Blog Archives

Why America’s Healthcare (Sickcare) System Is Broken and Unfixable

Here’s a two-word summary of why the American healthcare system is fundamentally broken and cannot be fixed with policy tweaks: perverse incentives.

If you type sickcare in the custom search box on this site, you get 10+ pages of articles. I have covered healthcare/sickcare in depth for many years. I have many correspondents within the sector (doctors and nurses), and have paid the unsubsidized costs of insurance as an employer or as a self-employed worker for 30+ years.

Here are two charts and three stories of many I’ve published over the years:

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What’s Lurking Beneath the Glossy Veneer of the Jobs Report?

The jobs report has little value if we don’t peer beneath the glossy veneer.

On the surface, last week’s jobs report was glossy good news: the U.S. economy added 288,000 non-farm jobs. Beneath the glossy veneer, however, the news wasn’t quite as good as advertised: full-time jobs declined by 523,000 and part-time jobs surged 840,000.

Courtesy of Zero Hedge, here’s a chart depicting the entire job market:

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How to Make a Million: Extortion Creates its own Antidote

The problem is its own solution. Whether we try to stop the Status Quo, or let it stop, it WILL stop.

Longtime correspondent Eric A. has a new essay describing a key dynamic of the years ahead: Extortion and skimming create their own antidotes. As the costs of skimming, extortion and corruption reach new heights, the savings to be gained by bypassing the Status Quo systems also increase.

Eric’s point is that the incentives to escape the debt-serf plantation are rising in parallel with the skimming of the state-cartel Elites.

Here’s is Eric’s provocatively insightful essay:


Concerning the Middleman-Skimming Economy, I’m here to tell you, it’s not all bad! The oppressive system you describe of graft, fraud, theft, and extortion creates its own antidote.
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Greed + Cartels = U.S. Sickcare/ObamaCare

Sickcare/ObamaCare is fundamentally broken at every level.

The incremental nature of change makes it difficult for us to notice how systems that once worked well with modest costs have transmogrified into broken systems that cost a fortune. Exhibit # 1 is higher education: 40 years ago, four-year public universities were affordable and two-year community colleges were almost free. Now students have to borrow $1 trillion to pay for the exorbitant privilege of higher education.

Longtime correspondent Ishabaka (an M.D. with 30+ years experience in primary care and as an emergency room physician) responded to this article with an insider’s account of what happens when greed and cartels take over healthcare.After reading What’s wrong with American hospitals?, a scathing deconstruction of for-profit healthcare, Ishabaka submitted this commentary:

I could have told you what was wrong with our hospital system by 1989 – nobody would listen to me back then.

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Our Middleman-Skimming Economy

The Internet is enabling sellers and buyers to bypass the predatory State and the parasitic middlemen the State enforces.

Why do we read commentaries and analyses? To understand why the Status Quo is dying and to have a hand in shaping the new way of living that will replace it.Longtime correspondent Zeus Y. recently encapsulated the core dynamic of our era:

“Here’s the deal between the two worlds right now: the Status Quo is dying but trying to take everything with it and the other is trying to hold the old world up enough to avoid complete collapse, buy time, and construct the airplane of the new world, all while flying.”

Humans avoid changing current arrangements until there is no choice left but to change them–usually when the arrangement collapses in a heap. Greece is an interesting example of just this dynamic: the political parties left, right and center are desperate to keep the corrupt Status Quo intact, while those whose slice of the swag has vanished have already moved on to new arrangements that no longer depend on Central State swag or the many layers of middlemen that skimmed off most of the wealth for various monopolies, cartels and Elites:
After Crisis, Greeks Work to Promote ‘Social’ Economy.

Here’s the Status Quo arrangement: the Elites trying to take everything they can before their vast skimming arrangement finally collapses:

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America’s Make-Work Sectors (Healthcare and Higher Education) Have Run Out of Oxygen

We can no longer afford the expansion of healthcare/education or their out-of-control costs.

If we strip away obscuring narratives, we can clearly see that the two employment sectors that have expanded rain or shine for decades have functioned as gigantic make-work projects. I refer of course to healthcare and education, specifically higher education.

We can see the outsized gains in these sectors by comparing total population growth to the number of full-time jobs and the number of jobs in education/healthcare since 1990. Here is total population: a 27% increase since 1990:

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Our Two Most Onerous Taxes: College Tuition and Healthcare Insurance

It is not coincidence that these two unofficial taxes–healthcare and college tuition–are soaring in cost, outpacing all other household expenses.

I have long argued that to make an apples-to-apples comparison of real tax rates in the U.S. and other equivalently developed advanced democracies, we have to include two enormous expenses that are funded by the central state in countries such as Denmark and France: healthcare and college tuition/fees.

In The Real-World Middle Class Tax Rate: 75% (July 5, 2012), I estimated that healthcare insurance (if paid out of gross income, as we self-employed workers do) in the U.S. is roughly equivalent to a 15% tax.

Now that the Orwellian-named Affordable Care Act (ACA) is raising costs and deductibles, the true cost of healthcare (a.k.a. sickcare, because being chronically sick is so darned profitable for the cartels) is more like 20% in America.

Correspondent Tim L. (whose daughter is attending a prestigious STEM–science, technology, engineering, math–university) recently called $40-$50,000 per year college tuition what it really is: a tax:

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