Tuesday, December 25, 2012

It's Not Greed - It's How Business Survives the Pressure to Centralize

(c) 2012 by Tom King

A friend sent me this link to an article about the practice of medical systems buying up doctors' private practices.  http://www.star-telegram.com/2012/12/23/4505491/as-hospitals-buy-practices-billed.html

He wrote above the article:  "Pure Unadulterated Greed". 

The article started like this:

By Fred Schulte
Center for Public Integrity
After Vermont hospitals started buying up local doctors’ practices, state Sen. Kevin Mullin of Rutland began hearing complaints that some patients were paying much more for routine care.

I disagree. I don't think it's so much greed as it is the added cost of centralizing any bureaucracy. Nobody seems to understand that any time you add layers on top of any organization, that those layers cost money.  I don't think the medical systems are necessarily greedy any more than are the doctors who sell their practices.  I think it's just the good old capitalist, free market system's response to outside pressures on independent physicians.  For years we've been hearing that independent physician's practices are disappearing.  Where did people think they were going anyway?

There are very good reasons for doctors to sell their practices and very good reasons for hospitals to buy them. Spiraling regulatory requirements layered on willy nilly by the government and mounting medical malpractice lawsuits, driven by TV lawyers (the real parasites in my opinion) promising to win the sue 'em till they squeal lottery for anybody whose doctor visit didn't turn out the way they had imagined.

Let's face it, doctors want to practice medicine, not accounting, law or tag-you're-it with government regulators.  To doctors, selling their practices to large medical systems with teams of accountants and lawyers and compliance officers just makes good sense.

And yes, it drives up your doctor bills.  How else are they going to pay for all those new federal employees Obama just hired and all those commercials by all those ambulance chasing lawyers and all those tax accountants it takes nowadays to keep a medical practice going.  It's much easier for doctors to sell out and have the gigantic health care system protect them from all those bureaucratic predators and buying practices is a way for health care systems to pay for all the accountants, lawyers and compliance officers they need to run their hospitals. 

THAT's why I find centralizing or worse yet, governmentalizing any business sector to be a very BAD idea.  I don't like paying for people who basically sit in offices generating paperwork for each other, making things ever more complex and hard to do and charging us poor schmuck consumers for services I never asked for and personally find worse than useless.

Just my opinion.



Saturday, December 22, 2012

What Next? Road Control Laws?

Without roads people wouldn't be able to drive
cars anywhere so they wouldn't have car
accidents anymore and the middle class would
be preserved - right?

I took two graduate courses in statistics and research. One thing I learned is that Benjamin Disraeli’s purported comment about statistics is true.  There are, in fact, “Lies, damned lies and statistics.”  Used properly statistics can be quite useful. They show us which medications work, what problems our society needs to solve and Mark Twain’s overall negativity at different stages in his life.  The study was based on the number of times he used a form of the word “NO” in Huckleberry Finn vs. Tom Sawyer.  It’s burning issues like that now that really show off the power of statistics. 
We are constantly showered with meaningful statistics on the news, in books, magazines and even in our Sabbath sermons. For some reason we accept cold mathematical statistics as proof over almost any other form of persuasive data. After all, how can math lie?
Well you might ask.  The truth is, math doesn’t lie.  People lie. They just use math as a tool to support the lies.  One group uses statistics to prove that gun control doesn’t work.  Another uses statistics to prove that it does.  Throw in a few logical sounding anecdotes and you’ve got enough proof for your average drive-by consumer of information - whichever he happens to hear that most closely meets his already preconceived notions.
I stumbled across an interesting set of statistics from the WHO today that I’d like to throw out there for your consideration and to point out how you can get a wrong-headed conclusion from any statistic.  I was looking at worldwide causes of death as parsed out by the income levels of the country in question.  Of the top 10 leading causes of death, the first nine are all forms of disease. The slaughter caused by so-called “natural causes” runs to a staggering 28.32 million deaths annually. We don’t get to the first non-natural cause of death till we get to #10: Road traffic accidents.  More than 1.21 million people die as a result of road-related accidents.
These roads must be stopped.  Ah, but “No!” says the chairman of the American Automobile Association. “Roads do not kill people.  People using roads kill people.” 
Immediately the chairman of the Amelgamated Society to Stop Highways and Open Lanes from Existing shoots back, “Well that’s just absurd. Everybody knows that when the nation of Lower Bulemia banned roads altogether, road-related accidents dropped by 46%.
Next thing you know, you’ve got some fool in Congress sponsoring a National Roads Limitation Act, especially after he sees polls that say that 52% of people in his district support the idea.
Or better yet, let the progressive socialists get hold of it.  Did you know that according to WHO, road accidents are highest among middle-income nations; ranking seventh in total deaths in middle income nations. Road accidents don't even show up in the top ten causes of death among poor and rich nations.  So, now roads are obviously a threat to the middle class.  Amid much hand-wringing and cries of “What shall be done to save our middle class from all the road-related carnage?”  The media starts pouring on stories about how roads are at war with the middle class and they lay the blame at the feet of the construction companies that build roads.  If it wasn’t for their incessant greed which drives this road-building madness, thousands of innocent middle class people would still be alive and actually going to the polls themselves to vote for Democrats.
“I know,” some bright would-be member of central planning says. “Let’s get rid of roads and we can all ride trains.”  The reasoning is like this.  Poor people don’t drive so that’s why road accidents are fewer in poor nations.  Rich people don’t need to go anywhere on roads, the central planner reasons, because everything gets brought to them by the middle class and the poor, so they don't need to drive on roads. Either that, or they fly helicopters, take their yachts or hire chauffeurs. In any case, the top 1% don’t need to use roads which road accidents don’t make top ten list. 

