Dylan Ratigan on Greensboro's [Cone Health's?] healthcare monopoly?: "Auction 2012: Bought Health Care"

"The point of seeing a doctor -- or being one -- should be to improve health.

...what I've found,
...is that the same incentives distorting banking, energy, education, and government
are distorting our very bodies.

The American health care system has incentives
so out of alignment for everyone involved...

"A walk through of the expanded Cone Health Cancer Center..."

"A walk through of the expanded Cone Health Cancer Center...

...From an outdoor wind chime with more than 1,500 individual butterflies attached — part of a “healing landscape” — to the latest technology (first in the state) targeting tumors deep within the body, the fruits of the $15 million expansion are notable.

...It’s a 38,000-square-foot expansion and renovation.

Yet Cone Health built it with intimacy in mind, thanks in part to $5 million from private donors.

...there’s a multi-disciplinary clinic with medical staff offices, exam rooms and waiting areas for breast cancer patients and families. The patient is visited in one place by each doctor — no longer having to make separate appointments that can delay planning treatments.

“They walk out with a summary of 'This is the plan,’” said Dr. Stacy Wentworth , a radiation oncologist. “It’s these are my doctors’ recommendations, these are my next appointments, this is when I’m going to chemotherapy class.’”

What is the average cost compared to elsewhere in the region?
.

Does Cone Health disclose how much they are charging whom for what?

Dear Cone Health, please tell the truth

"...The prices of many health-care services in the U.S. are extremely difficult for patients to obtain in advance.

For example, when the Government Accountability Office anonymously phoned doctors’ offices to inquire about the price of diabetes screening, most could not provide estimates of the associated lab fees.

And when GAO investigators called hospitals to find out the price of a knee replacement, they got similarly uninformative responses.

One of the more responsive hospitals said it would take a week to obtain an estimate; most of the rest seemed even less helpful.

When prices are revealed, typically after the fact, they often vary widely -- depending on both the provider and the patient’s insurance plan.

In 2009, for instance, the median charge for coronary-artery bypass surgery in Los Angeles County ranged from about $130,000 at Long Beach Memorial Medical Center to about $250,000 at Cedars-Sinai Medical Center and more than $300,000 at Garfield Medical Center, according to a California government website.

...most studies have found little, if any, connection between price and quality.

...when people bear more of the financial risk associated with their own health care, they are likely to become more responsive to information about price and quality.

...the coming years will see dramatic fights over health care.

...Providing more price transparency...should be part of the path forward."

Peter Orszag

Jim Melvin: "Cone and Alamance merger perfect match": How many jobs does Mr. Melvin want to cut?

"On Dec. 15, there was a very important marriage in our region.

Why is Jim Melvin for a healthcare merger

that could eliminate competition

and create a healthcare monopoly

that could raise prices at will?

This marriage put two great organizations together.

How many jobs will the merger eliminate?

Dear Cone Health: Free drug price comparison app debuts

"A new and free app
...lets you compare local prescription and generic drug prices.

Does Cone Health compare prices?

Dear Cone Health: "The Money Traps in U.S. Health Care"

Did the largest generation of parents in American history

promise themselves healthcare benefits

their children won’t have enough money to pay for?

"Why does an appendectomy in Germany cost roughly a quarter what it costs in the United States?

Or an M.R.I. scan cost less than a third as much, on average, in Canada?

...In 2009, we spent $7,960 per person, twice as much as France,
which is known for providing very good health services.

And for all that spending, we get very mixed results — some superb,
some average, some inferior — compared with other advanced nations.

I will prescribe regimens for the good of my patients

…and never do harm to anyone

In every house where I come

I will enter only for the good of my patients

keeping myself far from all intentional ill-doing

Hippocratic Oath

W. E. Heasley on Don Jud in Nancy McLaughlin's Cone Health Propaganda Piece

“We know that health care is a very important industry in our country

— it’s the only industry that didn’t lose employment in this recession….”.

And that reason is professor emeritus Don Jud?

Would it happen to be that the health-care industry
is approximately 55% government third party pay?

Would it be due to the third party pay phenomena in general,
public or private?

Would it be due to an economic sector that does not post its prices?

Would one shop at Target or Wal-Mart
if no prices were posted and after you buy,
a bill comes in the mail for previous purchases
of which you had no idea of the price.

