Posted on: April 2, 2009 3:55 pm

A prescription for condoms?! What size?

Our federalies want us all to have good quality, readily available healthcare. Who doesn't? Healthcare costs are ridiculously high and we must find a way to reduce the cost. Naturally government thinks they can turn the efficiency knob such that we all get the needed coverage at a lower cost. This is where people tend to start getting off the band wagon citing previous attempts like social security, medicare and medicaid that have failed to deliver the panacea of social promise. Everyone on board so far?

So the idea of national healthcare has been advanced and a plan is in place to drive us irrevocable in that direction. We have protagonists citing successes in France, Great Britain, and Canada. We have antagonists citing failures in France, Great Britain and Canada. What to do? Who to believe?

Mistress Smorgie is not afraid to advance a notion, nay a plan, to greatly reduce medical costs. And get this, it is simple! And I can guarantee success! I know, I know. Our well earned pessimism prevents us from getting on board. But I will give it a try anyway and I will base it on a bit of data to make you all feel better.

Everyday in every doctor's office around the country there are tens if not hundreds of patients plunking down money to see their doctors in the so called office visit. Let's assume it is no more than 10 patients an hour per doctor in the facility - so 80 patients per day. Let's assume the doctor charges $100 a visit (might be high but it makes the math easy). If you have insurance you may have to pay something like $25 or $30 bucks out of your pocket and your HMO or other insurance picks up something less than the balance. So for every doctor in the building it is conceivable to raise $8000 a day. If the facility has 5 doctors and they achieve 100% utilization they can generate $40,000 a day in billable sales. That is a whole bunch of money in a year and totals something over $10 million before taxes, wages, overhead, etc.

But for what? Let's assume we have a general practitioner office with 5 doctors and no shortage of patients ringing our phones. What percentage of those folks are showing up because they are sick? Let's say 50% are showing up because they have something wrong. What percentage of these folks know what is wrong with them? To be simple, how many know they have a fever and a cold? Or a very sore throaght? Or poison ivy? Or a bladder infection? Or an ear ache? You get the point. We know what is wrong with us usually. And we know what the treatment will be. Ear ache or strep - amoxicillan. Bladder infection more antibiotics, poison ivy - methylprednisone, pretty simple so far. Why not make these medications semi-over the counter? Meaning why not let the pharmacist dole out these types of medications as they see fit, skipping the doctor's office visit. When they come up on something that is above their call they can refuse to dispense the meds and advise you to see a doctor.

Want a great example? The yeast infection (sorry guys). We women know we have one immediately. No doubt. Not too long ago we had to go to the doctor everytime to get a prescription for a medication we know we need. Fortunately the powers that be (feds) made these medications over the counter so we could stay out of the doctor's office. Have you heard of anyone becoming addicted to Monostat 7 in the last decade? We women are not abusing the system.

In some European countries you do not need a prescription for eye glasses or contacts. You just pick up the corresponding set right off the shelf. And why not? Is there any benefit in wearing the wrong kind of glasses? Who wants to do that? I like mine blurry so I think I will get these. That is garbage. You still have to go to the optometrist to make sure you are healthy and to find out what your eye condition is. But beyond that, you should be responsible enough to pick them out. Think of it like this. To buy new wiper blades for your car you have to go to a mechanic to tell you what size you need and then you go the autoparts store and present your prescription for wiper blades. Not the same? Wiper blades help you with your vision don't they. OK maybe it is a stretch. Imagine if condoms were by prescription and some of you boys had to get measured - extra small for this one, ouch!!

The point is people should be able to be responsible for picking and choosing medications they need in the more mundane cases. Not the fancy life threatening variety to be sure.

But why do you need to pay $100 to have the doc take one look at you and scribble something out on a pad of paper when you already know what you need.

OK - you don't feel comfortable self medicating (I doubt that - think aspirin and a lethal dose). Remember, the pharmacist is more than capable of deciding who should and should not have amoxycillin or prednisone, et al. These are the facts.

So a simple way to cut costs is to make more medicines available over the counter or at least semi-OTC where the apotheke or pharmacist doles it out.





Posted on: February 5, 2009 10:59 am

Fear mongering? Or don't know what to do?

"Irreversible recession" Obama warned in his op ed piece in the Washington Post.  In all my schooling in Economics, macro and micro, I have never heard the term. 

What does it mean? I suppose it means Obama doesn't know what to do other than spend money to stimulate the economy with wish list pork spending and if he doesn't get his way we are doomed.  How can the Hope & Change candidate become so doom and gloom so quickly? 

Because there are myriad of ideas being floated that could stimulate the economy.  Things like tax cuts for individuals and business, you know, to let the people decide how to spend their money in their economy. This thing will take care of itself, you can bet on that.  When the government got involved in the Great Depression they prolonged it by 7 years by eliminating competition, instigating protectionism policy, granting sweeping power to Labor, legalizing collusion and anti-trust, wage fixing above market value, and the list goes on. Principles of Socialism, but I digress.