Therefore, using our best Socratic logic, as learned watching David Letterman on late night TV, road accidents makes the top ten death toll in middle income nations because:
  1. Using roads is what kills so many middle class people. 
  2. If these roads didn’t exist, middle class people couldn’t use them.
  3. If middle class people could no longer use roads and used trains instead then…..
  4. The death rate by road related accidents would go down if we passed a law banning roads.
Voila!  Something gets done. A law is passed.  Passing a law is always the solution step on any progressive's list of logical reasons we must do something about anything that shows up in the news. Remember the progressive creed. Never waste a good crisis! And to the progressive socialist, passing a law is always the thing that must be done since passing laws, according to their creed, solves everything.

Of course, nothing ever actually gets done about reducing the number of roads cause to the surprise of central planning, people actually need roads and trains are too danged expensive.  A new federal bureaucracy gets created, however.  It becomes more costly to build roads what with all the new paperwork.  The existing roads deteriorate because instead of maintaining them, the funding is going toward paying for the new road reduction regulations.

And the final kick in the teeth - death by train wrecks rise.
But, what about the dingbat who thought the whole thing up? Well he gets himself re-elected because the media trumpets said dingbat’s spectacular success at getting “important” legislation passed and nobody bothers to ask whether any of his legislation did any actual good.
And civilization careens merrily on down its poorly maintained roads toward a certain destruction of its own making.  God save us all – or at least the 52% of us who want to be saved according to a recent Gallup Poll.
© 12/22/2012 by Tom King

Tuesday, December 18, 2012

Let's Write Some MORE Laws - That's the Ticket!

(c) Tom King
License  Some rights reserved by jurvetson

After a week like this one, we're sure to see a string of teary-eyed politicians telling us we've got to do something to prevent these kinds of tragedies from ever happening again - as if politicians have the power to stop anything bad from ever happening or causing anything good to happen for that matter.  Politicians live to make laws.  It's the politician's raison d'ĂȘtre. A politician does not feel like he or she is a politician if there's not a law passed with that politician's name on it.  The media encourages that by remarking sagely as to the number of laws named after a politician when the pundits and political hacks are evaluating said politician's career (usually after the former senator, congressman, mayor, etc. is safely dead).  Passing law is the mark of political success.  I've never heard of a politician being praised on the six o'clock news for getting rid of laws, have you?

It makes sense then that in the wake of the Newtown, Connecticut school shootings that politicians would feel and overwhelming urge to pass a law. And you can bet it will be a gun control law.  The thinking is that if you get guns out of the hands of these people, then they can no longer go on shooting rampages. Only they won't go that far because the NRA is too powerful.  They'll just reduce the legal size of magazines, figuring criminals won't be able to kill as many people if they can't shoot so many without reloading.

Problem is, these guys aren't criminals that shoot up schools and shopping malls. They're people who should be in a mental hospital.  Virtually every one, from the guy who shot Gabbie Gifford to the autistic kid who felt no pain in Connecticut, virtually every one was identified as mentally ill at some time prior to their shooting rampages.

Making the gun harder to get is not going to stop them.  Making magazines smaller or doing away with semi-automatics isn't going to help.  Charles Whitman killed 13 people, an unborn child and wounded 32 others. He seemed normal enough, even exemplary in his behavior. He was an Eagle Scout and ex-Marine.  He used only bolt-action rifles, a shotgun and some pistols. He had no automatic weapons. 

A gentleman with a handgun stopped a man this past week who attacked people with a knife and was set to start a mass slaughter. He didn't have a gun.  An off-duty cop working as a movie theater security guard at a San Antonio mall stopped a man who was planning to shoot up the place.  The people who do this kind of thing are not generally working with both oars in the water.  Sweden has the most restrictive gun laws in the Western world and a terrorist managed to kill 70 unarmed people at an island resort there.

