The Christmas season is a time when doctors' offices are deluged with chocolates, brownies, fudge and lots of other goodies which staff and professionals enjoy, though with some guilt.
But there is another side to the holiday season which is more troubling then extra calories and saturated fat. It is the distress of many women we would see with serious holiday depressions because they were exhausting themselves physically, spiritually and financially, trying to make the holidays "perfect" for their families and other loved ones. To the women who read this blog - I wish you well and hope that you will do what you can reasonably do and recognize that perfection is not a human characteristic. To the men who read this blog and pay attention to what their spouses are going through, I suggest you make it a point to notice what is going on around you, support your loved ones and help set family holidays goals which will leave everyone refreshed, rather than exhausted physically, spiritually and financially.
Truly happy holidays depend on the strength and joy of family relationships. What ever holiday is yours, I wish you and yours holiday happiness.
Showing posts with label Depression. Show all posts
Showing posts with label Depression. Show all posts
Friday, November 19, 2010
Monday, April 13, 2009
The Shell Game
In New York, where I grew up, we knew that in a "shell game" a token was hidden by one of three shells, and no matter how good or confident you were when you put down your money, you never could guess which shell was hiding the token and you never beat the operator who was able, by sleight of hand, to divert your attention from what was really going on.
Today, while our primary focus is on our national depression, "health care reform" is dangled before us as a distraction. What is hiding under the shell is the likelihood of severe disruptive disabling inflation, as our nation's printing presses run overtime to compensate for the financial industry's greed-induced collapse of our economy. As painful as a depression may be over the next year, it will not be as destructive to our health care system and our citizenry, as the run-away inflation which looms ahead.
Persons now able to pay for their Medicare copayments and supplemental insurance, employers whose cash flows support employee insurance plans, and the self-insured, along with Medicaid programs, will be particularly vulnerable to inflationary pressures. Many of the Medicare-covered population, on fixed pension payments, will not have incomes which keep pace with health care cost inflation, copayments and Medigap insurance premiums: they will be wiped-out. Employers, facing escalating inflationary pressures, will be incentivized to retain (rather than spend) investible cash from business operations to survive, and will have to either borrow at crushing interest rates (causing a sharp contraction in profitability as premiums cut into profits) or forgo providing health insurance as an employee benefit. The self-insured will have to devote an increased share of their resources to health care costs and insurance premiums and, like the fixed-income Medicare population, run the risk of seeing their financial resources destroyed. States' revenues will not be able to keep pace with skyrocketing Medicaid costs.
Some credit card issuers have reduced the credit lines of many of their customers, which will wipe-out a resource which these customers have depended upon to finance health care services. Some credit card companies have sharply increased interest rates to levels worthy of organized crime syndicates, while their collaborators in Congress have protected the credit card industry by making bankruptcy discharge of credit cards debts for health care services unavailable. If you don't have insurance, or if you face a large co-payment, your credit is constricted, interest rates are exorbitant and you have big health care bills for serious illness, what will you do?
During the 1980s inflation (under Carter - 22% interest rates!), insurers held on to their cash and were slow to pay insured health care bills because they wanted to maximize the return from the float on their money, I predict that health care providers will be under significant financial pressure and those with significant bond obligations may not survive. General Motors may be the model for the health care industry.
You may not have entered this "shell game" voluntarily, but your life, savings and health care will be at risk. Pay attention and plan accordingly.
Today, while our primary focus is on our national depression, "health care reform" is dangled before us as a distraction. What is hiding under the shell is the likelihood of severe disruptive disabling inflation, as our nation's printing presses run overtime to compensate for the financial industry's greed-induced collapse of our economy. As painful as a depression may be over the next year, it will not be as destructive to our health care system and our citizenry, as the run-away inflation which looms ahead.
Persons now able to pay for their Medicare copayments and supplemental insurance, employers whose cash flows support employee insurance plans, and the self-insured, along with Medicaid programs, will be particularly vulnerable to inflationary pressures. Many of the Medicare-covered population, on fixed pension payments, will not have incomes which keep pace with health care cost inflation, copayments and Medigap insurance premiums: they will be wiped-out. Employers, facing escalating inflationary pressures, will be incentivized to retain (rather than spend) investible cash from business operations to survive, and will have to either borrow at crushing interest rates (causing a sharp contraction in profitability as premiums cut into profits) or forgo providing health insurance as an employee benefit. The self-insured will have to devote an increased share of their resources to health care costs and insurance premiums and, like the fixed-income Medicare population, run the risk of seeing their financial resources destroyed. States' revenues will not be able to keep pace with skyrocketing Medicaid costs.
