the article just yesterday. It struck me as begging for rebuttal, but I couldn't quite bring why into focus.

Perhaps that in part was due to the article itself resting on some fuzzy turns of phrase. Either way, it seems undeniable that the US is trading the means of production - seed corn - for things it burns up and wears out. What's more, it's not because of any congenital moral defect of the American people, but tax and monetary policies that could hardly be designed to be more effective to bring about that result. Easy credit and inflation combined with a much higher net tax on production than on consumption have been accomplishing just what you would expect.

[Jim Nickerson]

Re: Head of GAO -- World's Largest Employer Lost $450m Last Year

Summary: NIH budget = 28 billion.

http://wistechnology.com/article.php?id=3382

Quote:

One barometer of research and development in the United States is the National Institutes of Health (NIH) annual list of spending in grant money by states. The NIH's annual budget, some $28 billion, not only funds research activities in its own institutions in the Washington, D.C./Maryland area, such as the National Cancer Institute (NCI) and the National Institute for Allergies and Infectious Diseases (NIAID) - in fact there are 27 different institutions - but funds many universities and research institutions around the country to the tune of about $23 billion per year through extramural almost 54,000 annual grants.

And please realize, the NIH is just the main federal research supporting institute. Other federal institutions give grants for research. States, counties, local municipalities, universities, family trust funds, places like Hughes and Shriner's...

Folks, go find a Shriner's hospital and ask for a tour. And then tell me that China or India are going to obliterate the US in medical/biotech research.

The point I'm making is that there is A LOT of freakin money out there being put into technical, scientific, medical research. While the stem-cell research may spring ahead in china, korea, europe, and japan due to our presidency having been hijacked by a bunch of right-winged extremists, it is not a death-knell for the biotech and nanotech research. Embryonic stem cell treatments are still at least a decade or more away, and the long-term effect of Bush the Idiotic is that stem-cell based therapies will have been pushed out 5-10 years further than they should have been.

Now let's see, who is it that ultimately provides the money for the NIH, that then doles it out to fund research to help not only Americans but those all around the world if health care providers in other places can afford to subscribe to the journals and can read English. And we mustn't forget that some research is funded by gifts from the super wealthy, and charaties.

So the American tax-payers it occurs to me are those ultimately funding the NIH, so that they, the tax-payers, get to pay, whether they have health insurance or not, to fund the research utlitmately directed at helping them (some of them) live better lives. Now if you have insurance bought directly or provided through your employer, or have neither but do have moolah/bonars, then when you go to receive some benefit that came from the research you funded, you get to pay again. This is definitely a money winning proposition for some and definitely a money losing proposition for some others. Especially when what you are receiving, i.e. healthcare, is I think the most, or one of the most inflationary-susceptible aspects of our lives. Now generally when one pays a whole lot for something, one is willing to pay more if one believes one is getting real value for the bonars paid. However, with regard to healthcare few Americans are capable of determining whether the value for bonars paid might even come close to possible value received. That is not so difficult to understand in light of high level debates that go on among those who deliver healthcare whether or not certain things respresent good healthcare or do not represent good care.

However, when it comes to human doctors dealing with human patients, the doctors survive, generally handsomely, under a dictum like "humans are much more complicated that cars" and "we doctors are just humans dealing with humans." Mechanics can warranty their workmanship, but with recognition of the dictums, we certainly cannot offer warranties or guaranties that what we think is necessarily correct, that what we do is necessarily the right thing, or that it will ultimately benefit whoever receives it. Now in recognition of those facts, it is easy to understand why obtaining healthcare cost like the dickens.

For what might be an average American who happens upon what to me are some rather intellectual financial discussion by others here at itulip, I can understand if they are flummoxed (confused--for those unfamiliar with the term) by some of the financial perspectives offered on these pages--I certainly am quite often.

But for anyone with a lick of sense, it is not beyond his/her intellect to understand why healthcare costs so much. It is something you get to pay for twice or just once if you don't use it. Undoubtedly there must be some other reasons, but I cannot think of them just now.

[DemonD]

Re: Head of GAO -- World's Largest Employer Lost $450m Last Year

But for anyone with a lick of sense, it is not beyond his/her intellect to understand why healthcare costs so much. It is something you get to pay for twice or just once if you don't use it. Undoubtedly there must be some other reasons, but I cannot think of them just now.

Jim... am I correct in remembering you yourself were a doctor of some sort?

There are many, many, many reasons why healthcare costs have risen far above and beyond inflation levels. Lawsuits, malpractice insurance, collusion/merging of mega-health care plans, super expensive medications, low supply of nurses versus demand (have you seen how much money nurses make nowadays?), low supply of health-care workers in general versus demand as boomers get older and leave the medical profession and start consuming medical services, people living longer, better medicine allowing the sickest of the sick to live longer... Doctors' salaries are probably at the low end of that list. Also, I have a good friend who is a doctor. Many MD's coming out of med school are a quarter mil in the hole, they work their asses off, and have to continue working their asses off to keep their licenses and DEA numbers under constant threat of litigation from anyone who walks into their offices. If a doctor makes 150-200k/year, I say he pretty much deserves it. Much, much more than a hedge fund guy who has a flat fund and makes a couple million.

[jk]

Re: Head of GAO -- World's Largest Employer Lost $450m Last Year

Jim... am I correct in remembering you yourself were a doctor of some sort?

There are many, many, many reasons why healthcare costs have risen far above and beyond inflation levels. Lawsuits, malpractice insurance, collusion/merging of mega-health care plans, super expensive medications, low supply of nurses versus demand (have you seen how much money nurses make nowadays?), low supply of health-care workers in general versus demand as boomers get older and leave the medical profession and start consuming medical services, people living longer, better medicine allowing the sickest of the sick to live longer... Doctors' salaries are probably at the low end of that list. Also, I have a good friend who is a doctor. Many MD's coming out of med school are a quarter mil in the hole, they work their asses off, and have to continue working their asses off to keep their licenses and DEA numbers under constant threat of litigation from anyone who walks into their offices. If a doctor makes 150-200k/year, I say he pretty much deserves it. Much, much more than a hedge fund guy who has a flat fund and makes a couple million.

iirc 25% of healthcare expenditures in the u.s. now go to paper work - doctors' and hospitals' administrative staffs along with health insurers' adminstrative staffs -- submitting bills, getting authorizations, correcting rejected claims, providing documentation of medical necessity and appropriateness of care, making sure procedure codes match diagnostic codes, bundling procedure codes into master procedure codes, unbundling procedure codes into component procedure codes and so on.

[Corporate Plebe]

Re: Head of GAO -- World's Largest Employer Lost $450m Last Year

Perhaps "platform economy" is a worthy iTulip Glossary term?

[EJ]

Re: Head of GAO -- World's Largest Employer Lost $450m Last Year

Demon,

Nice thoughtful commentary above. I enjoyed it. Surely there are more who see the US contrarily to much expressed on iTulip. It is nice to know how some others see things. Keep it up.

Indeed. If we were agreeing here, no one would be learning anything.