What gets me really irked by his Carter-esque gloom and doom was this comment:

He rejected the argument that more tax cuts are needed in the plan and that piecemeal measures would be sufficient, arguing that Americans made their intentions clear in the election. "I reject these theories, and so did the American people when they went to the polls in November and voted resoundingly for change," he wrote. Talk about over reaching the results of the election.  Wow, the arrogance is astounding!  The people did not vote for a Pork Stimulus Package when they elected him president.  I am absolutely certain I did not see that plank in his platform when I vetted him all last fall on my blog.  I don't remember any Obama supporters chastizing me last fall that I had ommitted it either.

The honeymoon for Obama ended far sooner than I ever thought.  The media is now awake and will pick him apart.  I would now put his odds at re-election at 1 in 4.

On the bright side of the economy, consensual sex is still free! Thank goodness....

Category: NCAAF
Posted on: January 8, 2009 9:50 am

Felt up for 20 bucks....

Last week the Wall Street Journal ran an opinion article about what Obama's National Healthcare Plan might be like. The author took most of their points form Tom Daschle's book on the subject and for those that don't know he has been appointed to lead the effort in the new administration. The main point of the article was the almost certainty of metered health care. By metered, they mean there will be an oversight committee (appointed, not elected) that sets the treatment plans paid for under the plan and to which age groups the service will be provided. Sorry, grandma, you are too old for knee replacement surgery. The author was looking to put fear into her reader with these comments but there is truth to it none the less.

On Tuesday of this week, the WSJ printed several responses in the Letter's to the Editor page. These responses were from healthcare professionals (doctors and administrators). They brought up some great points. Like how is this any different from an insurance company today. They put limits on treatments today. True. But two such responders went on to write (paraphrasing) that many of the current treatments are marginal or only slightly better than cheaper treatments and, therefore, should not be used or more clearly, not covered under the plan. There is truth in this statement, but history shows that breakthrough invention is built on the backs of many failed attempts, marginal attempts and only slightly better attempts at improving whatever situation is at hand, be in medical or industrial or commercial. What this means to me is our healthcare system and the drive toward new cures and treatments may very well stagnate. We have to remember pharmaceutical companies are in the business to make money for their shareholders. It is that simple. If there is no money in new treatment options or the method of approval is too protracted, research will not happen. The regulations require a drug company to spend potentially hundreds of millions of dollars just to get it to market. If the National Healthcare System won't pay for the use or treatment, the drug companies will stop research and development. Progress in healthcare may cease or slow so greatly that twenty or forty years into the future we will have changed very little.

Think about the last 25 years with respect to heart by-pass surgery. It went from a radical surgery requiring many months of recovery to a ho hum procedure that sees the patient home in a few days. In those 25 years, the procedure has improved in small ways with better medicines and techniques. Each one slightly or significantly better than its predecessor. The result is what we have today. And those techniques and medicines have found their way into other procedures like joint repairs.

The root problem that causes a system to restrict the treatments is driven purely by cost. If it is too much, we will not do it. Eliminating treatments is one way to lower the cost. But what about lowering the cost of practicing medicine. I recently had my annual Ob-Gyn visit. The bill to the insurance company was $430 for one visit. Insurance paid $157. I paid $20 out of pocket. The doctor billed $430 and he received $177 (and was happy about it.) Does this make sense?

How about tort reform? You know, doctor screws up a procedure (they are human), sued for malpractice, settlement is for $5 million, lawyer gets $2 million, client gets $3 million. Oh, the patient is fine mind you, a little worse for the wear, deserves some compensation no doubt to make up for their loss. But the lawyer got how much!!! Doctor's insurance goes up. He passes the cost on to you and me.

So here is the rub. A National Healthcare System is probably a good idea. But how do we do it without killing our economy (cost) and still allowing the entrepreneurial drive that leads to innovation? How do we ensure that people want to be doctors in the future. If their hands are tied many may choose to do something else with their talents.  Caution is absolutely needed as we move forward.


Category: NCAAF
Posted on: December 12, 2008 2:12 pm
Edited on: December 12, 2008 2:15 pm

It's just my way...