Would one shop at a store with no prices posted?

You do in health-care!

“It means that a lot of those health care dollars

that might otherwise be spent outside the community

will be spent here.”

If each community purchased locally
ala an economy based on what was a requirement in medieval times,
then ninety five percent of what you demand
could never be supplied locally
[want a car, how about a computer, I-phone, bananas anyone?].

W. E. Heasly

Healthcare Ethics: "The anatomy of a ripoff": If Ed Cone is on the board of Cone Health, and Jim Melvin thinks the merger is a great idea, how do they feel about this?

"...my teenage son was rushed by ambulance
...to Good Samaritan Hospital in Suffern after choking on a piece of turkey.

The care he received was appropriate; the bill was anything but.

The charges, in fact, were mind-boggling.

A statement the hospital sent to my insurance company
...showed that Good Samaritan billed $22,214.92
for a four-hour emergency room visit that included a physical exam,
sedation, endoscopy and extraction of the stuck food.

...it’s easy to think that he was seen less as a patient
and more as an ambulatory cash machine...

We must tear down the entire medical system in this nation

and imprison virtually all of the financial folks involved in it

-- especially Hospital-affiliated entities.

Karl

Even more astonishing, Aetna agreed to pay only $2,885.67 for the services
— just 13% of the bill — and the hospital settled for that amount.

...my son had a second choking episode two weeks after the first,
and the charges for his treatment at Somerset Hospital in Pennsylvania
were included on the same ...statement.

So I was able to compare bills for similar procedures at two emergency rooms.

What I learned was that the numbers printed on hospital bills
often bear no relation to reality.

That hospitals grossly inflate their charges,
expecting insurance companies to radically cut the bills
while hoping to wring bigger fees out of the uninsured.

That the bill inflation can include double-charging for procedures.

This sort of game-playing, where the intent is to catch "uninsured" people

and "gotcha" them into bankruptcy,

would be felonious in virtually any other line of business.

Karl

Why would an anesthesiologist manufacture positive results in some pain medication studies?

¶

A New Low in Drug Research: 21 Fabricated Studies

by Sarah Rubenstein

 

Should those who test medicine

receive speaking fees and research grants

from those who want to sell what passes tests?

 

I will prescribe regimens for the good of my patients

…and never do harm to anyone

                     

In every house where I come

 I will enter only for the good of my patients

keeping myself far from all intentional ill-doing

 

Hippocratic Oath

Medicare Accounting Ripoff?

"Senate Democrats and Republicans agreed on -- and passed by a vote of 99-0 -- a one-year extension of the so-called "doctor fix" for Medicare.

The result is almost certainly going to mean higher deficits and more debt piled on the backs of our children.

the Obama administration and congressional Democrats made matters worse by including the "savings" from that 23 percent cut in the cost estimates for the ObamaCare law. This allowed them to pretend that the reform cost less than $1 trillion over its first 10 years...

...Now, faced with having the cuts kick in on Jan. 1, Congress, unsurprisingly, has once again voted to postpone them for a year, at a cost of $15 billion.

But wait. Congress found a way to pay for it: It voted to reduce subsidies under the president's health reforms -- in 2014.

That's right. Congress will spend the money next year, but you needn't worry because it will reduce subsidies four years from now.

...So, four years from now...Congress will use that repayment to repay the money it borrowed to spend this year to avoid making cuts in a program that is trillions of dollars in debt.

Feeling better now?

If November's election meant anything, it was that the American people were fed up with business as usual in Washington.

If this latest Senate deal tells us anything, it's that business as usual is alive and well."

Michael Tanner

Diana Furchtgott-Roth, Former Chief Economist at the U.S. Department of Labor, on Medicare Cuts

...on Dec. 1 all Medicare physicians will face a 23 percent cut in rates, postponed from June.
 
Reimbursements will decline an additional 2 percent in January.
 
...To create the appearance, if not the reality, of fiscal discipline in the new health care law,
Congress assumed $455 billion of Medicare and Medicaid cuts
— 73 percent of them in Medicare —
over 10 years, and thereafter 10 percent to 15 percent of annual cuts. 
 
So, physicians’ reimbursements affect not only doctors and seniors and Medicare’s price tag,
but also the cost of the new, national health-care plan.
 
Freeing Medicare physicians from future cuts could cost $250 billion to $400 billion over 10 years,
depending on how much the government allows doctors’ payments to rise.
 