Even though these things are horrific, they aren't really getting more frequent.  We just hear about them more often because we have 24 hour news and, as political commentator Armstrong Williams aptly noted, "If it bleeds it leads." Still, when we hear about this stuff, all of us are seized with a desire to make it stop.

The problem is, you can't stop it. Evil and lunacy exist in this world and will, on occasion, strike.  We decided almost three decades ago that putting people willy nilly in insane asylums was a bad thing to do.  Government-run asylums, we discovered, were terrible places.  So we turned them all loose - or at least most of them.  That's how the government solves a problem. If there are people locked up unjustly and you demand they stop doing it, the government just lets everybody go. Big government is not subtle We had an explosion of homelessness after the great release experiment in the 80s when all those who had been in institutions hit the streets with no place to go.

The problem with the folks at the government being the ones to stop school massacres is that the government always takes a sledge hammer approach to any problem it tries to solve.  You don't get a lot of nuance in decision-making when it comes to laws being written in Washington and designed to provide a one-size-fits-all solution for 350 million people.

So, they jump on gun control as the easy fix for what is actually a mental health problem. People can't get help for mentally ill loved ones who need it.  I know. In my own family I've had to watch loved ones with mental illness deteriorate to the point that they attempted suicide quite spectacularly. I've got a loved one living in a storage building 3000 miles away and I'm too broke to help him.  The system tries to do as little as possible and only helps when they absolutely have no other choice. Any kind of even temporary committment is next to impossible because they fixed that in Washington back in the 80s after a Mickey Rooney movie about the subject of unjust mental incarceration.  It was widely viewed and in true Washington fashion, laws were passed to "make it stop".

Our mental health system is a wreck. In working with therapists, psychologists and psychiatrists, I've experienced first hand what they go through in trying to help patients. I spent two years in a graduate rehab psych program and worked in mental health programs for 25 years.  The average mental health practitioner walks among his patients like a long-tailed cat in a room full of rocking chairs (occupied by lawyers).  They are so hemmed in by regulations and potential lawsuits that people who should be taken off the streets for their own good as well as the safety of the community can't be.  Sometimes a mentally ill person volunteers for a stint in the hospital, but if they volunteer, they can check themselves out whenever they want to, like when the killin' urge comes over them.

I worked at a treatment center for kids and watched severely disturbed kids turn 18 and be turned out into the world with virtually no supports. That's how the law worked. Some places tried to provide them help - usually faith-based facilities with church partnerships to help the kids integrate into the community. Most such programs operated without public support and under the disapproving eye of state mental health authorities.
In the past 30 years, we've learned more about the human brain and how to treat it and what to expect of various types of brain diseases.  Yet with all this knowledge, we find ourselves prevented from doing the very kinds of things that would prevent people from going berserk and shooting up an elementary school.

But that's what happens when you get politicians doing hip shot law-making. You want to prevent mass murders in our country?  Two things:
  1. Protect likely targets.  If a movie theater can hire a sharp-eyed security guard, a school can.  Off duty cops have the training and are always looking for extra work. Ex-military guys can be trained for the work and lots of them come home looking for jobs. Protecting kids is a job they were trained for.
  2. Get those with violent mental illnesses off the street.  Yes it will cost money, but not nearly as much as the massive bureaucracy needed to manage the highly restrictive gun control laws that are being proposed right now.  And hospitalization is not a life sentence. Proper treatment and medications can help unstable people cope and learn ways to avoid going out of their minds and committing these heinous acts.
Charles Whitman, the University of Texas Sniper, left a note. In it he said if his life insurance was any good, to pay off his debts and give the rest to mental health research so they could find out why he was compelled to kill all those people. 

Everyone asks why this happens every time it does. Some blame it on the devil. Others blame it on God.  Some, like the president in his memorial speech in Newtown, do both. Obama remarked that evil exists in the world and then qualified that by saying "God called them home". So we've assigned blame to both God and the Devil.  Throw in Republicans and the NRA and that should spread the blame around even more.

We look for a reason for the unreasonable, when these things happen. There is no reason other than the obvious one.  When you ask God to leave you be; when you tell Him you want nothing to do with Him, He goes away and leaves you alone.  We've no excuse for asking where God was.  We've asked Him to stay out of our schools.  We've left the crazy people out on the streets, uncared for till they lost their minds altogether.  And worse, when the angels left along with God, we didn't replace them with security guards.

If we're not willing to open our schools to God's protection and if we insist on trying to solve this problem in Washington instead of in our communities, homes and churches, where things like this happen, then the carnage will continue unabated. We cannot keep waiting for the government to do for us what can only be done by us.  We do not have to wait for permission to fix our own communities; to make them safer.

God will make things right in the end, despite our best efforts to muck it all up. While I don't believe He chose how those kids would die - that He "called those children home" as the President suggested - I do believe He will take them home one day when He comes back to clean up our mess. 

God help us all when He sees what we've done to this place.