Some credit card issuers have reduced the credit lines of many of their customers, which will wipe-out a resource which these customers have depended upon to finance health care services. Some credit card companies have sharply increased interest rates to levels worthy of organized crime syndicates, while their collaborators in Congress have protected the credit card industry by making bankruptcy discharge of credit cards debts for health care services unavailable. If you don't have insurance, or if you face a large co-payment, your credit is constricted, interest rates are exorbitant and you have big health care bills for serious illness, what will you do?
During the 1980s inflation (under Carter - 22% interest rates!), insurers held on to their cash and were slow to pay insured health care bills because they wanted to maximize the return from the float on their money, I predict that health care providers will be under significant financial pressure and those with significant bond obligations may not survive. General Motors may be the model for the health care industry.
You may not have entered this "shell game" voluntarily, but your life, savings and health care will be at risk. Pay attention and plan accordingly.
Thursday, March 19, 2009
Ethics Are Even More Relevant Today
If we had agreement on political contribution ethical standards (i.e., $$$ flowing from AIG to major political figures), would there be an issue today concerning AIG's $180 million bonuses to those who wrecked their company and severely damaged the international economy?
If we had standards of ethical conduct for those doing business in the financial industry, such as Madoff and Stanford, would America be in a depression?
If we had standards of ethical employer conduct, would the SEIU be at war with the union representing its own workers?
If we develop enforceable consensus concerning the ethical framework for health care reform before plunging into unguided action, will we have a more efficient, better quality, more accessible and more democratic health care system which does not bankrupt the country?
What prevents us from a national discussion of health care ethics and use an ethical structure as the framework for health care reform?
If we had standards of ethical conduct for those doing business in the financial industry, such as Madoff and Stanford, would America be in a depression?
If we had standards of ethical employer conduct, would the SEIU be at war with the union representing its own workers?
If we develop enforceable consensus concerning the ethical framework for health care reform before plunging into unguided action, will we have a more efficient, better quality, more accessible and more democratic health care system which does not bankrupt the country?
What prevents us from a national discussion of health care ethics and use an ethical structure as the framework for health care reform?
Sunday, October 12, 2008
Government Printing Presses Are Running
Historically, health care inflation is greater than general inflation. The availability of sophisticated diagnostic equipment and testing, use of new technology, and new expensive treatments have been responsible for this inflation. In those periods when government attempted to control health care inflation through price controls (Nixon) or limit access to new technology (Health Systems Agencies), these efforts postponed but did not limit inflation. Historically, attempts to control health care costs have delayed the introduction of new life-saving technology and treatment, which is not a sensible direction to pursue.
America's printing presses are running overtime printing dollar bills to correct for America's incompetency in regulating our financial industries in their obscene boom and bust activities. Inevitably, massive government spending of money it doesn't have is followed by another form of economic instability - severe inflation, a component of which is likely to be even more severe health care cost inflation. The elderly, in particular, who depend on fixed income and have no hedge against inflation, will be hard put to meet the inflated costs of health care, and particularly pharmaceuticals, if we continue our current system of financing and providing care. Those whose assets are depleted or destroyed during our current depression will be unable to create a financial cushion to protect themselves against health care inflation and may increasingly be unable to afford (or their employers may be unable to afford) health insurance. In short, our health care systems' troubles, while not attracting as much attention as the collapse of our banking, credit, insurance and financial systems, place us standing on a banana skin on the brink of a deep precipice. This is made all the more difficult because health care purchased with credit cards is essentially shielded from bankruptcy protection (another gift of our Congress to the credit card industry).
Neither Obama nor McCain is dealing seriously with these impending threats. The plan that I proposed in my last blog is a lifeboat which holds some chance of being able to provide appropriate health care in the time of economic turmoil which we have entered. We need real substantive change in our health system, not just words which are decoupled from action.
America's printing presses are running overtime printing dollar bills to correct for America's incompetency in regulating our financial industries in their obscene boom and bust activities. Inevitably, massive government spending of money it doesn't have is followed by another form of economic instability - severe inflation, a component of which is likely to be even more severe health care cost inflation. The elderly, in particular, who depend on fixed income and have no hedge against inflation, will be hard put to meet the inflated costs of health care, and particularly pharmaceuticals, if we continue our current system of financing and providing care. Those whose assets are depleted or destroyed during our current depression will be unable to create a financial cushion to protect themselves against health care inflation and may increasingly be unable to afford (or their employers may be unable to afford) health insurance. In short, our health care systems' troubles, while not attracting as much attention as the collapse of our banking, credit, insurance and financial systems, place us standing on a banana skin on the brink of a deep precipice. This is made all the more difficult because health care purchased with credit cards is essentially shielded from bankruptcy protection (another gift of our Congress to the credit card industry).
Neither Obama nor McCain is dealing seriously with these impending threats. The plan that I proposed in my last blog is a lifeboat which holds some chance of being able to provide appropriate health care in the time of economic turmoil which we have entered. We need real substantive change in our health system, not just words which are decoupled from action.
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