San Francisco Examiner columnist Diana Furchtgott-Roth
Former Chief Economist at the U.S. Department of Labor

If Medicare Cuts
are part of what makes the recently passed Healthcare Legislation “deficit reducing,”
and a 23% cut is not enacted in December,
how could those who voted for the legislation
be considered not guilty of misleeding the electorate?

On Medicare's 23% December phyisician fee cut: If "Obamacare" was dependent on the cuts to be "deficit reducing," could negating the cuts betray the electorate?

"The Centers for Medicare and Medicaid Services
has released the 2011 Medicare Physician Fee Schedule Final Rule,
which includes a 23 percent cut to Medicare physician fees...
 
...Congress delayed a scheduled pay cut of around 20 percent in June. 

Rachel Fields
Beckers Hosptial Review, November 04, 2010  

.
.
Did the delay of the June pay cut alter the "affordability"
of the Patient Protection and Affordable Care Act (PPACA),
and if so, who voted for both the initial legislation
and also voted to reverse the cuts making the law "affordable"?   

.
"...The report from Medicare's Office of the Actuary
...acknowledged that some of the cost-control measures in the [PPACA] bill
Medicare cuts, a tax on high-cost insurance
...could help reduce the rate of cost increases beyond 2020.
 
...the longer-term viability of the Medicare . . . reductions is doubtful."
wrote Richard Foster, Medicare's chief actuary"
 
Associated Press
.
. 

Have the American people been lied to,
if the government passed a law that said X,
and those who voted for it did Y,
that made the "affordability" non-viable?   

.
.
"...Neither the [the Patient Protection and Affordable Care Act (PPACA)] bill
...nor the accompanying reconciliation...
...addresses the flawed formula that dictates physician payments under Medicare
 
...a bill passed by the House in November would scrap the SGR altogether,
replacing it with a formula designed to ensure that doctors’ Medicare payments
reflect the true cost of delivering care.
 
Pricetag: $210 billion.  

...it was that cost that caused Democrats,
who’d vowed both to keep their reform package below $1 trillion and to offset the entire tab
to strip the doc fix from the larger reform bills."  

The issue has left Democrats in a pickle:
...with voters already weary of deficit spending,
[and/or borrowing] another $210 billion to fund a permanent fix."
 
Mike Lillis
Washington Independent 
. 

If Medicare Cuts
are what makes the recently passed Healthcare Legislation "deficit reducing"
and the 23% cut is not enacted in December,
how could those who voted for the legislation be considered
not guilty of misleeding the electorate?   

.
From an email from some supporting the elimination of the cut:
 
"Is the new healthcare law accounting dependent on the 23% payment reduction?  

If the can is kicked down the road,
does the math in the healthcare legislation become not operable?"  

George Hartzman 

The answer: 
 
"That is how the administration officials explained it to us... 

...Their numbers are based on the law as it stands,
and it currently stands that the cuts will occur.  

I think you know the answer to your last question."  

Lee Beadling
Managing Editor, Orthopedics Today  

Fact Check on Health Care Legislation

I will prescribe regimens for the good of my patients
…and never do harm to anyone.

In every house where I come,
I will enter only for the good of my patients,
keeping myself far from all intentional ill-doing.

Hippocratic Oath

"FACT CHECK: Obama's tone shifts on health care

President Barack Obama told voters repeatedly during the health care debate that the overhaul legislation would bring down fast-rising health care costs and save them money...

So far, the law he signed earlier this year hasn't had the desired effect.

An analysis from Medicare's Office of the Actuary this week said that the nation's health care tab will go up — not down — through 2019 as a result of Obama's sweeping law...

If federal budget figures indicated Medicare Part D
would cost more than $1.2 trillion between 2006 and 2015
why did supporters repetitively proclaim the program
would not cost more than $400 billion over ten years?

Obama offered some caveats when asked in his news conference Friday about the apparent discrepancy between what he promised and what's actually happening so far...

...OBAMA: Said he never expected to extend insurance coverage to an additional 31 million people "for free." He added that "we've made huge progress" if medical inflation could be brought down to the level of overall inflation, or somewhere slightly above that.

THE FACTS: Those claims may be supported in the fine print of the plan he pitched to Congress and a skeptical public months ago. But they were rarely heard back then. "My proposal would bring down the cost of health care for millions — families, businesses and the federal government," he declared in March.