“What happened to your arm?”  “I, ah, fell against the dresser.  It’s no big deal.” “Hey, I’m your friend, don’t give me that.  Did he do that to you?  Was he drinking again?” “You just don’t understand. He works hard but never gets ahead and I put demands on him and he just snaps sometimes. That’s just his way.”                                                                                                                                                                                                                                      Conversations like this happen everyday with regards to many different forms of abuse, be it alcoholism, domestic violence against a spouse or child, or any other sad situation where a person is abused. We have all been educated to look for signs of abuse and, hopefully, to report what we see to the authorities so that abuse can be stopped.  Medical professionals are now trained to look for signs of abuse. Teachers and others are also on the look out for forms of abuse and neglect.   By this time we are all paying attention or at least we should be.   That said I heard many discussions this week in the media where the punch line in each story was “that is just the way it is, the Chicago way.” Now this is different from physical or mental abuse of people since it is only politics.  Or is it? None of us can ignore physical or mental abuse when we come face to face with it.  But here we are using the same logic a victim of physical abuse uses to defend their tormentor.  That is just their way = that is the Chicago way.    Farfetched? I don’t think so. Our politicians are hired (elected) to do a job on our behalf.  When they abuse their power for personal gain we are being hurt by special interests or even criminal intent. If we choose to ignore it, to wash it away with a simple that’s just the way it is.  Then we are contributing to the problem. We are enabling them to continue their abusive behavior.  We are all so very cynical about politicians and their purported honesty.  We all know at least one joke where that is the punch line.  Yet we continue to fall for their promises and elect their selfish interests to represent us all.  We are all victims, victims of an abusive relationship where we hold the power to stop it but are either unwilling or afraid to act.   Americans – please stop enabling these abusive politicians or you will continue to play the part of victim.  When the Constitution was framed the founding fathers never dreamed anyone would want to serve multiple terms in any office because it took time away from the farm or their business.  They used words like civic and duty to describe the roles of office holders not bureaucrat or politician. It falls to the voter to invoke term limits on these life long politicians. But we don’t. We tolerate it. We re-elect them. We build statues and name streets for them.  We encourage them to abuse us more.   We are all victims. The Chicago way illustrates it for us. 
Posted on: November 11, 2008 8:29 pm

O vs. W = hmmmmm?

For everyone who thinks George Bush is an idiot with a myriad of failed policies and all that, explain the about face already by Obama on his "exit Iraq NOW!" strategy that was a cornerstone of his campaign.  My intent is not to start another who is right and who is wrong discussion about last week's election.  What is done is done.  I am moving along.

But what is interesting is how fast Obama changed his tune after only one briefing.  Now there are only two conceivable reasons he would change his direction so fast:

  1. He never really wanted to leave Iraq and was just pandering for peace votes - Not likely because I don't think he is that big of a liar (read politician).    - OR -
  2. He learned the facts of the world.  Things none of us are privy to.  The briefings were so scary sobering that he saw the light very quickly and put the brakes on the strategy.

Now if #1 is true then he is a major flipflopping politician who lied to the nation.  But if #2 is true it means that some of the critics of Bush may need to rethink their harsh rebukes.  I am only suggesting this for your consideration.  But it does make sense.  For ten months that is all we heard.  Get out of Iraq now.  But today we hear the opposite.  I can only imagine what changed his mind, but I think it bears careful reconsideration of the actions of George W. Bush.  No, he is not perfect and not deserving of a clean slate (just yet anyway), but perhaps he deserves to be seen in a different light not tarnished by vitriolic hatred fanned by a negative media, but looked at in careful review with due dilligence to all the facts, even the ones we don't know (yet).

Just my opinion.  Your thoughts.....

Keep it civil folks, I like it better that way.

Posted on: November 9, 2008 2:11 pm

Biden's warning....Leaves me still wondering

Joe Biden gave us an ominous prediction a few weeks ago about  an international test for the new administration.  In fact he used the word crisis to describe it and then went on to say the administration would appear wrong in their initial handling of the incident.  So the remark came and went and no one wants to talk about it.  Does Joe know something or was he just whistling dixie out his backside to scare little ole me?  (picture me batting my eyelashes and feigning fear)

So I have been wondering about what it might be. Failing to talk about it makes it fair game for conjecture.  And who doesn't like a little what if to make your mind wander?

Number one on the conspiracy hit parade is:  Netanyahu will likely be elected head of the Israeli state and the campaign promise to attack Iran's nuclear capability.  Wow, talk about a crisis.  So what does the administration do that will appear wrong?  Not come to the aid of Israel in the almost certain shooting war in the Middle East?  I wonder how the large number of American Jews who voted for Obama will like that scenario?

Number two:  V. Putin is on a mission without God (say it like Elwood Blues would say it).  We're putting the band back together.  First Ukraine, then Latvia, Blue Lou from Lithuania, Poland,.....   So much for NATO support, is that the "wrong" decision Joe speaks of?

Perhaps it is unfair to hold Joe to his pre-election rhetoric.  But it is a dangerous new world out there and I can't help but wonder what it was like for President-elect Obama when he got his first briefing from the guys in the know.  You know - the unfiltered stuff right out of the spigot.  Still feel like sitting down with the despots that lead our enemy states?  Rhetoric is easy, now comes action, resolve and a projection of strength.  You'd better be up to it if number 1 or 2 come to pass.

