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HIV testing

So it’s a law in New York that if you are admitted into an emergency room in a New York hospital, the staff HAS TO ask you if you’d like a HIV test performed while you’re there.

  • Mind you, the hospital won’t pay for the testing, that’s on you (but they don’t tell you that, at least, initially).
  • Mind you, age is no barrier: they will ask you if you’re 12 years old (Sheesh!!).
  • Mind you, the law just states that they just have to ask and show proof that they did ask (appropriate forms must be filled).

My question: with all that’s going on politically, economically, socially in this country, in this state, who was the Einstein who came up with this brainstorm and then believed this little time-saving nugget of an achievement was worth authoring and fighting for?

Solving the healthcare problem

Here we go again …

Here’s how to solve the spiraling costs of healthcare:

1. Take liability out of the equation – Doctors

To start with, we have to put a cap on malpractice suits. When something goes wrong there is not necessarily a lawsuit. Often a lawsuit depends upon the rapport the doctor had with the patient. If they had a great relationship, there’s usually no lawsuit. If they didn’t, there is. It’s surprisingly that uncomplicated.
That doesn’t mean the doctor should go scot-free but there could be extenuating circumstances (high-risk patient, etc.). If it’s a case of extreme doctor or practitioner negligence, then it’s strike one. Three strikes and you lose your license, go find another job, another career. It happens all the time to the rest of us.

2. Take liability out of the equation – Equipment

But liability in this instance encompasses the equipment itself too. Medical equipment is overly expensive due to -in part- product liability. When lawyers get a hold of a good case, manufacturers of medical equipment are called to task too.
If we can begin to limit malpractice and product liability, we can make great inroads into costs.
But we must train doctors in their bedside manners first, get them to build a greater rapport with their patients, and, regrettably, if those doctors can’t make the effort to connect with their patients then they really do need another job.

3. Reduce the over-proscribing of tests

This gets back to points 1 & 2. Doctors and the medical profession are now so ingrained defensively to protect themselves against lawsuits that they are abusing MRIs and CAT scan and the like. You don’t need multiple MRIs over a period of several weeks in order to understand a problem.

4. Universal coverage

No, no, no, I’m not suggesting a government-controlled public option. That would be the worst of all worlds. The last thing we need is government to create more administration. I do think though that one way to lower costs is to ensure that everyone has affordable healthcare. Doctors cannot refuse to see a patient in an emergency room, but emergency rooms are tremendously expensive and should be reserved for emergencies not regular care. When people use emergency rooms in place of a normal visit, they drive up costs.
If we can reduce extraneous procedures and tests and drive down the amount of overhead built now into the system (administration, forms, red tape, etc.) it would reduce costs significantly.

5. Inform the patient of the costs

If patients knew how much things cost, they might actually exhibit the kind of cost controls the system can’t do for itself. If I have a choice between a $300/day prescription and an identical $10/day generic prescription, I’m going for the $10/day. If we already know I have a blown disc and we already know it’s pinging the nerves going down my leg and we are looking at an MRI that’s only a few months old, why do we need to go through another round of $3000 MRIs? Why does an appendectomy cost $33,000 in some parts of the country and $5,000 in others? For the extra $28,000 you could have a very nice vacation in some of the more expensive parts of the country! And that would be more productive spending of money!
See? It’s easy. Done.

Insurance and Capitalism, welcome bedfellows

Rick: Louis, I think this is the beginning of a beautiful friendship.
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The last line of Casablanca. I think of this line every time I think about insurance companies and capitalism. What a pair! If ever there was an industry made for capitalism, it’s the insurance industry.
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First, class, let’s start with our definition, our formula:
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…….. insurance = legalized gambling
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It’s very simple actually, in the case of life insurance, for example, you’re betting you’re gonna die, they’re betting you’re not. Ahh, yes, you’re protecting your family from the wicked vicissitudes of the future, because we all know how cruel the future can be.

Some thoughts on GDP (and how to lower taxes)

Some thoughts on the US GDP

Gross Domestic Product (GDP) is a fascinating little number. As a basic measure of an economy’s performance, it measures the market value of all goods and services made in a nation in a year. Simplistically one way (there are 3) to measure GDP is to add together: consumer spending (or consumption), business spending (or investment), government spending and the net of imports and exports.


GDP = C + I + G + (X – M).