Why wouldn’t the healthcare industry’s position
as a top political campaign contributor,
correlate to subsidized healthcare
being one of the government’s largest expenditures,
and if not, why does the healthcare industry
contribute so much to those who wouldn’t reduce profits?

Last August he predicted: "The American people are going to be glad that we acted to change an unsustainable system so that more people have coverage, we're bending the cost curve, and we're getting insurance reforms."

On Friday, he conceded: "Bending the cost curve on health care is hard to do." The goal: "Slowly bring down those costs."

If the Veterans’ administration can haggle for lower drug prices
why can't the government negotiate for Medicare part D?

The White House contends that although health care costs will rise when most of the changes take hold in 2014 and coverage is extended to the uninsured, costs will go down over the longer term as controls kick in.

OBAMA: "We took every idea out there about how to reduce or at least slow the costs of health care over time."

Does recently passed health care legislation
prevent insurers, employers and taxpayers indirectly pay for agreements
between brand name and generic drug companies,
keeping lower priced medicines off the market?

THE FACTS: One idea that most experts believe would do the most to control health costs — directly taxing health benefits — was missing in Obama's plan. Opposition from unions and others was too great, and Obama himself had campaigned against the idea.

Would healthcare cost less
if medical insurance wasn’t subsidized by tax breaks
and regulated pricing mechanisms?

Some of the major cost controllers that did make it into the law — including a tax on high-value insurance plans — don't start until 2018. That tax was watered down and delayed, and other cost-control approaches also softened after opposition from hospitals and other interest groups.

Health spending already accounts for about 17 percent of the economy and is projected to grow to nearly 20 percent in 2019.

Did ~86% of fiscal 2004’s $11.1 trillion
federal unfunded future obligation growth
reflect the long term costs of 2003’s prescription Medicare legislation?

OBAMA: "So these policies of cutting taxes for the wealthiest Americans, of stripping away regulations that protect consumers, running up a record surplus to a record deficit — those policies finally culminated in the worst financial crisis we've had since the Great Depression."

THE FACTS: The president probably meant the broader economic crisis and not the meltdown of the financial industry when he talked about the "financial crisis." True enough, George W. Bush entered office with a $236 billion budget surplus in 2001, and in January 2009, before Obama was sworn into office, the Congressional Budget Office projected the deficit for the fiscal year 2009 to be $1.2 trillion.

Did the largest generation of parents in American history
promise themselves healthcare benefits
their children won’t have enough money to pay for?

But the surpluses the government foresaw in 2001 were based on a bubble economy that was bound to burst..."

Erica Werner And Calvin Woodward
Associated Press

Remember Medicare Part D?

You shall do no unrighteousness in judgment
 in length, in weight or in measure

 Leviticus 19:35

If federal budget figures indicated Medicare Part D
would cost more than $1.2 trillion between 2006 and 2015
why did supporters repetitively proclaim the program
would not cost more than $400 billion over ten years?

Did ~86% of fiscal 2004’s $11.1 trillion
federal unfunded future obligation growth
reflect the long term costs of 2003’s prescription Medicare legislation?

When spider webs unite,
they can tie up a lion.

Ethiopian proverb

If the Veterans’ administration can haggle for lower drug prices
why can't the government negotiate for Medicare part D?

I will prescribe regimens for the good of my patients,
…and never do harm to anyone.
 
In every house where I come,
I will enter only for the good of my patients,
keeping myself far from all intentional ill-doing.

Hippocratic Oath

Would healthcare cost less
if medical insurance wasn’t subsidized by tax breaks
and regulated pricing mechanisms?

Did the largest generation of parents in American history
promise themselves healthcare benefits
their children won’t have enough money to pay for?

How much should taxpayers pay for medical costs
to extend the life of a terminal patient for 3 months?

Holtz-Eakin on Healthcare Legislation Accounting

The Real Arithmetic of Health Care Reform

...the Congressional Budget Office reported that, if enacted, the latest health care reform legislation would, over the next 10 years, cost about $950 billion, but because it would raise some revenues and lower some costs, it would also lower federal deficits by $138 billion.

In other words, a bill that would set up two new entitlement spending programs — health insurance subsidies and long-term health care benefits — would actually improve the nation’s bottom line.