Have a great week minions!

Posted on: November 6, 2008 5:34 pm

The Urban Class War

The pundits and talking babblers have talked adnauseum about class warfare in the days leading up to and after the election.  Obama did all he could to ignite a class war with his tax the rich and give to the poor policies.  In the end it became the rallying cry for so many and the final decision point for others.  But I am not sure there is a class war at least as these learned journalists and politicians have stated.

I did a lot of studying of the electoral map in the last day or so.  It is obvious there is a "class" war in these Sort of United States when you look at the picture but it is not about low - middle -high income brackets at all.  It is about urban and rural.  By looking at the color map by county on CNN.com one could define where every large urban population AND university town exists throughout the country simply by looking at who voted democrat majority (colored blue on the map) and who did not (repubs). 

In straight up land mass, our country is a bright red republican majority. But where it is population dense it is pure democrat.  How would you like to be a farmer living in rural Illinois getting dominated by the Chicago democrat machine, or Indiana (Gary and Indy), Ohio (Cleveland, Columbus, Athens and Cincy).  You can look at any state and you will easily see where the cities are.  Texas is totally red except for the cities.

So why the difference?  I would suspect it has something to do with birds of a feather flocking together.  But it is deeper than saying poor people or minorities are attracked to cities.  I am sure there are poor folks that live in Nebraska and Texas who vote republican.  What is it that fundamentally divides us along these urban and rural lines?  Welfare is offered in every state and every county.  West Virginia is proof of that and they voted republican - no large cities either, though. ( I lived there for a while so that is not a dig, just an observation.) 

So the issue is what is the fundamental difference between living in a city and not?  Are country folks too proud to ask for a hand out?  Are city folks too easily conditioned not to?  Is it because the cost of living in the country is less?  If so, then why don't the have nots leave the city, come breathe the fresh air and raise their kids outside the failing schools of the cities.  And leave the crime behind when you turn your backs on the city.  Every city has higher taxes than the country too, so you automatically get a break by leaving.

Every politician promises more money for cops, more money for schools, and more money for the indigent.  Why don't we help them leave the cities so they can understand the values of the folks that live in the country?  That would be great for the cities and their failing budgets when they shed the burden of the untaxed resident.

I know what you city folks are saying.  "Now hold on just a darned minute, there is no way I am leaving the greatest city on earth (fill in your own city) to go live with back woods folks in the boring old country."  Well it probably was shorter than that and contained actual profanity but you get the point.  But tell me what is so great about living in a city.  Pro-sports, yeah got that.  A myriad of entertainment, ok sure.  Great restaurants, got it.  Culture sure.   Well what about grid-lock, crime, noise, pollution, crowding, dangerous failing schools - are those just the price to pay for good seats at the game?  Oh, my tv picks up all those games and shows, and I do know how to cook pretty well, too.

Nope there is no class war in this country.   It is urban - rural warfare.  And somewhere in there is the key to solving our nations problems.  For those who have read my posts you know where I stand on increasing taxes (especially my own), imagine what it is like for you city folks (you are the majority) to pass tax increases on the country folks (minority) to spend on your folks in the cities.  Now I realize there are Repubs and Demos in every part of the country, I am generalizing here, but can you see where the animosity might come from that leads to this "urban" class war?  To Mr. Obama, if you want to reach out to America, you will have to leave the cities to do so.

Seems obvious to me. 

(BTW- I do live in Cincinnati! but I have lived in the country most of my life and I see the best of both worlds.)

Posted on: November 5, 2008 8:31 am

The Death of Aunt Fillamina Buster

My mean old Auntie Fillie Buster has died.  She was a crusty old lady who could stop a discussion cold with a steely stare.  She could impose her will on the family without so much as a peep of descent.  This wouldn't have been so bad if we ALL agreed with her but she tended to be a pretty far left thinker and took no pleasure in listening to other's points of view.

For those who cannot see through my prose.  I am speaking of the one great victory for America last night.  The Democrats were unable to secure the fillibuster proof majority they sought in the Senate.  This is huge otherwise there would have been no checks and balances on this Congress or Administration what so ever.  And given their somewhat radical tendencies to the left I believe this was an imperative.


A final thought that really pissed me off as an American.  I wonder if I was the only one who picked up on it.  When it became apparent that Obama would win, the talking heads of the networks began to wonder out loud what kind of president he would be.  They began to make statements like:  Well, we don't really know where he stands on this issue or that issue and on and on. 

Wasn't that your job Media folks?  To find out by asking questions? 

The media is Dead along with Auntie Fillie Buster.

The fourth estate, guaranteed by the first amendment protecting free speech, failed to do its job through the primary season and throughout the election season. 

Most media outlets are bleeding cash, print media stock prices are one-fifth of their price a couple of years ago.  A correlation there?  I think so.




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