Could this really be true?

...How can the [Congressional] budget office give a green light to a bill that commits the federal government to spending nearly $1 trillion more over the next 10 years?

The answer, unfortunately, is that the budget office is required to take written legislation at face value and not second-guess the plausibility of what it is handed. So fantasy in, fantasy out.

In reality, if you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion.

Gimmick No. 1 is the way the bill front-loads revenues and backloads spending. That is, the taxes and fees it calls for are set to begin immediately, but its new subsidies would be deferred so that the first 10 years of revenue would be used to pay for only 6 years of spending.

Even worse, some costs are left out entirely. To operate the new programs over the first 10 years, future Congresses would need to vote for $114 billion in additional annual spending. But this so-called discretionary spending is excluded from the Congressional Budget Office’s tabulation.

Consider, too, the fate of the $70 billion in premiums expected to be raised in the first 10 years for the legislation’s new long-term health care insurance program. This money is counted as deficit reduction, but the benefits it is intended to finance are assumed not to materialize in the first 10 years, so they appear nowhere in the cost of the legislation.

Another vivid example of how the legislation manipulates revenues is the provision to have corporations deposit $8 billion in higher estimated tax payments in 2014, thereby meeting fiscal targets for the first five years. But since the corporations’ actual taxes would be unchanged, the money would need to be refunded the next year. The net effect is simply to shift dollars from 2015 to 2014.

In addition to this accounting sleight of hand, the legislation would blithely rob Peter to pay Paul. For example, it would use $53 billion in anticipated higher Social Security taxes to offset health care spending. Social Security revenues are expected to rise as employers shift from paying for health insurance to paying higher wages. But if workers have higher wages, they will also qualify for increased Social Security benefits when they retire. So the extra money raised from payroll taxes is already spoken for. (Indeed, it is unlikely to be enough to keep Social Security solvent.) It cannot be used for lowering the deficit.

A government takeover of all federally financed student loans — which obviously has nothing to do with health care — is rolled into the bill because it is expected to generate $19 billion in deficit reduction.

Finally, in perhaps the most amazing bit of unrealistic accounting, the legislation proposes to trim $463 billion from Medicare spending and use it to finance insurance subsidies. But Medicare is already bleeding red ink, and the health care bill has no reforms that would enable the program to operate more cheaply in the future. Instead, Congress is likely to continue to regularly override scheduled cuts in payments to Medicare doctors and other providers.

Removing the unrealistic annual Medicare savings ($463 billion) and the stolen annual revenues from Social Security and long-term care insurance ($123 billion), and adding in the annual spending that so far is not accounted for ($114 billion) quickly generates additional deficits of $562 billion in the first 10 years. And the nation would be on the hook for two more entitlement programs rapidly expanding as far as the eye can see.

Douglas Holtz-Eakin,
Director of the Congressional Budget Office from 2003 to 2005

Megan McArdle on the Healthcare CBO Report

First Thoughts on the CBO Score

…the CBO process has now been so thoroughly gamed that it's useless.

…The proposed changes increase spending dramatically, most heavily concentrated in the out-years…The net cost has increased even more dramatically, from $624 billion to $794 billion. 

That's because the excise tax has been so badly weakened.

…the one provision which had a genuine shot at "bending the cost curve" in the broader health care market has at this point, basically been gutted. 

…Medicare Advantage is being effectively outlawed--in some areas, the reimbursements will actually be below those of the fee-for-service programs.

A disturbingly high percentage of the revenues still come from insurance premiums for other programs.  About $53 billion of the net deficit reduction is from Social Security taxes collected on the wages people will now be getting in lieu of health care benefits.  But since those contributions raise the amount Social Security will eventually have to pay out, the Republicans convincingly argue that this is not true "deficit reduction"; it's just deficit shifting.  Ditto the premiums for the new long-term care insurance.

Ultimately, this rests on the question: are we really going to cut Medicare?  If we're not, this gargantuan new entitlement is going to end up costing us about $200 billion a year next decade…

There are offsetting taxes, but they're either trivial or likely to be unpopular--look forward to a 4% rent increase when your landlord has to stump over the same amount for the new tax on rents.  Then look forward to repeal of same.

I think this is a fiscal disaster waiting to happen. 

But no one on the other side cares, so I'm not sure how much point there is in saying that any more.

Megan McArdle
The Atlantic

Does America’s healthcare industry maintain high profit margins by providing superior care and/or medicine, or by financing the political process with profits provided by patients?

You shall do no unrighteousness in judgment
in length, in weight or in measure.

Leviticus 19:35

Premiums jump 14 percent on Medicare private plans

Millions of seniors who signed up for popular private health plans through Medicare are facing sharp premium increases this year…

…premiums for Medicare Advantage plans offering medical and prescription drug coverage jumped 14.2 percent on average in 2010, after an increase of only 5.2 percent the previous year. Some 8.5 million elderly and disabled Americans are in the plans…

…Private fee-for-service plans, which offer a broad choice of doctors and hospitals, saw increases averaging 31.2 percent…

...Seniors who did not shop around for lower-priced coverage during open enrollment in the fall got hit with some of the biggest increases, averaging 22 percent…

…higher Medicare Advantage premiums for 2010 followed a cut in government payments to the private plans last year.

… bills pending in Congress call for even more cuts, expected to force many seniors to drop out of what has been a rapidly growing alternative to traditional Medicare.

RICARDO ALONSO-ZALDIVAR
Associated Press

Is the US government working to pass health care “reform,” written with substantial input from lobbyists who channeled tens of millions of contributions, by a committee chairman who doesn't understand it, by a Congress that exempts itself from it, and by a president that made an undisclosed agreement with the pharmaceutical industry to prevent generic competition and price negotiation?

When spider webs unite,

they can tie up a lion.

 

Ethiopian proverb

Why wouldn’t the healthcare industry’s position

as a top political campaign contributor, correlate to subsidized healthcare

being one of the government’s largest expenditures

 and if not, why does the healthcare industry contribute so much

to those who would reduce profits?

  

Does America’s healthcare industry maintain high profit margins

by providing superior care and/or medicine,

or by financing the political process with profits provided by patients?

Does the U.S. Constitution allow the government to require citizens to pay privately held entities for health insurance, and levy fines and/or taxes if they refuse?

The Individual Mandate: An Unconstitutional Exercise of Congressional Power

 

…it is somewhat surprising that little attention has been paid to the critical legal question of whether Congress has the constitutional authority to require Americans to purchase a commodity from a private, for-profit corporation.

 

…A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States.

 

…Article I, Section 8 of the Constitution grants Congress the power “[t]o regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes.” Therefore, in order for Congress to have the authority to require Americans to purchase health insurance, the purchase of health insurance must constitute “commerce” within the meaning of the Commerce Clause. It does not.

 

In 1982, the Supreme Court declared that, in order for a commodity to be considered an article in commerce, it must be capable of being sold. Sporhase v. Nebraska,

458 U.S. 941 at 949 -- 950 (1982). While there is no doubt that the sale of health insurance by an insurer constitutes commerce, it does not follow that the purchase – or more precisely, the failure to purchase – health insurance by a consumer also constitutes commerce. Health insurance, once purchased by a consumer, is not capable of being further sold in commerce because there is no market for it; who would purchase a health insurance policy naming someone else as the insured?

 

…there is no market for health insurance benefits once the policy is issued. No one would buy my health insurance, because no one other than I can derive any benefit from it. Since there is no market, health insurance is not an article of commerce once issued. If it is not an article of commerce, Congress lacks authority under the Commerce Clause to require me to purchase it.

 

…For single-payer advocates, a very powerful argument is that, while the individual mandate to purchase private health insurance is unconstitutional, Congress can lawfully tax to support a government financed health insurance program. Article I empowers Congress to use its taxing powers in support of government programs that foster the public welfare; this is the constitutional authority for Social Security and Medicare. But to extend that authority to requiring Americans to purchase a private commodity raises profound civil liberties issues.  If Congress can compel the purchase of insurance from a for profit insurance company, it can compel the purchase of any commodity if there is an arguable public policy to support it.  The auto industry is collapsing?  Forget Cash for Clunkers, just order Americans to buy cars or tax them if they don't.  Obesity crisis?  Order Americans to join health clubs, or tax them if they don't.  If Congress gets away with this, there is no stopping point and Big Business will have  succeeded in making Americans into involuntary consumers whenever it so chooses.

 

Sheldon H. Laskin

After Downing Street, December 20, 2009

The Cost of Healthcare to Life Expectancy Relative to Other Countries